Mental Health Treatments

First off, most importantly, I would recommend that you seek evaluation and management by a psychiatrist. To find one, you can start by discussing referral with your surgeon, medical oncologist, and/ or current prescribing physician. A psychiatrist with specialization in palliative care or, more typically, psychosomatic medicine can be beneficial, since such training and practice is geared toward helping people with psychiatric problems – be they emotional concerns, behavioral difficulties, or problems with cognition or thinking, concentration, and memory – related to medical conditions, or addressing these issues as they emerge in the context of a serious chronic or advanced illness. A psycho-oncologist is a psychiatrist who works with cancer patients and has a specialty in psychosomatic medicine, also called consultation-liaison or C/L psychiatry because much of the work involves consultation for physicians in other fields and acting to facilitate complicated dynamics between patient, family, and provider within the medical setting. A psychiatrist with a specialty in palliative care is less common but specializes in dealing with the various psychiatric issues – e.g. mood or anxiety symptoms or emotional concerns – and their interaction with physical symptoms, along with social issues, and spiritual concerns that emerge for people dealing with a chronic advanced disease. On a practical level, such training subsumes developing additional skills in management of physical as well as emotional symptoms, and, for psychiatrists, provides a better understanding of their interaction within the patient who ought to be treated as a whole person rather than a manifestation of the consequences of a disease and a variety of associated symptoms. Less commonly, psychiatrists may have training in pain medicine given the complex interface of this physical symptom, in particular, with other elements within the psychiatric realm that are processed in the brain – such as mood, anxiety, and perception.

Regardless, a psychiatrist with expertise or experience dealing with patients and issues related to your medical problem is always helpful. There may be a psychiatrist within or closely affiliated with the practice of the physician who initially screened for depression, and specifically addressed the issue and prescribed a medication. Whatever the case may be, psychiatric evaluation and management in addressing problems with mood is essential and ought not be substituted or overlooked.

For one thing, clarifying and refining a diagnostic impression over time requires careful and ongoing assessment by an expert, in part to rule out and further assess the multitude of other factors which may potentially be contributing to the decline in mood – including related psychiatric conditions, other medical issues, and a host of distressing issues that may be at play in one’s social circumstances, with a variety of possibilities in each domain for which one is at risk, given a close association, after undergoing surgery or during chemotherapy treatment for cancer.

Pursuing a psychiatric evaluation is important for evaluation of psychopharmacologic – or medication management – options, as well as non-pharmacologic interventions for depression in cancer, including psychotherapy. Additionally, seeking counseling and support from a social worker, if on staff where you are being treated, be it at a cancer center, or in the practice of the oncologist providing your care, can be invaluable. Social workers providing clinical care in the oncology setting can help to provide counseling and emotional support as needed, as well as referral to community resources and practical assistance with the various stresses that emerge in the life of a someone with cancer or other medical illness – in relationships with family and friends, financially, and at work or school, etc.

There are a variety of medications to treat depression, with reasonable evidence to support their efficacy in cancer patients, including those in several classes of antidepressants, as well as other classes of medication which may be used adjunctively or alternatively. Choosing a medication to alleviate depressive symptoms requires careful consideration of a variety of factors which should be carefully assessed by a psychiatrist.

Conducted by psychiatrists, psychologists, social workers, or other types of therapists, various forms of psychotherapy and emotional or behavioral counseling, conducted supportively, are an important aspect of optimizing adaptive functioning when facing the challenges associated with a medical condition and associated mood changes. There are a variety of approaches, such as psychodynamically-oriented supportive or supportive-expressive psychotherapy, cognitive behavioral therapy, various existential therapies, and client-centered or humanistic approaches that may be used and have been shown to be beneficial – be it observationally or experimentally – and seem generally to be related in part to the establishment of a rapport between a patient and clinician to develop a working alliance in the service of improving one’s psychological well-being. This is routinely conducted on an individual or one-on-one basis, but work with families, couples, or in a group setting amongst peers, may also be valuable as a means of addressing emotional difficulties encountered, particularly in the setting of relationships affected by one’s illness. In addition to providing a safe and open space to engage in the task of processing one’s thoughts and feelings, psychotherapy in an individual and group setting involves an educational and informational component. Alternative therapies which may be beneficial and available in the medical setting include the creative arts therapy – such as art therapy, music therapy, and drama therapy – as well as other mind-body techniques, such as hypnosis or hypnotherapy, guided imagery, relaxation techniques, and mindfulness-based approaches – and may be incorporated to the approach of a given therapist. There are additional integrative therapy approaches provided by practitioners who are not just mental health providers. In general, when dealing with issues related to medical conditions, a supportive approach is employed to help the individual foster the use of pre-existing internal resources which may be challenged when confronted with mortality and the threat to one’s livelihood but can be harnessed or aided in providing assistance for coping with an otherwise overwhelming experience. In this vain, the individual is the agent of change with the support of the provider, such that approaches to helping oneself may be found within one’s own self, environment, and lifestyle, and, as such, may even include improving healthy behaviors such as exercise and diet and reducing harmful behaviors such as substance abuse. First off, most importantly, I would recommend that you seek evaluation and management by a psychiatrist. To find one, you can start by discussing referral with your surgeon, medical oncologist, and/ or current prescribing physician. A psychiatrist with specialization in palliative care or, more typically, psychosomatic medicine can be beneficial, since such training and practice is geared toward helping people with psychiatric problems – be they emotional concerns, behavioral difficulties, or problems with cognition or thinking, concentration, and memory – related to medical conditions, or addressing these issues as they emerge in the context of a serious chronic or advanced illness. A psycho-oncologist is a psychiatrist who works with cancer patients and has a specialty in psychosomatic medicine, also called consultation-liaison or C/L psychiatry because much of the work involves consultation for physicians in other fields and acting to facilitate complicated dynamics between patient, family, and provider within the medical setting. A psychiatrist with a specialty in palliative care is less common but specializes in dealing with the various psychiatric issues – e.g. mood or anxiety symptoms or emotional concerns – and their interaction with physical symptoms, along with social issues, and spiritual concerns that emerge for people dealing with a chronic advanced disease. On a practical level, such training subsumes developing additional skills in management of physical as well as emotional symptoms, and, for psychiatrists, provides a better understanding of their interaction within the patient who ought to be treated as a whole person rather than a manifestation of the consequences of a disease and a variety of associated symptoms. Less commonly, psychiatrists may have training in pain medicine given the complex interface of this physical symptom, in particular, with other elements within the psychiatric realm that are processed in the brain – such as mood, anxiety, and perception.

Regardless, a psychiatrist with expertise or experience dealing with patients and issues related to your medical problem is always helpful. There may be a psychiatrist within or closely affiliated with the practice of the physician who initially screened for depression, and specifically addressed the issue and prescribed a medication. Whatever the case may be, psychiatric evaluation and management in addressing problems with mood is essential and ought not be substituted or overlooked.

For one thing, clarifying and refining a diagnostic impression over time requires careful and ongoing assessment by an expert, in part to rule out and further assess the multitude of other factors which may potentially be contributing to the decline in mood – including related psychiatric conditions, other medical issues, and a host of distressing issues that may be at play in one’s social circumstances, with a variety of possibilities in each domain for which one is at risk, given a close association, after undergoing surgery or during chemotherapy treatment for cancer.

Pursuing a psychiatric evaluation is important for evaluation of psychopharmacologic – or medication management – options, as well as non-pharmacologic interventions for depression in cancer, including psychotherapy. Additionally, seeking counseling and support from a social worker, if on staff where you are being treated, be it at a cancer center, or in the practice of the oncologist providing your care, can be invaluable. Social workers providing clinical care in the oncology setting can help to provide counseling and emotional support as needed, as well as referral to community resources and practical assistance with the various stresses that emerge in the life of a someone with cancer or other medical illness – in relationships with family and friends, financially, and at work or school, etc.

There are a variety of medications to treat depression, with reasonable evidence to support their efficacy in cancer patients, including those in several classes of antidepressants, as well as other classes of medication which may be used adjunctively or alternatively. Choosing a medication to alleviate depressive symptoms requires careful consideration of a variety of factors which should be carefully assessed by a psychiatrist.

Conducted by psychiatrists, psychologists, social workers, or other types of therapists, various forms of psychotherapy and emotional or behavioral counseling, conducted supportively, are an important aspect of optimizing adaptive functioning when facing the challenges associated with a medical condition and associated mood changes. There are a variety of approaches, such as psychodynamically-oriented supportive or supportive-expressive psychotherapy, cognitive behavioral therapy, various existential therapies, and client-centered or humanistic approaches that may be used and have been shown to be beneficial – be it observationally or experimentally – and seem generally to be related in part to the establishment of a rapport between a patient and clinician to develop a working alliance in the service of improving one’s psychological well-being. This is routinely conducted on an individual or one-on-one basis, but work with families, couples, or in a group setting amongst peers, may also be valuable as a means of addressing emotional difficulties encountered, particularly in the setting of relationships affected by one’s illness. In addition to providing a safe and open space to engage in the task of processing one’s thoughts and feelings, psychotherapy in an individual and group setting involves an educational and informational component. Alternative therapies which may be beneficial and available in the medical setting include the creative arts therapy – such as art therapy, music therapy, and drama therapy – as well as other mind-body techniques, such as hypnosis or hypnotherapy, guided imagery, relaxation techniques, and mindfulness-based approaches – and may be incorporated to the approach of a given therapist. There are additional integrative therapy approaches provided by practitioners who are not just mental health providers. In general, when dealing with issues related to medical conditions, a supportive approach is employed to help the individual foster the use of pre-existing internal resources which may be challenged when confronted with mortality and the threat to one’s livelihood but can be harnessed or aided in providing assistance for coping with an otherwise overwhelming experience. In this vain, the individual is the agent of change with the support of the provider, such that approaches to helping oneself may be found within one’s own self, environment, and lifestyle, and, as such, may even include improving healthy behaviors such as exercise and diet and reducing harmful behaviors such as substance abuse.