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Lifestyle Makes a Difference in Combating Depression After Breast Cancer

Expert Analysis Highlights:

  • Psychological well-being ultimately improves one’s chances of surviving cancer
  • Largest study that has been reported to date comes from China regarding factors that help prevent depression among breast cancer survivors
  • Findings suggest strongly that regular exercise and tea consumption may offer an alternate or complementary approach to avoiding or minimizing depression symptoms in women with breast cancer

Mental health is an important component of cancer treatment and management. The video above is about research indicating that breast cancer patients with psychological support along with their medical treatment can improve their odds of beating the disease. As the study shows, psychological well-being ultimately improves one’s chances of surviving cancer, citing one statistic that the risk of dying from breast cancer dropped 60% when adding psychological support along with medical treatment compared to those with only medical treatment. So how does a cancer patient or survivor prevent depression and maintain a “healthy” mental condition?

Regular exercise and tea consumption may play an important role in prevention of depression among breast cancer survivors, according to a recent study  published in the prestigious Journal of Clinical Oncology from Shanghai, China (Journal of Clinical Oncology 28:991, February 20,2010). The authors performed a detailed study of 1,399 breast cancer patients who were followed for two years afterward treatment with a detailed analysis of their coping with the diagnosis of breast cancer.  They documented their daily exercise and nutritional intake, and also tested for depression and quality-of-life as reflected in validated test questions. They found that 26% of women reported depressive symptoms, while 13% met the criteria of clinical depression.

There were three important  findings:

1) Women who reported a higher exercise level were less likely to have depression compared to those who did not exercise.  Increased exercise level after diagnosis was also related to a significantly reduced risk of depression.

2) Women who had regular tea consumption (> 100 grams dried tea leaves/month) had a significantly lower incidence of depression

3) No associations were found for other forms of dietary intake or nutritional supplements (among those queried) , as reflected in the depression score.

This is one of several clinical trials that have observed some beneficial effect of short term life style interventions, such as exercise, on depression among women with breast cancer. This study from China is the largest that has been reported to date. All types of exercise decreased the risk for depression, while women with consistently higher levels of exercise had the lowest risk for depression.  Exercise may relieve depression symptoms through plausible mechanism, such as improved physical fitness, self-sufficiency, and distraction from common symptoms (such as sleep disturbances or pain) associated with cancer and cancer-related treatments.  More clinical studies are needed to evaluate the effect of exercise on depression.

According to the study, this is the first epidemiological evidence that tea consumption may be associated with a lower risk of depression among breast cancer survivors. Indeed, lifetime tea consumption was inversely related to depression. Tea is the most common beverage world-wide. Tea and its constituents contain high levels of caffeine and other substances that may be beneficial in adjusting mood disorders.  As the authors emphasize, even animal studies have shown an anti-depressant effect of tea extracts. A recent study has also reported that caffeine consumption, either from coffee or tea, reduced the risk of depression in the general population (that is, not just breast cancer patients). Clearly, more studies are needed to confirm the tea/depression association and to investigate the underlying mechanisms.

According to the study, there were no associations between depression  and habitual dietary intake (such as  meats, vegetables, soy foods), or with Chinese herbal medicine use and supplements, similar to that of previous studies. They pointed out that previous studies in the United States showed that neither alcohol consumption nor smoking was related to depression. This study confirms these results, since there was no association of alcohol consumption or smoking with depression. The authors concluded that regular exercise participation may play an important role in the prevention of depression among breast cancer survivors. Also, they did not identify any other nutritional or dietary supplements that were associated with a lower rate of depression.

These findings were based on the culture, cancer treatments, and dietary conditions of women with curable breast cancer in Shanghai China. They are likely to have application to a woman’s lifestyle in other parts of the world, but this would have to be proven with further studies. Nevertheless, these findings suggest strongly that modifiable lifestyle behaviors, exercise participation and tea consumption may offer an alternate or complementary approach to avoiding or minimizing depression symptoms in women with breast cancer.

*Other factors associated with depression symptoms occurred in women who were older, who were widowed or divorced/separated/single, had menopausal symptoms, or had lower education or income levels. The associations of exercise and tea consumption with depression remained significant even after adjustment for these factors.

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