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Is poor mental health due to progression of AIDS
Nov 30, 1999

I am a 48yo male homosexual. I was diagnosed with AIDS in March '97 when I was hospitalized with PCP. I had never been tested before that. In reviewing my history, I believe that I have been HIV+ at least since the mid 80's. My lastest blood test show viral load undectecable and CD4 at 138@8%. Also since the mid80's I have been suffering from depression, social phobia and panic disorder. I was diagnosed by my Physician and started taking Prozac and going to counseling in '93. I stopped taking Prozac in May '97 when I lost perscription coverage. Over the past year I have been experiencing constant and deep depression. On 11/1/99 I started taking Desipramine and also started counseling at the community services office.I felt that this was helping for a short time but, as time goes on I no longer feel that I am improving. During the past 6 months I feel as though "something" is going on in my brain. I don't know exactly how to describe what I feel. I have been totally drained of all energy both physically and mentally. I can feel sensations in my head, but I don't describe this as headaches. And my mental health is very poor in my opinion. I am not sure how to discuss this with my ID specialist because I don't know if this is psychological or physical, and I am afraid that I will come across as a complainer. This is not in any way connected to the way my doctor treats me, he is excellent. This is just a fear of mine. If I was to pose my thoughts as a guestion to you, I would ask: "Is my psychological/mental state a symptom of the progression of AIDS and what can I do to find some degree of relief in this area."

Response from Mr. Shernoff

First just describe how you are feeling to your ID doctor and ask for a referral to a psychiatrist who is also a specialist in HIV. It is difficult but necessary to obtain a good diagnostic assessment of how much of the problem is physiological and how much reactive to the disease. But from your own description, you have had a major and long standing depresive illness for many years that has responded well to treatment in the past. Many people plateau on their anti-depressant medications and often need to have the dosages or even the drugs changed. But you really need to have a sophisticated psychiatric work up done in order to obtain the best treatment. Michael Shernoff, MSW



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