Comprehensive, up-to-date information on HIV/AIDS treatment, prevention, and policy from the University of California San Francisco

If you are diagnosed with HIV, your physical health is not the only issue you have to deal with. Along with the physical illness are mental health conditions that may come up, such as depression and anxiety. Mental health refers to the overall well-being of a person, including a person's mood, emotions, and behavior.

Many people are surprised when they learn that they have been infected with HIV. Some people feel overwhelmed by the changes that they will need to make in their lives. It is normal to have strong reactions when you find out you are HIV positive, including feelings such as fear, anger, and a sense of being overwhelmed. Often people feel helpless, sad, and anxious about the illness.

Some things to keep in mind about your feelings: No matter what you are feeling, you have a right to feel that way. There are no "wrong" or "right" feelings; feelings just are. Feelings come and go. You have choices about how you respond to your feelings.

There are many things you can do to deal with the emotional aspects of having HIV. What follows are some of the most common feelings associated with a diagnosis of HIV and suggestions on how to cope with these feelings. You may experience some, all, or none of these feelings, and you may experience them at different times.

People who find out that they are HIV positive often deal with the news by denying that it is true. You may believe that the HIV test was not accurate or that there was a mix-up with the result, even after confirmatory testing shows that it is a true positive. This is a natural and normal first reaction.

At first, this denial may even be helpful, because it can give you time to get used to the idea of infection. However, if not dealt with, denial can be dangerous; you may fail to take certain precautions or reach out for the necessary help and medical support.

It is important that you talk out your feelings with your doctor, a therapist, or someone you trust. It is important to do this so that you can begin to receive the care and support you need.

Anger is another common and natural feeling related to being diagnosed with HIV. Many people are upset about how they got the virus or angry that they didn't know they had the virus.

Ways to deal with feelings of anger include the following:

		Talk about your feelings with others, such as people in a support group, or with a counselor, friend, or social worker.

		Try to get some exercise--like gardening, walking, or dancing--to relieve some of the tension and angry feelings you may be experiencing.

		Avoid situations--involving certain people, places, and events--that cause you to feel angry or stressed out. Using drugs or alcohol when you feel angry can be dangerous for you and lead to conflict or violence that might otherwise have been avoidable.

It is also normal to feel sad when you learn you have HIV. If, over time, you find that the sadness doesn't go away or is getting worse, talk with your doctor or someone else you trust. You may be depressed.

Symptoms of depression can include the following, especially if they last for more than 2 weeks:

		Feeling sad, anxious, irritable, or hopeless

		Gaining or losing weight

		Sleeping more or less than usual

		Moving slower than usual or finding it hard to sit still

		Losing interest in the things you usually enjoy

		Feeling tired all the time

		Feeling worthless or guilty

		Having a hard time concentrating

		Thinking about death or giving up

		Persistent loss of libido or interest in sex

To deal with these symptoms, you may want to:

		Talk with your doctor about treatments for depression, such as therapy or medicines

		Get involved with a support group

		Spend time with supportive people, such as family members and friends

If your mood swings or depression get very severe, or if you ever think about suicide, call your doctor right away. Your doctor can help you.

Finding the right treatment for depression takes time; so does recovery. If you think you may be depressed, don't lose hope. Instead, talk to your health care provider and seek help for depression.

Fear and anxiety may be caused by not knowing what to expect after you've been diagnosed with HIV, or by not knowing how others will treat you if they find out you have HIV. You also may be afraid of telling people--friends, family members, and others--that you are HIV positive.

Fear can make your heart beat faster or make it hard for you to sleep. Anxiety also can make you feel nervous or agitated. Fear and anxiety might make you sweat, feel dizzy, or feel short of breath.

Ways to control your feelings of fear and anxiety include the following:

		Learn as much as you can about HIV. HIV infection is now a very treatable disease and most HIV-infected people can live long, healthy lives if they seek medical care and take good care of themselves. Current HIV medications can be very well tolerated and in general do not lead to the body changes that were seen with older treatments.

		Have your questions answered by your doctor.

		Talk with your friends, family members, and health care providers.

		Join a support group.

		Help others who are in the same situation, such as by volunteering at an HIV service organization. This may empower you and lessen your feelings of fear.

		Talk to your doctor about medicines for anxiety if the feelings don't lessen with time or if they get worse.

If you are HIV infected, you and your loved ones constantly have to deal with stress. Stress is unique and personal to each of us. When stress does occur, it is important to recognize the fact and deal with it. Some ways to handle stress are discussed below. As you gain more understanding about how stress affects you, you will come up with your own ideas for coping with stress.

		Try physical activity. When you are nervous, angry, or upset, try exercise or some other kind of physical activity. Walking, yoga, and gardening are just some of the activities you might try to release your tension.

		Take care of yourself. Be sure you get enough rest and eat well. If you are irritable from lack of sleep or if you are not eating right, you will have less energy to deal with stressful situations. If stress keeps you from sleeping, you should ask your doctor for help.

		Talk about it. It helps to talk to someone about your concerns and worries. You can talk to a friend, family member, counselor, or health care provider.

		Let it out. A good cry can bring relief to your anxiety, and it might even prevent a headache or other physical problem. Taking some deep breaths also releases tension.

HIV/AIDS and some medications for treating HIV may affect your brain. When HIV itself infects the brain, it can cause a condition known as AIDS Dementia Complex (ADC). Symptoms can include the following:

		Forgetfulness

		Confusion

		Difficulty paying attention

		Slurred speech

		Sudden shifts in mood or behavior

		Muscle weakness

		Clumsiness

If you think you may have ADC:

		Don't be afraid to tell your doctor that you think something is wrong. These symptoms can be subtle in the beginning, and telling your care providers about your concerns can help them to diagnose and treat you early.

		Keep a notepad with you and write down details about your symptoms whenever they occur. This information can help your doctor to help you.

		Build as much support as possible, including friends, family, and health care providers. Although it's possible to treat ADC successfully, it may take a while for some symptoms to go away.

It is completely normal to have an emotional reaction upon learning that you are infected with HIV, such as anxiety, anger, or depression. These feelings do not last forever. As noted above, there are many things that you can do to help take care of your emotional needs. Here are just a few ideas:

		Talk about your feelings with your doctor, friends, family members, or other supportive people.

		Try to find activities that relieve your stress, such as exercise or hobbies.

		Try to get enough sleep each night to help you feel rested.

		Learn relaxation methods such as meditation, yoga, or deep breathing.

		Limit the amount of caffeine, nicotine, alcohol, and recreational drugs you use.

		Eat small, healthy meals throughout the day.

		Join a support group.

There are many kinds of support groups that provide a place where you can talk about your feelings, help others, and get the latest information about HIV/AIDS. Check with your health care provider for a listing of local support groups.

More specific ways to care for your emotional well-being include various forms of therapy and medication. Used alone or in combination, these may be helpful in dealing with the feelings you are experiencing. Therapy can help you better express your feelings and find ways to cope with your emotions. Medicines that may be able to help with anxiety and depression are also available.

You should always talk with your doctor about your options. There are many ways to care for your emotional health, but treatments must be carefully chosen by your physician based on your specific circumstances and needs.

The most important thing to remember is that you are not alone; there are support systems in place to help you, including doctors, psychiatrists, family members, friends, support groups, and other services.