World AIDS Day: Living With HIV
HIV and Depression
You don't want to eat. You lie in bed for hours with your mind racing. You can't seem to make yourself do any of the things you know you need to do, from regular doctor visits to taking your HIV medications.
These symptoms may seem normal following an HIV diagnosis. However, while these reactions are common, they're also signs of depression — a mental condition that can quickly have a big impact on your physical illness.
The relationship between HIV and depression is the subject of much research. “There are studies that quote widely varying rates of depression in people with HIV," says Karl Goodkin, MD, PhD, director of clinical research in the department of psychiatry and behavioral neurosciences at Cedars-Sinai Medical Center and a professor in the department of psychiatry and biobehavioral sciences at the University of California, Los Angeles. "The rates of depression could be anywhere from 20 to 60 percent."
Whatever the actual statistics are, depression in people with HIV is of great concern because it can significantly affect both the patient’s daily life and the progression of HIV to AIDS. Depression can negatively affect the function of your immune system, your relationships with others, and your general satisfaction with life.
Know the Signs of Depression
In people with HIV — as in people with other medical conditions — depression tends to be underdiagnosed and undertreated, says Goodkin. Here are warning signs that indicate you should be evaluated for depression:
- Always feeling sad, or feeling no emotion at all
- Feeling overly tired or sluggish
- Sleeping too much or having difficulty sleeping
- Inability to concentrate, pay attention, and make decisions
- Inability to find pleasure in activities that you used to enjoy
- Feeling guilty
- Not having an appetite and losing weight, or eating too much and gaining weight
- Feeling hopeless or worthless about your situation
- Overall sense of lethargy and sluggishness
- Thinking about suicide
Depression and HIV Help
Goodkin says there are effective ways of treating depression along with HIV. He stresses the value of working with a psychiatrist who has experience in treating HIV, because depression medications can interact with some common HIV treatment drugs, including antiretroviral medications. Also, if depression goes unchecked, you may forget or even refuse to take your HIV treatment medications, leaving you more vulnerable to the effects of the virus.
Though some patients see alcohol or drugs as a means to escape depression and life with HIV, substance abuse can worsen depression. Seeking effective depression treatment can keep you from medicating yourself with drugs and alcohol, which can also worsen HIV.
Another reason to discuss potential depression with your medical team is to get an accurate diagnosis, in order to make sure that depression and not another medical condition is at the root of your symptoms. In addition to starting an appropriate treatment plan, your doctor might also recommend lifestyle changes that can help you battle depression and keep your body healthier.
Managing Depression With HIV
There are many ways to manage depression when you have HIV, including:
Some people undergoing HIV treatment may consider natural or herbal treatments, but it's important to work with your doctor to manage your depression safely. For instance, you should not take St. John's wort to try to manage depression on your own because this supplement can have serious negative effects on people with HIV.
Your doctor can help you find an effective treatment for depression that doesn’t interfere with your HIV medications. Once you are being treated for depression, you can maintain control of your depression by sticking to your treatment plan and following up with your doctor regularly.
Video: My HIV Journey: Depression and Social Anxiety
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