Chemotherapy and Depression: Side Effects and Coping Strategies

Chemotherapy can be associated with depression symptoms, but depression often arises from a mix of cancer-related stress, treatment effects, and life changes. ^[1] Depression is a common and understandable reaction to cancer and its treatment, and it is treatable with the right support. ^[1] If feelings of sadness begin to affect daily life, this may suggest depression rather than a temporary low mood. ^[1]

What depression can look like

• Sleeping too little or too much, or changes in appetite. ^[2]
• Feeling sad, down, hopeless, or like nothing will help. ^[3]
• Loss of interest in activities you used to enjoy. ^[4]
• Low energy, feeling slowed down, or trouble focusing. ^[3]
• Anxiety, guilt, or feeling worthless or helpless. ^[3]
• Thoughts of death, suicide, or self-harm require urgent help. ^{[3] [5]}

Why chemotherapy may contribute

Chemotherapy can worsen fatigue, sleep disturbance, nausea, and pain, which can increase emotional distress and heighten the risk of depression. ^[1] The diagnosis itself, changes in life plans, financial or legal worries, and fear of mortality also play a role and can amplify mood symptoms during treatment. ^[1]

When to seek urgent help

Get immediate support if you have thoughts of suicide or self-harm, or if depression symptoms last two weeks or more and interfere with daily functioning. ^[6] Help is available 24/7 through crisis resources and through your care team, and depression can be treated effectively. ^[5]

Practical coping strategies

• Talk to your care team: They can assess your symptoms and connect you with counseling, psycho-oncology, or psychiatry. ^[7]
• Get emotional support: Hospital-based counselors, social workers, chaplains, and support groups can reduce isolation and worry. ^[7]
• Stay connected: Spending time with friends and family helps build a support system and ease fears. ^[8]
• Light physical activity: Gentle movement, as you’re able, can lift mood and energy. ^[8]
• Track symptoms: Noting sleep, appetite, energy, and mood helps your team adjust care quickly. ^[7]
• Set small goals: Break tasks into manageable steps to maintain a sense of control. ^[7]
• Consider therapy: Evidence-based approaches (like cognitive behavioral therapy) can improve coping and reduce depressive symptoms. ^[7]
• Ask about medications: Antidepressants may be appropriate; your oncology team will review potential interactions with anti-nausea drugs used during chemotherapy. ^{[7] [9]} Concurrent use of certain antidepressants with 5‑HT3 antiemetics (like ondansetron) can increase the risk of serotonin syndrome, so monitoring or alternative plans may be considered. ^{[9] [10] [11] [12] [13]}

Red flags to share with your team

Tell your clinician promptly if you notice sustained mood changes, severe anxiety, persistent sleep problems, or loss of interest in activities, especially if these last more than two weeks. ^[6] If emotions interfere with daily activities, or you feel confused, very restless, or have any thoughts of self-harm, seek help right away. ^{[6] [5]}

The bottom line

Depression during chemotherapy is common, multifactorial, and treatable, and early recognition leads to better outcomes. ^[1] With coordinated support medical, psychological, social, and lifestyle most people find strategies that meaningfully improve mood and quality of life during treatment. ^{[7] [8]}