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Author Topic: Better Numbers - Still Depressed.  (Read 13133 times)

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Offline ga1964

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Better Numbers - Still Depressed.
« on: June 25, 2009, 03:00:36 pm »
Last week I got my latest labs back and CD-4s are up to 694, triglycerides are down to 150. 

When I first heard the new numbers I had a rush of excitement for a hour or so, then the depression came back.  I know I should be happy that my numbers have improved, and I am, but I can't figure out why the depression came back so quickly.  I wish the rush of excitement would have lasted longer than it did.  For the first time in a long time, I felt happy and had a positive outlook, but it only lasted for a short period of time before the gloomy feelings came back. 

Is there something wrong with me, that even after getting good news, I can't get relief from the "Gloom and Doom" feelings that have taken back over.  I thought that as my numbers improved, so would my depression.  My mind is constantly contemplating how would be the best way to end it all.  Drug overdose, self-inflicted gun shot, driving head-on into a tree as fast as I can, slitting my wrists, jumping from a bridge.  I just want it to be quick and I don't want there to be a big mess for someone to have to clean up.  (I guess that rules out gun shot or slitting my wrist, unless I did it outside so that the next rain would clean everyting up.) 

At night I lay in bed and my mind won't stop going thru different scenarios on which would be the least painfull for me and the least messy for someone else to clean up.  I try to stop the thoughts, but my mind keeps running from one scenario to the next.  I wish these thoughts would go away, but they are constantly there and have invaded my day time thinking also.  Some days I can't work because of the constant scenarios running thru my mind.  I hate having these feelings and want them to stop, but I can't get them to stop.  I have been on Paxil for two years now, and maybe I'm expecting too much, but I thought they would help me to have a few "Happy Days" at least every now and then. 

I wish I could keep the feelings of joy that I had when I first got my new numbers.  Will I ever have a day, at least, that I don't think of how would be the best way to off myself?     

Offline Miss Philicia

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Re: Better Numbers - Still Depressed.
« Reply #1 on: June 25, 2009, 04:53:36 pm »
I see in your old posts that you see a therapist -- how often, assuming you are still going?  Also, if Paxil doesn't seem to be working after 2 years why isn't your prescribing doctor being informed and/or switching you to something else?  Are you supplementing any of this with local support groups?

Did any of these suicidal and depression issues pre-date your HIV diagnosis?  How upfront with your therapist are you being with the suicide thoughts?  Who else knows that you have these thoughts (partner, family, etc..)

But yes, considering you began with an AIDS diagnosis 2.5 years ago and are where you are at now with your lab numbers, there are irrational thought processes going on, though perhaps much of it is residual and in time you will work through it.
"I’ve slept with enough men to know that I’m not gay"

Offline ga1964

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Re: Better Numbers - Still Depressed.
« Reply #2 on: June 26, 2009, 01:57:57 am »
I see in your old posts that you see a therapist -- how often, assuming you are still going?  Also, if Paxil doesn't seem to be working after 2 years why isn't your prescribing doctor being informed and/or switching you to something else?  Are you supplementing any of this with local support groups?

Hi Philicia,

I was seeing a therapist, but have not been since Dec., 08.  I stopped going because I did not feel like I was making any improvement.  I don't believe she has had much experience dealing with HIV and the emotional roller coaster I have been going thru.  I do feel that she has given her best effort to help me, but I don't feel any better and sometimes I have felt worse after the session.

I was going to see if my ID. thought increasing my doseage would help.  I can't afford to change antidepressant.  With all the meds I'm taking, I can barely keep up with my co-pays and my insurance does not cover antidepressants.  I'm on Paxil, because it is the cheepest and it's all I can afford. 

As for previous issues with depression or suicidal thoughts, I had a few suicidal thoughts back when I was a teenager, but most of them were due to being gay in a small Southern town and having very religious parents.  I hid who I was most of my life to my family out of fear that I would be rejected for something I had no choice in.  My family now knows and is accepting, but do to all the years of hiding, I am not comfortable discussing personal issues.  I still worry that something will change and I will be outcasted once again.

Thank you for your thoughts.

Offline Assurbanipal

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Re: Better Numbers - Still Depressed.
« Reply #3 on: June 26, 2009, 09:45:52 am »
"I was going to see if my ID. thought increasing my doseage would help.  I can't afford to change antidepressant.  With all the meds I'm taking, I can barely keep up with my co-pays and my insurance does not cover antidepressants.  I'm on Paxil, because it is the cheepest and it's all I can afford. "


Ga

I'm sorry you are going through this.  But if the barrier to changing Paxil to a different drug that works better is solely financial perhaps there are solutions for you.

There's been a lot of changes recently with drug companies offering assistance with co-pays.  You might be able to free up some money if you aren't already using these new programs to the max.  There's a summary of all of the HAART assistance programs here with the phone numbers to call. http://positivelyaware.com/2009/news_briefs/news_briefs_09_02_03.shtml

There are also general patient assistance programs that cover a lot of drug classes.  One list of them is here http://www.rxassist.org/

So if Paxil isn't working for you why not get your doctor to suggest some alternatives and see if they  have a patient assistance program?

Best wishes
Assurbanipal
5/06 VL 1M+, CD4 22, 5% , pneumonia, thrush -- O2 support 2 months, 6/06 +Kaletra/Truvada
9/06 VL 3959 CD4 297 13.5% 12/06 VL <400 CD4 350 15.2% +Pravachol
2007 VL<400, 70, 50 CD4 408-729 16.0% -19.7%
2008 VL UD CD4 468 - 538 16.7% - 24.6% Osteoporosis 11/08 doubled Pravachol, +Calcium/D
02/09 VL 100 CD4 616 23.7% 03/09 VL 130 5/09 VL 100 CD4 540 28.4% +Actonel (osteoporosis) 7/09 VL 130
8/09  new regimen Isentress/Epzicom 9/09 VL UD CD4 621 32.7% 11/09 VL UD CD4 607 26.4% swap Isentress for Prezista/Norvir 12/09 (liver and muscle issues) VL 50
2010 VL UD CD4 573-680 26.1% - 30.9% 12/10 VL 20
2011 VL UD-20 CD4 568-673 24.7%-30.6%
2012 VL UD swap Prezista/Norvir for Reyataz drop statin CD4 768-828 26.7%-30.7%
2014 VL UD - 48
2015 VL 130 Moved to Triumeq

Offline Ann

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Re: Better Numbers - Still Depressed.
« Reply #4 on: June 27, 2009, 05:41:23 am »
Hi GA,

I see you're on Atripla - and the Sustiva component could very well be a contributing factor or cause of these unwanted thoughts. If I were you, I'd seriously start thinking about changing your hiv meds.

I have had this reaction to certain drugs too - most recently Champix (aka Chantix). I suddenly started having thoughts of suicide - and I'm not normally a person who suffers from depression, much less suicidal. I quit the Champix and was back to normal within a few days. Because I'm prone to this type of reaction to meds where there is a known possible side-effect of depression and/or suicidal ideation, there's no way I'm ever going to even try to take Sustiva.

Please discuss this with your doctor asap.

Ann
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline AndyArrow

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Re: Better Numbers - Still Depressed.
« Reply #5 on: June 27, 2009, 07:00:35 pm »
If you can get to a Targer or Walmart you can get several different ones besides Paxil for either
$4.00 for a 30pills or $10 for 90 pills.

Amitriptyline -- Elavil
Citalopram -- Celexa
Doxepin HCI -- Sinequan
Fluoxetine -- Prozac
Nortriptyline -- Pamelor
Trazodone -- Desyrel

Trazodone just put me to sleep and usually isn't used as an anti-depressant much these days.  Still you can check with the doc and see what he thinks. 

Good luck,
AA
It is not the arrival that matters.  It is the journey along the way. -- Michel Montaigne

Offline mecch

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Re: Better Numbers - Still Depressed.
« Reply #6 on: June 30, 2009, 09:04:45 pm »
Please ask your HIV specialist or regular doctor, to talk to your therapist, and vice versa.
You are not being treated completely and you must insist they help you return to an even keel.  Do you get me?  This isn't even negotiable.  Your anti-depressants are not working. And of course sustiva is not a picnic emotionally for a few people.

Constant thoughts of suicide needs to be addressed by your therapist and your doctor and it's a very serious matter. 

Insist on a better quality of life, you deserve it.  You are stronger than your current thoughts. See how far you came with your HAART. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline ga1964

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Re: Better Numbers - Still Depressed.
« Reply #7 on: July 07, 2009, 02:17:23 am »
Hi GA,

I see you're on Atripla - and the Sustiva component could very well be a contributing factor or cause of these unwanted thoughts. If I were you, I'd seriously start thinking about changing your hiv meds.


I'd like to stay on Atripla if possable.  I responded to it very well.  My CD-4 count rose and my Viral load became undetectable very quickly, according to my ID, and he wants me to stay on Atripla.  I know this may sound petty, but I take enough pills as it is, and sometimes I questioned if I have taken them all.  Then I sit up all night worrying.  It's hard sometimes keeping up with and/or remembering if I took them all.   I try my best to adhere to my meds and take them on a schedule, but there are days that I question whether or not I've taken them all.


If you can get to a Targer or Walmart you can get several different ones besides Paxil for either
$4.00 for a 30pills or $10 for 90 pills.

Amitriptyline -- Elavil 

I am currently taking Amitriptyline along with the Paxil.  Those are the only antidepressants that are under my Wal-mart generic program.  I tried the Welbutrin, but it did not seem to do anything either.   The Target here, does not have a Pharmacy, so their out of the picture. 

Please ask your HIV specialist or regular doctor, to talk to your therapist, and vice versa.
You are not being treated completely and you must insist they help you return to an even keel.  Do you get me?  This isn't even negotiable.  Your anti-depressants are not working. And of course sustiva is not a picnic emotionally for a few people.

Constant thoughts of suicide needs to be addressed by your therapist and your doctor and it's a very serious matter. 

Insist on a better quality of life, you deserve it.  You are stronger than your current thoughts. See how far you came with your HAART. 

I have not seen my Therapist for several Months.   I quit going because it felt like a waist of time.  I would sit and talk, she would ask questions, I would answer them, and then I'd leave.  Sometimes, feeling worse than when I went in.  She's in her mid twinties.  I'm older to say the least, actually, I could be her Dad.  I just don't think she can understand what its like to be told your Poz.  I'm not saying she's not trying, but how can she understand when I did not fully understand what the people I have known, that have passed from AIDS went through, until my diagnosis.  I'm not sure if I even know now, because I've read posts here, where it sounds as if HIV has not affected them all that much. 

I know everybody handles situations differently, I just wish I could feel as positive about being Poz. as so many here seem to be.  Don't get me wrong, I'm happy that they have found a way to come to terms with having HIV, I just wish I could feel so positive.

Thanks for the feedback.   
 

Offline Miss Philicia

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Re: Better Numbers - Still Depressed.
« Reply #8 on: July 07, 2009, 08:12:47 am »
Giving up on a therapist situation within "several months" isn't really giving it much of a chance, frankly.  And there are no promises that you're going to feel good instantly from the process, it often takes years.  If you honestly didn't like this one therapist I fail to understand why you didn't find another one.

For many people therapy sessions are initially like opening up a can of stinky worms, and you have to spend a good year airing out the dirty laundry before you even have the chance of your first breakthrough -- this is especially true if the patient has unresolved issues that pre-date their HIV diagnosis.

You have to be willing to do the work, the doctor can't do it all for you.
"I’ve slept with enough men to know that I’m not gay"

Offline Ann

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Re: Better Numbers - Still Depressed.
« Reply #9 on: July 07, 2009, 08:47:21 am »

I'd like to stay on Atripla if possable.  I responded to it very well.  My CD-4 count rose and my Viral load became undetectable very quickly, according to my ID, and he wants me to stay on Atripla.  I know this may sound petty, but I take enough pills as it is, and sometimes I questioned if I have taken them all.  Then I sit up all night worrying.  It's hard sometimes keeping up with and/or remembering if I took them all.   I try my best to adhere to my meds and take them on a schedule, but there are days that I question whether or not I've taken them all.


You sound like my bf. He's on Sustiva and it causes him a lot of sleep and mood-swing problems, even though he's only on 200 mgs. (Standard dose, and the dose that is in Atripla, is 600 mgs.) He says "if it ain't broke, don't fix it" but if it is causing problems, it IS broke. There are other drugs out there that are every bit as effective as Sustiva. It's beyond me why people would rather be undetectable and miserable when they could be undetectable and happy. What good are nice CD4 counts and an undetectable viral load if you end up committing suicide? What good are good counts if you're living your life in a deep depression? I don't get it.

I agree with Philly about the therapist issue. Get a new one! Therapists aren't one-size-fits-all, sometimes you have to shop around to find the right fit.

I wish you luck. I also wish you could see that you don't have to stay on Sustiva if it's making you miserable - but, well, it's your life.

Oh, and regarding the problems you have with trying to figure out if you've taken all you pills - get a pill container. They come in daily and weekly versions and they're terrific for keeping track. If the container for the day is empty, you've taken your pills. If they're still there, then you know, without doubt, that you need to take them. Simple.

Ann
 
Condoms are a girl's best friend

Condom and Lube Info  

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Offline mecch

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Re: Better Numbers - Still Depressed.
« Reply #10 on: July 07, 2009, 10:46:08 am »
Once again, I think you are finding many reasons and behaviours to stay in your dark period. But, you show the contradiction that you would like to feel better.

Alone I don't think you can manage - you must get your HIV doctor and a therapist on board, together to do their jobs and treat you appropriately.  What you are expiencing is not normal and, hey, by the way, it doesn't matter if the HIV DOC and or the Therapist can't fully relate to you.  It doesnt matter. 

You describe your suicide thinking and dark moods to them, and you insist they help find a solution. That is their specialty, really. 
“From each, according to his ability; to each, according to his need” 1875 K Marx

Offline ga1964

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Re: Better Numbers - Still Depressed.
« Reply #11 on: July 07, 2009, 05:02:06 pm »
Giving up on a therapist situation within "several months" isn't really giving it much of a chance, frankly.  And there are no promises that you're going to feel good instantly from the process, it often takes years.  If you honestly didn't like this one therapist I fail to understand why you didn't find another one.

I went to therapy for almost a year and I will admit that it is not easy for me to talk about my feelings, especially with a stranger, so to speak.  I have a fear that if I told them exactly how I feel and the thoughts that run thru my mind constantly, they will have me committed.  I do want to be happy.  I want to wake up every day seeing the glass half full instead of half empty.  I have gone so long hiding my true feelings from people and family, so as to NOT burden them with my issues.  I still, after 2-1/2 years, have not been able to draw up the courage to tell my siblings about my HIV.  It's easier to hide and smile like nothing is wrong.  I have done it for so many years now, that I don't know if I can handle it emotionally to let them in.

As for changing Meds, I just figured if it was working good on controlling my HIV, I should just stick with it and bear it.  I hate being a complainer, which seems to be the only thing I can do any more.  I want to be the up beat person that I used to be, but it seems lately that everything I have any involvement in, goes to shit, no matter what I try.  I used to have friends that would tell me "I could step in shit, and come out smelling like a rose."  Now it seems just the opposite.  I can be in a rose garden and turn everything to shit.
Once again, I think you are finding many reasons and behaviours to stay in your dark period. But, you show the contradiction that you would like to feel better.

Alone I don't think you can manage - you must get your HIV doctor and a therapist on board, together to do their jobs and treat you appropriately.  What you are experiencing is not normal and, hey, by the way, it doesn't matter if the HIV DOC and or the Therapist can't fully relate to you.  It doesn't matter. 

You describe your suicide thinking and dark moods to them, and you insist they help find a solution. That is their specialty, really. 

I will think about going back to therapy and explain all the emotions that I have.  Hopefully I won't get committed.


Offline AndyArrow

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Re: Better Numbers - Still Depressed.
« Reply #12 on: July 08, 2009, 02:52:46 am »
You might want to check again because according to the Wal-mart website all of the followng drugs are avail in either $4 or 30days or $10 for 90days.

Amitriptyline
Benztrophine
Buspirone
Carbamazepine
Citalopram
Doxepin HCL
Fluoxetine
Fluphenazine
Haloperidol
Lithium Carbonate
Notriptyline
Paroxetine
Prochlopreazine
Thioridazine
Thiothixene
Trazodone
Trihexyphenidyl

Here is a link to the list

http://i.walmart.com/i/if/hmp/fusion/genericdruglist.pdf
It is not the arrival that matters.  It is the journey along the way. -- Michel Montaigne

Offline Miss Philicia

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Re: Better Numbers - Still Depressed.
« Reply #13 on: July 08, 2009, 01:09:16 pm »

I will think about going back to therapy and explain all the emotions that I have.  Hopefully I won't get committed.


Obviously I can't get inside of your head from my computer and ascertain how intense any suicidal feelings are, and though I don't have them myself I know from talking with others that there are different levels to such thoughts.  It's feasible to begin treatment with a therapist and, if you don't think it's really intense, to focus talking about all the other things you're referred to.  It is, however, customary during initial screening for them to ask you the suicidal thoughts question so just be prepared for it.
"I’ve slept with enough men to know that I’m not gay"

Offline yairsinho

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Re: Better Numbers - Still Depressed.
« Reply #14 on: July 08, 2009, 04:10:37 pm »
 The Sustiva (atripa) worked very good on my numbers, but ruined my relations , made me lost my partener
and my job!

I takes just a few months,feeling sad, mooded, grumpy... untill I went back to my HIV doctor. My labs, he told me were  exellent,so how's life? he ask.
 Then I begin to tell'm about my lack of "luck", my mood and such..
 
You didn't know that Sustiva might be the reasson?-he said-...No doubt,you must switch to other meds!!
  Damn Sustiva, if it works so good on the bugs, but bug me bad my entire life!!!
poz since 2002 (acute HIV infection)
Sustiva+Zerit+Videx
CD4 450 VL<50
2003 no meds
2005 decided to go back to meds
Sustiva+Viread+Epivir (behavior troubles)2005
Lexivia+Viread+Epivir+Norvir
Kaletra+Viread+ Epivir
Norvir+Prezista+Truvada April 2009
CD4 750  VL<50
Isentress+Truvada
cd4 700  vl<40

Offline yairsinho

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Re: Better Numbers - Still Depressed.
« Reply #15 on: July 08, 2009, 04:20:34 pm »
 BTW...look down , my numbers....Yeah, I been back to Sustiva after a couple of years, there is a way to quite the stuff without developing resistency.   And there is no any reason that other HIV combos can't work even better than the Atripa-one-pill wander,
even with the  "many pills a day" deal!!!
  Love    Arny
poz since 2002 (acute HIV infection)
Sustiva+Zerit+Videx
CD4 450 VL<50
2003 no meds
2005 decided to go back to meds
Sustiva+Viread+Epivir (behavior troubles)2005
Lexivia+Viread+Epivir+Norvir
Kaletra+Viread+ Epivir
Norvir+Prezista+Truvada April 2009
CD4 750  VL<50
Isentress+Truvada
cd4 700  vl<40

Offline Joe K

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Re: Better Numbers - Still Depressed.
« Reply #16 on: July 09, 2009, 09:52:31 pm »
Hello Ga,

Very sorry to hear about your ongoing issues with depression.  I know how difficult the disease can be, as I have battled depression for 45 years, but if you truly want to feel better, then you need to start doing something about it, because a little good news will not make it go away.  That's the difference between being unhappy and depressed, because unhappiness is fleeting and soon forgotten, but depression is a totally different story.  I would urge you to read my Depression Redux, especially the top part, where I present the clinical definition of depression, that was developed by my shrink.  Hopefully it will give you some insight into your depression and therefore help you in treating it.

My advice to you is to make two appointments.  One with your HIV doc and one with a psychiatrist.  You should discuss with your HIV doc a new medication to replace the Sustiva, because there are many others that will work and taking any drug, that is know to acceberate depression, is just plain foolish.  Once you decide on a new drug, you will at least know that your HIV meds are not another potential source of your depression.

Then when you talk with the psychiatrist, you need to explore both how you feel and how intense it is.  They will not need specifics, like therapy, but more general feelings and they are very good at identifying elements of the disease that can be treated with medication.  I happen to take two antidepressents, an anti-anxiety drug and Ridlin to counteract the extreme fatigue from all of my drugs.  I use Trazadone to sleep, because without it, I would lay there tossing and turning, just like you do now.  My point here is that you may need more than one drug and you may have to try multiple variations of drugs, before you find a cocktail that works for you.

After you agree on some new psych drugs, you will want to review them with your HIV doctor, because psychiatrists are not familiar with all the possible side effects that psych drugs may have with HIV drugs.  The reason the drugs are so necessary, is that you suffer from chemical inbalances in your brain.  I don't believe you understand the true nature of depression, especially because you wonder why you can't just make it go away.  Parts of your brain are malfunctioning, if you will and you need the psych drugs to eliminate those inbalances, because as long as your brain remains unchanged, all the therapy in the world will not help you, because your brain is not ready for that help.

Although this may sound confusing, believe me when I tell you that it is not.  The issue now, is that your brain is unbalanced and that results in cognitive problems.  So until you get the brain somewhat back in balance, it is much harder to accomplish anything with therapy, because the brain has trouble processing all the information.  It would be like you need some surgery, but you have some type of infection, which would increase your risk of possible infections.  The prudent thing to do, would be for you to rid yourself of the infection and then under go the surgery.  It's the same with depression.  You need to stabilize or arrest the depression, so your resulting therapy can be as effective as possible.

Therapy also presents challenges, but it is one of those things, that you only get out of it, what you put into it and you don't need to explore your entire life, to quickly address issues that are problematic to you now.  You must also realize that a therapist is not there to judge you and if you do not feel comfortable with your current therapist, then you get another and another, until you find one that fits.  You might want to start listing the issues that you feel are most important to you and you and your therapist can then agree on a plan to address those issues.

But none of this matters, if you refuse to stop playing the victim and get the help you so desperately need.  THOUGHTS OF SUICIDE AND PLANNING SUICIDE are not to be taken lightly and I beg you to see somebody, like tomorrow.  Ga, you are playing with fire, with something you do not understand and never underestimate how powerful depression can be.  I once sat on the edge of my bed, with my 9mm Glock, cocked and in my mouth.  To this day, I cannot really tell you why I never pulled the trigger, but I know now, in retrospect, that it was probably a combination of not wanting to hurt the ones I love, nor did I want to take the selfish way out, because suicide is the ultimate act of selfishness.

You mention family and friends that you are afraid to disclose to and I think you need to explore why you feel that way.  My guess is you have self esteem issues, have yet to forgive yourself for becoming positive and you perceive having HIV as an unforgivable act.  I believe you need some professional guidance, to help you overcome these feelings and it will probably require both drugs and therapy, but aren't you worth it?  I know that medical costs can be a bitch, but just how much is your life and quality of life worth?

I will leave you with this.  You, my friend, need some help and you need it now.  Please do not wait, because thoughts of suicide do not subside, but rather intensity over time.  And regarding both your HIV and depression, please do not underestimate those who are closest to you.  Do not deprive them of the right to be there for you, when it really matters.  Sometimes we get so self absorbed, that we forget that there are those who love us, unconditionally and while the news may be disappointing at first, in the end it does not matter because they love you.  Just imagine how you would feel, if someone close to you had a life altering event and never told you, until it was too late.  How would you feel?

Probably, just like your loved ones would feel.  Please contact somebody tomorrow, for you and all those who love you, please.

edited to add: concerning your pills, get a pill box and fill it weekly with all your doses for the next week.  That way, you simply need to keep track of the pill case and not each individual dose.  I do mine for two weeks at a time and it makes adherence so much easier.
« Last Edit: July 09, 2009, 09:54:13 pm by killfoile »

 


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