Positive Living Association (PLA)
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HIV/AIDS and Mental Health

Clinical psychologist- Murat Yüksel

e-mail: murat.yuksel@pozitifyasam.org

If you are HIV+, you are recommended to take care to your mental health as well as your physical health. Mental health is mainly wellness of person's mood and behaviors.

The problems people living with HIV experience are due to the features of people around them and time the person living in. In 80's, the first diagnosis of HIV was not only a "medical tragedy", but also a "psychological tragedy". By this time, a lot of information was learned and thanks to new medicines, a healthy and long life was provided. Medical authorities claim HIV is not a fatal disease. On the contrary, it is a chronic illness like diabetes. However, the prejudice and myths about HIV could not change as fast as these medical developments. If you do not have any information about HIV/AIDS beforehand, you will behave, feel or think as affecting from these societal prejudices.

A lot of people are surprised when they got the positive diagnosis of HIV. Most of them may think that the changes which they have to practice in their life are very difficult. It is very normal you to be afraid, to be angry or to be shamed as a result of HVdiagnosis. Most people may feel hopeless and sad. Moreover they may worry about the illness.

The things you have to keep in mind about your feelings:

  • You have right to feel whatever you feel.
  • There is no "right" or "wrong" feeling.
  • Emotions are changeable.
  • You can chhose how to react to your feelings.

You have a lot of things to do about your emotional reactions when you learn that you are HIV+. Below, you can find common problems people face with when they get the positive diagnosis, and suggestions to deal with these difficulties. You may feel some or all of them, or you do not feel any of them. Moreover, whereas you can feel these at the same time, you can feel them at various times.

Denying

When a person learna that he/she is HIV+, he may choose to deny this condition in order to cope with this situation. He may think that the diagnosis is not his own test result. These first reactions are normal and natural.

At first, denying this result may even help you, because it will help you to gain time to adjust the idea that you are infected with HIV. Denying can be very dangerous in some ways: It may prevent you from taking medical treatment or other precautions. Researches showed that people living with HIV may impose a lot of meanings to HIV and it increases the fear level of them. So, they probably have difficulties with adjusting to the life with HIV. On the other hand, some people may not care about this situation sufficiently. These people accept that they are HIV+, but they avoid making essential changes to protect their physical and mental health in their lifestyle. Moreover they do not obey the rules which their doctor advise and hinder the treatment. As a conclusion, we can say that paying no or much attention to HIV/AIDS may lead problems.

At this point, talking about your feelings and life to a friend, relative or your doctor is very important. By this way, you can get the help you need.

Anger

Anger is a feeling which commonly seen after getting the positive result of HIV test. Most people get angry because of thinking about how they got the virus or not being aware of HIV untill they have the test result.

You can deal with anger by:

- Talking to other people about your feelings, joining a support group or getting help from a psychologist.

- Doing exercise in order to decrease your tension and anger.

- Being far away from the people and places that make you angry for a while.

Sadness and Depression

It is normal you to be sad when you learn that you are HIV+. However, if the case is getting worse, you can talk to your doctor or relative/friend and request help. If you have these symptoms for 2 weeks or much, you may be in depression:

  • Feeling sad, anxious or hopeless,
  • Gaining or losing weight
  • Sleeping more or less than general
  • Losing interest for activities you generally enjoy
  • Feeling tired most of the time
  • Feeling guilty or worthless
  • Having difficulty in concentrating
  • Thinking about death, harming himself or comitting suicide

If you feel that these symptoms are like yours, you should get help. However, do not forget that only a psychologist can understand that whether these symptoms' are result from depression, HIV or other diseases. Try to talk to your family, friends or partner about this issue. If you think that you need professional help, you can apply to Positive Living Association and communicate with your doctor.

Nobody will think that you are "weak" or "mad" because of going to a psychologist. Depression is a curable psychological problem.

Fear and Anxiety

After getting positive result of HIV test, not to know what to do or not being able to predict other people's reactions towards you may cause you to feel fear or anxiety intensively. Declaring that you are HIV+ to your family or friends may frighten you.

Fear may cause you to have difficulty while sleeping and to increase heartbeat. Anxiety will result in feeling angry and agitated. Sweating, dizziness or difficulty in breathing will occur because of fear and anxiety.

You can control fear and anxiety by doing these;

  • Learn any information you can know about HIV/AIDS
  • Talk to tour family and friends about your feelings
  • Join in a suppurt group
  • Help people who are in same condition as you. This will reduce your fear and make you feel stronger.
  • If these emotions continue, or get more, get help from a psychologist.

Stress

After getting the positive result for HIV test, how you deal with stres becomes very important for your physical and mentak health. The reasons which cause stress are personal. That's why, when you feel stressful, defining this situation and finding out the solutions are necessary. In order to find solutions, you can share your feelings with family members; friends or you can get professional psychological support. Do not forget that when your reactions are very intensive, you need to get help. By help, you can solve your problems. Thus, you can understand how stress affects you and you can find personal solutions to get away from stress. You can also use these ways for dealing with stress:

  • Physical activities: When you feel angry or nervous, you can do physical exercise.
  • Have rest as muc as you need and take care of your nutrition. If your physical conditions are not good enough, you will have difficulty with dealing with stress. You need going to psychologist if you can not sleep because of your stress level.
  • Talk about your emotions. Talking about your anxiety or fear will help you. You can talk to your family members, friends or a psychologist.
  • Let yourself express your feelings. Sometimes crying decreases anxiety and also may prevent headache or other physical problems. Deep breath also reduces anxiety.

  

Some Suggestions For Mental Health

It is normal you to have anxiety, temper, shame, depression after getting HIV+ result. These feelings do not continue forever. These reactions are natural and understandable after diagnosis results. If these feelings continue for a long time and they are strong, it means that there is a problem and you need proffessional help.

  • To satisfy your emotional needs, you can do several things:
  • Talk to your doctor, relatives or friends about your feelings
  • In order to deal with stress, do exercise or spend time on your hobbies.
  • Sleep enough to feel fresh
  • Try using breath tehniques, meditaiton or yoga so that you can relax.
  • Reduce the caffeine and nicotine amount you use
  • Have a balanced diet
  • Join a support group

Another specific way to protect your mental health is a combination of psychotherapy and medicine. According to your disturbance, one of these techniques or both of them may be used in order to cope with this situtaion.

You have to talk to your doctor about alternatives immediately. There are various ways to protect your mental health; but, the way of treatmenr must be determined according to your needs by your doctor.

Above all, do not forget that you are not alone!

How to Overcome Fear and Shame
When You Have Positive Test Result
By Brenda Calderon

Summer 2001

After obtaining the HIV positive test result, nearly everyone will face with these two feelings: fear and shame. Some people may not be very familiar with these feelings while others may be painfully familiar with them. I think it depends on our own life experiences. Many PLHIV have to analyze their feelings. The first thing that many of us feel when we receive an HIV positive test result is "fear."

Many misconceptions and issues related to HIV/AIDS may already be in our minds. For example, "AIDS equals with death, sickness, rejection, hostility from others, stigma and judgement (and many more)" sentence is not true.

Many of us feel shame because we are convinced of believing that we have made some mistakes, so we are HIV infected.

Since we're already feeling shame and fear, this brings up other feelings inside of us. For example, anger, anxiety, helplessness, and sorrow are all very common with a diagnosis of HIV.

HIV/AIDS have various meanings for every person. Information about HIV was not an interesting learning topic for me. Like most people, I didn't care about it, I didn't want to know. Of course, because I felt that I was not at risk.

Who wants to be HIV positive? I don't know anyone who has tested HIV positive who actually wants to have this disease. I don't know anyone who has tested HIV negative and who wants to have this virus either. I have asked HIV negative and positive people whether they want to have HIV. The fact is that I have not found one individual that would answer "Yes, I do want HIV."

Some HIV-diagnosed women, whether they are newly diagnosed or have been living with HIV for many years, may still be experiencing shame and fear and do not know how to feel better, nor can they overcome these feelings. They may need extra support from their peers or professional therapy.

I called one of Women Alive's mental health consultants (Renee Mosley) to obtain some information about these feelings. Her advice was to recognize that every person is different. The levels of fear and shame may be related to our life experiences, and also the things we have been told since we were children.

These feelings are generally part of our lives; they do not only result from this particular health issue. However, geting HIV+ result can make these feelings harder and so may be more difficult to overcome. In my life, I have always followed positive advisers, and this has helped me to deal with many changes that I have experienced. HIV came into my life at a very difficult time that I could not get emotional support from my family, friends, peers and my therapist. You can find positive resources and people that may help you.

These positive resources may be church, meditation, a relationship with a partner or prayer. It is different for everyone.

Some people may deny their cases, and this may be a way of overcoming fair and shame for them. The only thing that we should about HIV is our health. We cannot act or live for others, but I think we can take positive advices of them.

When you are ready, take the step to face with these feelings and win the fight.

(From Women Alive Magazine- 2001)

 

Sharing With Others That You Are HIV+

Is it a good idea to share this information with others?

You may think that you are only person who has to answer this question, but most of the people living with HIV had to do it.

After learning the positive diagnosis, you will have difficulty with sharing this information with others. Because of the societal prejudices, you may not be able to share your HIV situation even with your family and very close friends. Societal prejudices are based on the idea that there is a strong relationship between HIV and stigmatized social groups (homosexuals, sex workers, intravenous drug users). Even you are not from one of these groups, when you share your position with someone, you will be afraid of being included to those groups in that person's mind. Homosexuals who have to hide their sexual orientation from their families or friends may worry about that explaining their health status means explaining their sexual orientation.

Here, our aim is not advise you to do something; instead, giving some suggestions you may consider on.

Sharing that you are HIV+ may be a good idea; because,

You can get support about your health.
You inform your family or friends about this situation, and they will get farther information about these issues.
You do not have to hide this case from people
You can reach the suitable treatment for you.
You minimize the risk of infection of HIV to others.

Sharing that you are HIV+ may not be a good idea; because

It may be difficult to accept your health condition.
You may be stigmatized or discriminated by some people.
You may be rejected in some social environments or dating offers.
You do not have to inform everyone about that case.
Before deciding to say whom or how, give time to yourself to make sure that you are ready to do this speech.

When you think that you will say that you are HIV+,

Think about why you are going to say it to him/her and what you expect to happen after that,
Try to imagine the reactions after the speech and think about the best and worst reactions.
Get ready to inform the people that you shared this information. Give them the brochures, articles and PLA's contact information and you can provide that your family or friend support from PLA.
Get help about from your doctor or psychotherapist how to say it.

Ragard the reactions, you cannot control people's reactions.

Special Cases

Sexual Partners: It may seem very difficult to say that you are HIV+ to your partner. However, after being informed, your partner can have tests and may prevent or treat the illness, this case will help you.

Family Members & Relatives: It will be very difficult to decide whether to say the case to your family. A lot of HIV+ people are hesitate because they are afraid to make their family sad or angry. Some HIV+ people think that if they do not share this case with their families, the relationship between family and them will weaken, and they will not be able to get love and support they need from their family. Family members may want to learn how you have been infected. Before the speech, deciding whether to say or not to say the infected way will help you. Family members will also want to know if there are people that care for you, there is a reliable health support and you look after yourself or not.

Health Workers: It is your choice to say that you are HIV+ to any of health workers who provides service for you. Every health worker is in charge of taking the precautions while servicing. However, your dentist and other health workers had better knowing the case while giving you the suitable service.

Social Relationships: Meeting new people or dating with someone seem very threatening and difficult experiences to people living with HIV. These people will avoid talking about being HIV+ with their partners, because they are afraid of being rejected. Please do not forget that every individual and event is different from each other. A negative experience about these realtionship can not be a sign of other similar experiences. Remember that unless there is an infection way (sexual relationship etc.) you don't have to say that you are HIV+. In romantic relationships, sooner or later, HIV issue will be an important topic to talk. To be able to talk, allow yourself some time and do the speech when you are ready. Do not forget the more you postpone the talk, much more difficulty you have.

Getting Help: To be able to share that you are HIV+, getting help from PLA, your doctor or other people living with HIV; by analyzing theses, you can find the suitable way to express yourself and the case easily to the people around you. Societal prejudices and myths are some obstacles for HIV+ people to share the case with their families and friends. These obstacles may keep you away from realities while you are thinking about the reactions you will get after sharing. The social support you get from your family, friends and your partner will be the most important component that makes you powerful in this long way.

Information collected from: www.aids.org


Ten Things You Can Do to Enhance Your Emotional Well-Being

  1. Build a strong, supportive, trusting relationship with an HIV/AIDS doctor. You should be able to freely discuss everything with your doctor.
     
  2. Develop consistent contact with a health care case manager who can help to make the rocky road to benefits and services easier for you. One mold does not fit all, so try to find a case manager that you trust, even if you have to switch to a new one.
     
  3. Join an HIV/AIDS support group. Find out if they use an ongoing, drop-in format or if they are time-limited and require pre-enrollment. Also find out about the training and qualifications of the group leaders.
     
  4. Get a therapist, preferably a good licensed psychologist or certified social worker. Remember anyone can state they are a "therapist"; request more information about their background and experience. Keep looking until your instincts tell you that you have found a good match.
     
  5. Attend workshops or other HIV/AIDS events so that you can find out as much as you can about HIV/AIDS. You must be the expert on this disease and be on top of any new developments and programs.
     
  6. Stay informed about your HIV/AIDS medications by seeking out information from any and all sources, including people, Web sites, and periodicals. The more you know about the medication you are taking and its potential side effects, the more you know what to expect about your emotions and mental well-being.
     
  7. Address any substance use issues you may have by looking into substance use programs and groups. Consider working towards being clean and sober.
     
  8. Exercise regularly and maintain good nutrition because the mind and the body are closely linked, and physical health enhances mental health.
     
  9. Work if you can for income but also work for the structure and well being that employment can provide. Everyone can benefit from structure, and we all need to feel we are productive members of this world.
     
  10. Seek a sense of belonging outside of HIV/AIDS such as by starting a hobby, traveling and exploring, getting a pet, starting or finishing school, or volunteering. The bottom line is to keep your stress low; keeping your stress low will help you to keep your immune system high.

J. Buzz von Ornsteiner, Ph.D., is a New York State-licensed psychologist and author of the "Psychologically Speaking" column in Body Positive Magazine.






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