August 2001
Attitude: How to keep a positive attitude

"Have a positive attitude." How many times have we heard that one? While our emotions cannot cause HIV or an opportunistic infection, they no doubt affect our symptoms. But how can we maintain good thoughts when our bodies feel so lousy? This challenge, of course, does not pertain exclusively to HIV, but to any time when things do not go as we wish. But in the case of HIV especially, seeing the positive presents a continuous struggle.

Most likely we can all recall times that despite much pain or fatigue, we were able to cope and even achieve high spirits. Perhaps the weather was perfect, good friends visited, we just accomplished something or helped somebody, making us feel good about ourselves. Other times, depression seems to take hold even when our physical discomfort is at a manageable level. Why is this? Answering this question is the key to finding optimism.

HIV/AIDS can feel like a swim in the turbulent sea -- sometimes it seems we have fallen and the waves continue to crash on our heads, as we fight to rise, only to be knocked down yet again. But that same ocean sometimes allows us to find a wave we can ride smoothly to the shore.

What can we do when we feel under the waves? How can we find the strength to climb back on top, and the patience to know that we will? Here are a couple exercises I use to maintain the most positive attitude I can:

1. Expect bumps! It is important to acknowledge that we will sometimes feel down. Who doesn’t? But by expecting rather than dreading down time, such periods become more tolerable. In addition, recognizing that we will have blue periods helps keep them in perspective. We will be able to say to ourselves, "I was depressed before, and got out of it; this time, too, it will pass." It is easy to forget that before HIV, there were times when we felt down. Now these episodes are wrapped up in our medical problems; but everyone gets depressed some of the time. After accepting that we will sometimes feel sad, and even experience self pity, we can concentrate on ways to shorten these periods and make them fewer and farther between.

2. Track the changes. Keeping track of moods helps put ups and downs into perspective. During your best times, make a conscious attempt to capture the feeling. Leave notes or poems on your wall attesting to the way you feel. Living with HIV easily creates a Jekyll-and-Hyde persona, where your optimistic self and your flare-up self are not sufficiently acquainted. When we feel bad, it becomes quite difficult to imagine that things can be otherwise. Similarly, during times of improvement, it's amazing how quickly we may forget how bad a previous period was, making subsequent flare-ups not only intolerable but shocking. Counting and measuring the duration of the bad times -- as well as the good ones -- can put them into perspective.

3. Lean on me! A single most important predictor of how we do is the support network we create. We certainly appreciate what it means when someone helps us when we feel especially lousy. Make sure that, within your means, you continue to be a good friend to those you care about. We still have lots to give. During a good moment, write to a friend that you are thinking about him/her. There are now all sorts of support groups out there for women living with HIV.

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