More Depression for Mothers and Singles With Breast Cancer

Women who have children living at home and single women have higher levels of depression in the months after treatment than other breast cancer patients, new research shows.

The findings, from a study of 225 women undergoing radiation treatment at nine clinics in Missouri, offers a glimpse into the emotional toll of breast cancer, suggesting that some women face greater psychological challenges in the months after treatment ends. The study, published in the journal Psychology & Health, was conducted by researchers from the University of Missouri, Texas A&M and Tulane University.

To measure differences in depression, women completed questionnaires that resulted in a depression score. The study showed that while all women with a breast cancer diagnosis experience psychological stress, certain women are at greater risk for ongoing depression. Having children living at home, being single or having low income were all risk factors for depression among breast cancer patients during the year after treatment.

One explanation for differences in depression levels may have to do with the amount of emotional and practical support women receive at the time of diagnosis and during and after treatment. It appears that the women who do best are those with husbands or partners, perhaps because they can offer women continuing emotional and practical support. Women with breast cancer who have children at home may face more logistical challenges coping with treatment schedules and side effects and juggling the daily responsibilities of child-rearing, compared with similar women who don’t have children at home.

Although both high- and low-income women had similar levels of depression during the treatment period, low-income women showed more depression after treatment. The explanation may be that low-income women had more worries about missed work time or medical bills related to breast cancer.

Notably, women who lived a long distance from their doctors showed greater levels of depression after treatment ended. Even though the end of treatment signaled the end of a long commute, it may be that these women also lost their main sources of social support at the clinics where they received treatment.

Ann Bettencourt, professor of psychological sciences at the University of Missouri and an author of the study, said it was important for doctors to have a simple way to predict who among their patients is at higher risk for depression following treatment, so they can recommend appropriate support and services. In a separate study, she noted, women who were more depressed were less likely to regularly take medications.

Although the latest study didn’t examine the reasons certain women were at higher risk for depression than others, the study authors said doctors can work with both family members and patients to make sure women are receiving adequate emotional and practical support. Single women, for instance, may be encouraged to join support groups or even online discussion boards. Doctors can urge women with children living at home to arrange for practical support from friends and family, like meal preparation or shuttling children to activities, even if they don’t think they need it.

Dr. Bettencourt noted, however, that the reasons women with children at home are more likely to be depressed may go beyond the daily challenges of raising children, and have more to do with worries about a child’s future.

“Women’s concern about their own survival may lead them to worry about the care of the children living in their home, which in turn, may engender higher levels of depression,” she said.