Depression, Women and HIV
February 13, 2017
Table of Contents
- What Is Depression?
- Women and Depression
- Depression in Women Living With HIV
- Depression and Older Women Living With HIV
- Depression Can Cause Serious Problems
- Treatment Options
- Get Checked and Treated for 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 people living with HIV to feel down or anxious.
If these feelings become 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 shown in the list below. Depression is not a normal part of living with HIV and can have a negative effect on your overall physical health. 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
- Episodes of crying 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 or committing suicide, please tell someone immediately. In the U.S., you can call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255). To find a suicide hotline near you, try www.suicide.org/suicide-hotlines.html; this website lists U.S. hotlines by state as well as hotlines by country (click on the "International Hotlines" link at the top of the main page).
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 taking part in 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 depression or anxiety causes or adds to your substance use, ask your health care provider or HIV/AIDS service agency for a referral to a mental health provider.
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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 much more than men, there are several possible reasons. 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 reasons that women may feel depressed include having a lower household income, less education, and less social support. These are all major life stressors that can affect your overall well-being and lead to depression.
There is also a strong link between violence against women -- be it physical, sexual, or emotional -- and depression, post-traumatic stress, and suicide attempts. The World Health Organization reported in 2013 that women who experienced domestic or intimate partner violence were twice as likely to become depressed as women who did not experience any violence.
Depression has also been linked to increasing young women's risk of getting HIV. A 2010 study of almost 2000 young women and men in South Africa (15 to 26 years old) showed that one in five young women reported symptoms of depression, and that they were more likely to be in abusive relationships and to participate in transactional sex (sex for money, shelter, etc.). Both abusive relationships and transactional sex are known to increase sexual behavior that puts women at increased risk of getting HIV.
Women living with HIV (HIV+) are even more likely to suffer from depression than women in the general population. Although many people living with HIV lead long, healthy, and full lives, learning that you are living with HIV is life-changing news that can be very difficult to hear and accept. 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 women living with HIV experience may lead to social isolation and feelings of loneliness. All of these feelings -- helplessness, anxiety, loneliness -- are key elements of depression.
Many women living with HIV also experience large life stressors such as racial discrimination, poverty, violence, and single parenthood, which can lead to depression. An HIV diagnosis can simply add to this burden and to the chances of developing depression.
There is also now evidence that HIV may contribute directly to depression in people living with HIV. Researchers have found that people who have HIV in their cerebral-spinal fluid (CSF) -- a fluid surrounding the brain and spinal cord -- have an almost five times greater likelihood of developing new-onset depression.
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 more than six in ten women living with HIV from 50 to 76 years old suffered from depression.
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