Emotional health can be just as important as physical health, especially when living with HIV. Recognizing emotional or mental health issues can be difficult; we might not even be aware of them ourselves. We can all use a reminder or tips on how to look after ourselves and our emotional health.
The following is taken from TEAM (Treatment Education Adherence Management), a quarterly education workshop conducted by TPAN, the nonprofit organization that publishes POSITIVELY AWARE. The TEAM program encourages people living with HIV to learn together. If knowledge is power, then learning together can become support.
As you are read through this article, consider if these descriptions are relevant to you now or were at any point throughout your diagnosis. Reflect and ask yourself questions. Think about what actions helped you to create positive change, or consider what you might be able to do to take control of current feelings.
Identifying grief and depression
Grief may be seen as a reaction or response to loss, it is part of the healing process.
Although usually focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, cultural, spiritual, and philosophical dimensions. Consider what you might have grieved or are currently grieving after being diagnosed HIV positive.
There are five stages of grief, as outlined by Elisabeth Kubler-Ross: denial, anger, bargaining, depression and acceptance. Depression can be experienced in a variety of ways. A depressed mood or sadness is a normal temporary reaction to life events. If however symptoms intensify, or last many days or weeks, it may indicate a depressive disorder. Symptoms of depression can include:
Feelings:
• Sadness
• Hopelessness
• Guilt
• Moodiness
• Angry outbursts
• Loss of interest in friends, family, and favorite activities, including sex
Thoughts:
• Trouble concentrating
• Trouble making decisions
• Trouble remembering
• Thoughts of harming yourself
• Delusions or hallucinations can also occur in cases of severe depression
Behaviors:
• Withdrawing from people
• Substance use disorder
• Missing work, school, or other commitments
• Attempts to harm yourself
Physical problems:
• Tiredness or lack of energy
• Unexplained aches and pains
• Changes in appetite
• Weight loss
• Weight gain
• Changes in sleep—sleeping too little or too much
• Sexual problems
Understanding stigma and shame
Stigma is a set of negative and misconstrued beliefs that an individual, society or group of people have about someone, that sets the person apart from others. Examples of these beliefs can include: income level, mental illness, physical disability and HIV status. Shame can be seen as a painful emotional reaction to stigma, guilt or disgrace. It is best explained as a condition of how others (or ourselves) make us feel. Thoughts that we are somehow wrong, defective, inadequate, not good enough, or not strong enough. Feeling shame does not necessarily mean that you have done something wrong or “shameful.” Consider how we see shame throughout our communities and in people around us. Reflect on how stigma affects people.
How mental health and physical health can intersect
Stress and depression are intertwined. When stress hormones are released, they trigger high blood pressure, quicker heart rate, increased glucose in the blood, and shut off blood from digestive organs and brain.
Depression and cardiovascular disease are interlinked, with research showing that some patients who suffer from a cardiovascular disease also have depression. Depression also predisposes a person to engage in risky habits such as smoking and excessive alcohol consumption, all of which are risk factors for heart disease. Individuals suffering from depression also suffer from irregular sleep patterns, which worsen the risk of cardiovascular complications and heart attack.
Methods of coping
There are many healthy ways to address our mental health. You should seek help and support if you feel like you need it, or when your mood begins to have a negative impact on your social life, work performance, and relationships. Options include individual therapy, recovery groups (AA, NA, Smart Recovery, and others), therapy groups, in-patient or out-patient programs, peer support groups, and talking to your physician. Another effective method of coping is self-care. Self-care is any activity that we intentionally engage in to take care of our mental, physical and emotional health. Consider the support you or another might seek after receiving a positive diagnosis, reflect on some things one might gain as a result. Possible self-care activities can include:
Sensory
• Breathe in fresh air
• Snuggle under a cozy blanket
• Listen to running water
• Sit outdoors and listen to the night sounds
• Take a hot shower or warm bath
• Get a massage
• Cuddle with a pet
• Pay attention to your breathing
• Burn a scented candle
• Wiggle your bare feet in overgrown grass
• Stare up at the sky
• Lie down where the afternoon sun streams in through a window
• Listen to music
Pleasure
• Take yourself out to eat
• Be a tourist in your own city
• Take up gardening
• Watch a movie
• Make art. Do a craft project
• Journal—write down your thoughts
• Walk your dogs
• Go for a photo walk
Mental/mastery
• Try a new activity
• Clean out a junk drawer or a closet
• Take action (one small step) on something you’ve been avoiding
• Drive to a new place
• Make a list
• Immerse yourself in a crossword puzzle (or a jigsaw puzzle)
• Do a word search
• Read something on a topic you wouldn’t normally
Spiritual
• List five things you’re grateful for
• Read poetry or inspiring quotes
• Attend church
• Light a candle
• Meditate
• Write in a journal
• Spend time in nature
• Pray
Emotional
• Accept your feelings. They’re all okay. Really.
• Write your feelings down
• Cry when you need to
• Laugh when you can
• Practice self-compassion
Physical
• Try yoga
• Go for a walk or run
• Dance
• Stretch
• Go for a bike ride
• Don’t skip sleep to get things done
• Take a nap
• Eat a healthy meal
Social
• Go on a lunch date with a good friend
• Call a friend
• Participate in a book club
• Join a support group
Self-care can also mean remembering that others go through similar experiences and difficulties. We’re not alone!
Sources include depressiontoolkit.org and psychologytoday.com.
Learn more about TEAM; contact Christina Joly, c.joly@tpan.com.