It’s not uncommon for gay and bisexual men to experience mental health issues. In fact one-in-three of us will face some sort of mental health issue. However, as a gay/bi man newly diagnosed with HIV, your chances of experiencing mental health issues such as depression increase to one-in-two. And that is OK.

For many gay men, being diagnosed with HIV, can be life changing. You go from life as a HIV-negative man to life full of ‘what ifs’, buts and not knowing what life will have in store for you. It’s only natural that as a newly diagnosed person you might feel down and then experience issues such as depression.

What exactly is depression?

Depression in its medical sense isn’t the occasional sad feelings that we all get. The feelings of ‘clinical depression’, as it is known, happen when certain chemicals in your brain stop functioning properly, or are not there in sufficient quantities. What causes these chemical imbalances is unclear, and is the cause of much debate. External factors such as traumatic experiences, such as a being diagnosed with HIV, can trigger depression, but sometimes depression can happen with no apparent triggers at all. It may be a combination of things, stigma, low self-esteem and medication side effects.

Depression can be really debilitating, but it is treatable. There’s no need to suffer in silence, although often making that first step in going to speak to your GP or HIV doctor can be very difficult. Many people find that once they do make this step, things can really start to improve. Remember that depression is nothing to be ashamed of and it’s very common these days.

Depression isn’t something that you should be expected to just ‘snap out’ of by yourself. It’s a real medical condition, just as a broken arm is a real medical condition. No-one would expect you to mend a broken arm on your own, so in the same way no-one, including yourself, should expect you to mend your depression on your own. 

One of our volunteers explained his experience for us. Simon told us:

“When I was diagnosed with HIV, I thought I was fine. I took the information with me, I booked my appointments to get my new medication and I told some of my close friends about it so I had a support network. Then one day I was on the bus to work and I suddenly started crying and I couldn’t stop. I had no idea what was going on or why I was crying. I made an appointment with my HIV doctor and he diagnosed me with depression. He told me that bottling up emotions, especially after being diagnosed, can bring on bouts of depression. He said this was very common. And he was correct. I had bottled up all my emotions to show that I was not phased by the diagnosis. This was the wrong thing for me to do and it ended up with me being depressed. Luckily, with the support of my doctor I was put on medication and now I feel fine.”

How can I tell I’m depressed?

 You may have noticed a change in the way you’re responding or feeling about things. The following points are indications that it could be depression:

• Persistent sadness, lasting two weeks or more.
• Loss of interest in your favourite things.
• Finding no fun or enjoyment in life.
• Loss of self-confidence.
• Feeling guilty, bad, unlikeable, or not good enough.
• Feeling empty inside.
• Feeling useless or unable to cope with life.
• Feeling bored all the time.
• Increased feelings of anxiety.
• Inability to see a future for yourself.
• Thinking everything is pointless.
• Thinking life is not worth living.
• Thoughts of death or suicide.
• Wanting to go to sleep and never wake up again.
• Especially low mood in the mornings.
• Feeling more irritable, frustrated, or aggressive than usual.
• Trouble concentrating on things, poor memory.

Other signs may include:

• Loss of energy, feeling tired all the time.
• Changed sleep pattern – difficulty getting to sleep, bad nightmares, waking in the night, waking up too early, or sleeping much more than usual.
• Spending less time socialising with friends or family.
• Loss of sexual desire.
• Changed eating pattern – loss of appetite, weight loss or comfort eating.
• Getting lower grades than usual at school, college, or university.
• Not going to school/college/work, or becoming disruptive.
• Becoming a hypochondriac, worrying lots about illness.
• More headaches, backaches or stomach aches than you normally get.
• Turning to alcohol or drugs to try to make yourself feel better.

If you recognise some of these symptoms, or if you’re having feelings you can’t cope with, the best thing to do is contact your GP.

HIV and medication

 Some of the symptoms of depression can be caused by side effects of anti-HIV drugs. This is why it’s a good idea to speak to your doctor at your clinic so they can assess whether this could be what’s happening, and to work out whether to try changing your HIV treatment.

How can I treat depression?

Whatever the reason for it, most depression is treatable. The first step would be to go and see your GP or HIV doctor who will be able to assess what would be the best treatment for you

This first step can seem like a really hard thing to do. You may feel that you’re wasting people’s time and that people won’t be interested. However, it’s important to remember that these feelings are actual symptoms of depression in the first place.

Treatments can range from talking therapies, such as counselling or cognitive behavioral therapy (CBT), to drug treatments, such as anti-depressants, or a combination of both. What treatment you eventually decide to take will depend on how severe your depression is, what your doctor recommends after your assessment, and how you feel about the different options.

If you really don’t think you are able to talk about how you are feeling, remember that what you are going through is real, and that you are not making it up. This is a very common condition and going to see your doctor, however hard it is, really is the most important step you could make.

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I need help now

If you feel like you are in crisis and need help right now, going to see your GP or HIV doctor as soon as possible would be a good place to start. If you are in fear for your life and need to see a medical professional immediately then you could go to your local Accident and Emergency department and ask to see the duty psychiatrist. If you decide to do this try to take a friend with you so you won’t be on your own whilst waiting to be seen.

If you are in crisis and would prefer to talk to someone right now, Samaritans is there for you no matter where you are or what age you are. Samaritans provides confidential, non-judgmental support, 24 hours a day for people experiencing feelings of distress or despair, including those which could lead to suicide. Call: 08457 90 90 90, or email: [email protected]

You can also contact the LGBT switchboard on 0300 330 0630 or switchboard.lgbt, or find details of one-to-one counselling services on the NHS website: www.nhs.uk/counselling.