May is Mental Health Awareness Month, and most people with a chronic illness sometimes feel depressed. Depressive symptoms are extremely common in people with HIV.
We recently showed that improved mental wellness leads to improved HIV self-management, particularly among women living with HIV. This new evidence reminds us how important it is to address depressive symptoms when living with HIV.
What Causes Depression?
Depression is not caused by personal weakness, laziness, or lack of willpower. Depressive symptoms are related to a biochemical imbalance can are impacted by you genetics, your HIV and other chronic illness, and your medications.
The way you think, especially negative thoughts, can also produce and sustain a depressed mood. Negative thoughts can be automatic, recur endlessly, and are often not linked to any event or triggering cause.
Certain feelings and emotions also contribute to depression, including the following:
- Fear, anxiety, or uncertainty about the future. Feelings that stem from worries about the future, finances, your disease or treatment, or concerns about your family can lead to depressive symptoms
- Frustration. Frustration can have many causes. You may find yourself thinking, "I just can't do what I want," "I feel so helpless," "I used to be able to do this myself," or "Why doesn't anyone understand me?" The longer you accept these feelings, the more alone and isolated you are likely to feel.
- Loss of control over your life. Many things can make you feel like you are losing control. These include having to rely on medications, having to see a doctor on a regular basis, or having to count on others to help you do things you would normally do for yourself. This feeling of loss of control can make you lose faith in yourself and your abilities.
How Can I Improve Depressive Symptoms?
The most effective treatments for depression are self-help, counseling or medications.
Self-help
Self-help can also be an effective for dealing with depressive symptoms. You can learn many successful psychotherapy techniques on your own. For mild to moderate depressive symptoms or just to lift your mood, the self-help strategies discussed here can sometimes be productive.
- Plan for pleasure. When you are feeling blue or depressed, the tendency is to withdraw, isolate yourself, and restrict activities. However, this may make depressive symptoms worse. Maintaining or increasing activities is one of the best antidotes for depression. Going for a walk, looking at a sunset, watching a funny movie, getting a massage, cooking for friends or family, or joining a social club can keep your spirits up. Sometimes having fun isn't such an easy prescription. You may have to make a deliberate effort to plan pleasurable activities. Even if you don't feel like doing it, try to stick to the schedule. You may find that the nature walk, cup of tea, or half hour of listening to music will improve your mood despite your initial misgivings. Don't leave good things to chance. Make up a schedule for your free time during the week and what you'd like to do with it.
- Take action. Continue your daily activities. Get dressed every day, make your bed, get out of the house, go shopping, walk your dog. Plan and cook meals. Force yourself to do these things even if you don't feel like it as they will help reduce your depressive symptoms.
- Socialize. Join a group. Get involved in a church or other spiritual group, a book club, a community college class, a self-help class, or art class. Try to seek out positive, optimistic people who can lighten your heavy feelings.
- Move your mood. Physical activity lifts depression and negative moods. Depressed people often complain that they feel too tired to exercise. But the feelings of fatigue associated with depression are not due to physical exhaustion. Try to get at least 20 to 30 minutes a day of some type of exercise, from walking to dancing.
- Do something for someone else. Lending a helping hand to someone in need is one of the most effective ways to change a bad mood, but it is one of the least commonly used. Arrange to deliver food to someone who is homebound, read a story to someone who has vision problems, mentor someone newly diagnosed with HIV, or volunteer at a soup kitchen. Sometimes helping others is the surest way to help yourself.
Counseling
Several types of counseling can be highly effective to lighten depression, relieving symptoms up to 60 to 70 percent of the time. Even though it is often effective, it is important to know that counseling rarely has an immediate effect. It may be weeks (or longer) before you see improvement. Therapy does not have to last a lifetime; it can be brief, usually involving one
to two sessions a week for several months and can be either one-on-one or in a group.
Medications
If counseling and self-help do not relive depressive symptoms, antidepressant medications that help balance brain chemistry can be effective. Most antidepressant medications take from several days to several weeks before they begin to work. If your doctor prescribes an antidepressant, don't be discouraged if you don't feel better immediately. Stick with it. To get the maximum benefit you may need to take certain medications for six months or more.
Like your HIV medications, side effects of antidepressant medications are usually most noticeable in the first few weeks and then lessen or go away. If you experience side effects but they are not especially severe, continue to take your medication. As your body gets used to the medication, you will begin to feel better.
Don't be discouraged if it takes some time to feel better. If self-help strategies alone are not sufficient, seek help from your physician or a mental health professional.
Often some "talk therapy" or the use of antidepressant medications (or both) can go a long way toward relieving depressive symptoms.
Seeking professional help and taking medications are not signs of weakness. They are signs of strength.
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If you -- or someone you know -- need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.