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A Day in the Life of an Anxious and Depressed HIV Advocate

By Josh Middleton

January 23, 2017

Josh Middleton

Credit: Vincent Carrella

The days pass by and the voices inside my head seem to grow louder and louder. Is my advocacy really making a difference? Am I doing enough? Does anybody really care?

You read the title right. It wasn't a typo, and I didn't misspeak. This is a brief look into my life as an HIV advocate who battles anxiety and depression. I've spoken about mental health before, and while many times I speak from a "third-person perspective," today, I would like to speak from a "first-person perspective." That's right: Straight from the heart where the focus is now placed on my own life.

When I became an HIV advocate and decided to share my story with the world, I didn't realize how much my battle with mental health would affect my journey. Some days, I will have a list of things I want to get done only to become overwhelmed and in the end accomplish only one or none of them. It's frustrating; it's tiring. Especially when I know that the moment someone reaches out to me might be the moment they need me most, yet often, I don't have the energy even to reply.

Depression comes in cycles, and I do my best to combat it with exercise, daily positive affirmations, journaling and lots of prayer. But, sometimes, even that is not enough. Dozens of emails roll through my inbox on a daily basis. Many are from others living with HIV simply looking for support while others are from agencies and organizations seeking my participation in writing a blog or speaking at an event. I often find myself saying, "Yes," more often than not, and that's because my heart is there. But my depression doesn't always have the same plan.


As an advocate, it's easy to put on a front for a certain amount of time. It's simple to make it appear to the outside world that everything is OK when everything inside you screams to simply let your humanness show. But there is a tipping point: A point when one simply becomes numb to feeling. A point when reality sets in and one must remain vigilant and conscious of when and how bad the depression is affecting everyday life. Even for an extrovert like me, who speaks up for mental health awareness and wears my feelings on my sleeve, no one can truly know the depths of the depression I have reached except for God and me.

I talk with people who are going through some of the worst times in their lives, whether it is a diagnosis or a mental health breakdown. Juggle that with dealing with my own issues, such as overcoming a gambling addiction, continuing to grieve the loss of my second child, coping with the recent break up of an almost two-year relationship, leaving full-time employment to finish my degree and dealing with someone very close to me who is battling severe depression and suicidal tendencies.

Far too often, I believe advocates tend to be too hard on themselves and simply think too much. It's easy for the stress to build up in a matter minutes, hours and days. We all know about self-care, but do we really practice it? If we do, are we really doing enough of it to achieve an equal balance in our lives?

I've learned to take baby steps, and that is completely OK to do. I've learned it's not about how fast I accomplish something but having the consistent willpower to pick up and start over where I left off. If I have a day in which I absolutely get nothing done, that is OK. It's about giving my all the next day so, eventually, it does get done. Take this blog for example. This has been a work in progress for over two weeks now. I love to write, but when my depression hits hard, I literally can't find the creative voice inside my head to get my fingers moving and formulate my thoughts into a logical literary piece. So many times, I've sat staring at this title at a loss for words. Depression is writer's block's best friend.

My responses to those who have written me have been delayed a bit, but I've managed to respond to the majority, and what I realize is that so much of the feeling of being overwhelmed is all in my head. It's a line of anxious thinking that tells me I have to get this all done at once or within a certain period when, in reality, I can only do so much at a time. I'm not superman, and I shouldn't presume that others think I am either.

I'm simply Josh. An advocate who lives with HIV, depression and anxiety. Nothing more, nothing less. There will be days when I am feeling great and days when I am feeling down. It is part of life, and simply because I am a passionate advocate, I am not exempt and do not get a free pass from these issues. Self-care is something that needs to become a conscious thought followed by action rather than simply be a thought in the back of one's head from time to time.

I encourage all advocates to be open and honest with themselves and about where they are in their battles with mental health issues. We recently lost a beloved advocate from suicide, and all who knew and loved him will dearly miss him. It's easy to get overwhelmed. It's easy fall into the depths of depression. But never lose sight of hope. We must support one another to truly be effective and help others in the process.

Much love and light to all.

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Josh Middleton

Josh Middleton

Joshua, CEO of the California non-profit Pozitive Hope, Inc., was diagnosed with HIV at twenty-two and has been involved in advocacy ever since. Whether it be HIV, mental health, or LGBTQ rights, this self-identifying bisexual activist seeks to make a difference in the lives of each and every person possible. He is fluent in Spanish, a full-time college student currently pursuing his degree in Psychology with the hopes to one day be a Clinical Psychologist or Social Worker, and one day hopes to defy the odds once more by becoming a pilot. Your questions, opinions, letters and suggestions are welcome at pozitivehope1@
. Follow Josh on Twitter, "like" his videos on Youtube and check him out on Facebook. Visit his personal website,

Photo credit: Vincent Carrella

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