Keeping well: Anxiety and depression

What is anxiety?

Anxiety is a mixture of feelings. Such feelings include fear, worry, being ‘on edge’ or being ‘panicky’.

Why does it happen?

It is often not easy to find out why some people get anxious but it commonly happens when people are feeling very ill. One problem when we get ill is that there is a lot of uncertainty and this may make people feel especially anxious. Sometimes people try to ‘bottle it all up’ and this can make them feel worse.

What are the symptoms?

There are a mixture of symptoms, including:

  • tension, worry, fear or dread
  • difficulty sleeping (especially getting off to sleep at night)
  • restlessness, agitation, irritability and • shortness of breath, tingling fingers, feeling the heart
  • racing, frequent need to go to the toilet.

What is depression?

Everyone has bad days when they feel low and people with a serious illness can expect to feel emotionally overwhelmed at times. However, in some people these normal reactions may become more severe and persistent. If the person you are caring for has strong

feelings of depression, do take them seriously. They are not a sign of weakness, but they may need to get some help.

What is it like to have depression?

One of the difficulties about diagnosing depression is that many patients with serious physical illnesses lose their appetite or sleep badly and may feel low or sad some of the time. This is not necessarily a sign of depression. Other signs may be:

  • feeling restless and find it hard to relax
  • worrying more than is usual for them
  • wanting to avoid people
  • feeling snappy or irritable
  • losing confidence in themselves
  • feeling useless or a burden to others
  • noticing that they can’t concentrate properly or not being able to enjoy the things they usually do
  • feeling panicky
  • losing their sexual feelings
  • depression, worry and anxiety can affect memory and make people feel confused
  • feeling bad or guilty, dwelling on things from the past and perhaps getting things out of proportion or
  • thinking about suicide.

Why does it happen?

Depression can come out of the blue. More often it is triggered by something; some of us are more likely to get depressed when faced with a difficult or painful situation.

Any physical illness can trigger depression, especially if there are physical symptoms; or the patient is taking some drugs or having treatments with side effects that are hard to put up with; or there are family difficulties or worries. Although this makes the depression more

‘understandable’ it does not mean that it cannot be helped. This type of depression often responds well to treatment.

What can a carer do?

The most important thing is to recognise the problem and to try and talk about it, if possible (without forcing them). Talk to a member of the team at St Christopher’s or encourage the patient to do so.

What can St Christopher’s do?

  • It can help to talk to a good listener. Our nurses may be able to offer help, and our social work team is very experienced in helping people with depression.
  • Helping with pain and other symptoms often makes a difference.
  • Visits to the Anniversary Centre or Caritas Centre provide support, a chance to meet others who understand how you feel, and a change of scenery.
  • We have a CBT therapist who may be able to offer some sessions to help the person regain a sense of control (see page 7).
  • Antidepressants can be very effective – about 50-60% of people who take these tablets will find they help. They are safe and not addictive. We can ask your GP to organise a prescription, or we may suggest that you meet one of our psychiatrists as they have the expertise that is sometimes required.
  • We can provide practical support to manage difficulties which cause depression such as housing difficulties or problems with benefits.
  • Distraction may help too, for example trying to keep busy when you feel anxious.
  • Complementary therapies such as aromatherapy or hypnotherapy may help. These therapies are available at the hospice – ask your St Christopher’s nurse for details.
  • Exercises to help you control your breathing and your anxiety can be taught by our physiotherapists.