COVID-19, HIV, and Loneliness: Help From Dr. David Fawcett

I was recently glossing through my Facebook feed, and among the political muck, animal videos, and masked selfies was this post by an acquaintance that read, “It is really difficult being alone sometimes.” I stopped scrolling and stared at the simple sentence. It seemed to echo inside me, there was so much recognition. I’m a person who lives alone and has for quite some time. I don’t date much, and certainly not since COVID-19 hit the U.S. Managing my mood has become more challenging in the past six months or so, and with the continued quarantining and social distancing protocols to prevent transmission, the current pandemic only exacerbates my tendency to isolate.

I recently read that in a Canadian study, people living with chronic illness—and specifically those living with HIV—have a higher rate of loneliness than their HIV-negative counterparts. Loneliness is also more prevalent in middle-aged and older folks and can possibly lead to dementia. Not only does it feel terrible, but loneliness has the chance of scary long-term effects.

To learn more, I Zoomed with therapist, social worker, author, mental health expert, and TheBody contributor David Fawcett, Ph.D., L.C.S.W. I knew he could offer insight about loneliness in the current climate. He is sheltering in place with his partner at his home in Fort Lauderdale, Florida, and helping people in his community to get through these trying times.

“There’s an epidemic of loneliness in general in our society that’s just aggravated further among people living with HIV,” Fawcett said. “Stigma, shame, and isolation are contributing to a real decline in mental health. A lot of people are in crisis. It’s a real concern.” The lack of human real-life interaction and touch starvation is especially hard. “It’s a problem; people are suffering, for sure,” he said. “Remember, too, that people living with HIV, in any given year, nearly half meet the diagnostic criteria for clinical depressive disorder, and 40% for anxiety, so there are underlying mood concerns anyway.” Adding the stressful burdens of the pandemic, news media, and isolation can be overwhelming to some people. Fawcett said that the lack of a strong national response to the pandemic can add to the sense of hopelessness and fatigue that some are suffering.

“Also, a lot of people have physical issues—they may not be as ambulatory as other people, or they might not be able to get to their health care appointments or to grocery stores, that kind of thing,” Fawcett said. “Their mobility is limited anyway, and if they’re staying at home like most people are, just to be safe, that feeling of isolation is increased.”

Phone calls, emails, texts, and the rise in Zoom and other video conversation platforms have eased some of the sting surrounding social distancing and staying home protocols. Some people, however, can still find these social substitutes lacking, and can’t get passed the limitations of social media sites. “People living with HIV have all kinds of factors that can affect their ability to make up for the alternate ways of connecting that have come up,” Fawcett said.

He explained that the current pandemic can also be very triggering. “There’s a little bit of trauma and PTSD [post-traumatic stress disorder] at work. This one horrible pandemic [AIDS] that we survived, and here’s another scourge coming our way. I think we’re reacting with this sense that it really is life or death. It certainly feels like life or death. And I think that mindset is really different from the approach of a lot of people who, for instance, don’t wear a mask or think COVID-19 is a hoax or just don’t take it that seriously.” Fawcett went on to say that people living with HIV who have a greater fear of what bad things might happen sometimes don’t get the same kinds of social support that HIV-negative people get. “When they see people laughing it [the pandemic] off or dismissing it, and by extension dismissing them, it gets really hard,” he said. “When we’re so isolated, we lose touch with normalizing things like seeing other people, getting outside,” Fawcett said. “I recommend getting outside every day and connecting with the sky, taking a walk, just getting out of the same four walls. People can almost get into a trance, they get so used to this bubble of Netflix and TV and isolation, and it starts to really take an effort to break out of that.”

To combat the isolation, loneliness, and depression, Fawcett said the best antidote is making the effort to reach out to family and friends. “One thing I’ve been telling my clients,” Fawcett said, “is to make it a regular thing. A weekly coffee date [on Zoom] with Bill on Tuesdays for example, or a weekly dinner date. If some things are built into your week on a regular basis, it tends to actually happen, for one thing, but it’s also something to look forward to. Regularity is a great tool, scheduling something.” Fawcett also recommends that you call somebody new every day, as a way to reconnect with old friends and acquaintances and keep a social interest in people who you may not have been in touch with for a while.

“And this is going to sound really Pollyanna-ish,” Fawcett said, “but it’s really important to try to have a positive attitude. To some extent, we can control how we feel, and I always try to get out of bed with the intention to make this a great day and trying to keep myself feeling as upbeat as possible. I try not to let myself get into what psychiatrists call the ‘negativity bias,’ noticing everything that’s wrong.”

Fawcett recommends staying grateful. “I try to stay in gratitude, do a little gratitude list every day, just so I can notice the things that are good.”

He also advises us to be of service to others. “That is reaching out, sure; but also just trying to do something nice for someone else is huge. If we can be there for each other, it goes a long way in reassuring us. We can do that for each other.

Finally, Fawcett suggests kindness. “It’s kind of a silly meme that’s going around a lot these days, but here it is: Be kind. This pandemic is an experience that’s hitting everybody. It’s having an effect on certain communities to a greater extent, but there’s no one that’s not affected. I think if we can take a breath and be gentle with ourselves and each other, that goes a long way.”

If you feel like you are in crisis and need immediate help, reach out to your medical provider, local HIV service organization, or go to MentalHealth.gov.