Depression in Palliative Care 529 JOURNAL OF PALLIATIVE MEDICINE Volume 11, Number 3, 2008 © Mary Ann Liebert, Inc. DOI: 10.1089/jpm.2008.9943 Depression in Palliative Care ANDREA AXTELL, M.D. Depression is a distressing group of symptoms that interferes with activities of daily living. It is common in patients with life-threatening illnesses. Studies have shown that up to 75% of patients with terminal illnesses are depressed. Depression can decrease the amount of pleasure and meaning in life. It can take away hope and peace at the end of life. Depression can also be a cause of suffering, and can increase physical pain. It also makes treatment of other illnesses difficult. Additionally, depression is associated with an increased risk of sui- cide. It is important to identify depression in order to preserve quality of life. JPM Patient Information Feature Editor: Jocelyn White The information and recommendations appearing on this page are appropriate in most instances, but are not a substitute for medical di- agnosis. For specific information concerning your personal situation or medical condition, JPM suggests that you consult your physi- cian. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. Any other print or online reproduction is subject to approval by the publisher: Mary Ann Liebert, Inc. To purchase bulk reprints, call 914- 740-2100. Signs and Symptoms of Depression • Feeling sad, hopeless, or worthless • Loss of interest in activities • Weight loss or weight gain • Decreased or increased sleep • Fatigue or loss of energy • Decreased ability to concentrate • Inability to make decisions • Thoughts of early death or suicide • Spending less time with family and friends • Tearfulness • Being less talkative Preparatory Grief Preparatory grief is a normal reaction that people experience when they are preparing for death. The symp- toms of preparatory grief can be very similar to those of depression.