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Jun 16, 1998

Dear Michael,

I have been HIV+ now for 14 years. I have been on every approved medication that's out there and I am waiting on the approval for the expanded access meds. Lately I have become very apathetic about everything. I have a good job and I function in daily life but I just don't care. I have no sex drive at all, none. I went with my lover to his counselor and he suggested that I was depressed. He suggested that I talk to my Doctor about putting me on an antidepressant. What do you think.

Response from Mr. Shernoff

If your partner's therapist assessed you as being depressed than it is a very good possibility that you indeed are depressed. Do you agree with this? From the brief description you provided me I would concur with your partner's therapist. The only thing I would disagree with is not to ask your primary care doctor for anti-depressants, but to ask him or her for a referral to a psychopharmacologist who is an expert in prescribing these medications. In addition if you have not been in counseling or psychotherapy of your own, then it is a good idea to begin this as well as meds. Your therapist may or may not be the same person who prescribes the anti-depressants. Psychiatrists are the most expensive mental health professionals to see on an ongoing basis, so many people just use them for psychiatric medication and see another professional for the actual therapy. Living with a chronic life threatening illness for over a decade has to take its emotional and psychological toll, especially if you are not having the same miraculous results on the new combination therapies that so many others are lucky enough to be experiencing. Depression is an insidious and very serious illness. If left untreated, it can serious reduce your quality of life, and in its most serious manifestations can be life threatening by itself. Please, get your depression evaluated and treated by the appropriate professionals. You have been a long term survivor of HIV, so why not do everything you need to to enjoy your life?

Michael Shernoff, MSW

Angst of a

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