Depression

What approaches can help you manage depression?

We present many approaches to reducing depression and summarize the evidence regarding their effectiveness.

Seek professional help if needed. Diagnoses such as depression can require therapy from trained practitioners for management. We encourage you to explore the options available to you through your cancer team and others. Taking care of your mental health is as important as taking care of your physical health.

Top practices and therapies for managing depression

Therapies and practices we have reviewed

The effects of these practices and therapies are described below on this page.

Further therapies

Therapies recommended in clinical practice guidelines; see guidelines ›

Other therapies

Several other therapies have some evidence of benefit. The benefit may be meaningful or even substantial, but our reviews show the evidence so far is preliminary. These are listed below.

Conventional approaches

Prescription drugs and psychotherapies may help manage depression. Ask your doctor for recommendations, but also ask about side effects of drugs.

Self-care practices and complementary therapies

Strong, good, or modest evidence of benefit

Strong evidenceconsistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analyses of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results (this is the CancerChoices definition; other researchers and studies may define this differently) indicates confidence that the practice or therapy has an effect as noted. Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) indicates that the practice or therapy is linked to the outcomes described with reasonable certainty. Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) means the practice or therapy may be linked to the outcomes described, but with a lower degree of certainty.

A therapy may show a stronger effect or have more evidence in some situations than in others. The evidence supporting the effects for each therapy is listed in the full reviews available through the image links.

Eating Well: strong evidence

Moving More: mixed evidence

Recommended in clinical practice guidelines for managing depression; see guidelines ›

Combining Eating Well and Moving More: preliminary and modest evidence

Less depression among women with early breast cancer participating in an intervention of both diet and exercise (preliminary evidence)

Not specific to cancer:

• Less depression among overweight or obese women participating in an intervention of physical activity and/or diet (modest evidence)

Calorie restriction, behavioral therapy, and exercise leading to 30 pounds or more of weight loss: modest evidence

Not specific to cancer:

• Fewer self-reported symptoms of depression among people with symptoms participating in calorie restriction, behavioral therapy, and exercise leading to 30 pounds or more of weight loss (modest evidence)

Probiotics and prebiotics: preliminary and good evidence

Relaxation techniques: modest and preliminary evidence

Relaxation techniques combined with guided imagery: modest and preliminary evidence

Less depression among people with cancer treated with relaxation and visualization or guided imagery, including during cancer treatment (modest evidence)

Less depression among people with terminal cancer in hospice treated with interactive guided imagery and progressive muscle relaxation (preliminary evidence)

Not specific to cancer:

• Less sadness among parents of hospitalized children treated with progressive muscle relaxation and guided imagery (preliminary evidence)

Time in nature: modest and preliminary evidence

Preliminary or weak evidence of benefit

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) typically indicates that not much research has been published so far, although the outcomes may be meaningful. Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) may mean that the effects are small or that only very preliminary research has been published.

No evidence of benefit

Vitamin D › and and omega-3 fatty acids ›

Not specific to cancer:

• No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on mood scores, risk of depression incidence or recurrence, or clinically relevant depressive symptoms among people without depression treated with vitamin D and fish oil in a very large study (not specific to cancer)

Further therapies used to manage depression

These therapies are used to manage depression. Many are reviewed in this article: Complementary therapies for clinical depression: an overview of systematic reviews ›

Those in bold are recommended in at least one clinical practice guideline; see guidelines ›

Helpful links