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High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part One

By Bob Frascino, M.D.

September 3, 2010

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Over the last nearly 30 years, since the first reports of AIDS, countless numbers of adults have experienced overwhelming and often debilitating feelings of anxiety related to HIV/AIDS. Fear itself is not a mental illness. Rather it is a normal emotional response to the perception of danger or stress. In that regard it is both instructive and protective, informing us when danger is near and preparing us to take defensive action (fight) or retreat (flight). Anxiety is a more extreme manifestation of the fear response.

Fear and anxiety are actually intricate biological mechanisms mediated through a complex cascade of neurochemical and physical reactions designed to prepare the mind and body to deal with the threat at hand. Senses sharpen; attention broadens (hypervigilance); and the heart and breathing rates quicken. The hypothalamus, pituitary and adrenal glands spring into action, quickly increasing a variety of hormones (insulin, cortisol, adrenalin, etc.) and neurotransmitters (dopamine, etc.). This is all regulated by the body's autonomic nervous system. In essence we are hardwired for anxiety!

Medically speaking there is a difference between normal fear and what is referred to as an anxiety disorder. The key element in most forms of anxiety disorders is the distortion of a person's subjective perception, resulting in the inability to discern a minor problem from a true crisis. Unchecked, distorted perceptions can trigger a vicious cycle of anxious feelings that lead to an anxiety disorder.

Distorted perceptions include:

  • Being convinced that danger is inevitable and unavoidable
  • Perceiving a threat in the absence of any danger
  • Viewing minimally threatening situations as extremely dangerous
  • Perseverating on past threatening situations
  • Failing to recognize real and immediate danger
  • Perceiving every person or situation as a potential threat

One can easily appreciate how distorted perceptions such as these would apply to AIDS phobia.

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See Also
High Anxiety: AIDS Anxiety in the Worried-Wells and Worried-Sicks, Part Two
Guide to Conquering the Fear, Shame and Anxiety of HIV
Trauma: Frozen Moments, Frozen Lives
More on Coping With Stress and Anxiety

Reader Comments:

Comment by: Usanga J. (Lagos, Nigeria) Fri., Oct. 8, 2010 at 7:48 am UTC
Most of the fears are really due to ignorance. most people don't know the essence of this test
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Comment by: Alexandr (Moscow) Sat., Oct. 2, 2010 at 5:03 pm UTC
I love D.R Bob )
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Comment by: dave (nj) Wed., Sep. 29, 2010 at 11:33 pm UTC
Some of us wonder why after all the years into this epidemic that there is such a stigma associated with this disease? The reference on the blog re: university students being so misinformed about the transmission of HIV; aren't they (the our future?) Compound the aforementioned with the generalized bias against those with this disease and one still may wonder why people don't get tested, don't disclose etc. It really makes me sad to think that we really haven't come so very far in our war of HIV, notwithstanding HAART!
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Life, Love, Sex, HIV and Other Unscheduled Events

Bob Frascino, M.D., was President and Founder of The Robert James Frascino AIDS Foundation. He had been an outspoken, popular expert in's "Ask the Experts" forums on safe sex and fatigue/anemia since 2000. Once a Fellow of the American Academy of Allergy, Asthma, and Immunology, and the American Academy of Pediatrics, Dr. Frascino served as Associate Clinical Professor of Medicine, Division of Immunology, Rheumatology, and Allergy, at Stanford University Medical Center from 1983 until 2001. He was a member of the American Academy of HIV Medicine and had also been a distinguished member of the executive boards of numerous state and regional associations.

We're inexpressibly saddened to share the news that Dr. Frascino passed away unexpectedly on Saturday, Sept. 17, 2011. Click here to read more and to share your thoughts.

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