How to manage depression when you're living with HIV

depression-hiv-positive peers

By: Ann Avery, MD, Infectious Disease Physician at MetroHealth Medical Center

If you have HIV, you probably have experienced depression at some point or another. In fact, depression is very common among HIV-positive people, so common we screen for it when you visit the clinic.

The worst thing about depression is that it makes your whole world darker. Everything you see can look ugly or uninteresting. Sometimes you don’t even enjoy sex anymore, and your favorite food isn’t tasty like it used to be.

Extreme depression takes away all of people’s hopes and convinces them things will never get better. For some people, the pain is so bad that they think about killing themselves to get rid of the hurt.

If you’re thinking suicidal thoughts right now, stop what you’re doing and call a suicide hotline.

Really, right now.

(Come back and read the rest of this when you’re feeling a bit better.)

The National Suicide Prevention Lifeline is 1-800-273-8255.

depression-hiv-positive peers

Why you can’t ignore your depression

You gotta be tough to deal with HIV — changing your habits, taking your meds every day, and handling all kinds of discouragement.

But every HIV survivor — we’re talking millions here — is tough. That includes you.

Look at it this way: Depression is like walking around with 50 pounds of rocks in your backpack. You’re strong enough to carry that weight for a while, but no matter much muscle you have, the weight of depression just keeps dragging you down.

Depression makes people desperate for a shortcut to feeling better — sometimes they find that shortcut in drugs, booze, or risky behavior.

Depression also encourages HIV positive people to stop taking their anti-retroviral meds. That’s why it’s so bad.

depression-hiv-positive peers

Depression tells lies. HIV tells the truth.

An HIV infection is just science: A virus is attacking your immune system. If you take medications to fight the virus, you stay healthy. There’s something honest about that. It’s not a nice truth, but it’s real.

Depression is something else. It starts with something bad for sure, but makes it seem a whole lot worse. Any bad feeling you get with HIV gets magnified and exaggerated by depression.

Depression makes it hard to see any of the good in yourself and your world. It makes you think there’s no hope when, actually there’s plenty to be hopeful about.

In that sense, depression is a liar — a dangerous liar. And when you’ve got depression bad, it feels so real that it seems like the truth.


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You have to fight depression to stay healthy

Feeling sad means you’re reacting normally to your reality. HIV isn’t a vacation at the seashore; sadness is natural. But you don’t have to feel worthless or have a completely bleak outlook if you have HIV.

But sometimes you might. People living with HIV and other chronic illness are more likely to experience clinical depression.

These are all things your doctors, nurses, counselors, and social workers have seen before. They know what to look for and how to defend against depression or treat it if you’re struggling with it.

So, make sure your doctor knows exactly how you’re feeling, and how long you’ve been feeling it. If your mood gets worse when you go on a new medication, tell your doctor and see if there’s an alternative.

A combination of therapy and anti-depressant medicine should be able to make you feel better and turn off the most negative feelings. It’s not perfect and it could take months to find the right combination. But it’s worth the effort.

depression-hiv-positive peers

It’s all about staying here as long as you can

You’ve heard it a hundred times: Staying on your HIV meds can help you live a long and healthy life.

Depression makes you forget that.

Every day you’re alive, you’re one step closer to the day when scientists cure HIV.

As long as you have a breath in you, you have a chance — to feel joy, to find wisdom, to nurture friendships.

Depression will take all your chances away if you let it.

So don't.

Talk to your support group, get together with a therapist, find the best meds. Do whatever it takes to rule your moods or your moods will rule you.

(For more on depression and HIV, check out this informative article at

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