The Link Between Depression and Breast Cancer Survival

The Link Between Depression and Breast Cancer Survival

Cancer doesn’t end when treatment does, and the state of your mental health could influence your outcomes.
The Link Between Depression and Breast Cancer Survival
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for Awaken Your Wellness
Published on April 18, 2025
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Everyday Health Blogs

My mom was diagnosed with breast cancer when she was just 33 years old. I was 13.

Back then, I couldn’t fully understand what she was going through during and after treatment. But now in my late thirties, as a mom of two and a BRCA1 previvor myself on the other side of a preventive mastectomy and total hysterectomy, I see her experience through a completely different lens.

Over the past 10 years, I’ve cared for countless patients facing serious illnesses like breast cancer in my work as a palliative care physician. The one thing that rings loudly through every story is the emotional and mental burden that must be shouldered, which can be just as heavy to carry as the cancer diagnosis itself.

Looking back, my mom’s experience with cancer at 33 was very different from her recurrence at 49. Although she had our immediate family to support her through her initial treatment, it was as if she faced her first cancer diagnosis behind closed doors. We are South Asian, so culturally, there wasn’t space for her to openly process what was happening. There were no support groups with other women in their thirties juggling it all — cancer, menopause, motherhood, and everything in between.

Sixteen years later, when the cancer came back, she wasn’t alone. This time, she had me and a solid group of strong supportive women around her. Survivorship looked different this time. For the first time, we peeled back the layers of her first cancer experience — the grief, resentment, sadness, fear, and unresolved pain — and finally gave those emotions the space they deserved to be heard and processed. And I finally understood the years of severe anxiety and depression she struggled through after her cancer treatment ended.

Almost every cancer survivor will agree with this one truth: Cancer doesn’t end when treatment does.

Long after treatment ends, patients can struggle with a silent storm of complications, as well as their sense of self, their relationships, and a longing for the life they once had.

The State of Your Mental Health Affects Breast Cancer Survival

There is a growing body of research showing that psychological stress, anxiety, and depression don’t just impact quality of life but can influence survival.

 A large review of studies published in 2020 found that depression after a breast cancer diagnosis was strongly associated with a greater number of deaths from any cause and poor outcomes from breast cancer.

 There are several potential explanations for this, including chronic inflammation, cortisol dysregulation (an imbalance in the body’s stress response), impaired immunity, and poor treatment adherence,

 which can all affect healing and accelerate cancer growth.
My mom’s struggles during her cancer experience weren’t unique. Studies estimate that up to 1 in 3 women with breast cancer suffer from depression or anxiety, with rates highest in women undergoing chemotherapy or a divorce.

 Depression is a silent killer that needs early detection, screening, and management before, during, and after a breast cancer diagnosis to optimize quality of life and overall survival.

3 Simple Tips to Boost Mental Health During and After Cancer

As a lifestyle medicine physician and coach, I’m passionate about helping women grow through their struggles. And the good news is that there are many ways for us to support our mental health through our everyday lifestyle choices.

 While none of us chose cancer, we can choose how we carry our bodies, minds, and emotions through it. Here are three simple but powerful science-backed strategies that can help.

1. Move Your Body

A large review paper found that exercise significantly reduced depression and anxiety in breast cancer survivors.

 I always recommend finding ways to move that you enjoy. It could be as simple as a 10-minute walk with a friend or some gentle yoga. As you build up your stamina, you can incorporate more aerobic and strength-training exercises, which will also improve your energy and support your immune system in reducing risk of cancer recurrence.

2. Find Ways to Be Seen and Heard

Isolation is one of the most painful side effects of a chronic illness. But here is what I want you to know — you are not alone. We are social creatures, and if there is one thing I learned in my palliative care career, it’s that we need each other to thrive. Connection is a vital part of treatment, and people with a strong social support system have a lower risk of death regardless of the stage of their cancer.

We live in an age where access to support is all around us and we can connect with people living with exactly what we are going through. And being with others who can truly understand our experience can be extremely healing for our mental and emotional health.

3. Eat the Rainbow

Food isn’t just fuel; it can be medicine for our mental health.

 A plant-forward, nutrient-dense diet has been shown to reduce inflammation and boost mood, and may support overall outcomes in cancer survivors.

 Focus on eating more bright, colorful fruits and vegetables rich in antioxidants and cancer-fighting compounds.

My mom is a two-time breast cancer and divorce survivor, and no doubt the strongest woman I know. But I often wonder how her experience after cancer in her thirties would have been different if her mental and emotional health were prioritized just as much as the chemotherapy and radiation. How would life be different if she had access to spaces with other women where she could cry, vent, laugh, grieve, and rebuild herself with others who just got it?

My hope is that as cancer treatments advance, so will the incorporation of mind-body interventions for true healing through the cancer journey. So, if you are reading this and navigating life after breast cancer — your feelings are valid. Healing will take time. And you are not alone.

Important: The views and opinions expressed in this article are those of the author and not Everyday Health.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Wang X et al. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Molecular Psychiatry. August 20, 2020.
  2. Zhu G et al. Depression and survival of breast cancer patients: A protocol for systematic review and meta-analysis. Medicine. November 25, 2020.
  3. Lei F et al. Influence of depression on breast cancer treatment and survival: A Kentucky population‐based study. Cancer. May 21, 2024.
  4. Loving BA et al. Newly Diagnosed Mental Health Disorders in Patients With Breast Cancer Receiving Radiation Therapy. International Journal of Radiation Oncology, Biology, Physics. October 1, 2024.
  5. Merlo G et al. Mental Health in Lifestyle Medicine: A Call to Action. American Journal of Lifestyle Medicine. May 21, 2021.
  6. Zhang Y et al. Effects of Exercise on Depression and Anxiety in Breast Cancer Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cancer Medicine. March 2025.
  7. Wang F et al. Social Support, Social Strain, Stressful Life Events and Mortality Among Postmenopausal Women With Breast Cancer. Psychooncology. November 2024.
  8. Hardt L et al. Plant-Based Diets and Cancer Prognosis: a Review of Recent Research. Current Nutrition Reports. September 23, 2022.
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walter-tsang-bio

Walter Tsang, MD

Medical Reviewer
Castle Connolly Top Doctor, Member of American College of Lifestyle Medicine
Walter Tsang, MD, is a board-certified medical oncologist, hematologist, and lifestyle medicine specialist. Inspired by the ancient Eastern philosophy of yang sheng ("nourishing life"), Dr. Tsang has developed a unique whole-person oncology approach that tailors cancer care and lifestyle recommendations to each patients’ biopsychosocial-spiritual circumstances. He partners with patients on their cancer journeys, emphasizing empowerment, prevention, holistic wellness, quality of life, supportive care, and realistic goals and expectations. This practice model improves clinical outcomes and reduces costs for both patients and the healthcare system. 

Outside of his busy clinical practice, Tsang has taught various courses at UCLA Center for East West Medicine, Loma Linda University, and California University of Science and Medicine. He is passionate about health education and started an online seminar program to teach cancer survivors about nutrition, exercise, stress management, sleep health, and complementary healing methods. Over the years, he has given many presentations on integrative oncology and lifestyle medicine at community events. In addition, he was the founding co-chair of a lifestyle medicine cancer interest group, which promoted integrative medicine education and collaborations among oncology professionals.

Tsang is an active member of American Society of Clinical Oncology, Society for Integrative Oncology, and American College of Lifestyle Medicine. He currently practices at several locations in Southern California. His goal is to transform cancer care in the community, making it more integrative, person-centered, cost-effective and sustainable for the future.
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Simran-Malhotra-bio

Simran Malhotra, MD

Author
Member of American College of Lifestyle Medicine
Simran Malhotra, MD, DipABLM, CHWC, is a triple board-certified physician in internal medicine, hospice and palliative care, and lifestyle medicine, as well as a certified health and wellness coach. She is currently practicing part time as an inpatient palliative care physician at Medstar Health after serving as the palliative care medical director at Franklin Square Medical Center in Baltimore for a little over four years.

Dr. Malhotra completed her internal medicine residency at Medstar Franklin Square Medical Center, where she also served as chief resident in 2015. She completed her fellowship in hospice and palliative medicine at Johns Hopkins Hospital in 2016. She was named Top Doc in Palliative Medicine in 2019 and 2020 by Baltimore Magazine.

On a personal note, she is a BRCA1 previvor with a strong family history of breast and female reproductive cancers, and underwent a risk-reducing bilateral mastectomy and total hysterectomy in 2020 at 32 years old. After learning about her own genetic risk of cancer, and grounded in her professional experiences in palliative care, she founded Wellness By LifestyleMD, a platform where she works with and educates women at high risk for cancer with or without genetic mutations on the powerful impact that positive lifestyle changes can have on their quality of life and even longevity.

In addition to being a diplomate of the American College of Lifestyle Medicine, she completed the T. Colin Campbell plant-based nutrition certification in 2019, the CHEF culinary coaching certification in 2020, and the WellCoaches health and wellness coaching certification in 2022. She is a member of the ACLM women’s health member interest group and serves as the co-chair of the breast cancer subcommittee.

Malhotra has been featured on several blogs and podcasts, where she has shared her unique perspectives and experiences from palliative care as well as from being a genetic mutation carrier who is passionate about using lifestyle as medicine.
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