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Worried about being depressed
Jun 19, 2012

Hello. I've been positive and undetectable for about 6 years now. Obviously it's the same story, my life definitely changed dramatically when I was diagnosed, and I know I definitely lost my passion for lots of things for life. I've been on Atripla for 4 1/2 years and my counts are great. My CD4 ranges from 600 to 900, and I've been undetectable since I started taking it. My question is, lately I've noticed I've been really down. I've tried meditating consistently, exercising, writing, talking, etc. I can't seem to get through this hump. Nothing appeals to me anymore, and I feel totally lost and directionless. More than anything, I haven't felt like I am actually "alive" and that has been true ever since I became positive. What do I do?

Response from Dr. Fawcett

Thanks for writing. A significant portion of individuals living with HIV experience depressive symptoms. There is, of course, an adjustment period to the news that one is positive. How long this lasts or its intensity varies significantly by individual. Not feeling "alive" indicates a numbing that is common with painful emotions (that's why individuals living with HIV are at higher risk for substance abuse). That lack of an ability to experience pleasure (anhedonia) obviously affects one's quality of life.

You appear to have experienced a change lately, however, in terms of feeling "lost" and "directionless." This could be indicative of more serious depressive symptoms. In light of this, I commend you for all the self-care you describe: meditation, exercise, and expression are all very helpful in addressing negative moods.

Given these self-care skills and the change in severity, I would recommend an assessment by a mental health professional. It's important that any feelings you are experiencing (or may not yet be in touch with) get identified and expressed. Many people find talk therapy helpful, or an antidepressant. The literature shows that a combination of these is most effective. Finally, be certain your support system is strong. HIV can be a disease of isolation which only compounds depression.

Take care,

-David

Response from Dr. Fawcett

See follow up on July 1



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