Feeling Good Again: Mental Healthcare Works!
"I just don’t feel like myself anymore," she mumbled as she sat drooping in her chair. Ms. B. described feeling sad, withdrawn and hopeless since diagnosed HIV+ six months ago. She is a mother of two and feared that she would not be able to care for herself or her children. Ms. B. talked about not having any energy or appetite, not enjoying doing anything and not even answering her phone. She didn’t understand what was happening. As we talked more, I told her it sounded like she was suffering from depression. Have you ever felt like Ms. B.?
One survey found that more than 80% of HIV+ people have symptoms of depression or anxiety. Being HIV+ brings up many questions and negative feelings. The downward cycle might go like this:
- Many of these feelings are hard to talk about and then ignored.
- By not talking about these questions and feelings, you can feel alone.
- Feeling alone can cause you to feel depressed, anxious and hopeless about your situation.
Some of the HIV medications may also affect your mood and your body’s ability to cope with stress. It is important to let your doctor know if your mood has changed since taking any medications to treat HIV or HIV-related conditions.
What will help: Therapy (both individual and group), alternative therapies and antidepressant medications have all helped people feel better.
Individual therapy is a way to help you understand your feelings. You work with someone dedicated to helping you figure out why you feel bad. Being able to talk to someone who is educated about HIV is important. They can understand what you are going through and answer questions you may have. Call your local AIDS service organization (ASO) and ask if they offer psychotherapy or can refer you to a therapist.
One good place for finding encouragement is a support group. Joining a support group allows you to meet other people who have learned to cope in similar situations. You are both the giver and receiver of support. Groups help relieve the feelings of isolation and hopelessness that may come with an HIV diagnosis. They give you a chance to express your thoughts and feelings. Studies show that support groups improve quality of life for HIV+ people and may protect people from stress.
Some ASOs also have buddy or peer programs, where you are not in formal therapy or a support group, but are simply matched to a volunteer who you can talk to and share your feelings with. Check with your local ASO for support group listings and day treatment, buddy or peer programs.
Meditation, massage, yoga, breathing and relaxation exercises are all alternative therapies that may help you feel better. Acupuncture and acupressure therapies (that some insurances now cover!) may help reduce stress and improve your mood. (Try www.nccam.nih.gov or www.yogasite.com for more information.) Check with local agencies specializing in these alternative therapies.
If you think you are depressed or anxious, talk to your healthcare provider. Antidepressants such as Prozac, Zoloft and Paxil are often prescribed for depression or anxiety and have been shown to help decrease symptoms. Taking more pills may seem unbearable, but antidepressants have had great results for some. If your provider suggests them, ask about possible side effects and interactions with your HIV drugs. You may want to give them a try and then decide if you want to continue.
There are many approaches to mental healthcare. Try out some of the different things described above and see what works for you:
- Seek support and help
- Ask for a provider who specializes in HIV
- Wait or be embarrassed to ask for help
- Withdraw from others
Wondering what happened to Ms. B.? She joined a day treatment program and kept coming to individual therapy. She soon began to feel better. "I felt so alone, like no one would understand. I never knew other people were going through the same kind of things as me. Talking to someone one on one and having other people who I can relate to has changed my life forever. I never thought I would feel good again."
Alisa Lewis, LICSW is a Psychotherapist for Whitman Walker Clinic in the Washington, D.C area.