Ever feel blue around the holidays? Lots of people do, but depression can be especially damaging for HIV-positive people, for whom studies clearly show that depression has both physiological and psychological negative impacts.
Depression causes the body to produce higher levels of norepinepherine, a hormone related to blood pressure. But, norepinepherine also speeds up HIV reproduction, so depressed poz people are likely to experience higher viral loads – and thus faster disease progression.
Psychologically, too, depression is damaging. Treatment adherence is likely to falter during depression, and not keeping up with the pills, 95% or better, is a prime cause of treatment failure, AIDS, and death. Sufficient sleep, adequate food, and regular exercise also typically fall victim to depression, even for HIV-neggies. Drinking and drugging may climb, as people intuitively seek to “self-medicate,” and again, adherence suffers.
For some people facing clinical depression, a short course of antidepressants can be a useful tool for breaking the vicious downer cycle; some short-term psychotherapy may help, too. If you’re hitting bottom and can’t seem to get back up, ask your doctor for help. Depression is the most undertreated disease in America, often just because it doesn’t get discussed.
The most effective long-term tool, though, is building a network of support among friends, family (if available without adding stress!), and caregivers, whether professional (like a case manager at ASA or CARE) or volunteer. That can provide an outlet to talk and share concerns, help with physical chores, perhaps provide transportation, or go for coffee. Just having someone call now and then to check on you can do wonders. Multiple studies show that those with support systems are happier, stay healthier, and live longer.
Holiday season is a profoundly depressing time for many people, and it’s almost upon us – especially if you believe the big retailers’ displays. Start now to put together that web of strength and support, or shore up one you’ve already got in place. Don’t let depression catch you unprepared!
This article appears in November 5 • 2004.