Depression, Women and HIV

Table of Contents

• Women and Depression
• Depression in Women Living With HIV
• Depression and Older Women Living With HIV
• Depression Can Cause Serious Problems
• What Is Depression?
• Treatment Options
• Get Checked and Treated for Depression

Women and Depression

Studies have shown that, in the general population, women are two times more likely to be depressed than men. While it is not clear why women suffer from depression so much more than men, there are several potential contributing factors. One reason used to explain the high rate of depression among women is the burden many women bear as the primary caregiver for family members. Often, women will care for others and not care properly for themselves. Other factors that may lead women to feel depressed include having a lower household income, less education, less social support, and a greater chance of being physically and/or sexually abused.

Depression in Women Living With HIV

Women living with HIV (HIV+) are even more likely to suffer from depression than women in the general population. Although many HIV+ people live long, healthy, and full lives, learning that you are HIV+ is life-changing news that can be very difficult to hear. Some people feel overwhelmed, helpless, or unable to cope with an HIV diagnosis. Others are afraid for their future health, or of disclosing their HIV status to friends and family. The stigma that many HIV+ women experience may lead to social isolation and feelings of loneliness. All of these feelings -- helplessness, anxiety, loneliness -- are key components of depression.

Many HIV+ women also experience large life stressors such as racial discrimination, poverty, violence, and single parenthood which can contribute to depression. An HIV diagnosis can simply add to the burden and to the chances of developing depression.

Depression and Older Women Living With HIV

As HIV treatments have improved, there are more and more older women living with HIV. Growing older often involves its own life challenges, such as chronic disease, disability, or the loss of loved ones. These life changes can lead to feelings of sadness or depression. One study showed that over 60 percent of HIV+ women from 50 to 76 years old suffered from depression.

Depression Can Cause Serious Problems

Studies show that there is a direct connection between depression and reduced health for those living with HIV. Specifically, HIV+ women who are depressed seek HIV care less often, have more trouble sticking with their HIV drug regimens, and have more rapid disease progression. If you are experiencing symptoms of depression, you may miss doses, take the wrong dose, or take the dose with the wrong food or at the wrong time. Not taking your HIV drugs regularly can lead to the development of resistance, which makes HIV medications less effective at fighting the virus. This can cause your CD4 cells to go down and/or your viral load to go up.

Even among HIV+ women with similar CD4 counts and viral loads, being depressed can double the likelihood of dying compared to having few or no symptoms of depression. For those women who made contact with a mental health provider, the risk of death was cut in half. It is important that depression be diagnosed and treated as quickly as possible to avoid serious problems.

What Is Depression?

Being depressed, in everyday language, occurs when someone feels down, sad, blue, unhappy, or hopeless. These are all normal feelings, and almost everyone experiences them at one time or another. Receiving and living with a diagnosis of HIV can be stressful, overwhelming, and fearful at times. So it is not unusual for HIV+ people to feel down or anxious sometimes.

If these feelings are overpowering, disabling, or long-lasting, however, they may be a sign that you are experiencing a condition known as depression. Compared to sadness, depression is more intense, lasts longer (more than two weeks), and interferes with your day-to-day ability to function. In medical language, depression is a diagnosis based on having a certain number of specific symptoms (from the list below). Depression is not a normal part of being HIV+ and can cause some serious health problems. If you have any of these symptoms or are unsure if what you are experiencing is normal, it is important to talk to your health care provider.

Symptoms of depression include:

• Changes in appetite or weight
• Aches or pains for no clear reason
• Feelings of sadness, guilt, hopelessness, and/or worthlessness
• Irritability; getting into arguments easily
• Lack of interest or pleasure in activities that usually interest you
• Low sex drive
• Difficulty making decisions or concentrating
• Changes in sleep patterns
• Fatigue or loss of energy
• Thoughts of harming oneself or committing suicide

If you are thinking of hurting yourself of committing suicide, please tell someone immediately. You can call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255) or go to http://suicidehotlines.com/.

In addition to the symptoms listed above, you may also notice yourself doing some of the following if you are depressed:

• Not taking care of yourself in terms of grooming, dressing, and personal hygiene
• Skipping or not going to work; calling in sick
• Being very critical and down on yourself
• Not talking to or going out with friends
• Not pursuing doing your usual social activities, hobbies, or recreations
• Crying or feeling like crying more often than normal, and often without knowing why
• Using alcohol or other recreational drugs more than usual

Sometimes substance use hides depression. This happens when people try to "self-medicate" by using drugs or alcohol to try not to feel the pain of what troubles them. If you feel that an issue, such as depression or anxiety, causes or adds to your substance use, ask your health care provider or AIDS service agency for a referral to a mental health provider.