Many things can cause depression, including some HIV drugs (particularly efavirenz/Sustiva), medications for hepatitis C, vitamin deficiency and hormonal irregularities. Social factors and life stressors, like money problems or loneliness, can also contribute to depression.
Numerous studies have shown that HIV-positive women experience higher rates of depression than HIV-negative women and men. This is probably partly due to hormonal changes and the increased burden and isolation experienced by many women living with HIV.
Depression makes you feel bad about yourself and your environment, and it can make you feel hopeless about the future. Fortunately, depression usually responds well to treatment.
Support groups are sometimes just as effective as talking with a professional therapist, and they're often free. Many experts recommend that all positive people seek some form of support. Few, if any of us, were taught all the skills needed to cope with a life-threatening illness. Also, many books can be bought or checked out at your local library with useful information on overcoming depression.
|Because depression affects your daily routine, it's important to try to develop and maintain healthy sleeping, eating, and exercise patterns.
Small changes -- like eating regularly and well, sleeping enough but not too much, and getting out and moving your body -- helps your body and mind tremendously! When people are depressed they tend to skip their daily routines, missing meals and sleep and forgetting to take their meds. This only makes things worse.
Finally, never give up hope if you are depressed! Depression can be treated. There's a great deal of support out there to help you determine the best way to treat your depression. The sooner you tap into it, the faster you'll begin to feel better.
Other types of anti-depressants, like brupropion (Wellbutrin), and new treatments are in development. People respond to anti-depressants differently, and it might take time to find one that works well for you. Anti-depressants work best when coupled with some sort of talk therapy, be it with a trained professional or a support group.
An important consideration when talking to your doctor about choosing an anti-depressant is the potential for drug interactions, especially if you take HIV drugs. For example, ritonavir (Norvir) should not be used with brupropion: it can increase blood levels of SSRIs. Also, some anti-depressants increase or decrease blood levels of oral birth control; dose modifications of oral contraceptives may be necessary.
Again, talk to your doctor or pharmacist about possible drug interactions with anti-depressants and other therapies you take. (See Project Inform's "Drug Interactions Fact Sheet" for more information.)
Despite the success of anti-depressant therapies, not all people benefit from them nor do the effects always last. It's common for people to start with one anti-depressant and then either switch to another or add others to their daily regimens. Some end up using two to four anti-depressants at the same time. Even then, the drugs can fail, especially when a person ignores her other forms of support.
The herb also has a significant interaction with indinavir (Crixivan). Indinavir blood levels were greatly decreased when they were used together, greatly reducing indinavir's anti-HIV activity. This can lead to developing resistance to indinavir.
St. John's Wort is also likely to greatly decrease blood levels of other protease inhibitors as well as non-nucleoside reverse transcriptase inhibitors. People who take these drugs are advised not to use St. John's Wort. Individuals who use complementary therapies should always discuss possible interactions with their doctors and pharmacists.
A final reason for using caution is because all herbal remedies are completely unregulated -- there is no way of really knowing how much herb is actually present in a supplement, or even its quality. If you try St. John's Wort look for the active ingredients, hypericum at 0.3% and hyperforin at 6%, and seek advice as to which are the most reliable brands. Some nutritionists recommend trying 300 milligrams three times a day, but even this figure is uncertain. The kind of studies needed to determine proper dosing of a drug have not been done with St. John's Wort.
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