Depression secondary to medical illness is an appropriate diagnosis when the physiological effects of the illness on the brain directly result in depressive symptoms. Several medical disorders are associated with depressive symptoms in this way. Occult hypothyroidism exemplifies disorders in which recognition and treatment of the underlying condition may alleviate depression symptoms. In addition to organic causes of depression in the medically ill, other relevant factors to consider and explore with patients include: the meaning of the illness to the patient, the patient's causal attributions about illness, distorted cognitions or maladaptive behavioral responses to illness, coping mechanisms, and strengths or weaknesses which may be imbedded in patients' premorbid personality traits and style. When rapid improvement of depressive symptoms is the goal, psychostimulants have been useful in patients with advanced cancer. The suggestion that antidepressants increase the risk of cancer has been refuted.