Hi Doctor, thanks for being available to help people in distress. I recently messed up my chance to move to a better more peaceful home. My partner was furious and accused me of being incompetent and running us into the ground. I no longer can rely on myself to make sound decisions and deeply regret not making the move to a quiet location. To make things worse my partner has decided to dump me as a result of my incompetency and return to his country of birth USA, Iam an Australian. I am in agony over all of this. He wants to leave me and BLAME me for it. I can't help but feel badly about myself. How could I ruin such a great opportunity? Iam angry about my feeble mindedness. He says he wants someone rational. Basically, I'm not good enough. He is HIV neg and fit. I am very depressed. I never had a high IQ but the illness has caused me to be even less capable. My partner likes younger looking women who wear brassy clothes and makeup. Iam nothing like these women. I feel so inadequate. I really can't cope with this terrible situation. I can't bear the thought of not being with the person I want so much. He says things like " I wish I knew you when you were younger". I used to be attractive but now I look awful. How can I come to terms with my situation? I have nothing to look forward to but more poverty, deteriorating health, a home I dislike and the loss of my partner. Please don't tell me I'll find someone else - it's not going to happen. I am too unwell to leave the house much now. How do you continue when the quality is not there? I have often thought that if my dog was psychologically distressed like this,it would be unkind to keep her alive. I feel that there is nothing left for me.

I look forward to your reply and thank you for your thoughtful advice.

Sarah

It sounds like you are really depressed. I think that your sense of self confidence and self esteem have been eroded by both the illness and by your partner leaving you. You are suffering from the emotional complications of very real lossess in your life. I urge you to locate a good mental health professional and begin working with him or her.

The severity of your depression is worrisome. If left untreated it could result in your continuing to feel even worse and possibly even killing you by your doing something to harm yourself or through your not taking care of yourself by stopping medical treatment.

Clinical depression is treatable. Usually the best way to treat it is through a combination of regular sessions with a therapist with whom you talk about your problems at least once a week. But talk therapy is not enough to treat depression. You will probably require some kind of anti-depressant medication as well as talk therapy.

I am not by any means suggesting that if you take the step to get help that your life will turn around and become wonderful. But treating your depression will help you achieve as good a quality of life as possible within the limitations of your illness by helping reduce your sense of hopelessness, helplessness and powerless that are leading you to feel such despair.

So please ask your doctor for a referral to a good mental health professional, preferably someone who has experience in working with people with HIV.

Best of luck.

Michael Shernoff, MSW