The Link Between HIV and Mental Health

HIV (human immunodeficiency virus) is a virus that attacks cells in the immune system, leaving the body at risk for developing infections. It’s transmitted through contact with blood, semen, vaginal fluids, or breastmilk.

While recent advances in treatment have dramatically improved life expectancy for people with HIV, living with such a serious condition can still have a major impact on emotional health and well-being. Research shows that people with HIV are more likely to experience anxiety, depression, and other mental health conditions compared to the general population.

In addition to the psychological stress from an HIV diagnosis, factors like medication side effects, cognitive changes, and health inequities can exacerbate mental health issues.

This article explores the link between HIV and mental health and how to seek help.

The Link Between HIV and Mental Health

Mental health conditions are common among adults living in the United States. But people who have HIV are generally at a higher risk for developing mental health issues than people who don’t have the condition.

The link between HIV and mental health is complex, and may include one or more of the following factors:

• Chronic stress: Being diagnosed with a chronic illness like HIV can be extremely stressful. This stress can contribute to the development of mental health conditions like depression.
• Medication side effects: Antiretroviral therapy (ART) is a common form of HIV treatment, but it also has the potential to cause side effects that influence mood or mental health. These include depression, anxiety, and insomnia (sleep problems).
• Health inequities: Inequitable systems and structures across society and in health care have created barriers for people living with HIV. Obstacles include a lack of access to adequate medical care, stigma surrounding the diagnosis, and other forms of discrimination. Research shows these obstacles negatively impact a person's mental health and emotional well-being.
• Existing mental health issues: Studies have found that HIV is often more prevalent among adults who already have a serious mental health condition. These mental health conditions may put a person at risk of getting HIV because of injectable drug use and exposure to what are considered higher-risk sexual behaviors, as well as a lack of access to information about HIV prevention.
• Neurocognitive impact: HIV infections cause significant inflammation in the body. This inflammation can affect the brain and central nervous system, leading to changes in how a person thinks and behaves. This decreased cognitive functioning has the potential to prompt a mental health condition.
  

Living With HIV

Despite advances in treatment that allow normal or near-normal life expectancies for HIV patients treated in the early stages of the disease, living with HIV still has its physical and mental challenges.

Acceptance

Being diagnosed with HIV can have a big emotional impact on your life. Accepting any feelings of fear, sadness, frustration, anger, or guilt is key.

Acceptance may be easier knowing that effective treatment is available, and remembering that people can still live long, healthy lives with HIV.

Coping

Coping with the reality of living with HIV, as well as managing a mental health condition, is challenging. Moving through these challenges is an important step in the coping process.

If you feel you’re unable to cope, don't be afraid to reach out to a trusted source. Working in partnership with healthcare professionals and loved ones can help you stay the course.

Prioritizing Mental Health

Understanding how HIV can affect your mental health can make the diagnosis a little easier to manage.

When prioritizing mental health, making small changes to your daily routine and lifestyle can help support a strong and healthy mind and body. Experts recommend the following tips:

• Seek out reliable information about HIV to keep yourself educated, but not overwhelmed.
• Consider talking to a mental health professional or joining a support group.
• Eat a nutritious diet for strength and energy.
• Exercise regularly to decrease stress and help improve mood.
• Meditate or practice mindfulness to potentially improve mental health-related symptoms.
• Take medications regularly, and keep up with other medical and dental care.
• Maintain a regular sleep routine for physical and mental health.
  
• Avoid smoking and substance use.
  

Common Mental Health Conditions

Following an HIV diagnosis, mental health issues like depression, anxiety, mood disorders, or personality disorders are not only possible, but common.

Depression

Depression is the most common mental health condition found in people with HIV. According to some studies, it can affect up to 39% or more of HIV patients.

Experts believe the chronic stress, stigma, medication side effects, and immune system inflammation that accompany an HIV diagnosis can contribute to the chemical changes linked to depression and anxiety.

The many different types of depressive conditions can range from mild to severe, and interfere with daily life and functioning.

Symptoms of depression include, but are not limited to:

• Persistent sadness
• Feelings of emptiness
• Decreased energy or fatigue
• Losing interest in activities that once brought joy
• Difficulty sleeping
  

Anxiety

Anxiety disorders are a group of conditions that prompt intense and excessive fear, dread, and worry. Anxiety is another common mental health condition linked to HIV.

An estimated 1 in 5 U.S. adults living with HIV also experience generalized anxiety disorder (GAD), likely due to factors like stress, medication side effects, and HIV-related inflammation.

Symptoms can vary but commonly include:

• Feelings of nervousness or panic
• Difficulty sleeping
• Rapid heartbeat
• Nausea

Mood Disorders

People living with HIV are also at an increased risk for developing mood disorders, which impact the way a person thinks, feels, and goes about their daily life.

A combination of factors can cause a mood disorder in a person with HIV, such as chemical imbalances in the brain, genetics, and stressful life changes like an HIV diagnosis.

Not to be confused with normal mood fluctuations, mood disorders include conditions like major depressive disorder (MDD) and bipolar disorder, which significantly impact a person's emotional state and quality of life. Symptoms include dramatic shifts in a person's mood, energy, and ability to think clearly, along with distinct manic or depressive states.

Personality Disorders

Personality disorders are defined as a way of thinking, feeling, and behaving that deviates from the expectations of society, causing lasting distress and problems functioning.

Compared to the general population, people living with HIV are almost twice as likely to experience a personality disorder. Some research suggests that having an existing personality disorder could lead to the high-risk behaviors that make it more likely to be infected with HIV.

There are 10 different types of personality disorders—including borderline, antisocial, and narcissistic personality disorders—so symptoms vary widely. In general, signs can include experiencing notable changes to your patterns of thinking, functioning, and behaving.

Treating Mental Health Disorders

The goal of mental health treatment is to help you manage your symptoms and live as well as possible. Effective treatment plans usually involve a combination of medication, therapy, and social support.

Medication

Mental illnesses can be diagnosed under the care of a primary healthcare provider and a mental health professional.

Treatment may include medication. Depending on the specific condition, symptoms, and severity, this could include antidepressants, anti-anxiety medications, antipsychotics, or mood stabilizing drugs.

If you're currently taking antiretroviral therapy (ART) medication for HIV, your provider will want to be aware of that, as it can sometimes worsen symptoms of anxiety, depression, and sleep disorders.

Psychotherapy

Seeing a therapist or psychiatrist with experience treating people with HIV or chronic illness may be helpful. A therapist will be able to evaluate your mental health issue, determine the best therapeutic approach, and provide tips for maintaining mental health at home.

Talk therapy can take place on a regular basis in an individual, group, marital, or family setting.

Social Support

Building a strong support network can help boost your emotional well-being. Reaching out to others not only helps you maintain a positive outlook, but can also improve adherence to your HIV medication plan.

Support for both HIV and a mental health condition could come from sources like support groups in your area, the Substance Abuse and Mental Health Services Administration (SAMHSA) mental health treatment programs, your state's HIV/AIDS hotline, or online community forums.

Summary

Having HIV is linked to a greater risk for developing mental health conditions like depression, anxiety, personality disorders, and cognitive disorders. Factors like the extreme stress of the diagnosis, side effects from HIV medication, health inequities, and neurocognitive changes can contribute to these mental health issues.

It's critical for people with HIV to speak to a healthcare provider about any mental health concerns to discuss treatment options and get support for managing both conditions.

A Word From Verywell

Living with HIV can take a major toll on a person's mental health and emotional well-being. It's completely normal to experience fluctuating moods after being diagnosed. But if feelings like sadness, helplessness, emptiness, or isolation become intense, consider speaking with a healthcare provider or other trusted source as soon as possible. They will help develop a treatment plan that works for you.