There are few experiences more devastating than being diagnosed with a terminal illness. The feelings of grief that come with such a diagnosis can in some cases be more painful even than the illness itself, and for up to 77% of terminal patients, this can evolve into depression, anxiety and panic. One of the factors that can further complicate this situation is social stress: A terminal diagnosis brings with it not just the symptoms of the illness itself but also pressure from friends and loved ones seeking reassurance or coping with (or repressing) their own associated trauma.
How terminally ill patients feel and the support they have to navigate these stresses can significantly impact their quality of life in their final days. Here, we’ll look at how to understand a terminal diagnosis, how to spot signs of mental health distress and how to get help.
Understanding a Terminal Illness Diagnosis
Normally, a terminal illness is defined as any illness that can’t be cured and is likely to lead to the death of the patient. Alternative terms include “life-limiting illness” and “incurable illness.”
A diagnosis comes with lots of uncertainty. Despite the best efforts of health care professionals, it’s often not possible to know exactly how much time you have. In some cases, an incurable illness may not actually be terminal in the short term, and the patient could live for months or years. In others, the time elapsed between diagnosis and end of life might be measured in weeks. Experiences of terminal illnesses are, in other words, highly varied on the whole: The diagnosis doesn’t necessarily mean instant death, and the development of symptoms and overall health won’t necessarily take a straight path.
Understanding the variability of terminal illness can help provide at least a certain amount of perspective and an appreciation that it’s worthwhile to seek support for mental health as part of the journey. The first step in seeking that kind of support is being able to understand what end-of-life depression looks like.
Identifying End-of-Life Depression
There’s no “right” way to feel about facing a terminal diagnosis. Everyone has their own emotional responses, which they may experience at various points or in different sequences that are particular to them. These can include:
- Anger
- Anxiety and/or panic
- Bitterness
- Disbelief and/or denial
- Frustration
- Loneliness
- Peace and/or acceptance
- Sadness
- Vulnerability
While these are all normal and expected grief-related reactions to facing mortality, they’re distinct from the kind of depression that, for example, seniors are 60% likely to experience in the last month of life. While it isn’t true that depression can outright kill you physically, it can certainly affect your ability to cope. It can lead to severe hopelessness and suffering, place strain on relationships with family and loved ones, worsen physical symptoms such as chronic pain or lead to the failure of pain treatment and generally shorten survival.
The symptoms of depression can easily be confused with grief or with the physical symptoms of a terminal illness (in fact, up to 60% of people suffering from major depression are first aware of it only through physical symptoms). They tend to be severe enough to impact your ability to function “normally” or derive meaning or enjoyment from activities that were once desirable. They can include:
- Loss of energy
- Paralyzing anxiety
- Feelings of hopelessness, helplessness or worthlessness
- Trouble making decisions
- Changes in eating habits or sleep routine
- Reduced interest in activities
- Suicidal thoughts or attempts
Reporting these symptoms to a mental health professional can be helpful in sorting out the expected outcomes of grieving or the symptoms of the illness itself from a major depression diagnosis. Patients who know they’re suffering from end-of-life anxiety or depression can seek help to reduce suffering along their journey.
Tips for Getting Help
It’s the responsibility of health professionals not only to treat illness but, in the case of life-limiting illnesses, to improve the quality of a patient’s end-of-life journey and reduce mental and physical suffering. Terminally ill patients should never hesitate to get help in managing depression and anxiety, especially if they’re experiencing suicidal ideation.
Treatment can take the form of medication and therapy, in much the same way as for anyone suffering from depression. Antidepressants are as effective for patients in palliative care, for example, as they are for any other category of patient. Short-term psychotherapy can likewise be a powerful tool for identifying the causes and sources of depression. And it can be helpful to reach out to someone you trust, such as a chaplain, to talk through concerns and uncertainties.
A dedicated team of mental health professionals can provide multiple levels of care that include therapeutic and medical treatment. Just as importantly, they can provide support for caregivers and loved ones to help them cope with the stresses they’re experiencing.
How to Help Caregivers
A diagnosis of terminal illness will often require family caregivers to step in and help as the patient goes through the often-frightening and confusing changes associated with the end of life. Almost 96% of caregivers for terminally ill patients are family members, sometimes providing more than a hundred hours of a week of essential tasks — everything from daily chores to managing relationships with different health care providers.
These caregivers may suffer from their own problems of health and well-being stemming from the stresses and pressure of their responsibilities. More than that, they or other loved ones may unwittingly contribute to social stress on the patient as their own tensions, trauma or search for reassurances bring added pressure to bear on an already overwhelming situation.
Caregivers and families can seek out support groups and educational literature or engage in direct conversations with medical staff to better understand what their loved ones are going through. They can learn how to help, how to navigate boundaries and how they can take care of themselves in the process so they don’t experience burnout or breakdown.
After a Terminal Diagnosis, Mental Health Still Matters
Even for patients facing a terminal illness, quality mental health care is still important to reduce suffering and ease the journey. Contact Restore today at (877) 594-3566 and find out how our compassionate team of professionals can help.
