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Coping with depression and anxiety

There are many feelings to deal with when living with a terminal illness. You may try to appear cheerful in front of family members or friends, but inside you may feel very low or anxious. 

How you cope with your illness may depend on the type of person you are. You may be told regularly to be positive, but this is often hard to do. If you’re in denial about your illness, you may also be covering up feelings of depression, without realising it.

On this page:

What is depression?

Most people feel low or sad some of the time. It’s normal to have ups and downs. But when feelings like sadness and anxiety last for months without changing, it may be depression.   

People with a terminal illness are more likely to develop symptoms of depression but it’s not necessarily inevitable and should be treated appropriately. Depression can have a big impact on your quality of life and can also affect your family and friends.

Causes of depression

Causes for depression can include living with uncertainty and fear about what the future holds.

Factors related to your illness can make depression worse. These include:

  • pain
  • fatigue
  • some treatments and their side effects
  • being immobile
  • being isolated or lacking support
  • insomnia (lack of sleep)

Anyone can get depression – but you’re more likely to experience depression if you have a previous history, or a family history, of it.

Symptoms of depression

Symptoms vary between people and may affect you emotionally and physically. These can include:

  • sadness
  • crying all the time
  • not being able to find pleasure or enjoyment in anything
  • feelings of hopelessness
  • tired and low in energy, moving more slowly
  • irritability
  • a sense of helplessness
  • lack of interest in anything
  • feeling indecisive
  • not being able to concentrate
  • not wanting to see people
  • feeling persistently low in your mood
  • feeling helpless, worthless or having low self esteem
  • an inability to see the future positively
Noel was a very strong person with having all the problems that he had in life, but he got a shock when he was diagnosed with terminal cancer and became depressed, so that was hard for me too. 
Marion, carer/relative

Common symptoms of terminal illness, like loss of appetite, weight changes and not sleeping properly, can also be symptoms of depression.

Managing depression

Depression can get worse if you don’t or can’t admit your feelings or talk about them. Try and tell your nurse or doctor. They can assess you and decide how to help.

Tackling other symptoms like pain may help reduce symptoms of depression. Getting enough support and adjusting your other treatments might also help, but always speak to your doctor before you make any changes to your medication.

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Anxiety

Your depression may be linked with anxiety. Most of us feel anxious from time to time, but some people may often feel anxious and have difficulty managing these feelings. This can really affect quality of life and, for people with a terminal illness, anxiety can make other symptoms worse.

Causes of anxiety

These include:

  • medication
  • dementia
  • drug withdrawal
  • other symptoms being poorly controlled
  • concern for family and friends
  • personal matters
  • money worries
  • uncertainty about the future

Symptoms of anxiety

These include:

  • feeling on edge or apprehensive
  • feeling restless or agitated
  • finding it difficult to concentrate
  • finding it difficult to sleep
  • sweating
  • heart is racing
  • being unable to get rid of your worries
  • feeling breathless
  • loss of appetite

Managing anxiety

If you’re finding it difficult to control your anxiety or worries, it’s good to let your nurse or doctor know so they can find out more about your symptoms and how they can help you.

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Treatment for depression and anxiety

If your depression or anxiety is left untreated symptoms can become worse and more difficult to treat. It’s important to get help as early as possible. Treatment can really improve your quality of life.

It could include:

  • medication, including anti-depressants
  • exercise
  • non-drug therapies, like relaxation techniques and advice on how to manage sleep and anxiety
  • talking therapy, for example, cognitive behavioural therapy (CBT) or counselling
  • complementary therapy, like acupuncture
  • support groups
  • self-help tips

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Other low feelings

Telling family and friends you’re terminally ill can also make you feel very low. You might feel guilty, afraid, lonely, time-pressured or sad at knowing you won’t be around. You might also feel as if you blend into the background. This could be because of your illness, for example if people start to talk about you as if you’re not there, or if you can’t do very much anymore. This can affect self-esteem.

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Talking to a counsellor

Talking about how you feel can help. Understanding and trying to tackle the particular things that are concerning you can help both you and your family and friends. It can be difficult to talk to a close family member because they may be feeling emotional too, but it’s important not to keep your negative feelings inside.

A trained counsellor can help you understand and work through your feelings. It may seem strange to talk to a stranger at first. But someone who’s experienced in dealing with people living with a terminal illness, and isn’t emotionally involved, could help you express yourself and feel better.

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Getting help

You, and your family and close friends, can ask your doctor, district nurse or Marie Curie Nurse about the different types of counselling available and how to access it. Counselling is often free at hospices, hospitals or GP surgeries.

NHS counselling services usually focus on cognitive behavioural therapy (CBT), a talking therapy that could help you to deal with any issues you’re worried about. You may be referred to a mental health professional, like a psychologist or psychiatrist, for specialist help.

Alternatively, ask your doctor about private counselling, or visit the British Association of Counselling and Psychotherapy  to find out more.

Local support

Remember there are local support groups where you can meet people going through similar experiences to you.

You can also visit your local branch of MIND  , or Mindwise   in Northern Ireland, where counselling and befriending services are available.

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Helping yourself

Here are some things you can do to help yourself:

  • Exercise can help to boost confidence and lift mood – yoga and t’ai chi can have a calming effect. 
  • Talk to your doctor about lack of sleep, if this is something you experience.
  • Ask your doctor about medication, like anti-depressants. 
  • Complementary therapies – particularly touching therapies like massage – can lift your spirits and help you to sleep: they’ve been shown to help relieve depression and anxiety.
  • Ask your faith leader about counselling or speak to them about your fears and concerns.
  • A change of scene can sometimes help.
  • Try to do something that you really enjoy – listen to music, read or listen to an audio book, start a new hobby or rediscover an old one.

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External websites

NHS Choices website   - Low mood, stress, depression

NI Direct website   – Recognising the signs of depression

British Association of Counselling and Psychotherapy  

MIND website   – Your local MIND

Mindwise website   


This page is for general information only. It's not intended to replace any advice from health or social care professionals. We suggest that you consult with a qualified professional about your individual circumstances. Read more about how our information is created and how it's used.

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