Having breast cancer and going through treatment can stir up all kinds of emotions. You might cycle through a range of feelings, including sadness, anger, disbelief, and grief.

It’s common to feel depressed or anxious about a disease that affects your life in so many ways. Pain, tiredness, and other cancer symptoms make it hard to sleep and concentrate. Juggling treatments with work and family responsibilities can be stressful.

Some of the treatments you take to slow or stop your cancer could cause or worsen depression. Chemotherapy and hormone therapies like tamoxifen are among them.

Depression affects your quality of life and outlook, too. When you’re feeling this way, you may be less likely to stay on the treatment you need to get well.

Sometimes the sadness is short-lived. But when symptoms persist, day after day, you could have major depressive disorder, also known as clinical depression.

Know that depression is treatable. Watching for the symptoms and getting help if you need it can help you feel better. A review of several studies finds that treating depression when you have breast cancer might also help you live longer.

About 1 in 3 people with breast cancer have depression. You’re more likely to become depressed if you:

  • had depression or anxiety in the past
  • were diagnosed with breast cancer before age 40
  • don’t have good social support
  • have a lot of symptoms from cancer or its treatments
  • are diagnosed with a late-stage (stage 4) breast cancer

Depression is more likely to affect you in the first year of having cancer when you’re actively going through treatment. But studies find that depression can continue for more than 5 years after your diagnosis.

Major depression is when you have symptoms like these most of the day, every day for 2 or more weeks:

  • a persistent feeling of sadness, hopelessness, or emptiness
  • tiredness or lack of energy
  • loss of interest in activities you once enjoyed
  • sleeping more or less than usual
  • trouble focusing, concentrating, or making decisions
  • losing or gaining a lot of weight without trying
  • thinking about dying or hurting yourself

Though depression is common in people with breast cancer, it’s easy to miss signs like these. If you might find it helpful to speak with a doctor if you think you might be depressed.

While it’s OK to feel overwhelmed when you have breast cancer, you don’t have to live with depression. Better outcomes are possible once there’s a diagnosis and you begin treatment. Once you notice symptoms of depression, you might consider reaching out to a primary care doctor.

Your doctor can help you figure out whether your feelings are a side effect of your treatment. If a cancer medicine you take is causing these feelings, you may be able to switch to something else.

If your doctor suspects you have depression, they can refer you to a mental health professional. This might be a psychiatrist, psychologist, or clinical social worker.

Managing depression symptoms related to breast cancer can involve therapy, medication, or a combination of both treatments.

Therapy. Talking through your feelings with a mental health professional is one way to treat depression. Cognitive behavioral therapy (CBT) is a type of treatment for depression. With this approach, the therapist helps you reframe negative thoughts into more positive thoughts.

Therapy can happen one-on-one between you and the therapist or with a group of people. In a 2019 study of 100 participants, group therapy worked well at reducing anxiety and depression in people with breast cancer.

Antidepressants. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are two commonly prescribed medicines for treating depression. Although these drugs are good at relieving symptoms, they may be a problem for some people with breast cancer.

There’s some evidence that SSRIs might help breast cancer spread by increasing levels of the hormone prolactin. These drugs might also make the breast cancer drug tamoxifen less effective. Although antidepressants haven’t been proven unsafe for people with breast cancer. You can have a conversation with your doctor if you’re thinking about taking them.

A few complementary and alternative treatments are also helpful for improving mood, stress, and sleep quality, including:

  • yoga and tai chi
  • deep breathing
  • meditation and prayer
  • exercise
  • acupuncture

It helps to have people you can lean on when you’re going through a difficult time. Research finds that people with breast cancer who have more family support are at a lower risk of depression.

Your support doesn’t have to come from family members. Friends, co-workers, neighbors, and your partner can all offer a compassionate ear when you feel low.

A few organizations offer support groups and other services for people with cancer and depression. Here are a few worth checking out:

  • American Cancer Society. This national cancer organization offers a 24/7 helpline offering support. Its Reach to Recovery Program can connect you with other people who’ve been through the same experience and understand what you’re going through.
  • BreastCancer.org. This organization offers an online forum on depression and other mental health issues related to breast cancer.
  • CancerCare. Oncology social workers lead this organization’s free support groups, which include a breast cancer group.
  • Cancer Support Community. You’ll find this organization’s free support groups in many cities across the country.
  • Substance Abuse and Mental Health Services Administration (SAMHSA). This government agency can help you find a mental health provider near you.
  • Sanvello. This app connects hundreds of people who are experiencing anxiety or depression.

It’s common to experience depression when you have breast cancer. Feelings of distress might not ease up when you finish breast cancer treatment. It’s helpful to keep checking in with a mental health professional for as long as you have symptoms.

There are several approaches to manage symptoms and numerous avenues to find the support you seek. Working with a healthcare team can help you find what would work best for you.