BY Benjamin Ryan

October 14 2009 9:00 AM ET

Yes, It’s Real
Some researchers state that as much as 40% to 60% of the HIV-positive population will suffer from depression at some point in their lives. Using a more rigid set of criteria than most, Glenn J. Treisman, MD, Ph.D., who is director of the AIDS Psychiatry Service at Johns Hopkins Hospital in Baltimore, estimates that at any given time about one in five HIVers is suffering from major depression and requires psychiatric treatment. Regardless of how they define a diagnosis of depression, most scientists agree that HIVers suffer from the condition at a rate four to five times greater than the general population.

Robert H. Remien, Ph.D., who studies the psychology of HIV at Columbia University in New York City, cautions against concluding that rates are so high simply because HIVers have every reason to be depressed. Rather, he says, depression and HIV engage in a complex, interweaving dance -- each potentially influencing and exacerbating the other.

“Think about who is vulnerable to getting HIV,” Remien says. “They are often disen¬franchised people because of their sexual identity, substance abuse, etc.”

These populations, he explains, are already primed for experiencing depression and might also have a family history of mental illness. Their depression could then cause a sense of apathy about their own well-being that leads them to take the sorts of risks that expose them to the virus.

Furthermore, Remien points out, people who are facing a new HIV diagnosis should not see the onset of major depression or thoughts of suicide as a natural and expected reaction to the news.

“I think a good analogy is mourning,” he says. “It’s appropriate to feel sad when someone close to you dies. It’s not normal to go into a state of deep depression. Well, it’s the same thing about HIV. It’s normal to be bummed out, maybe feel sad, maybe feel teary. It’s not normal to have persistent symptoms of depression.”












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