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Psychological Problems with HIV - AIDS Patients

Beat The Blues
It doesn’t take a brain surgeon to defeat depression. But you do have to get help yourself . Depressed people often resist getting treatment, and those infected by HIV are no exception. In addition to “I’m not crazy,” “It’s my own fault I’m miserable,” “Nothing’s going to help” and other routine rationalizations.

Those with HIV have a special zinger to fling at folks who tell them to get over it: “You’d be miserable, too, with a life–threatening virus.” Well, get over it – untreated depression has serious health effects and can even shorten your life, not to mention just being a big bummer. What might surprise the downcast is the news that depression is very treatable.

One common but often–overlooked cause of depression in men (and some women) with HIV is low testosterone. So those with HIV should have their levels checked as part of any evaluation for depression. A study at Columbia University found that three–quarters of HIV–positive men with major depression who had deficient or even “Low to normal” testosterone levels showed improvement “Equal to that achieved with standard antidepressants” when given supplements of the hormone.

Other contributors to depression are overall malnutrition or deficiencies of B vitamins (especially B6 and B12), very common in those with HIV. And since nutrient–level blood tests are unreliable, eating better and adding a potent B complex plus extra B12 (by nasal gel or injection) are worth trying.

If the depression is diagnosed as mild or moderate, everything from psychotherapy to exercise to pets can help. The main issue is: Can you mobilize to take these actions? If you can get yourself to your support group, the gym or the dog run, all well and good. But if, as Emily Carter describes in “Woman on the Verge,” even finding a pair of clean socks in the morning (or late afternoon) looms as an overwhelming task – you may need to start an antidepressant.

Many practitioners recommend weekly visits with a psychiatrist, psychologist or social worker for four weeks, with at least one 30–minute consultation every month thereafter. Ongoing monitoring is especially important if your treatment of choice is pharmacological.

Forgetfulness
  1. Use calendars and appointment books.
  2. Place Post–It notes in conspicuous places as reminders.
  3. Make lists (questions for your physician, groceries needs, people to call etc.).
  4. Develop list for important things to check when leaving the residence (stove, lights, etc.).
  5. Use alarm clock as a reminder for medications.
  6. Keep a list of medications with dosages and times taken.
  7. Ask for help if medications must be taken at different times and dosages.
  8. Keep a journal detailing complex projects.
  9. Use a cassette tape recorder to dictate thoughts and questions.
  10. Purchase a noise–activated key chain.
  11. Keep a telephone log and important numbers by the phone.
Slowed Speech
  1. Allow more time to collect your thoughts and for conversations.
  2. Don’t hurry, give yourself permission to take your time.
  3. Keep talking. Good conversation is good practice.
Visuospatial Problems
  1. Don’t drive if unable to do so.
  2. If able to drive, plan routes in advance, allow plenty of time, and take a friend along when you can.
  3. Use verbal directions instead of maps.
  4. Realistically assess whether you are still able to drive at night.
  5. Cease driving at night if your vision has become too impaired for you to be able to do so safely.
Depression and Social Withdrawal
  1. Plan recreational activities.
  2. Be an active participant.
  3. Rekindle old hobbies and interests or create new ones.
  4. Directly ask friends and family members to initiate social contacts and instruct them not to take “No” for an answer unless you are too ill to socialize.
Concentration Problems, Inattentiveness, or Distractibility
  1. Try to limit distractions by confining your activities to a single task.
  2. Meet with people one at a time.
  3. Break large tasks down into more manageable jobs.
  4. Turn the TV off when conversing or needing to concentrate.
  5. Don’t drive in heavy traffic.
Problems with Sequential Reasoning or Multi–step Tasks
  1. Don’t take on new or unfamiliar job responsibilities.
  2. Avoid tasks in which speed of performance is important.
  3. Simplify such things as meal preparation.
  4. Plan activities when you are at your best, e.g., a “Morning person.”

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