Depression in the Gay Community
Anyone, regardless of age, gender, race, or socioeconomic status can suffer from depression. However, studies show that gay men and lesbians are more likely to suffer from depression than heterosexual men and women.1,2 A survey of households throughout the United States found that individuals who reported 1 or more same-sex partners in the past 5 years experienced higher rates of mental disorders, including anxiety and mood disorders.3
Part of the reason may have to do with the stress and feelings of isolation related to homophobia-both internal and from society at large. Researchers at the University of California at San Francisco found that the major risk factors for depression in gay and bisexual men included a recent experience of anti-gay violence or threats, not identifying as gay, or feeling alienated from the gay community.2
The good news is that depression is treatable. Regardless of the cause, screening for depression is an important first step you can take on your own and in the privacy of your own home. If you think you may be experiencing symptoms of depression, take the Depression Self-Screener and start taking charge of your mental health today.
HIV/AIDS and Depression
Dealing
with the diagnosis or the threat of HIV/AIDS is of special concern to
many in the gay community. Some studies have found that symptoms of
depression are more common among gay men with HIV.4 Research
also indicates that gay men who are depressed may be less likely to
practice safe sex and thereby increase their risk of HIV infection.5
Many think that experiencing symptoms of depression is an inevitable result of being diagnosed with a chronic condition such as HIV or AIDS. While the conditions may occur simultaneously, depression is a separate condition that needs its own treatment. 6 The good news is that if depression is appropriately treated, it may provide an additional benefit to HIV/AIDS treatment. 6
If you have HIV, AIDS, or any other chronic disease and think you may be experiencing symptoms of depression, take the Depression Self-Screener. Depending on your results, consider sharing them with your doctor so he or she can provide you with a proper diagnosis and help you find an appropriate treatment therapy.
References: 1. Cochran SD, Sullivan JG, Mays VM. Prevalence of mental disorders, psychological distress and mental services use among lesbian, gay, and bisexual adults in the United States. J Consult Clin Psychol. 2003;71:53-61. 2. Mills TC, Paul J, Stall R, et al. Distress and depression in men who have sex with men: The Urban Men's Health Study. Am J Psych. 2004;161:278-285. 3. Gilman SE, Cochran SD, Mays VM, et al. Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey. Am J Public Health. 2001;91:933-939. 4. Penedo FJ, Antoni MH, Schneiderman N, et al. Dysfunctional attitudes, coping, and depression among HIV-seropositive men who have sex with men. Cogn Ther Res. 2001;25:591-606. 5. Rogers G, Curry M, Oddy J, et al. Depressive disorders and unprotected casual anal sex among Australian homosexually active men in primary care. HIV Med. 2003;4:271-275. 6. National Institute of Mental Health (NIMH). Depression and HIV/AIDS. NIH Publication No. 02-5005. May 2002.
IMPORTANT SAFETY INFORMATION: Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Antidepressants increased the risk of suicidality (suicidal thinking and behavior) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of antidepressants in children, adolescents or young adults must balance the risk to clinical need. Patients of all ages started on antidepressant therapy should be closely monitored and observed for clinical worsening, suicidality or unusual changes in behavior, especially at the beginning of therapy or at the time of dose changes. This risk may persist until significant remission occurs. Families and caregivers should be advised of the need for close observation and communication with the prescriber. Lexapro is not approved for use in pediatric patients.
Lexapro is contraindicated in patients taking monoamine oxidase inhibitors (MAOIs), pimozide (see DRUG INTERACTIONS: Pimozide and Celexa), or in patients with hypersensitivity to escitalopram oxalate. As with other SSRIs, caution is indicated in the coadministration of tricyclic antidepressants (TCAs) with Lexapro. SSRIs and SNRIs (including Lexapro) and other psychotropic drugs that interfere with serotonin reuptake may increase the risk of bleeding events. Concomitant use of aspirin, NSAIDs, warfarin and other anticoagulants may add to the risk. Patients should be cautioned about these risks. SSRIs and SNRIs have been associated with clinically significant hyponatremia. Elderly patients or patients taking diuretics or who are otherwise volume-depleted appear to be at a greater risk. Discontinuation of Lexapro should be considered in patients with symptomatic hyponatremia and appropriate medical intervention should be instituted. The most common adverse events with Lexapro versus placebo (approximately 5% or greater and approximately 2x placebo) were nausea, insomnia, ejaculation disorder, somnolence, increased sweating, fatigue, decreased libido, and anorgasmia.
