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Coping with HIV/AIDS: Mental Health
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Overview
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Denial
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Anger
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Sadness or depression
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Fear and anxiety
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Stress
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HIV-associated neurocognitive disorders (HAND)
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Coping tips
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Resources
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Overview

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 have strong reactions when they find out they 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. These feelings are normal. With time, hopefully, these feelings will fade--although we are not able to cure HIV we do have excellent treatments, and people with HIV can lead long and full lives. But HIV can have a major impact on many parts of your life. People with HIV and those close to them are subject to many things that may affect their mental health.

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/AIDS. What follows are some of the most common feelings associated with a diagnosis of HIV/AIDS 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.

Denial

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 came out wrong or that there was a mix-up of test results. 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 health care providers or someone you trust. It is important to do this so that you can begin to receive the care and support you need.

Anger

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.

Sadness or depression

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

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

Fear and anxiety may be caused by not knowing what to expect now that you've been diagnosed with HIV, or not knowing how others will treat you after 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.
Get 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 or other treatments for anxiety if the feelings don't lessen with time or if they get worse.

Stress

If you are HIV infected, you and your loved ones may have to deal with more stress than usual. 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-associated neurocognitive disorders (HAND)

HIV/AIDS and some medications for treating HIV may affect your brain. When HIV itself infects the brain, it sometimes can cause problems with thinking, emotions, and movement. Symptoms of HIV-associated neurocognitive disorders (HAND) can include the following:

Forgetfulness
Confusion
Difficulty paying attention
Sudden shifts in mood or behavior
Muscle weakness
Clumsiness

If you think you may have HAND:

Don't be afraid to tell your doctor that you think something is wrong.
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 HAND successfully, it may take a while for some symptoms to go away.

Coping tips

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 and nicotine 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 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.

Resources

AIDS.org: Telling Others You Are HIV Positive
Issues and guidelines about telling family members, friends, and others that you are HIV positive.
American Academy of Family Physicians: HIV: Coping With the Diagnosis
Q and A about coping with fear, legal issues, and other information.
The Body: Mental Health
Articles and links on depression, anxiety, stress, relationships, and other mental health issues.
The Body: AIDS Hotlines and Organizations
A comprehensive listing of HIV/AIDS hotlines and organizations, including a state-by-state breakout of HIV/AIDS organizations and support groups.
HIV InSite Links: Hotlines
HIV InSite Links: Mental Health
Links to organizations and other resources dealing with depression, anxiety, stress and other mental health issues.
Pets Are Wonderful Support (PAWS)
A non-profit organization that focuses on pets as a way to improve the mental health and well-being of those most vulnerable in the community. Includes information on health issues and international list of organizations.