Depression

There is a strong link between HIV and depression. Clinical depression is a medical condition caused by biochemical disorders that interfere with normal functioning and can, in some cases, lead to death from suicide. It is distinct from 'depression’ as short-lived, unhappy feelings that may be linked to a particular event. Some of these symptoms may be induced by HIV disease itself or by HIV medications.

In addition, many recreational drugs can both cause depression or anxiety and be used as ‘self-medication’ by people suffering from them.

Drug-related depression can be caused by alcohol or alcohol withdrawal, amphetamines, cocaine, ecstasy, crystal, cannabis and ketamine. There is a lack of adequate scientific data about the relationship between depression and recreational drug use, however, there is significant understanding based on clinical experience.

The drug ecstasy affects the serotonin system, the same neurotransmitters that are affected by antidepressants. There is growing evidence to suggest that ecstasy may have very long-term effects that may ultimately bring on depression and anxiety problems. For some individuals, it may not take much ecstasy use for this to occur.

Depression may lead an individual to seek relief in the use of alcohol or other recreational drugs. In turn, these drugs may cause or exacerbate depression. If antidepressants are used with recreational drugs, it will decrease the users chances of getting better. It is therefore important for users to seek help in reducing drug use as well as getting direct treatment for the depression.

Individuals who have experienced physical and sexual assaults may be more susceptible to use alcohol and / or illicit drug use as a way of coping, and this can have a detrimental effect on the health of people who are HIV-positive. The role of trauma in HIV is only just starting to be explored. However, if sexual abuse is the route of transmission of HIV this can make it more difficult for an individual to come to terms with their diagnosis.

Psychosis

Psychosis is defined as a state of mental illness in which the subject has lost insight into their own thought processes. Whereas people suffering normal or ‘neurotic’ depression or anxiety will be only too well aware that they have a problem, psychotics attribute symptoms to influences outside themselves. Psychosis is most commonly caused by schizophrenia, but is also seen in severe bipolar illness (manic-depression).

For links between cannabis and psychosis, see under cannabis above; other hallucinogens like LSD can also precipitate psychosis, especially in young people and those with a predisposition to it.

References

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