Women and Depression
Depression is More Common in Women
While many people living with HIV (HIV+ people) suffer from depression, it is more common in HIV+ women than HIV+ men. In some studies, HIV+ women were twice as likely as men to be depressed (this is also seen in people who don’t have HIV).
It is not clear why HIV+ women are more likely to be depressed, but there are many factors that may contribute to the high rate of depression among HIV+ women. These include having a lower household income, using drugs and alcohol, having been sexually and physically abused, being the primary caregiver, and/or lack of social support.
How Do I Know if I’m Depressed?
Symptoms of depression include:
- Changes in appetite or weight
- Aches or pains for no clear reason
- Feelings of sadness, guilt, and/or low self-worth
- Lack of interest or pleasure in activities
- Low sex drive
- Thoughts of self-harm or suicide
- Difficulty making decisions or concentrating
- Changes in sleep patterns
- Fatigue or loss of energy
Some of the early signs of depression can be similar to those of HIV, making depression harder to diagnose. Depression can also be confused with sadness. But compared to sadness, depression is more intense, lasts longer, and interferes more with your day-to-day ability to function. Depression is not a normal part of being HIV+ and it is important to tell your health care provider if you have any of the symptoms listed above and to discuss treatment options.
Sometimes substance use hides depression. This happens when people try to â€œself-medicateâ€ by using drugs or alcohol to make their problems go away. If you feel that an underlying 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.
Depression can Cause Serious Problems
Studies show that there is a connection between depression and HIV care, treatment, and disease progression. For example, HIV+ women with chronic (long-lasting) depression go to their medical visits less regularly and are more likely to progress quickly to AIDS.
Starting HIV treatment and adhering to HIV medications (taking your HIV drugs correctly) are less likely in chronically-depressed HIV+ women. 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. Non-adherence can lead to the development of resistance, which causes the HIV medications to be less effective at fighting the virus. This can cause your CD4 cells to go down and/or your viral load to go up.
Studies have also shown that HIV+ women with depression are twice as likely to die as those with few or no symptoms of depression. For those women who made contact with a mental health provider, the risk of death was decreased by half. It is important that depression be diagnosed and treated as quickly as possible to avoid serious problems.
The good news is that depression is very treatable. Treatments include psychotherapy, social support, medication, alternative therapies, or any combination of these.
Various mental health professionals can provide psychotherapy, including psychologists, psychiatrists, and social workers. It may also be helpful to seek the support of other HIV+ women through support groups or peer counseling.
Social support from friends and family has been found to help HIV+ people avoid depression or cope better with it. Members of a social support network can help with chores like shopping or housework and act as caregivers if you get sick. Contact with others helps prevent feeling lonely and isolated. Friends and family can also provide emotional support, which is so important for people living with a serious illness like HIV.
Antidepressant medications are often prescribed for depression or anxiety and have been shown to help decrease symptoms. Care should be used when taking HIV medications with medications for depression. Many of the popular kinds of antidepressant and anti-anxiety drugs can interact with some HIV medications.
Generally, the safest class of antidepressants for use with HIV medications is selective serotonin re-uptake inhibitors (SSRI’s) such as Prozac, Zoloft, and Paxil. Popular herbal preparations used for depression that include St. Johns wort should not be taken with some HIV medications.
Meditation, massage, yoga, breathing, and relaxation exercises are all alternative therapies that may help you feel better. Acupuncture and acupressure therapies may help reduce stress and improve your mood. Good nutrition and exercise are beneficial, no matter which treatments you choose. Also have your testosterone level checked. Low testosterone can cause depression.
Get Evaluated and Treated for Depression
Talk to your health care provider about depression, especially if you are experiencing symptoms or having trouble sticking to your HIV medications. If you are suffering from depression, ask for a referral to see a mental health care provider. Mental health care (including psychotherapy, social support, medication, and alternative therapies) can not only improve your adherence to HIV medications, it can improve your health and quality of life.
Many people do not believe in the value of mental health treatment. Even if you have heard family and friends say that people who see therapists or take antidepressants are â€œcrazyâ€ or weak, try not to let these prejudices prevent you from getting treatment that will make you feel and live better.