HIV? AIDS? WTF?

Flirting with danger, or something deeper?

by Mary Turner
Gayly Health Columnist

Approximately 50,000 new cases of HIV infection are diagnosed each year in the United States. With all of the preventative measures available to help keep individuals safe, this seems to be an insanely large number (and it is). Some of you take unnecessary risks: You are lonely and don’t want to risk rejection, so you have unprotected sex to feel connected with someone. You like the adrenaline rush of living on the edge and flirting with danger. You believed someone that you thought you could trust, but you couldn’t. Or, you still live in a fantasy world in which you are invincible, so getting HIV won’t happen to you.

The purpose of this column is to reach out and take those of you who fall into these unfortunate categories by your sweet faces and scream WTF! What are you thinking? Why are you so willing to throw away your lives and dreams and all that you could be because you think this terrible virus will somehow spare you? WTF!

But, there’s another category of HIV positive individuals who haven’t been deliberately careless in their pursuit of life. These are the folks who are mentally ill and/or who have substance abuse issues. Just as cancer, diabetes and asthma are illnesses, so is mental illness. The difference is that mental illness is a category that marks people with a scarlet stigma. To be mentally ill is to be ‘less than human,’ so those afflicted often avoid treatment.

Likewise, alcohol and other substances can slowly take over a person’s body until he or she has no choice but to take risks in order to get more. Without them, the pain becomes too great. Even worse is the fact that the pain that may stem from certain mental illnesses leads people to self-medicate. Now there isn’t one controlling force that interferes with good choices, but two.

Besides substance abuse and addiction, the disorders that may cause a person to take risks and make them less capable of making prudent decisions are depression, bi-polar disorder, anxiety disorders, borderline personality disorder, or a combination of these. The most common mood disorder, depression, can leave a person feeling weak and helpless, and unable to enjoy anything in life.

Depression responds well to treatment. Once the mental fog and feelings of inexorable sadness lift, the person may feel as though he or she doesn’t need to continue to take the medications. The downward spiral then repeats itself.

Bi-polar disorder is arguably one of the most difficult mental health issues to treat. Those who are bi-polar cycle through a state of utter depression and hopelessness that may leave them curled up on the couch. That is followed by a manic phase in which the person may have boundless energy, but is also out of touch with reality. Feelings of paranoia and invincibility are common. During this phase, the person may be quite aggressive and unrealistic about his or her possibilities. This is when the person is most vulnerable because they believe bad things won’t happen to them. As they begin to cycle back into their depression, they may realize that they have made poor decisions, but they are incapable of doing anything about them.

It is hard for people with mental illness to accept that mental illness isn’t like the common cold. You can’t wait a few days and then start to feel better. You will have to work with a doctor and treat the condition for life. The same is true of addiction. Every day is a new day that will present challenges of its own. When HIV is added to the mix, the interactions of these very powerful drugs can cause unbearable side effects or even death.

In spite of the high correlation between those who are mentally ill and those who become HIV positive, there have been few studies to measure the interaction of HIV drugs, and drugs to treat mental illness. Friends, relatives, and community members have to support them in getting treatment, often for both conditions, and continuing that treatment until they can make better choices for themselves. When they can think, they may choose more wisely and keep themselves safer.

For those of you who do stupid sh*t because you think you can get away with it, know that the odds are stacked against you. For those of you who are mentally ill or who love someone who is, know that help is out there for you. Please be willing to ask for it.

October 19, 2013