People with cancer will experience a wide range of feelings, and certainly not all cancer patients become preoccupied with negative emotions. However, this diagnosis will almost always be very stressful and, at times will include some negative feelings. If you as a caregiver recognize these feelings, you will be better able to cope with them and offer assistance in managing them. A word of caution: don't allow your recognition of the patient's negative feelings to become a pattern of arguing against them. Instead, allow your loved one to talk through the feelings with you, and offer your support and love rather than attempting to "fix" the problem by denying their existence. Some relatively common emotions cancer patients experience include:

Despair — feeling guilty for having the cancer, or somehow responsible for disrupting a family's life; fear that recovery will not occur

Depression (beyond understandable sadness about having cancer). Depression is considered by many to be underdiagnosed in cancer patients, so be alert to the warning signs:

• A persistent depressed mood, most of the time
• Thoughts and comments about suicide
• Feeling you are "not yourself"
• Loss of interest and pleasure in life — an "empty" mood that does not lift
• Feelings of hopelessness and pessimism
• Difficulty or inability to concentrate*
• Frequent crying, or feeling close to tears
• Fatigue — extreme in some cases, inability to function normally*
• Feeling worthless or guilty
• Sleep problems — insomnia or oversleeping*
• Weight issues — decreased appetite, or overeating*
• Anxiety
• Aches and pains in joints and other parts of the body*

The symptoms above with asterisks (*) can also be side effects of cancer treatment. This fact can mask the presence of depression, if they are combined with other symptoms listed above. If you believe your loved one is depressed, discuss this with the health care team, and ask for a consultation for your loved one with a psychiatrist or psychologist experienced in working with cancer patients.

A special note: if your loved one is talking about suicide or expressing the sentiment that she or he would be "better off dead," no time is to be wasted in getting medical attention. Always take talk of suicide seriously, and get prompt assistance.

For more information, see Depression on this site, which includes special information for caregivers.

Feelings of isolation — Sometimes people with cancer fear that people, even close family members, will grow tired of providing care and comfort and may abandon the ill person. There is also fear of being cut off from "the real world" and locked into the world of illness. People with these concerns may or may not express them — but the caregiver can anticipate this concern and offer ongoing reassurance and encourage others to do so as well.

Anxiety about suffering and death. Cancer is almost always a terrifying diagnosis, and most people who receive this diagnosis will, at some point, find themselves thinking about the possible implications of the disease. If possible, encourage your loved one to talk about these fears, and offer support and information to help manage them. Anxiety can become severe and serious, however. Warning signs of accelerating anxiety include frequent mood swings, severe sleep problems, trembling, shakiness, and even shortness of breath. In the presence of one or more of these symptoms, seek assistance from the health care team. For more information on this topic, please see Anxiety on this site.

Fear of letting family and friends down by speaking out about one's feelings. Sometimes cancer patients feel that no one wants to listen to their feelings, or that discussing negative emotions just makes everyone feel worse. This is sometimes compounded by well-meaning individuals who encourage the patient to "always think positive thoughts" and to "always look on the bright side." While thinking positively can sometimes be helpful, do not allow your loved one to think for a minute that if she or he thinks less than cheerful thoughts, such thoughts somehow will make the cancer worse. There is absolutely not one shred of scientific evidence to support the notion that "positive thinking" has any impact on recovery from cancer. Make time to allow your loved one to honestly discuss his or her fears.

Feeling out of control over one's body — anger at weakness, pain, fatigue, and other side effects that reduce quality of life, as well as feeling out of control emotionally. There is no simple remedy for these feelings, except to see that the conditions causing the out-of-control feelings, like pain and fatigue, are treated medically. Remember, no person with cancer should be expected to live with significant untreated pain, and fatigue can and should be treated, as well. For more information on this site, please see Fatigue and Pain on this site.

Helplessness. Almost no one enjoys being dependent on others. In general, you should allow and encourage as much independence as possible for your loved one, and avoid constant offers to help when help is not asked for. Being able to participate in one's personal care and daily activities, even to a somewhat limited degree, often helps lift the spirit. Also, as caregiver, encourage your loved one to be as active as possible in "the real world," even if he or she is confined to the home. Spend time together talking about issues and news other than cancer; watch movies together and discuss them, play board games and so forth. If possible, do some of these things in rooms other than the patient's bedroom. Sit in the garden, take a drive, visit other family and consider other low-stress, undemanding activities like these. Even when one's body is unable to do all that could be done in former times, if the mind is engaged, often the spirit can and will rise. It is very important for every person to feel they have something to contribute to those they love.

Don't forget that as a family caregiver, you, too may experience some of these emotions and feelings — especially depression. Don't allow this to continue untreated; you deserve help and support, too, and seeking it is essential to allow you to continue as a caregiver. For more information, see Caring for the Caregiver on this site.

Resources