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Just Diagnosed

Are You HIV-Positive and Worried?


Our resident mental health doc answers one woman's question about how to deal with the uncertainty she feels since her HIV diagnoses.

I’ve been HIV-positive for a few years. I’m taking good care of myself, taking my meds, keeping the stress down as much as possible. But I have to tell you something. Some days, life feels so uncertain. I mean, let’s face it. I didn’t think I would become HIV-positive and then I did. So what else can happen to me? How do I get used to not knowing what’s around the corner? I feel anxious and sad when I think about how uncertain my life is. 

Life is uncertain. You think you’re doing everything right. At least, you hope you are. But life gets in the way of our plans. An unexpected turn of events can change everything. An event that you didn’t expect, maybe didn’t even think would ever come your way. 

Yes, life is uncertain. Nobody understands that better someone like you. Someone who is living with HIV. As you said, your diagnosis was proof itself that of the uncertainty of life. And, most likely, you have had some further evidence along the way. Like we all have. 

Living with all that uncertainty can pack an emotional wallop. Fear. Sadness. Disappointment. Anger. Over time, sitting with these feelings can lead to anxiety, constant worrying: What’s gonna happen to me next? As well as depression, helplessness and hopelessness: Why bother to expect anything good?  

Uncertainty is part of life. But that doesn’t mean anxiety and depression are inevitable. You can learn to cope with uncertainty by using the power of your mind. Yes, you’ve already got what it takes. Better coping is a matter of developing the tools needed to harness your mental capabilities. Rational mind to the rescue!   

Here’s the formula:

Accept that you are not in control. Life happens. And most of it happens regardless of our hopes and wishes. So talk to yourself. Gently but firmly say: “You can do a lot to take care of yourself. But you can’t control the outcome. And you can’t control what might come up along the way to throw you off course.” In other words, give up the battle before it starts. You’ll have a whole lot more energy left for much more productive thoughts and actions. 

Ask yourself: What’s the worse that can happen? Vague concerns about your life can add up to big fears. So take a step back and put some definition around your concerns. It might help to use a scale of one to ten, with one being “annoying” and ten being “catastrophic.” This will help you to have a more realistic view of the uncertainties in your life, and also guide you in getting better prepared for potential outcomes. Don’t create potential catastrophes where they don’t need to exist. Be ready to do what you can to cope with those that exist. The point here is to be fully present in your own life so that you can be more effective in your life. Rational mind can help you get there. 

Review your foundation. What do you have to rely on in the event your boat gets rocked? Your strengths? Your support network? Your healthcare team? This is your foundation. Being aware of it will help keep you from feeling overwhelmed when you’re in a situation that feels threatening in some way. Review your foundation every time things feel uncertain. This is a great way to build mental muscle strength. 

Consider how you have coped in the past. It might help to think back to situations in the past when the uncertainty of life weighed you down. Recount times in the past when life has thrown you a curveball. What did you do to hold onto your center? This is a great way to identify coping skills you might have forgotten you had. Dust them off and put them to good use. 

Avoid the rabbit hole. Our minds have a way of throwing scary, worst case scenario thoughts in our direction. These thoughts are automatic. And it is only human nature to grab onto these thoughts and use them to make ourselves feel worse. I call that chasing a thought down the rabbit hole. Getting stuck in the rabbit hole can lead to anxiety and depression. Here’s what I say to my clients: You have a choice. You can choose which thoughts you want to hold onto and which thoughts you want to dismiss. Acknowledge negative and unproductive thoughts and then let them go on their way. You can’t control your thoughts but you don’t have to let them control you. Again, engage rational mind. 

Honor your emotions. But don’t let them lead you around by the nose. When uncertainty causes you to wander into the rabbit hole of unproductive, catastrophic thoughts, lots of emotions are going to come up. Feel your feelings, talk about your feelings. When you hold them in, they just get stronger. Letting them out clears the way for more rational thinking.   

Give yourself encouragement.  The worst thing you can do is to constantly tear yourself down. The best thing you can do is to treat yourself with compassion. Talk back to the voice of fear and hopelessness with a confident, steady voice of encouragement. “You’re doing the best you can.” “You can’t control this but you’ve got a lot of support.” “You’ve been down this road and you got through it. You can do it again.” 

Have a game plan. Starting with a reasonable plan to manage your HIV. Work closely with your healthcare team to create your plan, ask for support when you feel you might wander off the path. Working the self-care plan is the best insurance you have in the face of life’s uncertainties. One day at a time. Having a plan in place to take the best care of yourself is going to increase your self-confidence. 

You, your HIV, and the uncertainty of life. As you travel the road ahead, harness the power of your rational mind to help you cope. 

Gary McClain, PhD, is a therapist, patient advocate, and author in New York City, who specializes in working with individuals diagnosed with chronic and catastrophic medical conditions, their caregivers, and professionals. He maintains a website, 










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