Managing depression in palliative care

Depression in children and teenagers

Children and teenagers can also become depressed. It is important that parents are aware of this and look out for any signs that their child is becoming depressed. This will include the child becoming quiet and withdrawn or irritable. If you suspect that your child is becoming depressed you should seek help for them as soon as possible. Effective treatments are available, just as they are for adults. However, treatments need to be carefully tailored and will usually involve the whole family.

If you are a teenager who is seriously ill, or know someone who is ill, you may find yourself feeling angry and resentful. It can be very difficult to cope with an illness at a stage when your life is opening up and you want to do more things for yourself and by yourself. If you have been diagnosed yourself, you may find that you will have to become more dependent on your parents again and this can be difficult. It may have come as a shock to have to think about your health when you may not be used to feeling ill.

You can find yourself tearful, depressed and unsure about how to cope with all the changing emotions you are experiencing. You may feel resentful that life is going on as normal for other people when you have so much to cope with.

You may find you are asking yourself a lot of difficult questions about the illness and how it’s affecting you. Feelings and experiences like these are all very natural and understandable, but it can be difficult to cope with such strong feelings on your own.

It’s sometimes difficult to talk about things like this, even with the people you are close to. If you’re finding it hard to talk, you may find it helps to discuss your feelings with a trained counsellor.

If you are ill, you could try contacting a support group for young people who have the same illness. This will give you a chance to talk to others who are in a similar situation and facing the same challenges.

Suicidal feelings

If you’re feeling extremely depressed or hopeless, it’s not unusual to feel that life is not worth living and even to think about killing yourself. It’s common for people who are very depressed to feel that they are a burden to others and that their family would be better off without them.

Suicidal thoughts are often a safety valve: a thought that there is an escape from the depression. However, if you often have thoughts of suicide, or you find yourself making plans for how you might actually go about it, tell your doctor or someone who is close to you immediately.

You can call the Samaritans on 116 123 – they offer a 24-hour confidential helpline providing emotional support from trained volunteers for people in emotional crisis.

Alternatively you can contact Breathing Space – a confidential phone and web based service for people in Scotland experiencing low mood, depression or anxiety. Breathing Space is free to call from a landline and some mobile networks. Call them on 0800 83 85 87.

Your doctor may suggest that you spend a few days in hospital so that specially trained staff can support you and help you to feel better as quickly as possible. In some areas, specialist psychiatric support teams can visit you at home.

As well as talking therapies, you will usually need drug treatment.

If you have the following symptoms you need to seek help immediately:

  • suicidal feelings or plans
  • hearing voices (hallucinations)
  • strongly believing things which are unlikely to be true (delusions)
  • self-harm

Sleep problems due to anxiety and depression

Many people diagnosed with a serious illness have trouble sleeping at some time. This can be due to general anxiety, worry about treatment or fears for the future. Actually getting to sleep may be the most difficult part. If you are depressed you may also notice that you wake early – often around 3am or 4am – and find it difficult to get back to sleep.

Most sleeping tablets only work for a few hours to help people get off to sleep, so they will not help if you wake in the early hours of the morning. It can feel frustrating when sleep is difficult, but remember that lack of sleep will not cause you any harm.

Some of the suggestions below may help you to get a better night’s sleep:

  • try to get into a regular routine at bedtime and go to bed at the same time each night
  • try having a warm milky drink before bed
  • have a warm bath with a few drops of lavender or geranium oil to soothe you, or sprinkle a couple of drops of lavender oil on your pillow
  • if you can’t sleep, or wake up early, don’t try so hard to sleep; instead, try to relax and rest your body. Rather than lying in bed tossing and turning, you could listen to music or the radio. You could get up and watch TV or read a book. Wait until you feel tired again and then go back to bed

Relaxation tapes or CDs, or recordings of stories, are also very useful for helping you get to sleep. They are stocked in most public libraries or drop in information and support centres.

Your body will still get some benefit from lying quietly in bed, resting, even if you are not actually asleep. Although you may feel as if you have been awake all night, you may well have managed to have several hours of good quality sleep.

Older people and people who have not been physically very active during the day need less sleep at night. If you are taking naps during the day and having problems sleeping at night, it may mean you do not need so much rest. Limit yourself to one rest or sleep each day to see if it helps.

Getting help with some of the emotional effects of your illness can improve your sleep pattern.

Loss of appetite due to anxiety or depression

Loss of appetite due to anxiety or depression Some serious illnesses or treatments for them can cause a loss of appetite. However, you can also lose your appetite if you are very anxious or depressed. This may make you lose weight.

Some people just don’t feel hungry, or feel full soon after starting a meal. Others find that food makes them feel sick or they notice a change in the taste of some foods.

Some of the following suggestions may help to improve your appetite:

  • eat little and often if you can’t face a big meal
  • tempt your taste buds by making food look as attractive as possible
  • having a small glass of sherry or brandy half an hour before a meal can stimulate your appetite. A glass of wine with your meal may help digestion
  • keep snacks handy to nibble – such as nuts, crisps, grated cheese or dried fruit
  • eat cold food if the smell of hot food makes you feel sick
  • try to relax and not do anything else while you are eating

Loss of interest in sex due to anxiety or depression

Many people notice that their interest in sex decreases as a result of a serious illness or its treatment. People can also lose interest in sex if they are depressed. People are often reluctant to talk about this very intimate area of their lives, but it can help to talk through how you feel with your partner. Explaining that your lack of interest is not a sign of lack of affection or respect for them, may help you both feel more secure.

You can also talk things through with your GP, who may be able to offer help. Your specialist nurse, if you have one, can also discuss this with you. Some treatments and antidepressants can cause sexual problems. Changing to a different medicine may return things to normal.

Other physical symptoms due to anxiety or depression

A serious illness can cause people to feel stressed and anxious. Stress and anxiety can sometimes cause physical symptoms such as a sensation of a lump in the throat, chest pain, a dry mouth, breathlessness, or feeling sick. People often worry that these physical symptoms are due to the illness or its treatment. If you are a family member or friend, you may worry that you might have the same illness. It can sometimes be difficult to tell what is causing the symptoms and this can make you even more worried.

If you have any symptoms and you are not sure what is causing them it’s best to talk to your GP. If necessary, your doctors can do tests to find out what is causing the symptoms.

Last updated:
06 May 2024