AHHHHHHHH....Depression

[jcelvis]

I haven't felt this bad since my dad passed away when I was fourteen. I have good things happening to me, but all can seem to focus on are the negative episodes that keep happening in my life.

I enjoy my job, but I feel like they treat me like a little kid. I sit there for majority of the day just surfing the internet with few responsibilities. Yes the pay is good, but I want to feel that I'm doing something worthwhile.

I'm stuck in a town I'm not particularly fond of. It's not bad, it just not interesting. To make matter worse I have met people who are interested in having a friendship much less anything else. I'm not asking for much just people in the city to hang out with.

To make matters worse two dates I went on, where the guys made comments which hurt my ego.

Finally, I have got shingles which i know was caused by my stress and depression. Which makes me upset even through I know it's nothing I can control. I went to my NEW doctor who is pushing me to start HIV meds. He keeps saying, if you started meds I wouldn't have these issues. I don't feel comfortable with that, I feel like he's guilting me into start medication. That makes me feel helpless because I feel he's going to make me start no matter what my numbers are, it's makes me not want to go get my labs done. I loved my Dr. in Houston.

I find myself randomly crying. Generally I can walk away before someone catches me. I don't want to take depression medications, I don't know what to do in order to get me over this hump.

[Miss Philicia]

First of all, you're young, skinny and reasonably attractive going by the tiny avatar picture so let's cheer up even if for only five minutes.

Second, I see no reason for you to go on medication if you don't wish to, though I can see in light of new data why you're doctor is pushing for it.  You're not going to be able to put it off forever, but if you're really not ready right now then I don't see why you should allow your doctor to mandate something.  He really can't force you to do it.

Third, if you don't want to try an anti-depressant why don't you start with one-on-one therapy assuming it's covered under your insurance -- most have at least some kind of mental health rider.  Find one that does cognitive behavioral therapy to address stress and depression -- it's better long-term than taking medication as far as I'm concerned.  Medication only addresses symptoms, not causes, certainly if there's no chemical imbalance and your depression is situational.

People get shingles even when they're on HAART, and of course someone on HAART can still have stress and depression issues, so I take issue with that comment by the doctor.

[jcelvis]

I'm not holding off taking meds, if my went to my old Dr. in Houston today and he said James you need to get on meds I would walk to the pharmacy and get my meds.

[BT65]

Jcelvis,

I totally agree with Ms. Philicia about getting into some therapy.  It seems (and I'm not psychiatrist), that most of your depression is situational, since you've seemed to have developed it after moving.  I would definitely get into a good therapist.  You could contact your nearest ASO (Aids Service Organization), about a good doctor who works with HIV+ folk.  And remember, situational depression isn't forever, and will dissipate quicker with a good therapist. 

[thenick]

First, I agree with those who have recommended talk therapy. I can attest to the fact that it has been very helpful to me in my own life when I have struggled with depression. There is no shame in seeking out or seeing a psychotherapist. I do, however, suggest that you try to find someone who is acquainted with HIV/AIDS issues.

Second, I encourage you to reconsider your reluctance to avoid anti-depressant medications. They help; they really do. Moreover, unlike HIV medications, you will not need to take them for the rest of your life. They are a temporary solution to help alleviate symptoms. The best plan is anti-depressant medications in combination with psychotherapy. Again, there is no shame involved in seeking or getting treatment for your depression, whether it be through talk therapy, medications, or, best of all, both. I've "been there" so I can assure you that you will find great relief by following your doctor's advice.

Finally, I do urge you to consider your doctor's recommendations regarding HIV medications as soon as possible. The most current recommendations are to start antiretroviral therapy if your CD4 count drops below 500. Looking at the numbers you've posted, it's my personal opinion that your CD4 count and viral load is at the level where you should seriously consider HAART. There's plenty of research that shows the sooner one starts treatment, the better the outcome.

Sorry to hear about the shingles. I can speak from personal experience that it's something really awful to deal with. I had shingles twice in six months, and with the second outbreak, it caused so much nerve damage that I've been on pain medications for the past two years. It was so bad that I was on morphine at one point. I assure you that it's not a road you want to travel. Moreover, shingles is considered an AIDS-defining condition, which is all the more reason to urge you to start HAART. I think your new doctor is giving you good advice.

Good luck!

Nick

[rschwass]

I have tried many combos of anti-depressants over the years, having a bi-polar diagnosis.  I'm now on the best so far, I think- low doses of Lamictal, Abilify and Lithium. Of course, everyone's best formula is different, and you might want to give it more time with talk therapy before trying the meds.  I agree that starting hiv meds may be a good decision, given their success rate in lowering viral load.  You might be able to look forward to treatment breaks if your numbers remain good.  good luck, Richard

[SouthSam7]

I don't know anything about talk therapy; I was recently in a small town so that was not an option.

Personally, Lexapro has done some great things for me for similar feelings you are having.  I can't even tell I'm on it except I don't get really down, which is great.  You could try it for a few months until you get to a bigger town where they have non-drug options.

Your job also sounds similar to one I had.  Fortunately I got fired so I get unemployment while I settle in to my new town.  An unpleasant job can really affect your health.  Move to a different town with a population similar to you so your friend pool would increase.

Finally, I recommend going on HIV drugs if your doctor says you should.  I didn't want to go on them either but thankfully I did.  I believe your health will improve and certainly your stress could go down.  Get a second opinion, if you like, but you should seriously consider HIV drugs it if your numbers suggest that you should.

Good luck.

Sam

[jcelvis]

I just want to clear things up. I don't have a fear of starting meds. My issue is i feel like my dr. is treating me like patient #165224422 instead of treating me like an individual. I understand doctors are often over worked, but you can change communication to feel like you are more empathic to individual in your waiting room.

[Okealyshire]

When I got laid off from my job last May I noticed that my mental outlook had changed. Slept very late, had little energy, derived no satisfaction from doing the things that used to be fun -- tinkering with my mountain bike, practicing my French horn, whatever. I engaged in a fair amount of research on the various antidepressants and felt that the SSRIs (the majority of drugs on the market) wouldn't be right for me -- however, bupropion (Wellbutrin) appeared to be a better choice because it acts on dopamine rather than serotonin. Dopamine is involved in the brain's reward pathway, which coincided with my definite lack of deriving any kind of reward from activities that used to bring me great satisfaction.

I made an appointment with my doctor and we went through some questions on the Hamilton depression scale test. Her results matched my thinking -- that a temporary boost in dopamine might be enough to re-energize me. I started with 150 mg Wellbutrin for seven days, then 300 mg for 60 days. The difference was amazing. Once I started a new job we backed off the Wellbutrin, returning to 150 mg for seven days then finally discontinuing altogether.

I'm very happy with the way this experience worked for me.

[Theyer]

Hello James,

I read your post yesterday as I am also trying to get out off depression. It is to do with loss and grief and the initial reason has bought up past loss that I guess still has to be dealt with. Like the other posts I would encourage you to find somewhere where you can Talk about what you posted,Its hard for me to do when i am depressed, but I have decided that is one off the symptoms off being depressed it reduces the very abilities one needs to use to get out off it. I can also remember being polaxed when a Dr I trusted left, it was very hard to deal with as up until she left I had no idea how important she was. Anyway good luck i hope you seek out help  and I am sure you will feel the benefit.

I have also found it helpful to read about loss, grief and resulting depression, I think its to do with knowledge being empowering
m

[webontheweb]

Hey jcelvis-  I had quite a thread going --"Dumb and dumber-  "  and was tested for everything under the suyn including an MRI and after going back to my therapist who I see occasionally, maybe once every six months or so for a "tune up"  she said that she definitely saw signs of depression and asked if I would try medication as she thought I was " anti meds"  I said I would try anthing that worked and with my doctor, they have me on Exefor and I have to tell you that for me,  THE VERY NEXT MORNING AFTER THE FIRST DOSE I WOKE UP ALERT AND HAPPY AND INTERESTED IN THE DAY"  I know that this is not common, bust since starting this treatment I feel like ME again. 
Talk to a prefessional who can help you determine if you truly are depressed and maybe talking is enough, but maybe you do need meds.  Best of luck pal, I have been where you are and I care!
Cheers!

[jcelvis]

Giving a little update, since someone sent me a PM and asked nicely on how I was doing.

As of right now I feel much better. I went to a psychologist for a bit, until I stopped feeling depressed. A lot of it had to with the weather changing. I'm pretty convinced my depression feelings coincide with cold weather, maybe I need to move to Hawaii.

Also, I went to the dr. today and he decided it wasn't time to start meds. I don't know my number, he doesn't give them to me (him and I will discuss that later), but he said other than my VL going up slightly (but still with log range) my numbers didn't really change and he did not have a strong case for me starting treatment. Even though he philosophy is to start treatment immediately. What was funny is I had walked into the office under the assumption that he would be writing me a RX to start treatment.

Other than that I've been working out to keep my mood up (the side effects of this prescription is much appreciated), and my job is finally picking up.

All in all March shaped up well, now if pool weather would just get here.

Thanks for the concern. Hope everyone else is doing well.

James

[poztoo]

Hello,

First of all, you make me feel depressed. If someone as young and cute as you are is depressed, what chance have I? I'm kidding, sort of. It's all true, but not your fault.

Good to know you're better. I go through periods when I don't get my #'s too. This can be a very good thing, because when I was new to all this, a drop in C4 cells would have me in a panic, and a big increase could make me feel I could drink, have tons of sex, quit my job, and rule the world. Therefore, if you only want to know if you have to, I suggest keeping your arrangement.

Now the bad news. Looking at your numbers, I see no reason not to start meds. Your viral load, although stable, is below normal. Any viral load means the virus is doing it's dirty work. The CDC recommends therapy start with Tcells <500 at present. Furthermore, the old theory of staying med "naive" for furure resistance really doesn't cut it anymore. The drugs now are numerous, diverse, and w/o most of the truely horrible side effects of 1st generation meds. In spite of what you read here, the vast majority of people have no side effects. Like any medicine, some do and they are the people who will be the loudest.

Another thing I think people think, as I did, is starting meds means "I really have HIV!". A completely illogical but understandable reaction. The fact is, You not only have it, but it appears to have affected you rather quick. A T-cell reading between 400-500 is what most in the "latent" stage have. Now however, we know there is no "latent" stage. A true non-progresser rarely would have a count that low. You actually have numbers that match mine 15 years ago. Before protease drugs. In fact, mine were usually higher. the lowerst I ever had was about 390. I was running 500-700 for mant years. My VL fluctuated much more than yours. Much more. But, it's quite possible your virus isn't wild type. And that's another good reason to start meds. You don't really know what you're dealing with otherwise.

As for your depression. Well, It's great your feeling better. However, don't freak out if that changes. You're still new to this, very young relatively, and I suspect are used to much compliments, getting who you want, and being "star of the bar". If so, you might still be vu,nerable to an "offensive comment" as you were. Remember to peruse the personals occasionally at least. There are other pretty boys in your situation.

Well, that's all. Except this. I've been pos 24 years (at least) Been on meds about 15-16 years. My VL is und, my last 3 T's were 1600, 1500, and 1200. It's been above 1000 years. Und VL 5 years. Same regimen 5 years. No major side effects.

As for depression, well, I'm sitting home on a sat. night with no friends, no sex, on disability (not HIV), and taking 5 meds for it. I an legend- when it comes to depression. Maybe I'll snap out of it and write about that sometime.

[alliance]

JC Im so glad your doing better!   I know how exercize helps the winter blahs like you say, it works for me, but this winter I tried a lamp for seasonal depression a couple times this year when I couldnt get going and it helped, not immediately but about 6 hours later or so. Maybe think about that before next November.
Anyhow, I heard April is the start of pool weather, a perfect time for working on the start of a no-tan-line-tan and doing whatever else you enjoy !
Take Care-

[Andy Velez]

JC, it's good to hear that things are looking up.

Don't give up on getting some professional support too suddenly. Take as much time as you need to put things into words as best you can. It doesn't happen suddenly but the positive effects are often more lasting than drugs and other quicker fixes.

Give yourself the good care and support that you're entitled to and that everyone needs.

Cheers.