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HIV and Depression

Medically Reviewed by Neha Pathak, MD on April 27, 2021

Depression is one of the most common mental illnesses in the U.S. -- especially among HIV-positive people. If you are living with HIV, you are three times more likely to face depression than those who are HIV negative. There are lots of reasons for this. Stress and stigma from HIV, medication side effects, and the disease itself can all affect your brain and body.

If you are depressed, tell your doctor. Treatment can ease your symptoms. Make sure you take your HIV medicine every day. Your odds of depression go down the longer you’re on an effective anti-retroviral therapy (ART).

Causes of Depression With HIV

Mental health problems are more common in people with an ongoing illness, including HIV. Studies show anywhere from 22% to 61% of people with the disease report symptoms of depression. People with HIV also have higher rates of anxiety and posttraumatic stress disorder (PTSD).

There isn’t one clear link between depression and HIV. But experts point to the following:

Inflammation. HIV can cause high levels of ongoing inflammation. There’s evidence that too much inflammation can lead to depression and anxiety. HIV-related inflammation can hurt your brain and spinal cord. This damage can affect your mood and how you think.

Life stressors. Some situations that can affect your mental health include:

  • Anxiety about your long-term health
  • Lack of access to medical or mental health care
  • Not enough social or family support
  • Worry about your job
  • Anger about being sick
  • Stress around your drug routine
  • Fear that people may treat you differently

Not enough ZZZs.  Sleep problems are common in people with HIV. You may have trouble falling or staying asleep. Insomnia or short sleep raises your odds of depression. In turn, depression can worsen your sleep. Tell your doctor if you can’t get enough shut-eye. They’ll look for any hidden health conditions, such as obstructive sleep apnea.

HIV medication. Some anti-retroviral drugs or their side effects may increase your anxiety or depression. Tell your doctor right away if mental health symptoms pop up or worsen after you start ART. They may need to put you on a different drug.

Poor nutrition. People who have HIV often don’t get enough of certain nutrients. Your body could have trouble absorbing nutrients because of inflammation or as a side effect of your medicine. HIV and the drugs that treat it can also take away your appetite or make food taste bad. Some vitamin and mineral deficiencies can cause fatigue and even depression.

Other illnesses. You’re a lot more likely to get certain kinds of infections when you have HIV. These illnesses can affect your mood.

Why Treatment Is Important

Good mental health improves your quality of life. That’s important because mental and physical health go hand in hand. It’s hard to take care of yourself when you don’t feel well. Studies show people with HIV who also have depression tend to be sicker than their nondepressed counterparts.

Treatment for depression can make it easier to do the following:

  • Stick to your treatment plan
  • Get good sleep
  • Go to work
  • Eat healthy and exercise
  • Avoid risky things, such as unprotected sex and drug use

How to Get Help

Tell your doctor, social worker, or case manager if you have depression or think you do. They’ll help you find the right treatment. Don’t give up if the first thing you try doesn’t work. It may take some trial and error to find what works for you.

Here are some things your doctor might suggest:

Keep in mind that depression affects your mind and body. Here are some common signs to watch for:

  • You feel hopeless, irritable, or angry
  • You don’t enjoy things you used to like
  • You sleep too little or too much
  • You eat more or less than usual
  • You get headaches or stomach problems
  • Your body hurts or you’re tired a lot

Call 911 or get to a hospital right away if you have thoughts of hurting yourself. Or call the National Suicide Prevention Lifeline at 800-273-8255 any time, day or night.

WebMD Medical Reference

Sources

SOURCES:

HIVinfo, National Institutes of Health: “HIV and Mental Health.”

American Journal of Epidemiology: “Inflammation and Risk of Depression in HIV: Prospective Findings From the Multicenter AIDS Cohort Study.”

Journal of Clinical & Diagnostic Research: “Prevalence of Depression in People Living with HIV/AIDS Undergoing ART and Factors Associated with it.”

National Institute of Mental Health: “Chronic Illness and Mental Health: Recognizing and Treating Depression,” “HIV/AIDS and Mental Health.”

AIDS: “Mental health and HIV/AIDS the need for an integrated response.”

Health and Quality of Life Outcomes: “Identifying factors associated with depression among men living with HIV/AIDS and undergoing antiretroviral therapy: a cross-sectional study in Heilongjiang, China.”

SAGE Open Medicine: “Sleep disturbances in HIV-infected patients associated with depression and high risk of obstructive sleep apnea.”

Journal of the Association of Nurses in AIDS Care: “Sleep Disturbances in Persons Living With HIV.”

U.S. Dept. of Veterans Affairs: “HIV: How do I keep from losing weight?”

NHS: “Symptoms: Malnutrition.”

HIV.gov: “Mental Health and HIV.”

International Journal of Environmental Research and Public Health: “Depression among Patients with HIV/AIDS: Research Development and Effective Interventions (GAP Research).”

National Suicide Prevention Lifeline

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