DEPRESSION AND HIV
WHAT IS DEPRESSION?
Depression is a mood disorder. It is more than sadness or grief. Depression is sadness or grief that is more intense and lasts longer than it should.
It has various causes:
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events in your daily life
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chemical changes in the brain
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a side effect of medications
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several physical disorders
About 5% to 10% of the general population gets depressed.
However, rates of depression in people with HIV are as high as 60%. Women with HIV are twice as likely as men to be depressed. Being depressed is not a sign of weakness. It doesn’t mean you’re going crazy. You cannot “just get over it.” Don’t expect to be depressed because you are dealing with HIV. And don’t think that you have to be depressed because you have HIV.
IS DEPRESSION IMPORTANT?
Depression can lead people to miss doses of their medication. It can increase high-risk behaviours that transmit HIV infection to others. Depression might cause some latent viral infections to become active. Overall, depression can make HIV disease progress faster. It also interferes with your ability to enjoy life.
Depression often gets overlooked. Also, many HIV specialists have not been trained to recognize depression. Depression can also be mistaken for signs of advancing HIV.
WHAT ARE THE SIGNS OF DEPRESSION?
Symptoms of depression vary from person to person. Most health care providers suspect depression if patients report feeling blue or having very little interest in daily activities. If these feelings go on for two weeks or longer, and the patient also has some of the following symptoms, they are probably depressed:
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Fatigue or feeling slow and sluggish
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Problems concentrating
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Low sex drive
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Problems sleeping: waking very early, or excessive sleeping
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Feeling guilty, worthless, or hopeless
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Decreased appetite or weight loss
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Overeating
WHAT CAUSES DEPRESSION?
Some medications used to treat HIV can cause or worsen depression, especially efavirenz (Sustiva). Diseases such as anaemia or diabetes can cause symptoms that look like depression. So can drug use, or low levels of testosterone, vitamin B6, or vitamin B12.
People who are infected with both HIV and hepatitis are more likely to be depressed, especially if they are being treated with interferon.
Other risk factors include:
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Having a personal or family history of mental illness, alcohol and substance abuse
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Not having enough social support
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Not telling others you are HIV-positive
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Treatment failure (HIV or other)
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Rejection of different kinds can also bring out bouts of depression
TREATMENT FOR DEPRESSION
Depression can be treated with lifestyle changes, alternative therapies, and/or with medications. Many medications and therapies for depression can interfere with your HIV treatment.
Your health care provider can help you select the therapy or combination of therapies most appropriate for you. Do not try to self-medicate with alcohol or recreational drugs, as these can increase depression and create additional problems.
Lifestyle changes can improve depression for some people.
These include:
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Increased exposure to sunlight
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Stress management
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Counselling
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Improved sleep habits
Alternative therapies
Some people get good results from massage, acupuncture, or exercise. St. John’s Wort is widely used to treat depression. However, it interferes with some HIV medications and antidepressants. Be sure to discuss it with your health care provider before taking St. John’s Wort. When it comes to conventional treatments it is highly recommended that you speak to a professional health care provider.
THE BOTTOM LINE
Depression is a very common condition for people with HIV. Untreated depression can cause you to miss medication doses and lower your quality of life. Depression is a “whole body” issue that can interfere with your physical health, thinking, feeling, and behaviour. The earlier you contact your health care provider, the sooner you can both plan an appropriate strategy for dealing with this very real health issue.
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