Does being diagnosed with HIV/ STI link to having Depression?

Did you know? The higher the frequency of depressive symptoms, the higher the risk of being diagnosed with an STD increases within one year for persons of both genders. Yes, you read that right, both genders! Depression is the most common mental health disorder among those diagnosed with HIV/ STI.

Let’s back up a little. Why does depression matter? When does it actually matter? So many people are affected by this affliction, yet not many seek for help. It could be due to the discrimination they will face upon learning they have contracted this infection. 

Depression

This common but serious medical illness, it negatively affects how one feels, the way one thinks and how they act. 

Depression symptoms can vary from mild to severe and may include:

• Feeling sad or having a low mood
• Loss of interest or pleasure in activities once enjoyed
• Changes in appetite 
• Increased or reduced in sleep pattern
• Loss of energy 
• Increase in purposeless physical activity (can be noticed by others)
• Feeling worthless or guilty
• Difficulty thinking, concentrating or making decisions
• Thoughts of death or suicide

As can be seen atop, this disorder can be life-threatening if not treated. Identifying a person with such issue takes a lot of time and patience. Not everyone will be ready to disclose their issue. They need someone that they can trust.  When one is tested positive for HIV/STIs, their whole world can change in an instant. From who to tell, to picking out their healthcare providers, to monitoring one’s immune system, and deciding how to deal with HIV in their life.

Do note that this disorder is not only limited to those tested positive, but also to those who had a risky encounter and are going to get themselves checked. During the window/incubation period, many will be feeling low or feeling guilty for what happened. They too need help! So, when does depression matter? It matters when you start questioning if you have depression. That is the first step of recognition and also an indication that you need help. 

What causes depression in high risk patients?

The STI infection itself does not cause depression. Likewise, the progression of the disease does not automatically lead to depression. There are many steps or “entry” points for one to have depressive symptoms.

These common crisis points include:

• Initial time when one was diagnosed with HIV/STI
• Telling friends and family that they have been HIV/STI-infected
• Introductions of new medications
• Return to a higher-level of functioning (back to work/school)
• Major life changes (pregnancy/ end of relationships)
• Making end-of-life and permanent planning decisions

Again, these are not only limited to those that are already infected, but also for those yet to get themselves tested. 

Common crisis points for such people include:

• Taking the first step to get themselves tested
• Guilt in why are they in such situation
• Not knowing where to look for help
• Worried of the test outcome
• incubation/ waiting period
• Anger at self 

HIV being a no-no topic here in MALAYSIA, causing some patients to start panicking and won’t know how to get help. Here in DTAP, we offer Anonymous HIV testing to ensure our patients feel comfortable and not needing to expose their identity.  

How important is it for people to get treatment for depression?

Patients with depressive symptoms will benefit from multiple types of treatments. In fact, studies suggest that depressed HIV/STI patients who are given treatment may be more likely to adhere to and benefit from, their treatment. 

At present, the most common treatments for depression include: 

• Psychotherapy: also known as talk therapy, that helps people change negative thinking styles and behaviours that may contribute to their depression 
• Antidepressants: few types of pills are available in the market, however it will only be prescribed based on the patients need. There is no “one pill for all” kinda med. 

*Patients will first be screened prior dispensing the medications as this category meds may have side effects on specific organs. We do not encourage over the counter medications as no blood work or monitoring will be done. 

• Support: research suggests that social support is highly associated with better treatment adherence for individuals with depression or anxiety.

Treatment for depression can make a significant difference both physically and emotionally, for individuals living with such conditions. Not everyone responds to treatment the same way. Medications can take several weeks to work and may need to be combined with ongoing talk therapy. 

So what can one do if they want to help? 

The answer is simple, to be there for them. Be a supportive listening ear. People in low spirits do not want answers or solutions. They want a safe place to be themselves, to be able to express their fears and anxieties. Some may wish to speak to someone about any feelings of guilt they may have, or how they are going to break the news to their family. Listen – really listen – it won’t be easy. We must control our “Asian” judgement and needing to say something – to make a comment, add to a story or offer advice. We need to listen not just to the facts that the person is telling us but to the feelings that lie behind them. We need to understand things from their perspective, not ours. 

DO NOT offer empty words. Do not give up on your friends – keep in touch with the person at risk. You are all they have. If you were to give up on them, they will feel lost and wont have support. Do not ever assume that the talk of having a bad mood/ the losing of interest is them trying to get attention or to talk themselves out of guilt. As mentioned earlier, they may already have feelings of guilt. Depression may seem like an unavoidable reaction to being diagnosed with HIV. But depression is a separate illness that can and should be treated. 

At DTAP we offer short counselling sessions along with consultations for STIs. 

Our friendly doctors at DTAP are willing to address your doubts. We also offer anonymous HIV testing. The range of our STI testing is also found here: STD Testing