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Mental health and HIV/AIDS

Women living with HIV/AIDS have to deal with many challenges. They may face stigma from other people, a lack of support, unemployment, low income, low self-esteem, sexual assault, and depression.

Caregivers of people living with HIV/AIDS also have a lot of stress. Caregiving involves a great commitment of time and energy, and can be an emotional roller coaster. It can be hard to focus on your own health and the needs of other family members.

Your mental health is just as important as your physical health. A support network can help you deal with the stresses of having HIV or caring for someone who does. Listed below are some ways to find help.

  • Contact a local AIDS organization. A local AIDS organization can direct you to support groups or to providers, services, and information.
  • Call the Centers for Disease Control and Prevention (CDC) National AIDS Hotline at 800-CDC-INFO (232-4636). They can connect you with resources in your area.
  • Find out if your health plan, including Medicaid, will pay for counseling.
  • Talk to a case manager. A case manager can help you with things like medical care, mental health treatment, job options, housing and transportation programs, food, domestic violence shelters, and child care. You can find a case manager through your health insurance organization or at an AIDS clinic or hospital.

It is normal to feel down, or even devastated, after being diagnosed with HIV or during the course of the disease. A support network can help you cope with tough times. But when feelings become severe, won't go away, and limit your ability to stay healthy, you should talk with your doctor. People living with HIV are more likely to have depression, anxiety, and other mental illnesses. They may suffer from post-traumatic stress disorder. Some may even have thoughts of suicide. It is important to address any of these mental health problems to ensure overall health in a person living with HIV/AIDS.

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Depression

Mental health screenings

Your doctor may recommend mental health screenings that will find other problems, such as:

  • Post-traumatic stress disorder
  • Anxiety disorder
  • Problems with sleep or appetite
  • Alcohol or substance use
  • Violent or suicidal feelings
It is very important to identify and get treatment for mental health conditions. They are separate from HIV/AIDS, but can have a big impact on your health and wellbeing with HIV/AIDS.

HIV does not directly cause depression. But depression is twice as common in people with HIV as in the general public. Depression is a separate medical issue that needs to be treated. Research shows that depression can speed up HIV's progression to AIDS.

Symptoms of depression include:

  • Sadness, anxiety, and irritability
  • Loss of interest in things you used to enjoy
  • Feelings of guilt, worthlessness, or hopelessness
  • Weight loss or gain
  • Loss of appetite
  • Sleep problems
  • Fatigue
  • Loss of concentration
  • Low sex drive
  • Thoughts of suicide

Diagnosing depression can be hard in someone with HIV. Some HIV symptoms and side effects of HIV drugs are the same as those of depression. These include fatigue, low sex drive, little appetite, confusion, nightmares, nervousness, and weight loss. But a true loss of interest in activities that someone used to enjoy is a sign that a person is depressed.

Treatment, such as talk therapy and antidepressants, usually can help people with depression. Antidepressants are usually safe for people with HIV. But there may be interactions with other drugs, so it's important that you let your doctor know about any and all medicines you are taking and that you both watch for side effects. Do not use St. John's wort, a drug or tea that some people use to treat mild symptoms of depression. It has harmful interactions with HIV medicines. Visit our section on mental health for more information.

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Other mental health disorders

Many studies show that women with HIV/AIDS are more likely to battle severe depression or anxiety disorders than people who don't have HIV. These are the most common disorders. But people with HIV/AIDS should be screened for other mental health disorders, too. Your doctor might evaluate you for post-traumatic stress disorder, alcohol and substance abuse, or suicidal thoughts.

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Problems in brain function

HIV, as well as some of the medicines used to treat HIV, can affect brain function. Possible problems include:

  • Memory loss
  • Confusion
  • Slowed thinking
  • Problems talking
  • Changes in mood and behavior

These issues can hurt your quality of life, and complicate HIV treatment. HIV-associated dementia may occur in late stages of HIV infection. Women, particularly those who are older or who have ever used illegal drugs, are more likely to develop dementia.

But thanks to antiretroviral treatment, HIV-associated dementia is less common today than it used to be. Some problems with brain function can get better or even go away with treatment. Counseling can also help people learn to cope with changes in brain function. Talk to your doctor if you or someone you care for has problems thinking.

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When you already have a mental health disorder

When you are diagnosed with HIV/AIDS, be sure to tell your doctor about your mental health history. Tell your doctor if you are taking any medications, because they can interact with your HIV drugs. Talk to your HIV doctor about any counseling you're receiving. You can also ask your HIV doctor for a referral to a psychologist, psychiatrist, or social worker who has experience counseling and treating patients with HIV. It can be overwhelming to deal with an HIV/AIDS diagnosis, but do not neglect your mental health. It is very important to manage all aspects of your health when you are living with HIV/AIDS.

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Content last updated July 1, 2011.

Resources last updated July 1, 2011.

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