ABSTRACT
There are many possible reasons why a patient could be withdrawn: perhaps by nature the person is reserved; pain, anger or anxiety may be so severe that it is preventing them from concentrating; drowsiness caused by drugs or chemical disturbances in the blood may be preventing a conversation; and they may be suffering from depression. It has been suggested that 25% of patients with cancer and AIDS suffer from depression. The diagnosis of depression is made on the following: there is a persistent low mood; and there is a change to their usual mood. Treatment may be strengthened with therapy such as cognitive therapy which gives the patient skills that reduce the chance of the depression returning. If the depression is persisting or has complicating features (e.g. agitation, paranoia) the doctor will seek advice from a psychiatric colleague.
