Your mental health describes how you think about yourself and your life on a day-to-day basis. It is about how you interact with your surroundings and the people around you.
From a medical perspective, mental health covers a wide range of symptoms. These include depression and anxiety that can range from mild (which are easy to manage) to moderate and severe (when they dominate your life).
Most people have times when their mental health is fragile. Life involves stress, and stress can change your mood and ability to cope with difficult situations.
If difficulties continue over time, this can increase the risk of other medical problems, including adherence to meds. Getting appropriate help and support is important, and the earlier the better.
You doctor can only help if he or she knows about these difficulties. It is important to say if you are worried.
It is very common for HIV positive people have to have symptoms of depression or mental health problems and these are often untreated.
This can be for several overlapping and complicated reasons.
- An HIV diagnosis affects how you feel about yourself and how you fit in to society. Prejudice is still around–as is ignorance about HIV. This leaves many people feeling more isolated and needing support to restore their confidence about themselves.
- HIV rates are higher in people who are already marginalised or disempowered. This can be related to sexuality, gender, drug use, poverty, sex work, previous abuses and other causes of vulnerability including mental health itself. An HIV-diagnosis can further add to this.
- HIV-positive people are more likely to use alcohol and recreational drugs which are associated with mental health issues.
- Some HIV drugs have side effects that change your mood and include depression, paranoia, anxiety etc. It is essential that someone with these side effects uses alternative drugs.
- HIV can increase the risk of infections in the brain. This is usually related to very low CD4 counts (under 100). Neurological symptoms (how you think, feel and behave due to a direct impact on the brain) have also been reported in very early HIV infection during seroconversion.
HIV and depression
Depression can include a wide range of symptoms and if these continue (for example occuring every day for two weeks) this should prompt referral for a specialist assessment. These include:
- Feeling sad, empty, anxious, restless or irritable in a way that affects your daily life.
- Feeling hopeless or pessimistic or that you are not in control of your life.
- Lacking energy, or interest in activities that you would normally enjoy.
- Feeling guilty, hopeless or worthless.
- Having difficulty concentrating, remembering things or making decisions.
- Not sleeping or eating properly, weight loss, overeating, lack of interest in personal care.
- Thinking about death or suicide or attempting suicide.
If you have any of these symptoms, you may be depressed, and your doctor or other heath care workers need to understand how you feel and the impact this is having on your daily life.
Depression can easily be overlooked in general consultations so is often undiagnosed. The earlier you talk about how you feel the easier it will be to get the support you need.
Recovery from depression, even with medications, can take time, but treatment and support can work.
Treatment and management
HIV does not mean you will have mental health problems, but if you are having problems, many things can help.
- Having a friend who you can talk to.
- Support groups reduce isolation and help you meet other people with similar experiences.
- Counselling and/or behavioural therapy can help you cope with issues related to HIV or earlier traumatic experiences.
- Keeping active can keep you occupied. Regular exercise reduces stress and mental health symptoms.
- Medications, such as antidepressants, can reduce symptoms.
1 July 2012