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Depression and HIV

July 23, 2014

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What Is Depression?

Depression is a mood disorder. It is more than sadness or grief. Depression is sadness or grief that is more intense and lasts longer than it should. It has various causes:

  • events in your daily life
  • chemical changes in the brain
  • a side effect of medications
  • several physical disorders

About 5% to 10% of the general population gets depressed. However, rates of depression in people with HIV are as high as 60%. Women with HIV are twice as likely as men to be depressed.

Being depressed is not a sign of weakness. It doesn't mean you're going crazy. You cannot "just get over it." Don't expect to be depressed because you are dealing with HIV. And don't think that you have to be depressed because you have HIV.

Is Depression Important?

Depression can lead people not stay engaged in their care, to miss appointments or doses of their medications. It can increase high-risk behaviors that transmit HIV infection to others. Overall, depression can make HIV disease progress faster. It also interferes with your ability to enjoy life. A study in 2012 showed that patients with depression, especially women, were more likely to stop receiving care and to not achieve undetectable viral load.

Depression often gets overlooked. Also, many HIV specialists have not been adequately trained to recognize or treat depression. Depression can also be mistaken for signs of advancing HIV.

What Are the Signs of Depression?

Symptoms of depression vary from person to person. Most health care providers suspect depression if patients report feeling blue or having very little interest in daily activities. If these feelings go on for two weeks or longer, and the patient also has some of the following symptoms, they are probably depressed:

  • Fatigue or feeling slow and sluggish
  • Problems concentrating
  • Low sex drive
  • Problems sleeping; waking very early or excessive sleeping
  • Feeling guilty, worthless, or hopeless
  • Decreased appetite or weight loss
  • Overeating

What Causes Depression?

There are many causes of depression. Having the diagnosis of a chronic disease, like HIV infection or AIDS, can make depressive symptoms worse. Some medications used to treat HIV can cause or worsen depression, especially efavirenz (Sustiva). Diseases such as anemia or diabetes can cause symptoms that look like depression. So can drug use, or low levels of testosterone, vitamin B6, or vitamin B12.

People who are infected with both HIV and hepatitis B or C (see Fact Sheet 506) are more likely to be depressed, especially if they are being treated with interferon. Other risk factors include:

  • Being female
  • Having a personal or family history of mental illness, alcohol and substance abuse
  • Not having enough social support
  • Not telling others you are HIV-positive
  • Treatment failure (HIV or other)
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This article was provided by AIDS InfoNet. Visit AIDS InfoNet's website to find out more about their activities and publications.
See Also
Feeling Good Again: Mental Healthcare Works!
More on Depression and HIV/AIDS