Garry Wotherspoon on some possible impacts of HIV on mental health
Mental health has had a bad press – images of lunatic asylums like Bedlam or Callan Park, and movies about ‘crazies’ with knives and hatchets, have, for so long, been fed to the public.
In recent years, increasing numbers of public figures have raised the issue of mental health. Former Premier of Victoria Jeff Kennett has championed mental health issues, and the current NSW Treasurer Michael Costa has ‘come out’ and talked about his own mental health concerns. And two recent Australian movies - Ten Empty and The Black Balloon - have treated mental health issues factually and sympathetically. So stigma is lessening and attitudes are gradually changing
The World Health Organisation (WHO) has projected that depression will only increase as a global issue. The WHO reports that it is currently the highest medical cause of disability worldwide, and predicts it will be the second highest medical cause of death and disability worldwide by 2020. According to the Mental Health Association of NSW, depression is a common mental health problem here. It is a long-lasting, often recurring illness, as real and debilitating as heart disease. About 800,000 Australians experience depression each year, and one in five people are likely to experience depression or anxiety in their lifetime. People who are depressed may feel symptoms like oppressive sadness, fatigue and guilt. They may report feeling lonely, isolated, helpless, worthless and lost. And many people with HIV experience not only unhappiness or sadness, but also depression.
For most of us with HIV, there are a range of circumstances which might cause a shock to our usual mental state. The moment when our doctor tells us that we are HIV+ is often stressful, and for some, it can generate anything from anxiety to acute depression, depending on the situation. Then, when we have come to terms with diagnosis, the next hurdle might well be disclosure – who should we tell? Or can we avoid telling people? But if we are ‘careful’ not to tell people, how do we get support?
Fighting prejudice was a key theme at the recent 17th International AIDS Conference in Mexico City. The 20,000 delegates heard stories that indicated that there is still widespread concern about the stigma attached to HIV.
Stigma, or the fear of stigma, might be especially fraught for people from different language or cultural backgrounds. This can be because of their communities' different beliefs about health, illness and medicines. And since Australia has cultural communities from all corners of the globe, these fears might be an 'iceberg' - we only see the tip of it, with a massive burden hidden below the surface. Similarly, some positive Asian gay men may be particularly hesitant to disclose their status, given that their communities can be quite interconnected. It happens. Someone you meet knows someone you know, and talks about someone they know. Other cultural groups often have similar experiences.
But some causes of metal health stress are common. Many of us may worry about the impact of HIV, whether actual or feared, on our health. While this can be a source of anxiety, there are strategies for looking after our physical health: eating well, getting enough exercise, compliance if you are on medications, cutting down on those pleasures that might have a negative impact - too many big nights out, too much pill popping, etc. I don't have to spell them all out, you know what I mean. But there is one strategy to take particular note of - cut out smoking - it helps in all health issues.
We might also worry about the impact HIV might have on our lives in general. Will we be able to do the things we’d planned or hoped to do in the future? What impact will it have on our sex lives? Will it affect our relationships? And if we’re not in a relationship, will forming a relationship be more difficult?
Talking to someone can be a strategy for dealing with the impact on mental health. A friend, counsellor, or peer support group could diminish that sense of dealing with worries in isolation. Here, groups like Genesis or After Hours (for newly diagnosed gay men), and 729 (for men living longer with HIV), are invaluable. Organisations like ACON provide one-to-one counselling. And there is also beyondblue, an organisation that has been recently established in Australia, to provide support for people with depression.
If one still feels that one’s world has collapsed, then we may need a different approach. The first step might be to acknowledge we are not coping, and look for other strategies. These could be anything from treatment to 'preventation'. There are many treatments, but most of them fall into two main groups: antidepressant medications or psychological treatments. There are a range of anti-depressants on the market, but you should take your doctor's advice when considering if you need these. And a range of 'preventative strategies' can also help people manage their condition: everything from getting enough rest to gentle exercise or using relaxation techniques, to moderate use of alcohol or recreational drugs, to trying to maintain supportive friendships. Every little thing helps.
And finally, we should accept the fact that we can go easy on ourselves, treat ourselves kindly (taking some time out if needed), and here, the benefits flow to both our mental health and our HIV situation. Some people have called it 'the power of positive thinking'!
Services mentioned in this article:
- ACON Counselling (02) 9206 2000 or Freecall: 1800 063 060 www.acon.org.au
- Multicultural HIV/AIDS and Hep C Service (bilingual/ bicultural co-workers provide emotional support, advocacy and information to people with HIV from diverse cultural backgrounds) www.multiculturalhivhepc.net.au Freecall: 1800 108 098
- beyondblue (an organisation established to create a community response to depression) www.beyondblue.org.au
- Peer support: For information about Genesis phone Positive Living Centre on 9699 8756. For information about After Hours, 729 or other peer support groups phone 9361 6011. www.positivelife.org.au/peersupport
