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Fatigue and AnemiaFatigue and Anemia
           
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Depression & HIV
Jan 28, 2005

I've been reading the forum postings on fatigue and actually feel a little better. Misery loves company.

Have a question about "depression." I have been on and off anti-d's since diagnosed with AIDS in 86. Am I correct in my understanding that there are 2 different types of depression (I realize that there are MANY different types of depression within the clinical diagnosis) but as I undertand it there is 1) Depression that is caused by a chemical imbalance in the brain. This type depression is treatable with anti-d's, and then there is 2) The type of depression that comes say, after your dog of 13 years dies. And this depression isn't necessarily caused by a chemical imbalance in the brain but rather by life itself, and it eventually passes. And in this case anti-d's wouldn't do any good.

Am I making any sense here? I just want to clear things up in my mind regarding when anti-d's are useful and when they really aren't.

Thanks.

Response from Dr. Frascino

Hi,

There are as many types of depression as shoe styles in Carrie Bradshaw's closet, but what you are probably referring to is situational depression versus chronic depression. Situation depression is stuff like Diana leaving the Supremes, Dubya being reelected or finding out your butch boyfriend still wets the bed and only answers to "Jessica." This type of depression is usually transient and lifts spontaneously in six months (or four years, in the case of the Dubya thing).

Many types of depression are indeed related to low levels of certain crucial brain chemicals. Antidepressants are indeed helpful for this! Compared to older classes of antideps, the new SSRIs (like Prozac) are much better tolerated, but they may put a few extras miles between you and your orgasm, which can be somewhat "depressing". So, when are anti-d's useful? The best answer is when they are needed. But also, it's worth pointing out that counseling (yeah, the ol' couch therapy "tell me about your mom" stuff) really does work and has no side effects!

Finally, true misery does love company, but usually it's not the kind of company you particularly enjoy having around. You might try being "Mr. Happy" for a change just to see what happens and if the company you get might have a higher fun quotient.

Good luck.

Dr. Bob


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