World Aids Day look at patients’ mental health

As South Africa marks World Aids Day on 1 December, Pharma Dynamics – one of SA’s leading providers of central nervous system medication – highlights the often overlooked link between HIV and mental illness.

Mariska Fouche, Public Affairs Manager for Pharma Dynamics says those living with HIV/Aids are at high risk for developing depression and other mental illnesses.

People with HIV often suffer from depression and anxiety as they adjust to being diagnosed with the infection and face the difficulties of living with a chronic life-threatening illness. Challenges range from stigmatisation, shortened life expectancy, dealing with complicated therapeutic regimes and the loss of social support from family or friends,” she says.

A recent study done by the Human Sciences Research Council supports this notion, which found that 44% of the 900 HIV-positive persons that participated in the survey were in fact suffering from a mental disorder.  Fouche also points out that the psychological effects of being diagnosed with HIV are particularly strong for pregnant mothers.

“Most women only find out about their HIV status after being screened for antenatal care. Pregnancy alone renders women vulnerable to mental health problems, but when also diagnosed with HIV it makes them even more vulnerable to developing depression and other mental illnesses.” Equally, mental illness can in itself be a risk factor for HIV.

Mental illnesses linked to HIV infection

US-based research shows a high prevalence of HIV infection in people with serious chronic mental illnesses. Prevalence rates in mentally-ill inpatients and outpatients have been reported to be between 5% and 23%, compared with a range of 0.3% to 0.4% in the general American population over comparable time periods.

“People living with mental illness may act in ways that increase their risk of HIV infection. Some mental disorders lead to greater promiscuity, others can make sufferers more vulnerable to sexual abuse and exploitation – even depression can increase an individual’s HIV risk,” says Fouche.

Apart from the psychological impact, the HIV infection also has a direct effect on the central nervous system (CNS) and causes various neuropsychiatric complications including HIV encephalopathy, depression, mania, cognitive disorder and frank dementia.

As things stand in SA there are no specific mental health services aimed specifically at people living with HIV nor are there any special guidelines on how to adapt HIV/Aids treatment to the special needs of psychiatric patients, however Fouche cites education and support as vital factors in helping patients to manage their overall physical and mental well-being.

“It is normal to have strong reactions when you find out you are HIV positive, including feelings such as denial, anger and a sense of being overwhelmed. Often people feel helpless, sad and anxious about the illness.

How to cope with anxiety

She offers the following suggestions on how to cope with these feelings:

  • Find activities that relieve your stress, such as exercise or hobbies
  • Get enough sleep each night to help you feel rested
  • Try meditation, yoga or deep breathing to help you relax
  • Eat small, healthy meals throughout the day to keep your strength up
  • Join a support group

“Supportive counselling carries multiple benefits including that of increased ARV adherence. There are many forms of therapy and medication, and when used alone or in combination, may be helpful in dealing with the feelings that HIV positive individuals experience.

“Patients often do not reveal their psychological state to healthcare professionals for fear of being stigmatised further. However, patients should talk with their doctor about their physical and mental health concerns. There are many ways to care for your emotional health, but treatments must be carefully chosen by a doctor based on each patient’s specific circumstances and needs. 

“The most important thing to remember is that you are not alone – there are support systems in place to help you, including doctors, psychiatrists, family members, friends, support groups and other services,” says Fouche.

Those living with HIV who are suffering from depression, trauma or anxiety can contact the Pharma Dynamics toll-free helpline on 0800 20 50 26, which is manned by trained counsellors who are on call from 8am to 8pm, seven days a week. 

(Press release, November 2012)

Read more: 

HIV patients prone to mental illness

1 in 5 South Africans suffers from mental illness 

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