NEWS

Ask the Doctor: HIV and Mental Health

Every month HIV specialist Theresa Mack, M.D., M.P.H.--an associate medical director at St. Luke's-Roosevelt Hospital's Medical Group in Harlem, N.Y.--will answer your most pressing HIV/AIDS questions.

May is Mental Health Awareness Month. So let's focus on the fact that mental health plays a major role in the prevention and treatment of HIV.

People experience a wide range of mental-health challenges. Among them are the following:

  • Low self-esteem
  • Stress
  • Anxiety
  • Depression
  • Bipolar disorder
  • Schizophrenia
  • Post-traumatic stress

Sexual abuse and substance abuse are among many factors that can lead to mental-health issues.

Mental Health and HIV Prevention

Four out of five people who have mental illnesses do not receive effective treatment for their disorder. Not only does this mean that many people are suffering needlessly from mental and emotional distress, but it also puts more people at risk of HIV. In fact, those who have a mental illness and engage in substance abuse are 12 times more likely than the general population to become infected with HIV.

One reason for this could be that if you have a mental-health disorder or you abuse drugs or alcohol, your judgment is impaired. With impaired judgment, you're more likely to engage in risky behaviors such as having sex without a condom.

By treating mental-health issues, you can decrease your chances of getting HIV.

Mental Health for People with HIV/AIDS

For those living with HIV, mental health is a particularly great concern.

Approximately 30 percent of people living with HIV/AIDS suffer from depression, and depression is twice as common among those living with HIV as it is in the general population. Anxiety and substance-abuse disorders are also higher for people living with HIV/AIDS.

There are a number of reasons for this:

  • People living with HIV sometimes isolate themselves because of guilt and shame about their illness.
  • Some people living with HIV experience rejection from their families.
  • It's natural to feel sad about an HIV diagnosis.
  • Some people may feel helpless about their condition and engage in risky sexual behavior or stop taking their HIV/AIDS medications after learning that they have HIV. But although HIV was a death sentence years ago, today there is no reason to feel helpless about an HIV diagnosis. Instead focus on getting into treatment so that you can stay healthy.

If you're currently being treated for HIV, it's also important to know that some ARV medications can worsen your mental health. For example, Sustiva, a medication used to treat HIV, can cause adverse effects such as depression, difficulty sleeping and nightmares.

Treating Mental-Health Issues

Treatment for mental-health issues is just as important as HIV treatment. In fact, if you address your mental-health issues, you're more likely to keep your doctor's appointments and adhere to your HIV-treatment regimen.

If you have ongoing feelings of sadness, anxiety or even low self-esteem, talk to your medical provider. Simply describe how you're feeling and ask your provider, "Is it normal for me to feel this way?"

While anyone can feel sad one day, you should be concerned if your sadness or any other emotion is causing you to isolate yourself or is otherwise affecting your day-to-day life. For example, a woman experiencing depression may stop cooking, exercising and doing things that used to give her pleasure.

There is no need to suffer in silence. Antidepressants and antianxiety medications can help you.

If you're not part of a medical home, where your physical and mental-health needs are taken care of in one place, ask your medical provider to refer you to a psychiatrist, therapist or counselor who can work with you. Also look for support groups in your area that are designed specifically for people coping with an HIV/AIDS diagnosis. If substance abuse is a problem, drug-treatment and -rehabilitation programs can help you overcome your addiction.

Other ways you can improve your mental health include these:

  • Maintaining a healthy diet
  • Exercising regularly
  • Giving up smoking
  • Getting the proper rest

Some people use herbal supplements to treat their mental-health issues. Always talk to your doctor before taking an herbal supplement in order to avoid having an adverse drug reaction. For example, Saint-John's-wort, an herb often used as an antidepressant, can interfere with some ARV medicines.

Staying in treatment for HIV is also important to maintaining your mental health. Untreated HIV can affect the brain, causing such symptoms as memory loss and depression.

Whatever happens to the mind does affect the body. Mental-health disorders must be addressed in order to promote overall health.

Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about health, wealth and personal growth.