Anxiety and depression can be seen as two sides of the same coin. For many survivors, anxiety is fear related to losses that may occur in the future, while depression is sadness related to losses that occurred in the past. Both of these emotions are a normal part of anyone’s life, but both can become troublesome for survivors.

In the case of anxiety, survivors can become focused on the fear of a relapse or fear of late effects. If the anxiety grows too large, it may compromise a survivor’s ability to seek appropriate healthcare. In essence, the survivor becomes afraid of knowing. Sometimes survivors become embarrassed or ashamed of their concerns about their health and body. After all, young adults aren’t generally worried about things such as cancer or heart problems. So normal health concerns for survivors may make them feel strange and out of step with their peers.

Some survivors worry that they are hypochondriacs—that they are overly concerned about their health. They become fearful that their doctors will view them as complainers or find their health worries crazy. This type of anxiety can interfere with getting good, thorough follow-up care. Anxiety that interferes with life in this way can be crippling and detrimental. Survivors who feel extreme anxiety should seek help from a professional. There are many ways to reduce anxiety and not allow it to overwhelm your life.

Depression should be distinguished from the normal sadness about the real losses that can occur from treatment. Sadness can arise from temporary losses, such as the loss of hair, to permanent losses, such as the loss of fertility or mobility. Depression takes over normal sadness when a person is only able to focus on the losses and can no longer find any pleasure in life. It can become crippling and prevent the survivor from seeking and getting appropriate care and from enjoying the positive aspects of life.

When people are profoundly depressed, they may feel life is not worth living, or that they are not worthy of care and help. They often lack the energy to participate in activities that used to interest them, and they may withdraw from important relationships and social interactions. These feelings make it especially hard for them to get the help they need, both physically and emotionally. No one should have to suffer alone through depression; it can be successfully treated with counseling and/or medications.