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Concerned about increasing depression

Jan 13, 2013

I have been HIV positive since 1994. My labs are good and my overall life is decent, but I am becoming increasingly depressed. I am not suicidal, but withdrawn. I don't eat well and don't care. I tried a counselor once and felt awkward. I am on the generic Prozac. Do you have any suggestions? Switch meds? How do I find and talk to a counselor?

Response from Dr. Fawcett

Thanks for writing. Depression is a significant concern for people living with HIV/AIDS. Many people continue to experience mood disorders despite good labs and overall health.

I am, of course, glad to hear that you are not suicidal but I strongly encourage you to move forward with some interventions to address your moods. Generic Prozac (fluoxetine) is a common antidepressant that is certainly effective for some people. Not every medication works for every person, so I would recommend discussing your concern with your physician and getting a recommendation for a psychiatrist who could do a more thorough evaluation. Although fluoxetine may not be effective for you, something else might work well. Sometimes it is a case of trial and error until you find relief.

It is also important to note that the best results come from a combination of medication and psychotherapy, so I encourage you to pursue finding a therapist. It can be very awkward to begin therapy. It is not a natural process to meet someone and just start talking about very personal details. For that reason, I remind people that it's good practice to have an initial consultation with a therapist. Sometimes there will be chemistry and sometimes not. Go with your gut. My best advice for finding a therapist is to ask other people you know (professionals and peers) for recommendations. A consensus of names in your area will probably quickly emerge.

Good luck.


Scared to start antidepressants
Low sex drive

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