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Depressed, lonely and fatigued
Jan 16, 2001

Michael, I've recently been infected. I've been trying to deal with both the physical and emotional aspects of the situation I've been seeing a psychiatrist but we have just mostly "talked" in our sessions (about stress). I have been experiencing fatigue (probably to hypogonadism), insomnia, anxiety attacks (which felt like I was having a heart attack) and depression. I haven't pressed the issue, even though I thought she would have placed me on medication already. I know that I'm clinically depressed. I've cried numerous times and afterwards wondered why I did so. The only thing I am not is suicidal -- aside from that I am a psychiatrist's "dream patient". Do you think I should press the medication issue? I don't want to sound like a Dr. diagnosing myself -- but my work, family, and everything else is being impacted by my problems. what do you think?

Response from Mr. Shernoff

From what you have described I do not understand why the two of you have not discussed the possibility of using medication to reduce your symptoms. Talk therapy is very good, but it can be enormously enhanced by the correct psychiatric medications. I urge you to bring up this issue in your next session and ask why she has not raised the issue of medications with you. Also have your primary care doctor do a blood test to determine if your testosterone levels are low. If so, then he or she and you need to discuss beginning testosterone replacement therapy to reduce your fatigue.

Michael Shernoff, MSW

Michael Shernoff MSW is a psychotherapist in private practice in Manhattan who has been providing mental health services to people living with and affected by HIV/AIDS since the onset of the epidemic. He can be reached at his home page (http://www.gaypsychotherapy.com) or via e mail at mshernoff@aol.com)



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