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Is Clinical Depression A Side Effect Of This Too?
Nov 22, 2011

I'm been HIV positive 22 years. My CD4 count is 487 and my viral load is undetectable. I've been depressed for quite a few years now. I thought my life was going good but I can't shake this damn down-in-the-mouth, whoa-is me, blue-funk feeling that hangs around me like a freakin' cloud day-in and day-out. Is it my meds? I've done quite a few HIV meds over the years but none have produced the results that the Atripla has. What can I do about this? And I'm sick to death of this big-a** belly!

Response from Mr. Vergel

I am so sorry about your long term struggle with depression.

I have to battle depression frequently. I have a strong family history of clinical depression and know when I am on the train heading to that dark side. But I manage it by exercising, keeping my testosterone and thyroid hormone levels normal,taking breaks to do pleasurable things like sex, dance, and surrounding myself with the craziest of my friends. If everything fails,I take antidepressants for a while. When I have taken antidepressants, I have to go through 4 before I found the right one for me (in a study, the average person with depression switches 6 times before they find one that works without too many side effects).

Some depression can be genetic and some can be drug induced. Efavirenz (Sustiva, in Atripla) is well known to cause this problem in a minority of patients. Luckily, we have Isentress, Selzentry, Complera, Truvada, Viramune, Intelence, Endurant, and all protease inhibitors are options to Efavirenz.

Last but not least, being aware of the negative chatter that happens in my head when I am heading to that dark side has been very important. I have read many books seeking answers on how to cope with the chatter. One of the best ones I have read is Eckard Tolle's "The New Earth". I learned to manage that chatter with just saying to myself "Will I chose to be an enemy or a friend to this situation?".

Lately, I have been trying to get a better hold at Mindfulness. It has been proven in two small studies to improve stress and even immune function in people living with HIV. Practice of mindfulness meditation slows the progression of HIV, study shows

Mindfulness-based stress reduction for HIV-positive men a randomized trial

Mindfulness presentation [Bram Conley at the HIV Mental Health Task Force]

Hang in there and do not succumb to depression. You are not alone and many of us are learning how to manage this problem so that it does not rob us of the present as we survive HIV and try to build a future.

Nelson



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