Living With a Terminal Illness
Grief is common in people facing the end of their lives as a result of a terminal illness. It’s a feeling that can cause a terminally ill person to experience even more pain than they do from their illness. However, it’s considered a normal reaction to their situation.
But in many terminally ill people, grief evolves into depression. In fact, researchers at Baylor University Medical Center believe it affects up to 77 percent of people with a terminal illness.
Experts say the risks of depression increases as a disease advances and causes more painful or uncomfortable symptoms. The more a person’s body changes, the less control they feel over their lives.
Additionally, some people who are terminally ill have more risk factors for depression. These include:
- past history of depression
- past attempts at suicide
- social stress
- problems with substance abuse
- addiction
- family history of depression
Some medications may also contribute to depression.
Depression is a serious mental condition, but it can be treated. Treating depression in people with a terminal illness can significantly increase their quality of life.
What Symptoms are Considered "Normal" for Someone With a Terminal Illness?
There is no “right” way for people to feel at the end of their lives. Any combination of the following symptoms are considered “normal” in terminally ill people:
- disbelief
- panic
- anxiety
- anger
- bitterness
- denial
- vulnerability
- sadness
- frustration
- loneliness
- peace
- acceptance
What is Considered Depression?
According to the Mayo Clinic, depression is classified as having the following experiences that last for at least two weeks, and are severe enough to interfere with everyday life:
- sadness
- frustration
- anxiety
- depressed mood
- reduced interest in activities
- change in sleep routine
- change in weight
- loss of energy
- trouble making decisions
- change in eating habits
- recurring thoughts of death or suicide, or a suicide attempt
In the terminally ill, it can be sometimes hard to tell whether some of these symptoms are caused by the person’s primary illness, or by depression. A subtle sign of depression in the terminally ill is pain that doesn’t respond to treatment as expected.
People who think or attempt suicide are thought to be suffering from depression. They may also repeatedly request that doctors help hasten their deaths. This kind of request, however, may be a person’s attempt to exercise autonomy over how they live, and not depression.
How is Depression Diagnosed in Someone With a Terminal Illness?
Because depression is not always clearly identified, it tends to be underdiagnosed in people with terminal illnesses. This means many terminally ill people with depression are left untreated.
It’s important for doctors to carefully examine terminally ill people for depression, if they show symptoms. A doctor will make a diagnosis of depression by doing the following:
- taking a medical history
- doing a physical exam
- sometimes performing lab tests, such as blood and imaging tests
For additional articles on depression and terminal illness, see What Types of Treatments are Available for Someone Who is Depressed and Terminally Ill? and Coping With Depression and Terminal Illness.
Sources: National Suicide Prevention Lifeline and Substance Abuse and Mental Health Services Administration
(article courtesy of Healthline Media; see it here; medically reviewed by Timothy J. Legg, PhD, CRNP on March 14, 2016 — written by Erica Cirino)