Duovir-N (Lamivudine, Zidovudine, Nevirapine)
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WHEN FIRST DIAGNOSED: UNDERSTANDING AND COMMUNICATING ABOUT
HIV-REACTING TO THE DIAGNOSIS: THE TURNING POINT
One way or another, people’s strategies usually work, and their acute distress fades. They come to understand they can live with the virus. This understanding often comes as a sudden turning point. Alan Madison, after a few days of isolating himself, talked to his mother, who told him to get over it. “That didn’t help,” he said. “Then the next day in the shower I said to myself, ‘This stinks, but I’m stuck with this virus and would rather have my life happy than sad.’”
Steven Charles had a similar turning point: “After I was diagnosed with the virus, I read up on it, and decided my life expectancy was eight years. So I took my bank account and divided it into eight piles. Then I thought, what if I live nine years? That sort of settled me. I decided to let tomorrow take care of itself.”
Lisa Pratt’s turning point was more religious: “At first, I let the house go. I let junk pile up. After a while, the facts started sinking in. I said to God, ‘You’ve got your .work cut out for you. I’m going to turn a lot of this over to you until I can handle it.’ Then I went out and bought one hundred narcissus bulbs because I knew we’d need a reminder of the renewal of life. And it worked. My husband said, ‘They make me feel so good.’”
Occasionally, however, nothing works. Even after a few months, people remain extremely depressed: they are still preoccupied, or think seriously about not wanting to live, or persist in having problems eating and sleeping. This more serious type of depression happens to about 5 percent to 15 percent of people with HIV infection (the same percentages of people who become severely depressed after being told that they have cancer or some other serious illness). Some people deny they are infected and persist in behavior that puts the health of both other people and themselves at risk. Some people consider suicide, though less than one percent of those with HIV infection actually commit suicide. People who experience severe depression, denial, or thoughts of suicide need to get help from a psychiatrist, psychologist, or other mental health professional. Persistent depression may be best treated with medication, which a psychiatrist can prescribe.
Most people gradually understand and believe that they are not going to die tomorrow. They have time to get used to the infection, to find answers to their questions. They restabilize, and they continue living. “Life changes, then comes back to normal,” said Steven. “I’m no longer sitting around waiting to get sick.”
HIV Some people, at their own pace, begin thinking how they might change their lives. Alan’s hobby had always been writing, and now he thought he would like to write a really good book. Steven, who worked as a technician for a scientific laboratory, had always wanted to teach, and volunteered as a teacher in a community adult education course.
Some people begin tidying up relationships: Lisa’s husband called his brother more often, and they began going to ball games together. Steven eventually asked his cousin to come stay with him: “We’ll spend more time enjoying the things that give us pleasure.”
This is not to say that under normal circumstances, fear or depression or isolation go away and stay away. The feelings almost seem to cycle, to come back in waves over and over again. But with each cycle, the feelings become easier to deal with, and the strategies people use to deal with them become almost automatic. “I was fearful and depressed for a whole summer,” Alan said. “But now, when it starts washing over me again, I know what to do. I get busy, and then I’m not afraid.” Steven said, “At first, my diagnosis was the only thing on my mind. That was a year ago, and I still get pretty depressed, but now it’s not the only thing on my mind.”
*14/191/2*
