In people with this type of cancer, these feelings may be caused by many things, including changes in how they are able to fill family or work roles, the loss of control over life events, body image changes, fear of death, fear of suffering and pain, or fear of the unknown. Family members may have these feelings because they are afraid of losing their loved one. They may also feel angry because someone they love has cancer, frustrated that they cannot "do enough," or stressed because they have to do more at home.

It's important to remember that people can feel distress at any time after cancer diagnosis and treatment, even many years after the cancer is treated. As their health situations change, people with cancer must cope with new stressors along with the old, and their feelings often change, too. For instance, people with advanced mesothelioma cancer may have more emotional distress than those with earlier-stage mesothelioma cancers.

People who have physical symptoms such as pain, nausea, or extreme tiredness (fatigue) also seem more likely to have emotional distress. Most of the time, these physical symptoms can be controlled with medicines but it may take more than one try to find the right drug or combination of drugs. This is one reason to stay in touch with your cancer care team, so that they can help you with these kinds of symptoms before you feel overwhelmed.

It is normal to grieve over the changes that cancer brings to a person's life. The future, which may have seemed so sure before, now becomes uncertain. Some dreams and plans may be lost forever. But if you are caring for a person who has been sad for a long time or is having trouble carrying out day-to-day activities, that person may have clinical depression. In fact, up to 1 in 4 people with cancer do have clinical depression. Clinical depression causes great distress, impairs functioning, and may even make the person with cancer less able to follow their cancer treatment plan. The good news is that clinical depression can be treated.

If you are caring for someone who has symptoms of clinical depression, encourage him or her to get help. There are many treatments for clinical depression including medicines, counseling, or a combination of both. Treatments can reduce suffering and improve your loved one's quality of life.

Symptoms of clinical depression

-ongoing sad or "empty" mood for most of the day

-loss of interest or pleasure in almost all activities most of the time

-major weight loss (when not dieting) or weight gain

- being "slowed down" or restless and agitated almost every day, enough for others to notice

-extreme tiredness (fatigue) or loss of energy

-trouble sleeping with early waking, sleeping too much, or not being able to sleep

- trouble focusing thoughts, remembering, or making decisions

-feeling guilty, worthless, or helpless

- frequent thoughts of death or suicide (not just fear of death), suicide plans or attempts

Keep in mind that some of these symptoms, such as weight changes, fatigue, or even forgetfulness can be caused by cancer treatment. But if 5 or more of these symptoms happen nearly every day for 2 weeks or more, or are severe enough to interfere with normal activities, encourage the person you are caring for to be checked for clinical depression by a qualified health or mental health professional. If your loved one tries to hurt himself or herself, or has a plan to do so, get help right away.

Steps to take to overcome the depression are:

-Encourage the depressed person to continue treatment until symptoms improve, or to talk to the doctor about different treatment if there is no improvement after 2 or 3 weeks.

-Promote physical activity, especially mild exercise such as daily walks.

-Help make appointments for mental health treatment, if needed.

-Provide transportation for treatment, if needed.

-Engage your loved one in conversation and other activities they enjoy.

-Realize that negative thinking is one of the symptoms of depression and should get better with treatment.

-Reassure your loved one that with time and treatment, he or she will begin to feel better.

Keep in mind that caregivers and family members can also become depressed. If you suspect you may be depressed, see a doctor. Make time to get the help and support you need. If you notice symptoms in another friend or family member, try to get them help.