Emotionally

What you can expect

Learning that one has been infected with HIV can cause emotional distress for the individual, as well as for sexual partners, friends and family who are aware of the individual's status. Even if a person is without symptoms, the person may have to cope with years of uncertainty about their future health and constant fear of developing AIDS. The most common psychological reactions to being HIV positive are:

Anxiety

  • Studies have shown that an individual who is diagnosed HIV positive seems to experience more anxiety than an individual who is already in the AIDS stage. One suggestion for this finding is that these individuals appear very concerned about their future health and have an intense fear of developing AIDS. These fears and anxieties tend to re-surface every time a change is experienced in their physical status.
  • However, there are cases where certain people experience a sense of relief when diagnosed as being positive. The uncertainty of becoming infected was a cause of a great deal of anxiety. Unfortunately, in most of these cases the relief appears to be temporary as uncertainty about their future health increases.

Depression

  • Depression is the most common psychological experience, after anxiety, following a diagnosis of HIV.
  • Isolation from others (as a result of you withdrawing from others or when existing social support networks withdraw) is a common feature among people living with HIV.
  • More than half of people with HIV and AIDS express fear about others negative reactions, and one-third prefer to remain silent rather than risk personal rejection (until the symptoms make it impossible to maintain any pretense of normality).
  • The obvious disadvantage of self-isolation and nondisclosure is that you simultaneously lessen any possibility of receiving emotional support, which can contribute to depression.
  • Signs of depression are:
    • Loss of interest in normal daily activities;
    • Feeling hopeless;
    • Feeling sad;
    • Crying more than usual or for no apparent reason;
    • Increased or decreased need for sleep;
    • Problem concentrating;
    • Difficulty making decisions;
    • Weight loss (loss of appetite) or weight gain (comfort eating);
    • Restlessness;
    • Irritability and easily annoyed;
    • Feeling worthless;
    • Feeling fatigued or weak;
    • Loss of interest in sex; and
    • Recurring thoughts of suicide or suicidal behavior.

Anger

  • While anger is a common experience, the reasons may differ from person to person.
  • Anger can result from a feeling of being a victim of the virus.
  • Anger can be directed towards those who may have transmitted the virus to them.
  • Uncaring reactions and social insensitivity may be encountered and can contribute to the feeling of anger.
  • The inability of health care workers to provide immediate solutions and cures can become frustrating to many, resulting in anger.
  • Many become angry with themselves for engaging in behavior that exposed them to the HIV viral infection.
  • Anger can also result from feared progression from HIV to AIDS, social discrimination and stigmatization and the absence of any reassurance that medical solutions will emerge in the future.
  • The experience intense anger can sometimes result in excessive drinking and drug abuse (as a form of coping). This will contribute to deterioration of the client's future health.

Somatization

  • Many of the subjective symptoms detected by HIV positive clients reflect a preoccupation with the illness rather than any actual physical changes.
  • Realistic concern about one's health is reasonable and a common outcome of being HIV positive, but may alternate with exaggerated sensitivity and preoccupation with HIV.

Denial

  • Denial may be self-protective in the short term because it reduces emotional distress. However, in the long-term denial precludes making the behavioral changes that will prevent further HIV transmission or repeated exposure to the virus (re-infection).
  • If a person infected with HIV is in denial of the fact that he is positive, it could contribute to the deterioration of his health. By not accepting the fact that you are HIV positive, you are denying yourself medical treatment that can contribute to your health and well-being.

What you can do

  • Managing your anxiety (and tendency to somatise): If concerned about any changes in your physical health then consult your doctor on a regular basis to allay your ongoing fears. Discuss your feelings with your doctor and be sure to get as much information as possible, even if you must ask the same question over and over again. Another option could be to go for counselling (with a counsellor you can relate to) to explore the cause of your anxiety and to learn better ways of managing your anxiety. Through counselling you could also learn strategies for managing stress and setting realistic goals. You may also find it helpful to start meditation, massage, yoga or Tai-Chi, which can bring enormous relief from anxious energy. There is no need to cope with anxiety on your own.
  • Reducing Isolation: You do not need to disclose your HIV status to everyone. Instead start by identifying a small number of trusted people you know who will be supportive and helpful (such as a family member, friend, colleague, doctor, or counsellor). In addition, you could consider joining a support group. Research has shown that accessing and receiving support can reduce symptoms and prolong life. There is no need to be alone.
  • Managing your depression: If you experience any signs and symptoms for more than two weeks then consult your doctor. Treatment is available. It may also be a good idea to speak to a counsellor, who could assist you with self-acceptance and self-care. Research has shown that a combination of medication and therapy are better than either on their own. Self-care is very important. There is no need to cope with depression on your own.
  • Managing your anger: If you are feeling constantly angry it may be a good idea to speak to a counsellor to assist you in processing and managing your anger. Some useful tips for managing anger include getting a boxing bag, regular exercise and meditation. Joining a support group could also help by giving you a safe space within which to vent.
  • Overcoming denial: HIV is not a death sentence. By changing your lifestyle and living healthily you can live a normal life. By going for counselling after receiving a diagnosis, you will be able to work towards a level of acceptance that will motivate you to make the necessary changes that can benefit your life.
  • In general: Accept, love, and spoil yourself. Do things that make you feel happy and good. Laugh more. Learn to communicate more effectively. Be more assertive. Replace negative self-talk with positive self-affirmations. Explore your spiritual life. Surround yourself with uplifting people.
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