HIV

Mental Health and HIV: Entire Lesson

Mental health refers to the overall well-being of a person, including a person's mood, emotions, cognition and behavior.

Many people have strong reactions when they find out they have HIV, including feelings such as fear, anger, and a sense of being overwhelmed. Often people may feel helpless, sad, and anxious about the illness, despite knowing that HIV can be effectively treated. People might also have negative thoughts related to the stigma of an HIV diagnosis. These feelings and thoughts are normal. With time, hopefully, these will fade.

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

When diagnosed with HIV, people sometimes deal with the news by denying that it is true. You may believe that the HIV test was wrong or that there was a mix-up of test results. This is a natural and normal first reaction.

If not dealt with, denial can be dangerous. You may fail to take certain precautions or start HIV medications right away or reach out for necessary help and medical support.

It is important that you talk about your feelings with your VA health care provider 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. Many of these feelings and thoughts are often related to feelings of helplessness and being overwhelmed with the new diagnosis.

Ways to deal with feelings of anger and other challenges include the following:

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

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 provider. You may need treatment for depression.

Symptoms of depression can include the following, especially if they last for more than two 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 provider about treatments for depression, such as therapy or medications.
• Start HIV treatment, if you haven't done so already. Taking this positive step for your own health may help with depression.
• Join 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 provider or the Veterans Crisis Line (1‑800‑273‑8255 and Press 1 or text to 838255) right away. No matter what you are experiencing, there is support for getting your life back on track.

Finding the right treatment for depression takes time — so does recovery. If you think you may be depressed, talk to your VA provider and seek help for depression.

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 have HIV.

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. Others experience anxiety and fear by avoidance behavior or feeling paralyzed and overwhelmed.

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

• Talk to your provider about treatments for anxiety if the feelings don't lessen with time or if they get worse.
• Learn as much as you can about HIV.
• Start HIV treatment (antiretroviral therapy, or ART). Taking action to control HIV will protect your health and the health of sex partners, and this in turn may lessen your fears about the future.
• Get your questions answered by your VA health care provider.
• 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.

If you have HIV, 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 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.

• 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 provider for help.
• 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.
• Talk about it. It helps to talk to someone about your concerns and worries. You can talk to a friend, family member, counselor, or VA health 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 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 VA health care provider that you think something is wrong.
• Keep a notepad with you and write down 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.

For additional information, see the Cognitive Symptoms and HIV Fact Sheet, which you can bring with you to your health care appointment.

It is completely normal to have a negative reaction when you are diagnosed with HIV. These reactions do not last forever. As noted in this lesson, there are many things that you can do to help take care of your mental health needs. Here are just a few ideas:

• Start HIV medications (ART) right away — an effective ART regimen will improve and protect your health, and protect your sex partners, and the knowledge you are taking this positive step may improve your feelings about yourself and the future.
• Talk about your feelings with your providers, 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 like 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. Check with your VA health care provider for a listing of local or virtual support groups. Some VA medical centers have support groups available at the clinic or hospital.

More specific ways to care for your emotional well-being include various forms of therapy and medication. Used by themselves or in combination, these may help you deal with the symptoms you are experiencing. Therapy can help you better express your feelings, negative thoughts, and unhelpful behaviors and find ways to cope with your experiences. Medications may help with managing these symptoms.

You should always talk with your provider about your options. There are many ways to care for your emotional health, but treatments must be carefully chosen by your VA provider 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, psychologists, social workers, family members, friends, support groups, and other services.

• Veterans Crisis Line Connect with the Veterans Crisis Line to reach caring, qualified responders with the Department of Veterans Affairs. Many of them are Veterans themselves.
• The Healing Arts
  Veterans share their artwork and their experiences using art therapy to express their feelings.
• The Body: Mental Health
  Articles and links on depression, anxiety, stress, relationships, and other mental health issues.
• Depression
  An overview of depression from the National Institute of Mental Health. Includes discussions of the various forms of depressive disorders, signs and symptoms, risk factors, and treatments and therapies.