A Beyond Blue reader asked: “What do you do when you are afflicted by BOTH cancer and depression? Your twelve steps work great for healthy people. But what do you do when you’re sick while trying not to plunge into a deeper depression?”

I waited until Michelle Rapkin’s book, “Any Day with Hair Is a Good Hair Day: How to Get Through Cancer and Get On with Your life (Trust Me, I’ve Been There),” was out to answer you, because offers great suggestions in her chapters: from helpful self-talk to prayer to shopping.

The first thing you need to do, though, if you think you’re depressed (and have cancer) is get honest with yourself and your medical team about your depression. In a section called “Dealing with Depression,” she writes:

It’s one thing to be sad. If you weren’t sad about having cancer, that would be very strange. But there’s a real difference between being sad and being depressed. At any given time, 10 percent of the American population suffers from depression. Thirty percent of cancer patients suffer from it; so if you think you might be depressed, the odds are with you.

I’ve suffered from bouts of major depression in my life, and I can assure you that you really don’t want to be in the middle of cancer and depression at the same time. One is bad enough, but in combination they’re brutal.

Ongoing symptoms of depression include:

• Exaggerated feelings of hopelessness, despair, worthlessness, and inadequacy.

• Little, if any, interest in things that used to be pleasurable.

• Crying often and easily.

• Thoughts of suicide.

• Loss of interest in sex.

• Extreme feelings of worthlessness and guilt.

If you experience some or all of these feelings much or most of the time, please, please tell your medical team as soon as you realize that they’re not going away. Your body needs all of its energy to heal. Why force it to undergo the added stress of depression? Also, the medical community has determined that there is a strong connection between depression and a suppressed immune system, which is the last thing you need right now.

Finally, don’t worry about antidepressants. I know how hard it is to accept the fact that you might need them. But I can tell you from experience that taking them is like taking aspirin or allergy medicine. In fact, if you’ve ever taken Zyban to quit smoking, then you’ve already taken an antidepressant. Zyban is Wellbutrin, one of the most widely used antidepressants in the country.

Remember, don’t suffer in silence. Don’t just hope the depression will go away by itself. It won’t. Tell your doctor as soon as you think that you might be depressed.

Like pain, the earlier depression is treated, the more quickly and easily it will be alleviated. Not to mention that you’ll avoid unnecessary strain on your already overworked body.

A wonderful blog I have discovered on this topic is Beyond Breast Cancer. It has a huge following and has won many awards. Plus a friend of mine writes it!