HIV/AIDS and Mental Health

Being diagnosed and living with a serious illness like Human Immunodeficiency Virus/Acquired Immunodeficiency Virus (HIV/AIDS) can have a big emotional impact on your life. The challenges you can face include coping with the reality of living with a chronic illness and having to manage any mental health conditions that may occur. When you have HIV or AIDS, it’s important for you to not only take care of your physical health, but to take care of your mental health as well. While not all HIV-infected individuals will face these challenges, for those who do, a thoughtful treatment plan is very important.

HIV/AIDS can increase the risk of mental health conditions

While mental health conditions are common in the United States, those living with HIV have higher rates of mental health conditions than those who do not.

• People living with HIV are twice as likely to have depression compared to those without HIV. [1]
• People with HIV/AIDS have an increased risk for developing mood, anxiety, and cognitive disorders. [2]

How does HIV/AIDS increase the risk of mental health conditions?

Being diagnosed with any chronic health condition can be extremely stressful and it is completely normal to have an emotional reaction upon learning that you are HIV positive. However, when stress becomes prolonged and is left untreated, conditions like depression and anxiety may develop. Chronic stress has also been linked to reduced ability to fight off viruses like HIV. [3] 

Some stressors that might come with HIV/AIDS are having trouble getting the services you need, managing your HIV medications, having to tell others you are HIV-positive, and facing the stigma associated with HIV/AIDS. Additionally, people with HIV/AIDS may feel depressed as a result of having to make lifestyle changes, coming to terms with the potential for a shortened lifespan, or losing contact with friends and/or family who may not understand the realities of the condition.

The HIV virus itself increases risk of mental health conditions because it causes major inflammation within the body. The entire brain, including the lining, becomes inflamed as a result of the body’s attempt to fight off the virus. This causes irritation and swelling of brain tissue and/or blood vessels, resulting in non-traumatic brain damage over the long term; having brain damage is a known risk factor for developing a mental health condition. [4] 

Because HIV affects the immune system, you have an increased chance of getting other infections, such as Pneumonia and Tuberculosis, which also affect your brain and nervous system. This can then lead to changes in behavior and functioning. [5] 

Changes in the nervous system don’t often occur until the HIV has advanced and become AIDS. About half of adults with AIDS suffer from neurological conditions linked to HIV. [6] 

Treatments and Therapies

The HIV virus is treated using a combination of medicines called antiretroviral therapy (ART). ART has come a long way over the years and by starting these drugs as soon as you are diagnosed, you will improve and protect your health and protect your sex partners. Starting antiretroviral therapy can affect a person’s mental health in different ways.

You may find that beginning treatment and knowing that you can slow the progression of the virus relieves some symptoms of anxiety and depression and gives you a sense of control over your health. Taking this positive step may improve your feelings about yourself and the future.

Alternatively, some antiretroviral medications have been known to cause symptoms of depression, anxiety, and sleep disturbance, and may make some mental health conditions worse. [7] 

If you notice that your mental health is beginning to suffer after you begin taking medicine for HIV, contact your doctor immediately to discuss your symptoms. They may suggest therapy or adding a medication for your mental health to your treatment plan. Studies show that treating depression leads to improved health behaviors and clinical outcomes for people with HIV. [8] 

Finding the right treatment for depression takes time--so does recovery. It is important to be open and honest about all symptoms – mental and physical – throughout your treatment.

Other ways to help yourself

• Get involved with a support group.
• Spend time with encouraging people, such as family members and friends and talk about your feelings.
• Find activities that relieve your stress, such as exercise or hobbies; learn relaxation methods like meditation, yoga, or deep breathing.
• Eat small, healthy meals throughout the day; limit the amount of caffeine you consume.
• Get enough sleep each night to help you feel rested.

Mental health screening can help

Research suggests integrating behavioral health services, such as screening, with primary HIV care to allow for a more effective treatment outcome. Screening provides a quick and easy way to spot the first signs of serious illnesses and initiates the connection to care during the early stages. Take a screen at https://screening.mentalhealthamerica.net/

If you or a loved one is in a mental health crisis, please either visit your local Emergency Room, call 911, reach out to The National Suicide Prevention Lifeline's 24 hour toll-free crisis hotline, 1.800.273.TALK (1.800.273.8255), or text "MHA" to 741741 to receive text-based crisis help.

Sources

U.S. Department of Health and Human Services, National Institutes of Health (2019). HIV and Mental Health. Retrieved from https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/27/92/hiv-and-mental-health

U.S. Department of Health and Human Services, National Institutes of Mental Health (2016). HIV/AIDS and Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/hiv-aids/index.shtml

Cohen, S., Janicki-Deverts, D., Doyle, W. J., Miller, G. E., Frank, E., Rabin,B. S., Turner, R. B. (2012). Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.1118355109

Whitney, N. P., Eidem, T. M., Peng, H., Huang, Y., Zheng, J. C. (2009). Inflammation mediates varying effects in neurogenesis: relevance to the pathogenesis of brain injury and neurodegenerative disorders. Journal of Neurochemistry, 108 (6), 1343-1359. Retrieved from https://doi.org/10.1111/j.1471-4159.2009.05886.x

U.S. Department of Health and Human Services, National Institutes of Mental Health, National Institute of Neurological Disorders and Stroke (2018). Neurological Complications of AIDS Fact Sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Neurological-Complications-AIDS-Fact-Sheet

Pence, B. W. (2009). The impact of mental health and traumatic life experiences on antiretroviral treatment outcomes for people living with HIV/AIDS. Journal of Antimicrobial Chemotherapy, 63(4), 636–640. Retrieved from https://doi.org/10.1093/jac/dkp006