HIV and mental health

Depression and anxiety were common problems for the people we interviewed. Depression affects the way you think, your feelings, behaviour and physical wellbeing. Depressed people can feel sad, lose interest in life and lack energy. They may also feel guilty and worthless, lack confidence, have poor concentration, sleep badly, feel fearful and have thoughts of suicide. A number of people pointed out that depression can creep up on you, so your friends may notice your depression before you do.

People also talked about other problems including grief, loneliness, insomnia, isolation, manic-depression, phobias (e.g. of leaving the house), panic attacks and being suicidal.

The World Health Organisation (WHO) says that mental health is: ‘A state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.’ (May 2017) Mental health problems involve the lack or loss of these abilities. Nearly everyone we talked to faced such issues at one time or another and many said there should be no shame in having an emotional problem.

Why people have problems feeling good

Even if people could not understand their problems at the time, they usually gave reasons for their difficulties. Some people had a family history of emotional problems and most people’s stories described how life problems affected their wellbeing. When problems multiplied or seemed overwhelming, their health could suffer. One man said, “I mean I just cracked up. I just found I’d had too much stress for too long, from too many sources.”

He cannot feel good about himself when he faces so many problems.

Age at interview 49

Gender Male

Age at diagnosis 28

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People talked about a number of different things that made them feel depressed or anxious, including:

  • Being diagnosed with HIV
  • Physical illness and side effects of drugs
  • The difficulties of managing life with HIV
  • Loss of family, friends or partners e.g. relationship break-ups
  • Problems with growing up and dysfunction in the family
  • Dealing with sexuality issues including homophobia and ‘coming out’
  • Problems with immigration
  • Low self-esteem
  • Money problems
  • Poor housing and physical environments
  • Winter
  • Dealing with aspects of getting older
  • Isolation and lack of meaningful social activities
  • Feeling different and not ‘fitting in’
  • When drug or alcohol use changes from being recreational to a way of dealing with life’s problems.

HIV is difficult to manage.

Age at interview 26

Gender Male

Age at diagnosis 17

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Had panic attacks and became suicidal when taking anti-HIV drugs.

Age at interview 39

Gender Male

Age at diagnosis 28

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He felt different, anxious and isolated from an early age.

Age at interview 38

Gender Male

Age at diagnosis 24

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Describes what happened when he used recreational drugs to treat his depression.

Age at interview 48

Gender Male

Age at diagnosis 32

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He became addicted to heroin when he could not find a job.

Age at interview 47

Gender Male

Age at diagnosis 41

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Compared to white people born in the UK, people from Black and minority ethnic backgrounds often face more pressures. Black Africans we spoke to had a range of extraordinary pressures to deal with including seeking asylum, financial problems, difficulties in getting work and cultural differences.

Sees people as more isolated in the UK and misses her extended family ties in Africa. (Read by an…

Age at interview 35

Gender Female

Age at diagnosis 33

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She faced multiple life problems including asylum seeking, lack of work and separation from her…

Age at interview 30

Gender Female

Age at diagnosis 29

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It is more difficult to look after yourself when you have a mental health problem. Many people also thought that too much stress was not good for your immune system once you had HIV. While some people found it hard to ask for help, people frequently needed help to overcome their emotional difficulties.

His senior position in a school was very stressful and his mental and physical health suffered.

Age at interview 57

Gender Male

Age at diagnosis 39

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Who can help?

Either the GP or the HIV doctor is a good place to start. Doctors can prescribe medication for mental health problems e.g. an antidepressant, discuss options available, mobilise more support within the health system e.g. psychiatrists, sign a person off work, and some have good counselling skills. A range of other professionals can also help. For instance, HIV clinics and hospitals usually have counsellors, nurses and social workers available in who can help.

Talking to a nurse about her fever helped her to overcome her depressed state. (Read by an actor.)

Age at interview 44

Gender Female

Age at diagnosis 44

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What can you do?

People find their own way of dealing with their emotional problems: there is no one right way. While there are many professionals and people who can help along the way, you have to do a lot of the work yourself. The good news though is that for conditions like depression, people do tend to recover, even if things seem very bad at the time.

He was depressed and had little support when he was diagnosed with HIV and yet he now feels…

Age at interview 31

Gender Male

Age at diagnosis 29

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Apart from getting good treatment for HIV and so feeling better physically, people mentioned several other things that helped them:

  • Talking about your problems with friends, family or professionals
  • Getting out of the house, socialising and being more active
  • Joining a support group
  • Exercise – research shows that exercise can help combat depression
  • Avoiding the use of alcohol and drugs to deal with problems
  • Prayer
  • Doing voluntary work
  • Focusing the mind on more positive things
  • Complementary approaches to health e.g. acupuncture, yoga, meditation
  • Personal development courses and self-help books
  • Working through grief

How he deals with his anxiety about his health.

Age at interview 41

Gender Male

Age at diagnosis 38

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A simple ceremony helped him to grieve for his partner who had died.

Age at interview 63

Gender Male

Age at diagnosis 48

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