HIV and Its Impact HIV and Its Impact on Mental Health and on Mental Health and Emotional WellbeingEmotional Wellbeing

The PLUS SeminarThe PLUS Seminar

Rafael Chang, LMFTRafael Chang, LMFTUCSF Alliance Health ProjectUCSF Alliance Health Project

7/29/20137/29/2013

ItIt’’s Normal To Have Some s Normal To Have Some Reaction!Reaction!

• Receiving an HIV+ diagnosis is a Receiving an HIV+ diagnosis is a major life stressor. Itmajor life stressor. It’’s s naturalnatural to to have some reaction of distress, have some reaction of distress, sadness, denial, anxiety and/or anger.sadness, denial, anxiety and/or anger.

• No matter what you are feeling, you No matter what you are feeling, you have a right to feel that way. There have a right to feel that way. There are no "wrong" or "right" feelings.are no "wrong" or "right" feelings.

• Feelings come and go. You have Feelings come and go. You have choices about how you respond to choices about how you respond to your feelings. your feelings.

Common Emotional Common Emotional Changes and SymptomsChanges and Symptoms

• DenialDenial• Very common to want to deny oneVery common to want to deny one’’s s

HIV infection and HIV infection and ‘‘pretendpretend’’ it isn it isn’’t t there. there.

• This is a natural and normal This is a natural and normal psychological response. But, it can be psychological response. But, it can be harmful to you if it prevents you from harmful to you if it prevents you from seeking support or medical attention.seeking support or medical attention.

Common Emotional Common Emotional Changes and SymptomsChanges and Symptoms

• Shame and StigmaShame and Stigma• HIV is still a very stigmatized and misunderstood HIV is still a very stigmatized and misunderstood

disease in our communities. Itdisease in our communities. It’’s common to feel s common to feel shame, guilt and fear of othersshame, guilt and fear of others’’ reactions or reactions or judgments about our HIV status.judgments about our HIV status.

• Some HIV+ LGBT people feel as though they Some HIV+ LGBT people feel as though they have to go back have to go back ‘‘in the closetin the closet’’ about their HIV about their HIV status, and hide again who they are, for fear of status, and hide again who they are, for fear of rejection by others.rejection by others.

• It is a common response to not want to be It is a common response to not want to be ‘‘singled outsingled out’’ or identified as HIV+, however it or identified as HIV+, however it also may limit the support or services you can also may limit the support or services you can receive.receive.

Common Emotional Common Emotional Changes and SymptomsChanges and Symptoms

• AngerAnger• Common to be angry at oneself or at Common to be angry at oneself or at

the person(s) we believe may have the person(s) we believe may have led to HIV infection.led to HIV infection.

• A natural reaction, but, if it goes A natural reaction, but, if it goes unchecked and worsens, can result unchecked and worsens, can result in harm to yourself or someone else.in harm to yourself or someone else.

Common Emotional Changes and Common Emotional Changes and SymptomsSymptoms

• Sadness and DepressionSadness and Depression• Common to have feelings of sadness, Common to have feelings of sadness,

depressed mood, desire to pull away depressed mood, desire to pull away from others after an HIV diagnosis.from others after an HIV diagnosis.

• Tearfulness, crying episodesTearfulness, crying episodes• Sleeping more or less than usualSleeping more or less than usual• Pulling away from loved ones, isolating Pulling away from loved ones, isolating

from activitiesfrom activities• Feelings of guilt and shameFeelings of guilt and shame• Difficulty concentratingDifficulty concentrating• Thoughts about oneThoughts about one’’s own death or dyings own death or dying

Common Emotional Changes and Common Emotional Changes and SymptomsSymptoms

• Anxiety, Nervousness, StressAnxiety, Nervousness, Stress• Being fearful for oneBeing fearful for one’’s own health, and s own health, and

worrying about health of partners, family, worrying about health of partners, family, friendsfriends

• Fear about telling others around you Fear about telling others around you about your HIV statusabout your HIV status

• Difficulty sleeping, due to worryingDifficulty sleeping, due to worrying• Constant worrying and Constant worrying and ‘‘running thoughtsrunning thoughts’’

about HIVabout HIV• Worry about how to share your diagnosis Worry about how to share your diagnosis

with family, friends and potential dates.with family, friends and potential dates.

What Can I Do To Cope?What Can I Do To Cope?• Self-Care: Eat right, Self-Care: Eat right,

try to get sleep, try to get sleep, exercise exercise (cortisol/oxytocin)(cortisol/oxytocin)

• Manage stress by Manage stress by engaging in relaxing, engaging in relaxing, enjoyable activitiesenjoyable activities

• Get support! Talk to Get support! Talk to your partner, your partner, friends, family, friends, family, religious community religious community or join a support or join a support group.group.

• Educate yourself Educate yourself about HIV. Talk to about HIV. Talk to your doctor. Attend an your doctor. Attend an HIV education forum HIV education forum or training.or training.

• Breathe! Inhale 5 Breathe! Inhale 5 countcount

hold for a count of 5hold for a count of 5 exhale – 8 countexhale – 8 countManage feelings by Manage feelings by

placing them outside placing them outside of yourself through a of yourself through a journaljournal

When To Look For HelpWhen To Look For Help

• DepressionDepression• If symptoms persist or worsen over 2 weeks, If symptoms persist or worsen over 2 weeks,

and you are noticing increased depressed mood, and you are noticing increased depressed mood, lack of enjoyment in activities, weight gain or lack of enjoyment in activities, weight gain or loss, sleeping more or less than usual, feeling loss, sleeping more or less than usual, feeling excessively guilty or ashamed, increasingly excessively guilty or ashamed, increasingly hopeless.hopeless.

• If you are having thoughts about suicide, seek If you are having thoughts about suicide, seek help help immediatelyimmediately! Seek support, counseling.! Seek support, counseling.

• Join a support group. Enter into therapy. Join a support group. Enter into therapy. Discuss with your doctor or see a psychiatrist.Discuss with your doctor or see a psychiatrist.

When To Look For HelpWhen To Look For Help• AnxietyAnxiety• If you are having increased and worsening If you are having increased and worsening

symptoms of shortness of breath, muscle symptoms of shortness of breath, muscle tension, irregular heart rate, difficulty tension, irregular heart rate, difficulty sleeping due to worrying about HIVsleeping due to worrying about HIV

• If you are unable to focus or concentrate, If you are unable to focus or concentrate, and find yourself putting yourself at risk of and find yourself putting yourself at risk of harm (e.g., erratic driving, walking without harm (e.g., erratic driving, walking without noticing your surroundings, etc.)noticing your surroundings, etc.)

• Consider entering into therapy and Consider entering into therapy and discussing with your primary doctor or discussing with your primary doctor or psychiatrist if anxiety medications might be psychiatrist if anxiety medications might be right for you.right for you.

When To Look For HelpWhen To Look For Help

• Suicidal Thoughts Suicidal Thoughts • Call 911 or go to the nearest ERCall 911 or go to the nearest ER• Seek crisis counseling services from Seek crisis counseling services from

the SF Suicide Prevention Hotline the SF Suicide Prevention Hotline (781-5000), AHP Crisis Team (476-(781-5000), AHP Crisis Team (476-3902), CBHS Mobile Crisis Team 3902), CBHS Mobile Crisis Team (355-8300).(355-8300).

• Inform your doctor or loved ones Inform your doctor or loved ones immediately and ask for help!immediately and ask for help!

When To Look For HelpWhen To Look For Help• Increased use of alcohol and/or drugsIncreased use of alcohol and/or drugs• It is common to use increased amounts of It is common to use increased amounts of

drugs or alcohol to want to cope with onedrugs or alcohol to want to cope with one’’s s HIV status and HIV status and ‘‘avoidavoid’’ thinking about it. thinking about it.

• However, increased use can lead to However, increased use can lead to problems maintaining your physical health, problems maintaining your physical health, can worsen depression or anxiety, and can can worsen depression or anxiety, and can lead to problems in your life (at work, with lead to problems in your life (at work, with your partner or family, or legal problems).your partner or family, or legal problems).

• Consider seeking support through a support Consider seeking support through a support group (like AA or NA) or seeking substance group (like AA or NA) or seeking substance abuse counseling.abuse counseling.

Available Services and Available Services and ResourcesResources

• Positive Force - Positive Force - Plus seminar, Doctor is In, Urban Plus seminar, Doctor is In, Urban Adventures, 1-1Adventures, 1-1

• Positive Life – newly positive UCSF-AHP.orgPositive Life – newly positive UCSF-AHP.org

individual psychotherapy, psychiatric services, drop in groupindividual psychotherapy, psychiatric services, drop in group

• Poz.comPoz.com AIDSMeds.com AIDSMeds.com ProjectInform.orgProjectInform.org

• Gaylesta.orgGaylesta.org• SFAF.org Stonewall ProjectSFAF.org Stonewall Project• 12-Step Groups12-Step Groups• SF Behavioral Health ACCESS- centralized referral SF Behavioral Health ACCESS- centralized referral

hotline for SF public behavioral health services hotline for SF public behavioral health services (255-3737)(255-3737)

• Contact your insurance provider to see how and Contact your insurance provider to see how and what mental health services are provided and what mental health services are provided and covered under your health insurance plan.covered under your health insurance plan.