At Loma Linda University Cancer Center, patients can connect with social workers like Desandra Gonzalez, as well as counseling services, support groups, and other resources, often the same day.
A cancer diagnosis brings fear, uncertainty, and emotional ups and downs. But how do patients and families know when those feelings are something more, like depression?
During Mental Health Awareness Month, experts at Loma Linda University Cancer Center say that the question is critical and often overlooked.
“Mental health is such a big part of your treatment that sometimes patients and caregivers don’t realize,” says Desandra Gonzalez, a social worker at Loma Linda University Cancer Center. “If you’re not mentally well and you’re not getting that support, it can impact your entire journey.”
When emotions shift into something more
Feeling overwhelmed after a cancer diagnosis is normal. But for many patients, emotional distress begins even before treatment starts.
“For a lot of patients, the first thought is, ‘How much time do I have?’” Gonzalez says. “There isn’t always a conversation about everything in between, such as treatment, recovery, or remission.”
As treatment begins, physical and lifestyle changes can take a toll. Patients may lose their independence, face financial strain, or struggle with visible changes to their body.
“I’ve had patients tell me they don’t recognize themselves anymore,” she says. “They’re struggling with the loss of their hair, their routine, or the way they see themselves.”
The warning signs families shouldn’t ignore
Depression doesn’t always look obvious. Instead, it can show up in subtle but serious ways. Patients may withdraw, stop sharing how they feel, or lose motivation to continue treatment.
“All of a sudden, they’re not getting out of bed. They’re not wanting to come to treatment,” Gonzalez says. “That’s when we know we need to step in.”
Missing appointments can also be a red flag.
“When a patient stops showing up, we ask why,” she says. “Are they overwhelmed? Are they giving up? Or do they just not have that fight in them anymore?”
Who may be more at risk
Some patients face a higher emotional burden during cancer care. Younger patients, for example, may struggle with isolation as their lives are suddenly put on hold.
“They’re watching their friends live life while they’re fighting for theirs,” Gonzalez says. “That can lead to a lot of fear about the future.”
Others may face financial pressures or lack a strong support system.
“I’ve had patients say, ‘I was the provider, and now I can’t even move on my own,’” she says. “That shift can lead to anxiety and depression.”
Why many patients don’t ask for help
Even during Mental Health Awareness Month, stigma remains a major barrier.
“There’s this idea that if you go to therapy, something is wrong with you,” Gonzalez says. “But there’s nothing wrong with needing that extra layer of support.”
She encourages patients to see mental health care as part of their overall treatment.
“The work you get out of therapy is what you put in,” she says. “It helps you process what you’re going through and gives you tools to cope.”
When to seek help
So, when is it time to reach out? Gonzalez says one simple guideline is to pay attention to emotional patterns over time.
“If you’re crying more than you’re happy, then we need to talk,” she says.
Other warning signs include:
“The worst thing we can do is suppress what we’re feeling,” she says. “That’s when mental health starts to decline.”
Taking the first step
For many patients, getting help can feel overwhelming — but it doesn’t have to be.
“The first step can be as simple as telling your nurse what’s going on,” Gonzalez says. “They can connect you to the support you need right away.”
At Loma Linda University Cancer Center, patients can connect with social workers, counseling services, support groups, and other resources, often the same day.
“You don’t have to have all the answers,” she says. “You can just say, ‘I want to talk to someone,’ and we’ll meet you where you’re at.”
Above all, Gonzalez wants patients and families to know they don’t have to go through cancer alone.
“You’re not just a name on a chart,” she says. “You have a story, and we’re here to support you through every part of this journey.”