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Send in the clowns... I'm done
Jul 23, 2004

I too would like to THANK YOU and every other person that provides this website, information, care and concerns. I hope I am in the correct section for this question as it is inter-related to others as well...

Dr. Horwath, I was diagnosed HIV+ 10/01. I had a great job that I LOVED (manager of a finance company branch office - on a fast track to district mgr or other...)! I am/was a definite Type A personality and strived on the stress! I easily worked 60hr a week. I started meds immediately (at the time Combivir, Sustiva and something else, I don't remember). I experienced side effects so bad that I could not function! I was away from my "home" state and not in any support groups and my doctor wasn't an HIV specialist in any way. I suffered tremendously for a year! It finally got so bad that I decided I could not continue in my position. I stepped down from mgmt, took a 50% pay cut, packed up and headed back to my home state to die basically! I've always been a loner, so there was no support (there or here); I struggle with HAART to this day (currently OFF -- was taking Kaletra, Epivir, Bactrim, Zerit, Wellbutrin, Remeron and Elavil). I can't tolerate the side effects of any regemin so far... I was diagnosed with AIDS 11/03. I lost it! I completely caved! My mental state is such that I know I'm severely depressed; have anxiety attacks from no where -- it feels like I'm going to have a stroke or heart attack, my head pounds and I get dizzy and break out in a serious sweat. I have no energy; am completely fatigued and absolutely no will! I'm currently pursuing Long Term Disability with my job (I still have insurance) and seeking to get approved for Social Security.

I finally have realized that I have a life-threatening illness. I am with a program called LifeCare. I have a great doctor & nurse practitioner! I've been referred to the social worker with the program and see a counselor (LCSW) once a week. I am in the process of seeing a psychiatrist. I don't want to talk to anyone, have completely isolated myself and have become obsessed here at The Body. I read constantly about EVERYTHING related to HIV/AIDS and what I'm feeling that day...

I really don't feel that there is anything truly left to fight for. I'm exhausted, overwhelmed and just want it to be OVER! I have a VL over 100K, CD4 of 108 and have never had an OI, but think I may be contracting something (persistant cough w/yellow-green phlegm & "wet-sounding" lungs -- I recently started smoking again). It seems that every disorder that I read about I have all the symptoms (not every one, but most)... I've advised my doctors that I'm afraid of being a hypochondriac but everyone agrees that I am just very aware of changes in my body; I always have. I feel this disease taking over my body and winning! I'm not sure if I'd actually commit suice since I know it would hurt people, most of all my doctors/caregivers...

After all of that, my question is this... Do I need to put myself in some type of assistance program/treatment facility? I think of death EVERYDAY, don't see an end to this feeling and don't see how I can get my quality of life back (or a resonable fact similie thereof)!!! I'm at a loss! and honestly don't know what is driving me to stick around! What is wrong with me, I just can't seem, to cope and am doing all of this alone...

Lonely, desperate, confused, exhausted & overwhelmed...

I am so sorry for the length, but felt it necessary to honestly explain what I'm feeling. Thank you again in advance for all that you do!

Response from Dr. Horwath

You urgently need treatment for your depression. You should see the psychiatrist as soon as possible. If you start to have feelings that you might hurt yourself, you should immediately go to an emergency room and get help.

Excellent treatment for depression is available and you don't need to suffer like this. Treatment is extremely effective. If you have problems with side effects, there are multiple alternatives. Non-medication treatments are also available or in development, eg. cognitive-behavioral therapy, interpersonal therapy, vagus nerve stimulation (Just approved by the FDA), and transcranial magnetic stimulation (TMS), which is being studied, and you might be able to find at a university medical center.

Stay hopeful! There is help for you.



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