Coping with AIDS and HIV

Basic Information on HIV and AIDS

AIDS (Acquired Immunodeficiency Syndrome) is a condition in which the body's immune system breaks down and is unable to fight off infection. AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. When a person is infected with HIV, the virus enters the body and lives and multiplies primarily in the white blood cells--cells that normally protect us from disease. The HIV virus weakens the immune system leaving the body vulnerable to infections and other illnesses, ranging from pneumonia to cancer.

The virus is spread when HIV-infected fluids of one person pass into the body of another person. Infection can occur through unprotected sex (anal, vaginal, or oral); through use of contaminated needles, syringes and other piercing instruments; and from mother to child during pregnancy, delivery, or breast feeding. In the U.S., screening of the blood supply has virtually eliminated the risk of infection through blood transfusions. Some people fear that HIV might be transmitted in other ways (such as through air, water, or insect bites); however, no scientific evidence to support any of these fears has been found.

HIV-Related Mental Health Problems

Mental health problems can affect anybody, but people with HIV are more likely to experience a range of mental health issues over the course of their lives. More common are feelings of acute emotional distress, depression, and anxiety which can often accompany adverse life-events. HIV can also directly infect the brain causing impairment to memory and thinking. In addition some anti-HIV medications can have mental health side effects.

Emotional distress

Receiving an HIV diagnosis can produce strong emotional reactions. Initial feelings of shock and denial can turn to fear, guilt, anger, sadness, and a sense of hopelessness. Some people even have suicidal thoughts. It is understandable that one might feel helpless and/or fear illness, disability and even death.

Support from family and friends can be very helpful at these times, as can professional help. It is important for people with HIV to talk about their feelings. Physicians, including psychiatrists, as well as knowledgeable and supportive friends and loved ones can help. Remember that any strong and lasting reactions call for some kind of assistance and that there is always help through counseling.

Depression

Depression is a serious condition that affects thoughts, feelings, and the ability to function in daily life. It is twice as common in people with HIV as in the general population. Depression is characterized by the presence of most or all of the following symptoms: low mood; apathy; fatigue; inability to concentrate; loss of pleasure in activities; changes in appetite and weight; trouble sleeping; low self-worth; and, possibly, thoughts of suicide. There are many different types of treatments for depression, including antidepressants and specific types of psychotherapy, or "talk" therapy. Treatment, however, must be carefully chosen by a physician or a mental health professional based on the patient's physical and mental condition.

Anxiety

Anxiety is a feeling of panic or apprehension, which is often accompanied by physical symptoms such as sweating, shortness of breath, rapid heartbeat, agitation, nervousness, headaches and panic. Anxiety can accompany depression or be seen as a disorder by itself, often caused by circumstances which result in fear, uncertainty or insecurity.

Each person with HIV and each experience of anxiety is unique and must be treated as such. Many drugs offer effective treatment, and many alternative remedies have proven useful either alone or in combination with medication. Among them bodywork, acupuncture, meditation, cognitive behavioral therapy, aerobic exercise, and supportive group therapy.

Substance Use

Substance use is common among people with HIV infection. Unfortunately, substance use can trigger and often complicate mental health problems. For many, mental health problems predate substance use activity. Substance use can increase levels of distress, interfere with treatment adherence, and lead to impairment in thinking and memory. Diagnosis and treatment by a psychiatrist or other qualified physician is critical as symptoms can mimic psychiatric disorders and other mental health problems.

Cognitive Disorders

Direct or indirect effects of the HIV virus can affect brain functioning. Some medications used to treat HIV infection can also cause similar complications. In people with HIV infection or AIDS, these complications can have a significant impact on daily functioning and greatly diminish quality of life. Among the most common disorders are HIV-associated minor cognitive motor disorder, HIV-associated dementia, delirium, and psychosis. Signs of trouble may include forgetfulness, confusion, attention deficits, slurred or changed speech, sudden changes in mood or behavior, difficulty walking, muscle weakness, slowed thinking and difficulty finding words.

People with HIV who have any of these problems should discuss their concerns with their physician immediately. New anti-HIV therapies in combination with psychiatric medication can reverse delirium and dementia and markedly improve cognition; however, special care must be taken to ensure that the drugs do not interact with HIV medications. Psychotherapy can also help patients understand their condition and adapt to their diminished level of functioning.

Conclusion

HIV infection and AIDS affect all aspects of a person's life. People with HIV/AIDS must adapt to a chronic, life-threatening illness and corresponding physical and mental challenges. In addition, they often face a myriad of emotional demands ranging from stress, anger, and grief to helplessness, depression and cognitive disorders. If you have concerns about your or a loved one's mood, memory, thinking process, or other mental problems associated with HIV discuss them with your doctor or counselor. Treatments are available and can greatly improve the quality of life. With comprehensive and compassionate care, many mental health challenges can be overcome with support, counseling, and understanding.

Because HIV infection and AIDS are associated with a number of physical, psychiatric and psychological issues, it cannot be sufficiently reviewed in a brief summary. Please consult your physician for further information. This summary is not intended to stand on its own as a comprehensive evaluation of HIV and AIDS.