Stress Management

by Kelly Williams, R.D, L.D.
July 2003

Stress and HIV

Everyone deals with a certain amount of stress every day. But if you're an HIV+ woman, stress can become overwhelming. Prolonged and excessive stress can depress your immune system and become the underlying cause of physical and emotional illnesses. Numerous studies have shown that stress can accelerate the progression of HIV.

Signs of Stress

You will be able to manage stress better if you recognize the symptoms. The chart below lists some common symptoms. (Tell your doctor if you experience any of these symptoms since some may have causes other than stress, such as side effects of medications or HIV.)

Physical Symptoms 

• Allergies
• A change in appetite
• Back pain
• High blood pressure
• Breathlessness
• Chest pain
• Clammy hands
• A cold
• Constipation
• Diarrhea
• Dizziness
• Fatigue
• Headaches
• Racing heartbeat
• Muscle tension
• Nightmares
• Rashes
• Restlessness Sleeping problems
• Stomachaches

Emotional Symptoms

• Anger
• Anxiety
• Denial of a problem
• Depression
• Difficulty making decisions
• Loneliness
• Nervousness
• Feeling powerless
• Feeling rejected
• Feeling trapped
• Feeling unhappy for no reason
• Being easily upset
• Worrying frequently

ehavioral Symptoms

• Increasing use of alcohol, tobacco or other drugs
• Neglecting appearance
• Arguing with friends or partner
• Avoiding tasks and responsibilities
• Difficulty concentrating
• Crying easily
• Being late to work
• Overeating or under eating
• Snapping at people
• Watching more TV
• Withdrawing from family and friends

Common Causes of Stress

What are some of the things that can make you feel stressed?

• Health problems in the family
• Dealing with HIV drugs
• Financial difficulties
• Children and childcare issues
• Substance use
• Social isolation
• Disclosure issues
• Insurance worries
• Housing concerns
• Fatalism (preoccupation with death and dying)
• Chronic impatience
• Grief
• Absence of purpose and goals
• Lack of self-assertiveness
• Lack of support
• Poor coping skills
• Poor eating habits and nutrition
• Sleep disturbances
• Inadequate exercise
• Limited capacity for self-care when sick
• Limited understanding of HIV-related health issues
• Poor relationship with doctor

How to Decrease Stress

Stress often results from feeling like things are out of control. A key to stress management is to stop trying to do it all by yourself. Find resources that can help. That way, even if you have a lot on your plate, you will feel better able to cope with it and less helpless. Figure out:

• What it is that you need
• Who or what can help
• How to get available services

Some cities publish books on resources and agencies that are available to the public. Some towns have an information and referral service that can help. Often a caseworker or advocate at an AIDS service organization can help you sift through the information.

What kinds of free or low cost services can help with stress? It depends on where you live, but some of the many are: medical services, counseling and psychological help, babysitting, taxi rides, bus passes, acupuncture, yoga classes, community college classes, massage, support groups, HIV+ dating services, free computers, legal services, drug and alcohol counseling, etc.

Apply to as many programs, agencies, or services as you can and don't feel guilty about accepting money or services! That's what they are there for. If there are limits to the number of services you can receive from a certain agency, choose the most important or necessary services first. Persistence is also important. Don't give up. Even if it takes months of paperwork, it will be worth it in the long run.

Don't forget about friends and family. If someone offers help or asks you what you'd like for a holiday or your birthday, speak up! If what you really need is for someone to watch the kids for a weekend or help pay your rent, ask. The worst that can happen is they will say no.

Another key to dealing with stress is to be just a little selfish. Many HIV+ women are too busy caring for kids or partners to notice that they are “burning out” mentally, physically, or emotionally. But if you become overwhelmed by stress, who will take care of your children and partner? Try to find a balance between giving and receiving help.

Depression

Untreated stress can lead to depression. Lack of appetite, low sex drive, decreased energy, or sleep problems are all symptoms of depression. Depression is often undiagnosed and untreated in HIV+ people because many of the symptoms are common to HIV disease or HIV drugs.

Depression is very treatable through therapy (individual or group), medications or alternative treatments. If you think you are depressed, talk to your healthcare provider.

Other Tips for Reducing Stress

Everyone has different stressors in their lives and everyone finds different methods effective in dealing with those stressors. Look for stress-reducing techniques that work for you. Here are some ideas:

• Talk about it: a friend or family member may help you sort out your feelings and get a new perspective on problems
• Join a support group
• Get regular exercise
• Change your own outlook and actions, rather than trying to change others
• Keep a journal
• Practice assertive communication (learn how to say no to things you don’t want to do and yes to things you do want to do)
• Get enough sleep: most people need about six to nine hours of sleep at regular times
• Take a break and treat yourself
• Practice hypnosis, biofeedback or massage to relieve tension
• Listen to music
• Try relaxation techniques such as meditation, deep breathing, or visualization
• Watch what you eat: eat breakfast, cut back on caffeine, watch sugar intake, and stick to a regular meal schedule
• Remind yourself of your accomplishments
• Look positively at change, instead of fearing it
• Look back on a crisis as a learning opportunity

See your doctor to discuss stress and how it affects you. Also consider seeing a therapist or counselor if stress gets out of hand.

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