Call or text 988 in the U.S. for the Suicide & Crisis Lifeline. For treatment referrals related to mental health or substance use, call SAMHSA’s National Helpline at 1-800-662-HELP (4357). These services are free and available 24/7.
Mental health basics
Mental health is your emotional, psychological, and social well-being. It affects how you think, feel, and act. Good mental health helps you cope with stress, work productively, build relationships, and make healthy choices. People with HIV face added stressors like stigma and disclosure worries, so attention to mental health is especially important in HIV care. Mental health conditions are common and treatable.
Why mental health matters. Mental health influences physical health and daily life. For people living with HIV, good mental health makes it easier to engage in care and take medications as prescribed. Unaddressed depression, anxiety, or substance use can make HIV outcomes worse.
Common mental health concerns
Stress
Stress is your body’s response to challenges. Short-term stress can help you act quickly. Long-term stress can harm sleep, mood, heart health, and immunity. You can manage stress with regular activity, social support, good sleep, and relaxation skills. If stress interferes with work or relationships, consider therapy.
Anxiety
Anxiety becomes a disorder when worry is hard to control and persists for months or when you have intense fear in specific situations. Symptoms can include restlessness, trouble concentrating, sleep problems, and physical symptoms like a racing heart. Anxiety disorders are treatable with psychotherapy, medication, or both. Finding the right plan may take time.
Depression
Depression is more than feeling sad. Core symptoms include low mood or loss of interest, along with changes in sleep, appetite, energy, concentration, or thoughts of death. Treatment options include psychotherapy, medications, or a combination, plus support for sleep, exercise, and routine. People do improve with care. Seek urgent help for thoughts of self-harm.
PTSD and trauma
Post-traumatic stress disorder can follow a traumatic event. Symptoms may include re-experiencing (intrusive memories or nightmares), avoidance, negative changes in mood and beliefs, and hyperarousal. Effective treatments include trauma-focused psychotherapies such as cognitive processing therapy and prolonged exposure, and certain medications like SSRIs and SNRIs.
Addiction
Addiction is a chronic condition that changes brain function and behavior. Effective care often combines medications, counseling, and support for related medical, social, and legal needs. Treatment should be individualized and continue long enough to be effective. Reach out for help if alcohol or drug use is causing problems in your life.
Dealing with grief and loss
Grief is a natural response to loss. Feelings can include sadness, anger, guilt, relief, or numbness. Most people find grief eases with time and support. Seek help if grief stays very intense, interrupts daily life for a long time, or brings thoughts of self-harm.
Getting help
What is therapy?
Psychotherapy (talk therapy) involves meeting with a trained professional to learn skills, process experiences, and make changes that improve well-being. Common approaches include cognitive behavioral therapy (CBT), interpersonal therapy, trauma-focused therapies, and others. Therapy can be in person or via telehealth.
Finding a therapist
Look for someone licensed whose expertise matches your needs. Consider language, cultural fit, and practical issues like location, cost, and insurance. The American Psychological Association’s Psychologist Locator and similar directories can help you find qualified providers. Primary care clinicians can also provide referrals.
Medications
Medications can reduce symptoms of many conditions. Antidepressants, anti-anxiety medications, mood stabilizers, antipsychotics, and medications for substance use disorders are common tools. Work with your prescriber to choose a safe, effective option, understand side effects, and give time for benefits to build. Do not stop medications suddenly without medical guidance.
Combined care works well
Many people do best with a combination of therapy, medications, healthy routines, and social support. This blended approach is also helpful when mental health conditions occur alongside HIV or other medical issues.
Daily tools that support mental health
Self-care habits
Small daily actions can support your mood and resilience. Aim for steady sleep, regular movement, balanced meals, time outdoors, and connection with supportive people. Limit alcohol and non-prescribed drugs. Plan enjoyable activities. Set small goals and celebrate progress. (CDC)
Meditation and mindfulness
Mindfulness and meditation practices can lower stress and help with anxiety and depression for many people. They are generally safe and can complement, but not replace, professional care. Start with a few minutes a day and build gradually.
Mental health and HIV: what to know
Why mental health matters in HIV care
People living with HIV are at higher risk for some mental health conditions. This is linked to stress from managing a chronic illness, stigma, and life challenges such as money, housing, or relationship strain. Studies show that people with HIV are about twice as likely to experience depression compared with people who do not have HIV. The good news is that mental health conditions are treatable and people can recover.
Mental health affects HIV outcomes. Depression, anxiety, trauma, or substance use can make it harder to attend visits, start treatment, and take medicines on schedule. Better mental health is linked with stronger engagement in care and better viral suppression.
Common mental health conditions among people with HIV
- Depression and anxiety. These are the most common conditions. In some large studies, about one in three people with HIV had major depression, and anxiety was also more frequent than in the general population. Symptoms include low mood, loss of interest, worry, poor sleep, and concentration problems. Effective treatments include talk therapy, medicines, or both.
- PTSD and trauma. Trauma can come from past violence, discrimination, or serious illness. Symptoms include intrusive memories, avoidance, negative shifts in mood, and hyperarousal. Trauma-focused therapies and some medicines help.
- Substance use disorders. Alcohol and drug use can worsen mood, sleep, and judgment and can conflict with HIV medicines. Integrated treatment that addresses both substance use and HIV works best.
- Sleep problems. Sleep issues are common and can worsen mood and concentration. Addressing sleep helps overall well-being and adherence.
HIV, the brain, and cognition
HIV can affect the brain and thinking abilities, even with modern treatment. This spectrum is called HIV-associated neurocognitive disorder. People may notice slowed thinking, forgetfulness, or trouble focusing. Regular HIV care limits risk, and a clinician can check other causes such as medications, sleep disorders, or depression.
Stigma, disclosure, and social factors
Stigma can harm mental health and discourage people from seeking care. Many people with HIV report unmet mental health needs alongside housing, food, or job challenges. Addressing these needs improves quality of life and supports HIV goals. Ask your clinic about case management, support groups, and practical resources. (CDC)
Special groups who may need extra support
- Adolescents and young adults. Young people with HIV have higher risk of sleep and mental health problems and may face barriers to care. Youth-friendly services, family support, and school accommodations can help.
- People with past trauma or violence. Trauma-informed care that emphasizes safety and choice improves engagement and outcomes.
Screening and when to ask for help
Ask your clinic to screen for depression, anxiety, PTSD, substance use, and cognitive changes at least once a year or any time you feel off. Tell your team about mood, sleep, energy, substance use, or thinking changes. Early attention prevents bigger problems and helps you stay on track with HIV care. (HIVinfo)
Urgent signs to act on now: thoughts of self-harm, suicidal thoughts, severe panic or agitation, confusion, or inability to care for yourself. In the U.S., call or text 988 for the Suicide & Crisis Lifeline, or go to the nearest emergency department. For treatment referrals related to mental health or substance use, call 1-800-662-HELP.
What treatment looks like
- Talk therapy. Cognitive behavioral therapy, interpersonal therapy, and trauma-focused therapies help with depression, anxiety, and PTSD. These can be in person or via telehealth. Group therapy and peer support can reduce isolation.
- Medicines. Antidepressants, anti-anxiety medicines, mood stabilizers, and treatments for substance use can be safe with HIV treatment when interactions are checked and monitored. Give medicines time to work, and do not stop suddenly without guidance.
- Integrated care. The best results come when HIV care and mental health care are coordinated. This model improves retention in care and viral suppression. Ask your clinic if they can coordinate with a mental health professional.
Daily steps that support both mental health and HIV
- Keep a regular sleep and wake schedule.
- Move your body most days, even with short walks.
- Eat balanced meals and limit alcohol and non-prescribed drugs.
- Stay connected with supportive people and consider a peer group.
- Use reminders or pillboxes to take HIV and mental health medicines on time.
- Practice brief mindfulness or breathing exercises to settle stress. (HIV.gov)
How to talk with your care team
Bring a written list of symptoms, medicines, and goals. Ask:
- Could my symptoms be from a medicine, an interaction, or another condition?
- What therapy options and support groups are available?
- Which mental health medicines are safest with my HIV regimen?
- How will we follow up and measure progress?