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.

Depression may also be a symptom of stress. If stress is contributing to your depression, managing your stress will be important in reducing it.

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. Full details of evidence are on the therapy reviews, accessible through the image links below.

Further therapies

Therapies recommended in clinical practice guidelines but that we haven’t yet reviewed; see guidelines

Acetyl-L-carnitine

Behavioral approaches

DHEA

Folate

Hypnosis

Lavender

Light therapy

Massage therapy ›

Meditation

Music and arts therapies

Omega-3 fatty acids ›

Saffron

S-adenosyl-L-methionine (SAMe)

Sleep deprivation

St. John’s wort

Transcranial direct current stimulation (tDCS)

Vagus nerve stimulation (VNS)

Psychosocial therapies:

  • Cognitive-behavioral therapy
  • Cognitive-behavioral stress management (CBSM)
  • Mindfulness-based stress reduction (MBSR)
  • Psychoeducation
  • Supportive/expressive therapy

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 approaches

The evidence supporting the effects for each practice is listed in the full handbooks available through the image links.

Eating Well: strong evidence

Moderate improvements in depressive symptoms among people following the recommended diet patterns of increasing vegetables and fruits, nuts, and fiber, and reducing fat, salt, sugar, and cholesterol (strong evidence)consistent, 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)

Recommended in a practice guideline for managing depression; see guidelines ›

Moving More: mixed evidence

Less depression among people participating in exercise without regard to treatment phase (strong evidence)

Less depression among people participating in exercise during cancer treatment (preliminary (conflicting) evidence)significant 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)

Less depression among people participating in exercise after cancer treatment (good evidence)

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 depression among adults with advanced lung cancer participating in exercise training in a combined analysis of studies

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)

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

Managing Stress: good evidence

Lower depression among people with better acceptance of cancer (good evidence)

Stress and depression are closely linked, and depression triggers may also be stressors. Therapies and approaches that manage stress may also relieve depression.

Recommended in a practice guideline for managing depression; see guidelines ›

Sleeping Well: modest evidence

More depression among people with breast cancer or prostate cancer with poorer sleep quality (modest evidence); improving sleep quality may lead to less depression

Creating a Healing Environment: preliminary evidence

Less depressed mood among women with moderate-to-severe premenstrual syndrome / premenstrual dysphoric disorder not using hormonal contraceptives treated with morning light therapy high in bright and blue light (preliminary evidence)

Sharing Love and Support: modest evidence

Less depression or hopelessness among people with higher levels of social support (modest evidence)

Manage your body weight: preliminary evidence

A link between a large waist-to-hip ratio and depression among middle-aged women (preliminary evidence)

Complementary approaches

We present complementary therapies supported by evidence for managing depression. Those with the best evidence are presented first.

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.

Good or modest evidence of benefit

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 a relatively high degree of confidence that the therapy is linked to the outcomes as noted. 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 several smaller or at least one large study have found the effect described.

Acupressure: modest evidence

Less depression among people with cancer treated with acupressure (modest evidence)

Guided imagery: modest to weak evidence

Guided imagery is often used with other mind-body therapiesapproaches that enhance your mind’s capacity to positively affect your body’s function and symptoms. Some interventions focus on calming your mind, improving focus, enhancing decision-making capacity, managing stress, or resolving conflict. Other interventions have a goal of relaxing both your mind and your body..

Less depression, better mood, or less negative emotions during chemotherapy among people with cancer treated with guided imagery, often with other mind-body therapies (modest evidence)

Less depression during radiotherapy among people treated with guided imagery and relaxations (modest evidence)

Better mood among men undergoing surgery for prostate cancer treated with guided imagery and other mind-body therapies (preliminary evidence)

Less sadness among parents of hospitalized children with cancer participating in progressive muscle relaxation and guided imagery (preliminary evidence)

Less depression among people with breast cancer treated with guided imagery and other mind-body therapies (weak evidence)

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

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

Mediterranean diet: modest evidence

Not specific to people with cancer:

  • Less depression or better mood among people following a Mediterranean diet (modest evidence)
Relaxation techniques: modest and preliminary evidence

Relaxation is often used with other mind-body therapies.

Less depression among people with cancer treated with relaxation training, sometimes with other mind-body therapies without regard to treatment phases (modest evidence)

Less depression during chemotherapy among people treated with relaxation, sometimes also with guided imagery (modest evidence)

Less depression during radiotherapy among people with cancer treated with relaxation, sometimes also with another mind-body therapy (preliminary evidence)

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

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

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

Tai chi or qigong: modest evidence

Fewer depressive symptoms or mood disturbance among people with cancer practicing either tai chi or qigong (modest evidence)

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

Time in nature: modest and preliminary evidence

Not specific to people with cancer:

  • Better mood among people listening to nature-based sounds (modest evidence)
  • Lower risk of depression among people with more day-to-day exposure to nature (green space) (preliminary evidence)
  • Lower depression scores among people participating in forest therapy (preliminary evidence)
  • Less use of psychotropic drugs for anxiety or depression among people in urban areas visiting natural spaces, although no evidence of an effect of living near or having views of green and blue (terrestrial and water) spaces (preliminary evidence)
Turmeric and curcumin: modest evidence

Not specific to people with cancer:

  • Lower incidence of depression among people with major depressive disorder treated with curcumin (modest evidence)
Yoga: good evidence

Less depression among people with cancer practicing yoga (good evidence)

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

Therapies with preliminary or weak evidence of benefit for depression

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.

Acupuncture Learn moreSee Less
Electroacupuncture Learn moreSee Less
Healing touch Learn moreSee Less
Melatonin Learn moreSee Less
Polarity therapy Learn moreSee Less
Reiki Learn moreSee Less
Reishi mushroom Learn moreSee Less
Support groups Learn moreSee Less
Combining vitamin D with outdoor walking, light exposure, and several other vitamins Learn moreSee Less

No evidence of benefit

Vitamin D ›

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 people with cancer)

Further therapies used to manage depression

These therapies are used to manage depression, but we have not yet reviewed their effectiveness or safety. 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 ›

Acetyl-L-carnitine

Behavioral approaches

DHEA

Folate

Hypnosis

Ketamine

Lavender

Light therapy

Massage therapy

Meditation

Music and arts therapies 

Omega-3 fatty acids

Probiotics

Psilocybin

Repetitive transcranial magnetic stimulation (rTMS)

Saffron

S-adenosyl-L-methionine (SAMe)

Sleep deprivation

Spiritual care

St. John’s wort

Transcranial direct current stimulation (tDCS)

Vagus nerve stimulation (VNS)

Psychosocial therapies:

  • Acceptance and commitment therapy (ACT)
  • Cognitive-behavioral stress management (CBSM)
  • Cognitive-behavioral therapy
  • Mindfulness-based stress reduction (MBSR)
  • Psychoeducation
  • Supportive/expressive therapy

Resources for managing depression

Helpsy Health

Helpsy empowers members to take control of their health through a real-time virtual nurse support service. This service is available via mobile devices, a Helpsy website and automated phone calls.

Access the Helpsy website

Authors

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Nancy Hepp, MS

Lead Researcher and Program Manager
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher, program manager, and writer for CancerChoices. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher and Program Manager

Maria Williams

Research and Communications Consultant
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Maria Williams is a research and communications consultant who brings over 15 years’ experience in research, consumer education, and science communication to CancerChoices. She has worked primarily in public health and environmental health.

Maria Williams Research and Communications Consultant

Last update: February 3, 2023

Last full literature review: November 2021

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.