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+ Choices -- An Upward Spiral

Spring 1999

There are many people who suffer a lot of anxiety around treatment options. They've been presented with choices that scare them: either take drugs or, to put it bluntly, get sick and die. Nobody talks about it in precisely those terms because the words aren't very friendly. People use words like drug therapy and disease progression, but the choice is still very limited.

When you call the PWA Health Group I'm often the guy who picks up the phone: "Health Group, Mark speaking." Sound familiar? I've talked to a lot of you, and it's clear that most of you are experiencing concern. On any given day, I hear that someone ... isn't very happy about going on any of the anti-viral combinations ... is very grateful to finally have something to take, but balks at the thought of taking something for the rest of her life ... hates that the only options he's presented with are western traditional choices ... is terrified of side effects ... isn't sure if or when to start ... is afraid she's already waited too long ... is afraid of starting too early ... is afraid the drugs will give her secret away at work ... is afraid the combo he's chosen isn't working anymore ... or, worst of all, is afraid that the smart choices made today may be the wrong choices of tomorrow. These issues are real and, right now, there are no clear answers.

When everything is fluid and changing, how do you maintain your equilibrium? Is it enough to just put on a happy face? I don't think so. Putting on a happy face doesn't even buy you time. When I'm confronted with a situation for which there are no immediate answers and everything keeps changing, I search for the positives and try not to dwell on the negatives. It sounds Pollyannaish, but what other options do I have? I'm not interested in sinking into a black hole of depression. Been there, done that. I'm not interested in boarding the barge for a trip to denial. Water sports can be dangerous. What I can do, which doesn't cost me any money and is available 24-7 is to adopt a positive attitude. This is much more complex than a happy face. While there's no proof that thinking positively works, consider the mystery of the placebo effect, which happens in almost all double blind clinical trials.

What's the placebo effect?

It's when, unknown to you, you're given "sugar pills" (pills with no medicine in them) and you get better anyway. No one is sure why it happens or who it's going to happen to, but it does happen. This, of course, means that there's an unknown mechanism working in some people which is triggered by the belief that what they're taking is going to give them benefit. Somehow, it's possible to manifest a positive physical response simply by believing it's possible to manifest a positive physical response. Now that's what I call positive thinking. If such good things can happen by accident, then what would happen if I put a little energy into it? The answer is that absolutely nothing might happen, other than my feeling good about myself because I have a positive attitude. Don't get me wrong. I don't expect to be cured because I maintain a positive attitude. But I do believe that everything concerning my health is enhanced by my positive thoughts.

How do you maintain a positive attitude?

My trick is to take a few moments at the end of the day, when I have total privacy and quiet, and review the good things that have happened to me during my day. I refuse to spend time on the negatives. I devote my energy to compiling a list of all the good things I can remember from my day -- those I've done to or for others and those that have been done for me. Then I try to let all of the good feelings wash over me and, at least for the moment, all is good in my life. This helps me to be more aware of the positive experiences I have on a daily basis as they're happening. It's hard work and sometimes I find myself standing on a street comer cursing a cab driver or wanting to stick my foot out another six inches to trip the big so-and-so who just cut in front of me. If the worst I do is vent my anger and frustration at a retreating cabby through a verbal tirade, I'm not doing so bad.

That's a good example of finding a positive spin. If, at the end of the day, I can say I've learned something because I didn't trip the big so-and-so (in spite of wanting to), I've done exceptionally well. The obvious good things are easy to put on the list. The harder work is finding ways to turn the crap into positives. If you do the work, it makes getting through the day a lot easier. Just knowing that most of the bad stuff can be turned into something positive helps me find more positive things. It's an upward spiral.

You may ask how this helps me with my treatment choices. By practicing this and other techniques for positive living, it starts to become second nature to see the positives in the choices I make, including my treatment choices. I'm not yet the perfect practitioner of positive thought, but by committing myself to not giving up on it, I get better at it every day. I still suffer from depression like anyone who, long term, has experienced the AIDS epidemic. But it gradually becomes easier to count on my instincts. I've made one of the scariest choices possible: I'm waiting as long as I can to start anti-virals. Because of my exercises in positive thought, my anxiety level is greatly reduced. I'm prepared to trust the choices I've made. And I feel assured that even if I've made a wrong or bad choice, somewhere in that choice is a positive if I look hard enough.

I've told you my tricks, now I'd love to hear how you keep it positive even when the pit of negativity is so very tempting. If you write to us we'll share your tips with everyone.

Author's Note: There is a fine line between negative thought and depression. If you or your loved ones suspect that the trouble you're having maintaining a positive outlook is due to depression, it's time to seek professional help. Maybe start with talk therapy and work with your therapist to determine if medical intervention is needed. If so, your therapist will recommend a psychiatrist who may prescribe antidepressants and/or anti-anxiety medications. You may be pleasantly surprised to find that life no longer sucks. I was.

This article was provided by PWA Health Group. It is a part of the publication Notes From the Underground.
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