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6 years HIV+ and still depressed...
Feb 20, 2003

Previous to being infected with HIV I had already been diagnosed with panic disorder and recurrent major depressive disorder. I am on medication for the panic disorder (klonopin) but have given up on the anti-depressants (too many side effects, not nearly enough relief). Anyway, understandably, coping with finding out I was HIV+ was difficult emotionally and psychologically as it is for everyone. But my observation is that for the most part people "adjust" to it one way or another and eventually get out of bed and back on with life. Well, not so with me. It has been 6 years last month since I was diagnosed as being positive and I think I am just as miserable, depressed, even sometimes despondent, as I was the day I found out. Can I attribute this lack of adjustment to my prior mental health history or do some people really just never adjust to the fact that they are living with this possibly deadly disease? You always read about the great "success" stories, those who "came back from the dead" or those who, after they locked themselves in their bedroom for a year (or a bar room), bounced back, had an epiphany of some sort, and became more productive and loving, etc., than ever. I don't hear about people like me, but I'm sure that there have to be more out there. Do some people just not have the capacity to adjust to such major adversity? And if so, what should we (I) do? Again, I've tried anti-depressants (over 12 of them over the past 12 years) as well as "talk therapy" but nothing seems to help. Am I one of those suffering from drug-resistant depression and therefore "talk-therapy" resistant depression, heightened by my HIV status? I feel like all these years I have been healthy and asymptomatic that I should have been out there really LIVING and instead I have chosen to cut myself off from the world imposing a sort of self-isolation upon myself and have become more and more depressed, miserable, hopeless, despondent, and even angry than ever. I hate to sound so dramatic or desperate, but this is the truth. Is there any help for someone like me, or am I one of the few that are unable to be helped?

Response from Mr. Shernoff

Since you were depressed prior to becoming HIV positive it is understandable that you would still be depressed now, especially as you are not receiving treatment for your depression. LEft untreated, depression almost never gets better or goes away.

As you have so eloquently described, not taking antidepressants and not being in talk therapy have left you still depressed and with a corresponding fairly lousy quality of life. Yes, there are a small minority of individuals who have a treatment resistant depression. All anti-depressants have some side effects. If you want to experience relief from the symptoms of depression then yes, you have to make a concession to having to live with those side effects that affect you. These medications are not perfect, but they do help reduce or alleviate depression's side effects. I guess you feel that for you living with the depression and how it has caused you to isolate and suffer a reduced quality of life is preferable to having side effects. That is your decision to make, but do not then say that you have a treatment resistant depression. You have decided that the side effects as well as the benefits of taking antidepressants is simply not worth the trade offs for you. In my clinical experience people who like you complain of how overwhelming the side effects of the antidepressants are, are not ready to make the kind of compromises necessary that are part of a successful treatment for depression.

Michael Shernoff, MSW



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