Emotional and mental wellbeing is an important aspect of living well with HIV. There may be many aspects of our emotional and mental health make-up that all converge together (sometimes not at the same time) that will determine if we are having a good day, a good week, or a good life, such that we may be generally happy, well and content. Often too, our emotional and mental wellbeing may also be linked to physical wellbeing and health.
There are number of studies which show the association between improved CD4 counts and our state of relaxation or harmony with our surrounds. Stress raises a hormone in the body called ‘cortisol’ and HIV itself can raise cortisol levels, where excess cortisol depletes the immune system and can lead to fatigue. Persistent fatigue can lead to depression, among other causes of depression (such as loss, grief, pain or some illnesses). Depression is often characterised by persistent low mood, loss of enjoyment in things you once enjoyed, persistent low energy, difficulty concentrating or making a decision, worries, frustration, irritability, impaired sleep, and sometimes avoiding social contact.
Sleep is essential for emotional and physical wellbeing. There is no hard and fast rule on the number of hours an adult should sleep each night, but generally about 7 hours is sufficient and this may change slightly with age. What matters is the quality of your sleep and how refreshed you feel each day. There are a number of conditions which can affect sleep quality and quantity such as insomnia (difficulty falling asleep or staying asleep), sleep apnoea (persistent waking during sleep). The underlying cause can be identified by your doctor or health practitioner.
Lack of quality sleep can lead to depression, fatigue, drowsiness, mood swings and increase anxiety levels. Certain medications, alcohol, stimulant drugs, and certain health conditions (such as those that affect breathing or incur pain) can all lead to lack of good sleep. Depression or anxiety can also lead to lack of quality sleep, so cyclic patterns can come about and compound each other causing chronic patterns of ill-health.
Developing good sleep habits can prevent chronic sleep problems – such as going to bed at the same time each night, avoiding TV or the internet before bedtime (electromagnetic stimulation), sufficient darkening of your room, good air quality and temperature, avoiding alcohol, tea, coffee, or other substances well before bed.
Having a good diet containing fresh and varied food also helps to build physical and mental energy. HIV+ people generally do not need to adopt a special diet (unless instructed by your health-care provider or dietician) so the Australian dietary guidelines apply to all people: www.eatforhealth.gov.au/guidelines/australian-guide-healthy-eating
Good sources of poly- and monounsaturated-fats in the diet called ‘essential fatty acids (EFAs)’ can also help with thoughts and moods as they assist in brain and nerve functioning. Nuts are very good source of EFAs.
Some medications and substance use can decrease your desire for food, as well conditions such as depression (which can cause over or under eating), so it is important to speak to your health-care provider about diet and appetite.
It is a good idea to talk with your doctor about any substances you might be using. Your trusted doctor is not interested judging your substance – he/she is interested in your health associated with your use. This can be useful in times if alcohol or substance use may become a concern for you in daily life or begin to impact on your health. Your doctor is a key source of helping with any addictions and providing support and therapy if you feel you need it.
Ultimately, what is important is that a good quality of life is achieved and maintained, and good mental and physical health are the keystones. HIV treatments will keep HIV at bay for you, but there are other lifestyle pursuits which you can do for greater physical, emotional and mental wellbeing – such as a having a nutritious diet, getting quality sleep, adequate exercise and physical activity, socialising and enjoying life with friends and partners, and seeking engagement with communities that enhance your sense of wellbeing and belonging. Relaxation therapies and recreation can also help improve quality of life – these could be as simple as walk by the ocean…
If you find that you are not coping and your thoughts, feelings and mood are affecting you, reach out and mention these things to your doctor or community support worker. They will be able to help you identify the things that most concern you and provide the supports, therapy, treatment or referrals that you identify may help you.
There are a number of FREE self-help mental health programs and counselling lines, a few follow:
- Lifeline (24 hours) – for crisis and suicide support phone line: 13 11 14
- Suicide Call Back Service (24 hours) – provides free counselling and support to anyone at risk of suicide or affected by suicide: http://www.suicidecallbackservice.org.au/ 1300 659 467
- Counselling Online (24 hours) – online text-based (or phone) counselling for people concerned about their own drinking or drug use. http://www.counsellingonline.org.au/
- Beyond Blue (24 hours) – provides information and support to help everyone in Australia achieve their best possible mental health, whatever their age and wherever they live. Email support service and online chat is also available: http://www.beyondblue.org.au/ 1300 22 4636
- SANE Australia (Weekdays 9am to 5pm): A national online and Freecall service, providing information, support and referral to people concerned about mental illness. http://www.sane.org/ 1800 18 7263
- Queensland Injecting Health Network (QuIHN) – provides a variety of health services to illicit drug users in Queensland, including mental health supports: http://www.quihn.org/ 1800 172 076 (freecall) or 07 3620 8111
- StimCheck (NSW – About Crystal Meth): www.stimcheck.org.au/stimcheck
- Mindfulness Stress Reduction Course – is a free online at your own pace. Mindfulness is practicing the art of being in the present moment, reducing the persistence, intensity and effect that fears, stress, worry and anxiety might have on the body. The aims of this program are to reduce the effects of being lost in pain and suffering, by restoring the capacity to come back to balance & ease in our lives: http://www.palousemindfulness.com/
If you are in medical crisis call the Queensland Ambulance Service on TRIPLE 000