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The Resource Train
Stress and HIV

By Terri L. Wilder, M.S.W.

November 2000

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"Sustained stress erodes immune function and hastens the onset of AIDS."

-- Dr. Jeffrey M. Leiphart


Finding ways to reduce the number and intensity of stressors in your life seems to be a never-ending battle. I went to Mexico a few months ago and felt wonderful when I returned. Unfortunately, the "stress bug" came back within a couple of days. My back began to ache, the headaches returned, and I felt "icky."

Stress is costly. It is a major contributing factor to coronary artery disease, cancer, respiratory disorders, accidental injuries and cirrhosis of the liver and suicide. It is estimated that over two-thirds of office visits to physicians are for stress-related illness. These contacts with the medical system cost over one billion dollars per year in the United States.

So, how do we maintain a stress-free existence? How do we eliminate the people and the situations that stress us out? How do we change our mindset so that those people or situations do not encourage stress in our mind, body, and spirit?

As I was researching this topic, I ran across a number of articles by Dr. Jeffrey Leiphart. Dr. Leiphart has written extensively about stress and HIV. His writings inform people with HIV that stress levels are something that "erodes the immune function and hastens the onset of AIDS." He goes on to explain that decades of research has established that the immune system is directly influenced by psychological processes and that the immune system is directly linked to the psyche by a complex network of nerves, hormones and neuropeptides. This network of specific physiological pathways allows thoughts and emotions to have a direct impact on immune function and, consequently, on physical health. Dr. Leiphart came up with a list of sources of stress. The following is a list of psychological, behavioral, and medical issues that may impact the stress level of a person living with HIV:


Psychological Issues:

1) Fatalism -- This refers to a preoccupation with death and dying. "Fatalistic" folks should talk with long-term survivors and to those who have learned how to contain their anxieties and focus on achievable, rewarding, short term goals.
(For example, if you are in the Altanta area, join the Positively Living Support Group on Monday nights at AIDS Survival Project or join a support group near you.)

2) Chronic Impatience -- Haste makes waste. Haste can waste CD4 cells. If you are a "Type A" person, find ways to relax or a regular routine of "deep relaxation."

3) Sustained Survival Stress -- Stress that endures for months on end. This can have effects on the immune system. Common symptoms may include: poor appetite, disturbed sleep patterns, etc. Diminished appetite and disrupted digestion eventually cause partial malnutrition, weight loss, reduced overall vitality, as well as decreased immune function. Repeated disturbance of sleep patterns produces a "jet-lag" like condition that leads to suppressed immune function. Sustained survival stress results in immune system inhibition, and eventually causes erosion of immune function. Persons should be encouraged to find ways to eliminate identifiable sources of stress from their life.

4) Protracted Grieving -- People who experience life-disrupting grief for more than six months should be encouraged to plan a "leave-taking" ritual (a final "celebration of life" gathering for the person who has died). Plan the activity on a specific day at a specific time. This may help bring the mourning to a close. Also short-term counseling can bring closure to the mourning.

5) Depression -- The symptoms of global demoralization, a profound sense of hopelessness and loss of direction, purpose, and self-esteem are all symptoms of depression. Depression is often undiagnosed and untreated in people with HIV because many of the symptoms are common to symptomatic HIV disease. They are often incorrectly assumed to be "normal" responses to the harsh realities of living with HIV and therefore require no treatment. This is incorrect. Chronic depression is never normal.

6) Absence of purpose and goals.

7) Lack of self-assertiveness.

8) Lack of trusted support.

9) Poor coping ability in times of crisis.


Behavioral Issues:

10) Inadequate breathing patterns.

11) Insufficient fluid intake.

12) Poor appetite, eating habits and nutrition.

13) Sleep disturbances.

14) Substance use.

15) Inadequate or inappropriate exercise.


Medical Issues:

16) Repeated exposure to HIV and other infections.

17) Limited capacity for self-care when sick.

18) Limited involvement/understanding of HIV-related health issues.

19) Passive, uninformed relationship with primary care providers.




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