Saturday, November 8, 2008
Diet and Exercise
Be glad of life, because it gives you the chance to love, and to work, and to play, and to look up at the stars. ~Henry Van Dyke
Currently, life expectancy in the United States, according to the CDC, is 77.8 years. That breaks down to 75.2 years for men and 80.4 years for women. Interestingly, life expectancy in the year 1900 was only 47.3 years. There is no definitive data on life expectancy for gay populations. However, many of the major health concerns for heterosexuals are the same for homosexuals. Two of the best methods anyone can utilize to live a long, healthy life are regular exercise and healthful eating habits.
Exercise: Physical activity should be as integral a part of your daily routine as showering, eating, or brushing your teeth. No medication your doctor can prescribe, or vitamin you can take, or “energy drink” you can buy, will make you feel as good or benefit your health as much as regular exercise. The benefits of exercise are numerous, including:
-Improved energy, mood, and self-esteem. Regular exercise helps reduce feelings of depression and anxiety.
-Decreased risk of chronic disease. Exercise lowers blood pressure and improves cholesterol levels, two of the main contributors to heart disease, which is still the #1 cause of death in the United States. Exercise also reduces the risk of osteoporosis, diabetes, and certain types of cancer.
-Improved sleep patterns. Exercise helps you fall asleep faster and promotes deeper sleep.
-Improved sexual performance. Men who exercise regularly are less likely to have problems with erectile dysfunction.
The American College of Sports Medicine recommends doing cardiovascular exercise (such as walking, jogging, or swimming) for 30 minutes, five days per week, as well as strength training two times per week. This may seem like a lot. If you’re currently not exercising at all, start slow, and build your way up. Considering the benefits, there are few activities in your day that should have a higher priority than exercise. So, turn off the TV, log off the computer, and get moving. Try exercising first thing in the morning. You get it out of the way, and it’s a great way to start your day.
I like Matthew McConaughey’s advice: “Just break a sweat, somehow, every day.”
Eating: We live in a culture that surrounds us with food. Food is cheap, easily available, and for the most part, is laden with empty calories and void of nutritional value. You can’t swing a gym sock over your head without hitting a fast food store, a convenience store, or a vending machine. Up to 25% of Americans eat some type of fast food every day. It’s no wonder, then, that two-thirds of Americans are either overweight or obese. Managing your food intake is a challenging process, and requires commitment, effort, and planning. Some of the principles that I have found most useful include:
-Always make sure you have food with you. Pack a lunch, as well as healthy snacks, every time you leave the house. Fruit, nuts, or (my favorite) low-carb tortillas with peanut butter, are much more healthful choices than most of the sugary junk laying around workplaces. Carrying your own food empowers you, because you’re not at the mercy of eating junk when you get hungry. You’ll also save money.
-Avoid fast food. If you must eat “on the run,” get a (6 –inch) sub sandwich on wheat bread and load it up with vegetables. And skip the chips.
-Drink water. Don’t drink soda. What is soda anyway? Colored, liquid fizz with chemicals. Is this really what you want to put into your body? Water is pure liquid refreshment. It helps with digestion, detoxifies the liver and kidneys, and works as a natural appetite suppressant. It also prevents dehydration, which can contribute to the formation of kidney stones.
-Avoid processed or pre-packaged foods. In other words, try to avoid eating anything out of a box, a can, a vending machine, or a convenience store. This type of “food” is loaded with calories and chemicals, and has very little nutritional value. It reeks havoc on your digestive system, as well as your cholesterol and blood sugar levels.
-Eat five or more servings of fruits and vegetables a day. Try eating fruit in the morning with breakfast, and raw vegetables with your sandwich instead of chips or fries.
-Watch your portion sizes. A “portion” is about the size of your fist. Bigger is not always better. Contrary to what our parents taught us, it’s OK to leave food on your plate. Eat enough so that you don’t feel hungry, but try not to stuff yourself.
-Be “mindful” of your eating. Before you go shoveling something into your mouth, ask yourself: “Am I really hungry? Or am I bored? Or stressed out? Or depressed?” Be aware if something other than hunger is prompting you to eat.
If you want more information on exercise and eating healthy, visit www.cdc.gov/healthyliving.com. It’s always advisable to visit your physician before starting a new exercise or diet program.
Currently, life expectancy in the United States, according to the CDC, is 77.8 years. That breaks down to 75.2 years for men and 80.4 years for women. Interestingly, life expectancy in the year 1900 was only 47.3 years. There is no definitive data on life expectancy for gay populations. However, many of the major health concerns for heterosexuals are the same for homosexuals. Two of the best methods anyone can utilize to live a long, healthy life are regular exercise and healthful eating habits.
Exercise: Physical activity should be as integral a part of your daily routine as showering, eating, or brushing your teeth. No medication your doctor can prescribe, or vitamin you can take, or “energy drink” you can buy, will make you feel as good or benefit your health as much as regular exercise. The benefits of exercise are numerous, including:
-Improved energy, mood, and self-esteem. Regular exercise helps reduce feelings of depression and anxiety.
-Decreased risk of chronic disease. Exercise lowers blood pressure and improves cholesterol levels, two of the main contributors to heart disease, which is still the #1 cause of death in the United States. Exercise also reduces the risk of osteoporosis, diabetes, and certain types of cancer.
-Improved sleep patterns. Exercise helps you fall asleep faster and promotes deeper sleep.
-Improved sexual performance. Men who exercise regularly are less likely to have problems with erectile dysfunction.
The American College of Sports Medicine recommends doing cardiovascular exercise (such as walking, jogging, or swimming) for 30 minutes, five days per week, as well as strength training two times per week. This may seem like a lot. If you’re currently not exercising at all, start slow, and build your way up. Considering the benefits, there are few activities in your day that should have a higher priority than exercise. So, turn off the TV, log off the computer, and get moving. Try exercising first thing in the morning. You get it out of the way, and it’s a great way to start your day.
I like Matthew McConaughey’s advice: “Just break a sweat, somehow, every day.”
Eating: We live in a culture that surrounds us with food. Food is cheap, easily available, and for the most part, is laden with empty calories and void of nutritional value. You can’t swing a gym sock over your head without hitting a fast food store, a convenience store, or a vending machine. Up to 25% of Americans eat some type of fast food every day. It’s no wonder, then, that two-thirds of Americans are either overweight or obese. Managing your food intake is a challenging process, and requires commitment, effort, and planning. Some of the principles that I have found most useful include:
-Always make sure you have food with you. Pack a lunch, as well as healthy snacks, every time you leave the house. Fruit, nuts, or (my favorite) low-carb tortillas with peanut butter, are much more healthful choices than most of the sugary junk laying around workplaces. Carrying your own food empowers you, because you’re not at the mercy of eating junk when you get hungry. You’ll also save money.
-Avoid fast food. If you must eat “on the run,” get a (6 –inch) sub sandwich on wheat bread and load it up with vegetables. And skip the chips.
-Drink water. Don’t drink soda. What is soda anyway? Colored, liquid fizz with chemicals. Is this really what you want to put into your body? Water is pure liquid refreshment. It helps with digestion, detoxifies the liver and kidneys, and works as a natural appetite suppressant. It also prevents dehydration, which can contribute to the formation of kidney stones.
-Avoid processed or pre-packaged foods. In other words, try to avoid eating anything out of a box, a can, a vending machine, or a convenience store. This type of “food” is loaded with calories and chemicals, and has very little nutritional value. It reeks havoc on your digestive system, as well as your cholesterol and blood sugar levels.
-Eat five or more servings of fruits and vegetables a day. Try eating fruit in the morning with breakfast, and raw vegetables with your sandwich instead of chips or fries.
-Watch your portion sizes. A “portion” is about the size of your fist. Bigger is not always better. Contrary to what our parents taught us, it’s OK to leave food on your plate. Eat enough so that you don’t feel hungry, but try not to stuff yourself.
-Be “mindful” of your eating. Before you go shoveling something into your mouth, ask yourself: “Am I really hungry? Or am I bored? Or stressed out? Or depressed?” Be aware if something other than hunger is prompting you to eat.
If you want more information on exercise and eating healthy, visit www.cdc.gov/healthyliving.com. It’s always advisable to visit your physician before starting a new exercise or diet program.
Test Your STD IQ with Dr. Wayne's STD Quiz!
“There is hardly anyone whose sexual life, if it were broadcast, would not fill the world at large with surprise and horror.” --William Somerset Maugham
According to the CDC, rates of sexually transmitted diseases (STDs) among gay men have been increasing in recent years. While some STDs are curable (such as gonorrhea, chlamydia, and syphilis), others are not (such as herpes and HIV). Having any STD, even one that is curable, makes you much more likely to acquire HIV if you’re exposed.
Here are some questions to help you assess your knowledge of STDs. Remember, knowledge is power, and prevention is the best strategy.
Q: True of False? Washing or showering after sex is a good way to protect yourself against STDs.
A: False. According to the CDC, washing the genitals, urinating after sex, or douching will not prevent any STD. Abstinence from sex, or monogamy with an uninfected partner, are the surest ways to prevent STDs. Condoms can greatly reduce the risk of STDs if used correctly, and consistently.
Q: True of False? It burns when I urinate. I must have a urinary tract infection.
A: Maybe. But you might have gonorrhea or chlamydia. Urinary tract infections can be common in some women, but they are rare in men. Anyone having “genital” symptoms such as discharge or burning with urination should see a doctor for testing. Untreated infection with gonorrhea or chlamydia can lead to serious complications, such as pelvic inflammatory disease and ectopic pregnancy in women, or epididymitis (swollen, infected testicles) in men. Both men and women are at risk for infertility if not treated.
The symptoms of gonorrhea or chlamydia usually appear within a week of being infected, but may take as long as 4 weeks. Many infected people have no symptoms. Testing involves a simple urine test, and infections can be cured with antibiotics.
Q: True or False? Gonorrhea and chlamydia are not spread by oral sex.
A: False. Gonorrhea and chlamydia can be spread by oral, vaginal, or anal sex. They are bacterial infections, and the bacteria can grow not only in the genitals and reproductive organs, but also in the mouth, throat, eyes, and rectum. They can also be passed from an infected mother to her baby during childbirth. Ejaculation does not have to occur during sex for these infections to be spread. Symptoms of a throat infection include – a sore throat. Rectal infection can cause anal itching, discharge, bleeding, or painful bowel movements. Again, there often are no symptoms.
Q: True of False? Lesbians don’t get STDs, so they don’t need to get pap smears.
A: False. While STD rates among lesbians are low, lesbian sex is not without risk. HPV (human papilloma virus), the virus that causes genital warts and cervical cancer, is spread through genital contact, including lesbian sex. There are over 40 strains of the HPV virus, classified as either “low risk” or “high risk.” A person with a healthy immune system can usually clear the virus within 2 years. In some people, “low risk” strains can cause genital warts, which appear within a few weeks of exposure, but may not appear for several months. They can be anywhere in the genital area or around the rectum, or even in the groin and inner thighs. They can be treated with topical medication, or frozen or surgically removed by a physician. They do not progress to cancer. “High risk” strains of HPV can cause cervical cancer in women or anal cancer in men. These cancers do not have symptoms until they are advanced, so it is important for all women, including lesbians, to get pap tests every year. Pap tests look for early cell changes, which can be treated before they progress to cancer. Anal pap tests are also being used to detect early cancer in gay men, particularly those infected with HIV. There is an HPV vaccine that is approved for women, and it is currently being studied for use in men.
Q: I had a sore on my penis, but it didn’t hurt, and it healed up after 2 weeks. It must have been nothing, and I’m OK now, right?
A: Wrong. What you described sounds like syphilis. Syphilis is a bacterial infection spread by oral, vaginal, or anal sex. Syphilis occurs in stages. The first stage is a painless ulcer that appears at the area of contact (the genitals, rectum, or mouth, but it can be anywhere on the body), usually within a few weeks from the time of exposure. The ulcer heals on its own, but the bacteria remain in the blood. Within a month or two, the second stage occurs, which can include fever, headache, swollen lymph nodes, or a rash in the mouth or on the palms of the hands and soles of the feet. These resolve within a few weeks, and the infection then enters a latent stage, which may last for years. During the latent stage, the infection begins to slowly and steadily damage the internal organs (heart, brain, and liver, and also the eyes, joints, and blood vessels), causing blindness, dementia, and even death. Several famous people throughout history are alleged to have contracted syphilis, including Vincent Van Gogh, Friedrich Nietzsche, Adolf Hitler, and Karen Blixen (aka Isak Dinesen, the author of Out of Africa).
Rates of syphilis have increased substantially in recent years. According to the CDC, men who have sex with men account for 64% of syphilis cases in the United States. Additionally, Phoenix and Maricopa County have one of the highest rates of syphilis in the nation. Syphilis is diagnosed with a blood test, and if it’s detected in the early stages, is easily cured with antibiotics.
Q: True of false? People with genital herpes aren’t contagious unless they’re having an outbreak.
A: False. Herpes is a viral infection transmitted by oral or genital contact, and can be transmitted even if the infected person has no visible sores. Herpes causes painful, fluid-filled blisters that occur within a few weeks of exposure. The blisters heal, but can recur. There is no cure for herpes, and there is no vaccination. Medication is available that, if taken daily, can decrease not only the frequency and severity of outbreaks, but also the risk of transmitting the infection to others. Consistent condom use can also reduce the risk of spreading the infection.
Having any STD infection makes you up to five times more likely to become infected with HIV if you’re exposed to the virus. The CDC recommends getting tested for STDs every 6 months if you’ve had new or multiple sexual partners and have engaged in unprotected sex.
So, how did you score? If you’d like more information about STDs, talk with your doctor, or visit the CDC website at www.cdc.gov/std.
According to the CDC, rates of sexually transmitted diseases (STDs) among gay men have been increasing in recent years. While some STDs are curable (such as gonorrhea, chlamydia, and syphilis), others are not (such as herpes and HIV). Having any STD, even one that is curable, makes you much more likely to acquire HIV if you’re exposed.
Here are some questions to help you assess your knowledge of STDs. Remember, knowledge is power, and prevention is the best strategy.
Q: True of False? Washing or showering after sex is a good way to protect yourself against STDs.
A: False. According to the CDC, washing the genitals, urinating after sex, or douching will not prevent any STD. Abstinence from sex, or monogamy with an uninfected partner, are the surest ways to prevent STDs. Condoms can greatly reduce the risk of STDs if used correctly, and consistently.
Q: True of False? It burns when I urinate. I must have a urinary tract infection.
A: Maybe. But you might have gonorrhea or chlamydia. Urinary tract infections can be common in some women, but they are rare in men. Anyone having “genital” symptoms such as discharge or burning with urination should see a doctor for testing. Untreated infection with gonorrhea or chlamydia can lead to serious complications, such as pelvic inflammatory disease and ectopic pregnancy in women, or epididymitis (swollen, infected testicles) in men. Both men and women are at risk for infertility if not treated.
The symptoms of gonorrhea or chlamydia usually appear within a week of being infected, but may take as long as 4 weeks. Many infected people have no symptoms. Testing involves a simple urine test, and infections can be cured with antibiotics.
Q: True or False? Gonorrhea and chlamydia are not spread by oral sex.
A: False. Gonorrhea and chlamydia can be spread by oral, vaginal, or anal sex. They are bacterial infections, and the bacteria can grow not only in the genitals and reproductive organs, but also in the mouth, throat, eyes, and rectum. They can also be passed from an infected mother to her baby during childbirth. Ejaculation does not have to occur during sex for these infections to be spread. Symptoms of a throat infection include – a sore throat. Rectal infection can cause anal itching, discharge, bleeding, or painful bowel movements. Again, there often are no symptoms.
Q: True of False? Lesbians don’t get STDs, so they don’t need to get pap smears.
A: False. While STD rates among lesbians are low, lesbian sex is not without risk. HPV (human papilloma virus), the virus that causes genital warts and cervical cancer, is spread through genital contact, including lesbian sex. There are over 40 strains of the HPV virus, classified as either “low risk” or “high risk.” A person with a healthy immune system can usually clear the virus within 2 years. In some people, “low risk” strains can cause genital warts, which appear within a few weeks of exposure, but may not appear for several months. They can be anywhere in the genital area or around the rectum, or even in the groin and inner thighs. They can be treated with topical medication, or frozen or surgically removed by a physician. They do not progress to cancer. “High risk” strains of HPV can cause cervical cancer in women or anal cancer in men. These cancers do not have symptoms until they are advanced, so it is important for all women, including lesbians, to get pap tests every year. Pap tests look for early cell changes, which can be treated before they progress to cancer. Anal pap tests are also being used to detect early cancer in gay men, particularly those infected with HIV. There is an HPV vaccine that is approved for women, and it is currently being studied for use in men.
Q: I had a sore on my penis, but it didn’t hurt, and it healed up after 2 weeks. It must have been nothing, and I’m OK now, right?
A: Wrong. What you described sounds like syphilis. Syphilis is a bacterial infection spread by oral, vaginal, or anal sex. Syphilis occurs in stages. The first stage is a painless ulcer that appears at the area of contact (the genitals, rectum, or mouth, but it can be anywhere on the body), usually within a few weeks from the time of exposure. The ulcer heals on its own, but the bacteria remain in the blood. Within a month or two, the second stage occurs, which can include fever, headache, swollen lymph nodes, or a rash in the mouth or on the palms of the hands and soles of the feet. These resolve within a few weeks, and the infection then enters a latent stage, which may last for years. During the latent stage, the infection begins to slowly and steadily damage the internal organs (heart, brain, and liver, and also the eyes, joints, and blood vessels), causing blindness, dementia, and even death. Several famous people throughout history are alleged to have contracted syphilis, including Vincent Van Gogh, Friedrich Nietzsche, Adolf Hitler, and Karen Blixen (aka Isak Dinesen, the author of Out of Africa).
Rates of syphilis have increased substantially in recent years. According to the CDC, men who have sex with men account for 64% of syphilis cases in the United States. Additionally, Phoenix and Maricopa County have one of the highest rates of syphilis in the nation. Syphilis is diagnosed with a blood test, and if it’s detected in the early stages, is easily cured with antibiotics.
Q: True of false? People with genital herpes aren’t contagious unless they’re having an outbreak.
A: False. Herpes is a viral infection transmitted by oral or genital contact, and can be transmitted even if the infected person has no visible sores. Herpes causes painful, fluid-filled blisters that occur within a few weeks of exposure. The blisters heal, but can recur. There is no cure for herpes, and there is no vaccination. Medication is available that, if taken daily, can decrease not only the frequency and severity of outbreaks, but also the risk of transmitting the infection to others. Consistent condom use can also reduce the risk of spreading the infection.
Having any STD infection makes you up to five times more likely to become infected with HIV if you’re exposed to the virus. The CDC recommends getting tested for STDs every 6 months if you’ve had new or multiple sexual partners and have engaged in unprotected sex.
So, how did you score? If you’d like more information about STDs, talk with your doctor, or visit the CDC website at www.cdc.gov/std.
The Unholy Ghost: Depression
“My melancholy – she is the most faithful mistress I have ever known” --Soren Kierkegaard
Andrew Solomon, author of “The Noonday Demon: An Atlas of Depression,” describes depression as “the aloneness within us made manifest. It destroys not only your connection to others, but also the ability to be peacefully alone with yourself.” Depression is among the most burdensome diseases in the world. The annual economic consequences of depression are estimated at 83 billion dollars in the US. Up to 20% of the adult population experiences a major depressive episode at some time in their lives. Depression rates in the gay population are thought to be significantly higher, and as high as 40% in patients with HIV.
Depression has been an area of intensive clinical study in recent years, both in defining what it is, what causes it, and in formulating effective treatments. According to the DSM-IV, depression is defined by the following:
-Feelings of sadness or hopelessness
-Loss of interest in pleasurable activities
-Changes in sleep patterns, like sleeping too much, or not being able to sleep well. The classic complaint is waking up in the early morning and not being able to go back to sleep.
-Changes in appetite, such as eating too much, or not eating enough
-Loss of energy
-Trouble concentrating
-Thoughts of worthlessness or guilt
-Thoughts about death or suicide
A major depressive episode includes at least five of the above symptoms, which are present most of the day, nearly every day, for at least 2 weeks, and cause significant distress or dysfunction. A minor episode includes two of the symptoms, at least one of which is feelings of hopelessness or loss of interest in pleasurable activities. In addition to emotional symptoms, depression can also manifest in physical symptoms, such as headaches, muscle aches, or abdominal pain.
Most cases of major depression occur between ages 30-40, but can occur at any point from childhood to old age. Episodes usually last from several months to a year. Many people with major depression have recurrent episodes throughout their lives. Genetic factors can predispose some people to depression, especially when combined with environmental influences. Life stressors, such as chronic illness or the death of a loved one, can be triggers for depression. Use of cocaine and crystal meth can affect brain chemistry and contribute to the onset of depression. Some depressive episodes occur without any obvious trigger.
Depression has become one of the most important factors in the HIV/AIDS epidemic. Major depression increases the risk of becoming infected with HIV. People with untreated depression may attempt to “self-medicate” with alcohol and other drugs, and have more self-destructive behavior patterns, such as using crystal meth and engaging in unprotected sex with multiple partners. Concurrently, people infected with HIV are at higher risk for developing depression. This is thought to be due to several factors, including the direct effects of the virus on the brain and central nervous system, low testosterone levels (common in HIV infection), and also from the social isolation, guilt, and stress that often accompany a diagnosis of HIV. People with depression who are HIV positive are less likely to take their HIV medications, and are at increased risk for progression of their HIV disease.
Fortunately, depression is treatable. The first step in treatment is to visit your doctor for a thorough physical examination. He or she may perform lab tests to see if your symptoms have an “organic” cause (thyroid disease, diabetes, etc). When a diagnosis of depression has been established, you can discuss with your doctor what treatment option is best for you.
Aerobic exercise, when performed regularly (three times per week), can help with depression. Psychotherapy and antidepressant medications are the main ways depression is treated clinically. Cognitive behavior therapy (CBT) works to change negative thinking and behavior patterns. Interpersonal therapy (IPT) focuses more on working through troubled relationships which can contribute to depression. The most common antidepressant medications are the SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft, which work to normalize neurotransmitters in the brain and improve mood. Once the medication is started, it takes about four weeks to get the full benefit, and most patients need to take the drugs for at least six months in order to minimize the risk of relapse. They are popular drugs and have helped many people with depression, but they can have serious side effects, and should be used only under close medical supervision.
For more information on depression, visit the National Institute of Mental Health website at www.nimh.nih.gov/health/publications/depression
Andrew Solomon, author of “The Noonday Demon: An Atlas of Depression,” describes depression as “the aloneness within us made manifest. It destroys not only your connection to others, but also the ability to be peacefully alone with yourself.” Depression is among the most burdensome diseases in the world. The annual economic consequences of depression are estimated at 83 billion dollars in the US. Up to 20% of the adult population experiences a major depressive episode at some time in their lives. Depression rates in the gay population are thought to be significantly higher, and as high as 40% in patients with HIV.
Depression has been an area of intensive clinical study in recent years, both in defining what it is, what causes it, and in formulating effective treatments. According to the DSM-IV, depression is defined by the following:
-Feelings of sadness or hopelessness
-Loss of interest in pleasurable activities
-Changes in sleep patterns, like sleeping too much, or not being able to sleep well. The classic complaint is waking up in the early morning and not being able to go back to sleep.
-Changes in appetite, such as eating too much, or not eating enough
-Loss of energy
-Trouble concentrating
-Thoughts of worthlessness or guilt
-Thoughts about death or suicide
A major depressive episode includes at least five of the above symptoms, which are present most of the day, nearly every day, for at least 2 weeks, and cause significant distress or dysfunction. A minor episode includes two of the symptoms, at least one of which is feelings of hopelessness or loss of interest in pleasurable activities. In addition to emotional symptoms, depression can also manifest in physical symptoms, such as headaches, muscle aches, or abdominal pain.
Most cases of major depression occur between ages 30-40, but can occur at any point from childhood to old age. Episodes usually last from several months to a year. Many people with major depression have recurrent episodes throughout their lives. Genetic factors can predispose some people to depression, especially when combined with environmental influences. Life stressors, such as chronic illness or the death of a loved one, can be triggers for depression. Use of cocaine and crystal meth can affect brain chemistry and contribute to the onset of depression. Some depressive episodes occur without any obvious trigger.
Depression has become one of the most important factors in the HIV/AIDS epidemic. Major depression increases the risk of becoming infected with HIV. People with untreated depression may attempt to “self-medicate” with alcohol and other drugs, and have more self-destructive behavior patterns, such as using crystal meth and engaging in unprotected sex with multiple partners. Concurrently, people infected with HIV are at higher risk for developing depression. This is thought to be due to several factors, including the direct effects of the virus on the brain and central nervous system, low testosterone levels (common in HIV infection), and also from the social isolation, guilt, and stress that often accompany a diagnosis of HIV. People with depression who are HIV positive are less likely to take their HIV medications, and are at increased risk for progression of their HIV disease.
Fortunately, depression is treatable. The first step in treatment is to visit your doctor for a thorough physical examination. He or she may perform lab tests to see if your symptoms have an “organic” cause (thyroid disease, diabetes, etc). When a diagnosis of depression has been established, you can discuss with your doctor what treatment option is best for you.
Aerobic exercise, when performed regularly (three times per week), can help with depression. Psychotherapy and antidepressant medications are the main ways depression is treated clinically. Cognitive behavior therapy (CBT) works to change negative thinking and behavior patterns. Interpersonal therapy (IPT) focuses more on working through troubled relationships which can contribute to depression. The most common antidepressant medications are the SSRIs (selective serotonin reuptake inhibitors) such as Prozac and Zoloft, which work to normalize neurotransmitters in the brain and improve mood. Once the medication is started, it takes about four weeks to get the full benefit, and most patients need to take the drugs for at least six months in order to minimize the risk of relapse. They are popular drugs and have helped many people with depression, but they can have serious side effects, and should be used only under close medical supervision.
For more information on depression, visit the National Institute of Mental Health website at www.nimh.nih.gov/health/publications/depression
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