If you are diagnosed with HIV, your physical health is not the only issue you have to deal with.
(Coping with HIV/AIDS: Mental Health) HIV also affects a
person’s mental health. Mental health is defined as a state of emotional and
psychological well-being in which an individual is able to use his or her
cognitive and emotional capabilities, function in society, and meet the
ordinary demands of everyday life. A HIV diagnosis brings about a wide range of
emotions. These emotions include fear, anger, helplessness, sad, anxiety,
denial, fatigue, grief, shock, and confusion. The patient is often overwhelmed
with the changes to be made in life. HIV and AIDS also can have a condition
called AIDS Dementia Complex, or ADC. These emotions and ADC affect the
patient’s mental health.
The most natural and normal first reaction after a positive HIV test is denial. Many patients deny the test is true and often believe there is a mix-up in results. Denial can be dangerous if not dealt with. Patients in denial may fail to take safety precautions or reach out for help. The best way to deal with the denial emotion is to talk early with a doctor, therapist, or other support person.
Another common and natural reaction is anger. Some patients are angry about how they got HIV or that they didn’t know they had it. A person experiencing anger may feel frustration or loss of control. Anger can sometimes lead to depression. Ways to deal with anger are to talk about feelings, exercise to ease tension, and avoid other situations that cause anger. It is also important not to drink alcohol or use drugs. These behaviors can cause the patient to participate in actions that can intensify the anger or place others at risk for infection.
Sadness and depression are also common among HIV and AIDS patients. Grief can also factor into these. Some patients feel a diagnosis is a big loss of life. Some patients feel hopeless, alone, tired, or uninterested in life. The patient should talk to a doctor, support group or supportive friend or family member if they have these feelings. Anti-depressants can also be prescribed.
Fear and anxiety for a HIV/AIDS patient may be caused by a variety of factors. They may be caused by not knowing what to expect with the illness. The patient may be afraid of telling others and afraid of how others will treat them. The patient may fear being rejected by their peers and communities. The patient is sometimes uncertain about their health and future. They may feel uncertain about the medications given to help them or about the whole experience. One of the best ways to deal with the feelings of fear and anxiety are to learn as much as possible about HIV. Asking the doctor any and all questions about treatments, medications or about HIV and AIDS in general may help reduce some of the anxiety. Talking to supportive friends and family is a good way to handle the fear and anxiety. There are also support groups a patient can join that will help them as well as let them help others also living with HIV or AIDS.
Fatigue affects 33% - 88% of HIV patients.
(Fatigue remains common in people with HIV, and often
connected with social factors and mental health issues) Fatigue has been
defined as “a lessened capacity for work and reduced efficiency of
accomplishment, usually accompanied by a feeling of tiredness that is not
reduced by a good night’s sleep.” Fatigue can be either physical or
psychological or even both. Anxiety and fear are usually the causes of
psychological fatigue. While medication can help the patient, success has also
been found using cognitive behavioral therapy.
An AIDS patient also feels guilt when diagnosed and sometimes throughout the illness. They feel guilty about how they could have put themselves at risk. They also feel that their diagnosis is punishment for some sort of bad behavior such as drug use or sexual promiscuity. As the illness progresses, the patient feels guilty about depending on others. An important part of working through the guilt is to understand one’s self-worth. Therapy can help the patient with this.
AIDS Dementia Complex, or ADC, occurs in approximately 70% of those infected by HIV.
ADC may be the first sign of AIDS. Symptoms of ADC vary from person to person.
ADC is considered a progressive brain disorder and causes a decline in
cognitive functions such as memory, reasoning, judgment, concentration, and
problem solving. Symptoms of ADC include confusion, memory loss, difficulty
thinking and speaking, and balance problems. Changes also occur in personality
and behavior. ADC causes severe changes in four areas. These are cognition,
behavior, motor coordination and mood. There are several theories for the
development of ADC. One such theory is that the HIV virus reaches the brain
when it becomes active therefore affecting the mental and physical processes of
the brain. (Sue, Sue, & Sue, 2010) Another theory is
that because AIDS affects the immune system, AIDS related infections causes
infected cells to release toxic substances. (Sue, Sue, & Sue, 2010) These toxins cause
changes in psychological processes. A third theory is that the cortex, or outer
layer of the brain, gradually thins as the disease attacks the immune system. (Wood, Wood, & Boyd, 2011) In almost all HIV
patients with dementia, there is some level of cerebral atrophy. Cerebral
atrophy is defined as a wasting away or diminution in the size of cells or
tissue structures of the brain.
AIDS Dementia Complex usually occurs when the CD4+ count falls to less than 200 cells per micro liter.
(Dementia Due to HIV Infection) ADC is caused by the
HIV virus itself and not by an opportunistic infection. Antiretroviral therapy
(ART) has prevented or improved the symptoms of ADC symptoms. ART has also
delayed the onset of ADC. The frequency of ADC has declined to about 20% of all
HIV infected persons since the use of ART. Some methods of treatment for ADC
include education and information, psychotherapy, self-help groups,
anti-depressants and anti-anxiety medications.
The HIV virus and AIDS causes physical and emotional health problems. Former Secretary of State Colin Powell said it best, “The HIV virus, like terrorism, kills indiscriminately and without mercy. As cruel as any tyrant, the virus will crush the human spirit…” (2003)
Coping with HIV/AIDS: Mental Health. (n.d.). Retrieved November 27, 2011, from HIV InSite: www.hivinsite.ucsf.edu/insite?page=pb-daily-mental
Dementia Due to HIV Infection. (n.d.). Retrieved November 27, 2011, from E Medicine Health: http://www.emedicinehealth.com/dementia_due_to_hiv_infection/article_em.htm
Emotional Effects of HIV and AIDS. (n.d.). Retrieved November 27, 2011, from Livestrong: http://www.livestrong.com/article/87706-emotional-effects-hiv-aids/
Fatigue remains common in people with HIV, and often connected with social factors and mental health issues. (n.d.). Retrieved November 27, 2011, from AIDS Map: http://www.aidsmap.com/Fatigue-remains-common-in-people-with-HIV-and-often-connected-with-social-factors-and-mental-health-issues/page/1439035/
Stine, G. J. (2011). AIDS Update 2011. New York: McGraw-Hill.
Sue, D., Sue, D. W., & Sue, S. (2010). Understanding Abnormal Behavior. Boston: Wadsworth.
Wood, S. E., Wood, E. G., & Boyd, D. (2011). The World of Psychology. Boston: Pearson Education, Inc.
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