According to the National Institute of Mental Health (NIMH), people who are HIV positive are twice as likely to be depressed as people without the virus. Compounding the problem, people with HIV may withdraw from friends and family as a way of hiding their physical and emotional issues. Doctors at NIMH and around the country now recognize that HIV itself may contribute to mental health problems because the virus can spread to the brain. Unfortunately, some of the antiretroviral therapies (ART) used to control HIV and acquired immunodeficiency syndrome (AIDS) can trigger symptoms of depression, too.
Coping With an HIV Diagnosis
Once you’ve received an HIV diagnosis, you’re going to need to figure out how to deal with it on a number of levels. Many clinics offer post-test counseling, during which a health professional or public-health worker can discuss the HIV resources available to you, offer advice on how to talk with current and previous sexual partners, and help you understand the best ways to care for yourself. At first, it will be hard to absorb all this information, but if you find a way to focus, you’ll improve your chances of moving forward in a healthy way. Everyone uses different coping strategies, and you’ll know that your approach is effective when any feelings of depression or anxiety begin to dissipate. “Where people get into trouble is if their coping strategies aren’t working and their distress persists,” says the psychologist Mallory O. Johnson, PhD, a professor of medicine at the University of California in San Francisco. “Some people turn to very negative, harmful forms of coping — substance abuse is one. How people cope is central to how they function, and how they function is important to how they approach their HIV and get involved in their own treatment.” In other words, the better you’re able to cope with the news of your HIV diagnosis, the more likely you are to be successful with your treatment.
Reach Out to Others for Support
Many people with HIV have a very hard time figuring out whom to tell about their diagnosis. The best person to approach first, says Dr. Johnson, is someone whose response you can more or less expect will be supportive. Often these are people who have had a personal experience with HIV, but they can also be close friends or coworkers. It’s important to find at least one person you can confide in about your HIV status. “Just talking with someone can help alleviate emotional distress so you can become more focused on solving problems,” says Johnson. After you open up to at least one person, find someone else who can offer practical insight, including information about doctors, clinics, and treatments (including side effects). For many people, this means joining a local or online support group. “If someone finds they don’t know anyone living with HIV or they haven’t told people about their own HIV status, it can be very challenging,” Johnson says. “Try to get linked up with a support group if that’s an option. This helps to normalize the experience, to get perspective from other people who are dealing with it.” Note that in the United States, many states and some cities have partner-notification laws. This means that if you test positive for HIV, you or your healthcare provider must tell your current or past sexual or needle-sharing partners. For help locating an HIV support group, ask your doctor or a social worker if there are any groups nearby. Many people have luck finding help through Meetup groups for people with HIV or through faith-based organizations such as churches and synagogues. Learning about the experiences of other people living with HIV through podcasts and other recorded interviews can be comforting, uplifting, and make you feel less alone.
HIV, Denial, and Unhealthy Coping
Many unhealthy coping strategies can tempt you after your initial diagnosis — for example, using alcohol or illegal drugs, having unsafe sex, or not getting treatment. It can be challenging to overcome denial about HIV. The problem is that people with this diagnosis are often afraid of losing friends and family because of the stigma attached to HIV. “It’s very easy to be in denial about something where there’s a heavy stigma associated with it,” says Johnson. “Aside from the health consequences, there’s the societal aspect that makes it that much easier to avoid talking about.” And while it’s fine to be selective about who knows your HIV status, Johnson says you have a moral obligation to let your sexual partners know if you have the virus. Your situation will determine how and when you do this, and post-HIV-test counseling can usually offer helpful guidelines. “There’s not a one-size-fits-all approach,” Johnson notes. “Imagine a situation where a woman tests HIV positive, and she’s in what she thought was a monogamous relationship with the same man for 10 years. Then compare that to the situation of a woman who is a sex worker.” If you have concerns about how to start an especially difficult conversation, talk with a friend or a therapist to get some help. After the initial shock of receiving an HIV diagnosis, you may need some assistance with how to cope and how to build your HIV support network. Both are essential to successful HIV treatment, so it’s best to get started as soon as you can.
Groups That Provide Emotional and Psychological Help
If you’re HIV positive, it’s important to remember that you are not alone. There are many organizations, professionals, and volunteers offering help. Start with some of the resources below and see what feels right to you.
The Health Resources and Services Administration (HRSA) keeps an online listing of state-specific HIV hotline numbers.Find help lines and counseling programs located near you by searching the Substance Abuse and Mental Health Services Administration (SAMHSA) website. You can search by zip code to find community health centers and specialists in your area.Call the HIV Health InfoLine, which is run by an advocacy group named Project Inform. (This is a call-back service: Leave a message and your call will be returned.) Their staff, many of whom have HIV themselves, can give you insight and support.San Francisco Suicide Prevention operates a number of phone hotlines and textlines that are staffed 24 hours a day, seven days a week, by volunteers who are trained to help anyone (suicidal or not) in need of emotional support. Resources include the Crisis Line (415-781-0500 or 800-273-8255) and the HIV Nightline (415-434-2437 or 800-273-2437) and Textline (415-200-2920).
