Struggling

[Central79]

I'm writing this because I don't have anybody to talk to. Everything is getting a bit too much for me and I feel like something in me is slowly breaking under all the things going on in my life. There are quite a few things going on, and I'm not sure how much each of them is contributing:

1. Work.
I'm 2 months out from sitting my finals in medicine. I also have to study for an obstetrics and gynaecology exam in little under 3 weeks' time. I cannot concentrate and whenever I sit down to try and do some study I get incredibly anxious and become really aware of myself - it's almost like I can see myself in my mind's eye sitting at the desk, struggling to concentrate. There's a lot of work to do, and I am avoiding it - making myself cups of tea, jerking off, reading trashy fiction to take my mind off things.

I'm also not going into my clinical placement. I wake up feeling anxious, and it takes me a long time to coax myself out of bed, and into a shower. Even ironing a shirt seems too much, and going into a hospital and interacting with other people seems scary and impossible, even though I know I can.

2. Therapist on holiday.
I've been doing an analysis (50 Min's, 5 times a week) for a year. Before that I did psychodynamic psychotherapy for a couple of years. I started because of a nasty couple of bouts of depression just before I came out to my family, and a couple of years later. These caused me to take breaks in my degree and have to go and work instead, which I actually quite enjoyed. Anyway, she's away right now and I don't think it's helping much. It's served to make my feeling of isolation worse. All I can do right now is take my antidepressant (mirtazapine) and do my best.

3. Relationship.
I have a boyfriend. He loves me. I know that this should make me feel lucky, but I don't. We were together before, then apart when I caught HIV, and now we've been back together for a year. We broke up because he was going through a lot of stress and his sex drive took a dive. I thought it was about me, and pestered him for sex. One day he snapped "I think we should have an open relationship" at me, and I, to disguise my pain said "OK". Although he changed his mind, I kept saying I wanted an open relationship. I'm not sure why - maybe I felt threatened. Or angry. I wanted to destroy the relationship and I did. I realised that I'd made a mistake pretty soon after moving out, and we met up - but he'd already fucked some other guy, and this added to the feelings I'd had when he'd suggested an open relationship - a feeling of being vulnerable, rejected and angry.

We kept fucking occasionally for months afterwards, but never got back together. He made me out to be the bad guy, and I felt like I'd done something wrong. I kept going back, feeling pressurised and threatened and backing out. This went on for ages. He'd always have some hoop I'd have to jump through to make him feel safe - and that was impossible, as I didn't feel safe with him after what he'd blurted out and done. I ended several promising relationships to try again.

After I caught HIV he was there for me. All of a sudden he wasn't demanding reassurances. He's making it as easy for me as he can right now. I don't understand why he couldn't have done that before. I'm so angry with him for making it hard for us to get back together, and for destabilising me after we'd broken up - I keep thinking that if I'd been allowed to fall back into my old pattern of serial monogamy, I wouldn't have caught HIV. I find that thinking about this, getting angry and hurt, is taking up a lot of my thoughts. I think that if I dumped him I might be able to concentrate on work. And the sex still sucks, and isn't often enough - it's almost like he's pressed a button in his mind and gone from being a guy I loved fucking, to one I feel anxious and hesitant about even touching.

I miss the few months after my diagnosis when I was having sex with other poz guys, and had started going back to the gym. I was able to study. I feel like my anger with him is being turned back on myself and fuelling  behaviour like jerking off (I'm horny all the time), not studying, eating shit, not exercising. But maybe it's just my anxiety about my exams being projected onto this relationship...

4. Isolation.
I think I've always felt like this. About being gay, and now about the HIV. I really struggled to tell my family about my homosexuality, and before I came out I came close to suicide. Maybe that's why I came out - because it came down to that choice. I've spent most of my adult life relating to the world through sex, which although fun, has left me with few friends I feel I can talk to. I feel like I've talked enough about HIV to those I feel I can and now I feel like I'm inflicting a story they don't want to hear on them. I feel like I should have gotten over it by now, and be able to deal with it. I feel like a looser because HIV still dominates my thoughts all the time. It's gotten better over time, but so slowly as to make me question whether it's really happening. Anyway, I don't feel like anybody in my life really understands what this is like - not my therapist, not my bf, not my friends. They just placate me and say things will be different once I qualify and am working...

5. HIV

I feel like a looser for getting this disease. I feel like I didn't protect myself against the destabilising effects of my bf when we were apart, and against whoever infected me. I always wore a rubber, but had probs with my gums and failed to link that to a risk of HIV. I'm finding it really hard to forgive myself, and the people around me who I feel contributed: my poz friends who only told me after I was diagnosed their status; the mates who discouraged me from getting back together with my ex-; my bf for introducing me to drugs, and the idea promiscuity is harmless and the guy who infected me (if he knew his status). Most of it is on me though, and I feel polluted, dirty and worthless. I think lots of those feelings were there before the HIV, and have gotten projected into this disease - it's almost like it's evidence for feelings I have about myself anyway.

Anyway, you deserve a medal if you read until the end. I'm not really sure what else I can do. I'm trying really hard with everything, but feel very alone with it all. I just wanted to spill my guts and see what people think. I try and coach myself along, but it's not doing much good. The happy pills aren't making me happy, but stop me from crying and letting it all out. I spend most of my time feeling stunned, or anxious, or miserable. And helpless to do anything about it.

Answers on a postcard please.

[milker]

Postcard answer:

Go to the gym, and pre-pay 3 months of personal training 2 or 3 times a week. If you can't afford it, try to find someone that you can commit to and go to the gym with him 4 times a week at a very regular time. Seeing your body getting back in shape, feeling rejuvenated after good sweaty workouts, being committed to someone, either a trainer or a workout buddy will be the first step towards getting your life back into YOUR control. The power of the physical wellbeing is much more than anything else and will serve as a basis to recovery.

Milker.

[Moffie65]

Sorry Matt, but my answer will follow, when I have thought about this. 

Love,

[Andy Velez]

Dear Matt,

If you practice medicine with anything like the eloquence and honesty with which you have written here, your patients are going to be very, very lucky to be in your care.

You've articulated so well so many different issues -- ones which are too often overlooked in general and specifically in terms of living with HIV.

I'm grateful to you for taking the time and energy to put it all out like this. There's a lot to talk about in what you have written here. You've done a real service to others by opening like this about yourself.

This is a great way of stepping out of isolation.

Cheers, 

[woodshere]

Matt, 

No doubt that exams especially these are adding great stress to your life.  After they are over hopefully things will get better.

If you felt better when you were working out and going to the gym, then perhaps you need to start back, even if you have to force yourself.  I find if I can muddle through things and force myself back into things that make me feel better I am in much better shape.

Finally, you are not a loser and should stop punishing yourself.  Things happen despite our best intentions.  A loser would quit, you haven't.  Your path may have changed but your journey continues.  You and I both know that each person comes to term with their HIV in their own way and time.  I am certain that you will also.

Best to you,
Woods

[SASA39]

Just a quick postcard thought : It seems to me that an HIV virus increase all our life asperity`s to the max.Otherwise your life would be so usual -  homo or not...........Hang on-you have to........
                          Al

[Dragonette]

I think Milker's advice is great and I will adpot it if I have the $$$$.

Academic work is so stressful, but in the forseeable future, you will be a doctor, and a poz doctor, let alone one who was a poz even before he was a doc, is such a valuable thing to be in this world (nothing against neg docs, right), and being a doctor will open so many possibilities for you, there will be so much meaning in your life, places you could go work at, people you could help, people you could meet. Besides, a medical Dr. title will do wonders to your elligebility, as any Jewish mother can tell you ;0).

On a more serious note, I have the same relapses. The same distrust in my BF (and I didn't even know him when I was infected and it has nothing to do with it), the same concentration and overeating problems (although I am not big in the jerking off dept.), the same love-hate relationship with my body, the same boredome with the gym.... add some sleeplessness to the mix, some being far away from home and anxiety about the future, and that is one potent home made explosive.

You know what these are all signs os stress and you are under a lot of stress, in fact, I wouldn't be surprised if your fellow students/collegues are going through the same crap, without being positive, and of course being positive is the straw breaking the camel's back in this respect (although, more like a 100 kg weight than a straw).

I think the only way to get through this is to accept that this is how things are right now and that any thought/negative emotion you experience is legitimate. It's like being stranded at sea, sometimes you have to give in to the currents. Do what you can do, don't do what you can't, let it flow...

No magic solution here but I will try to do the same thing myself, accept that I am going through a lot, that there are normal, inevitable flactuations, that it's part of the ride. I am so used to struggling but sometimes there is a time to gain to gain some flab, to get 70 out of 100 and not 90, to be ticked off, to be petty, mean and angry, it's all in the spectrum....

[keyite]

Matt,

No answers, I'm afraid. Largely because I struggle with most of these issues myself. What I can offer you is the assurance you're not alone and that probably more of us than you might think can relate.

I've just finished an all-too-short run of counselling with the THT and one of the issues that came up again and again was my sense of isolation and inability to allow myself to be intimate with other people, to really let them get close. The reality is that I've been using sex for the majority of my life to give me the illusion of intimacy, all the while shielding myself from truly showing myself or making myself vulnerable. As cliched as it sounds, I think it's pretty clear a lot of this inability stems from my upbringing. Even with this degree of insight I have no idea how I go about changing it.

I also relate to your feelings about having become HIV+. I was so incredibly angry with myself during the first few months. Much less so now, but I still don't feel ready to forgive myself. I know I will have to sooner or later though, or it'll eat me up. It no longer is all I think about, but it continues to occupy an inordinate amount of space - although I haven't missed any days at work I cannot deny my work has suffered a lot. I spend far too much time at home and at work browsing websites about HIV (not least this one!). I hope - but am also pretty sure - it will lessen over time. Right now it is just how things have to be.

I obviously don't know your bf but I do suspect you're going to have to let him in on all these thoughts and feelings, warts and all. To keep all the anger, the hurt, the unresolved questions to yourself is going to be corrosive to the relationship. It is one key thing I learnt from the few relationships I've had. It'll be tough and perhaps it'll be more than the relationship can bear - but if you can weather it together then the relationship will be infinitely stronger. I'm not suggesting you do that here and now, so close to exams, but I wonder if the relationship will last if you don't eventually talk to him about 'the elephant in the room'?

As Andy rightly pointed out, judging by your contributions on this forum so far, all the empathy and understanding you have offered others, I'm absolutely sure you'll be a damn good doctor one day. You know, the best doctors are those who acknowledge they don't necessarily have all the answers, who know they are as imperfect, weak and prone to mistakes, as the rest of us. Not to mention how valuable it is when a doctor knows something of what it's like to be on the other side of the desk, being the patient. I rather selfishly hope you'll specialise in HIV.

Thank you for spilling your guts in such a brave, honest and personal way. It has blown me away and I'm sure I'll be thinking about your post in days to come. I'm really glad you're here and hope you'll continue to use this forum to share, get help when you're struggling, and hopefully lessen that sense of isolation. I know it's working for me.

K xxx

[Central79]

Hey Everybody

Thanks for your replies. I'm really grateful to you for taking the time to read about my problems, and offer your experiences, advice and thoughts. It's been very helpful, not least in that I don't feel so alone with this stuff right now.

I do need to try and get on top of this as best I can, whilst not beating myself up about feeling like I'm not coping. In fact I think the second bit is the key to the first bit!

Will keep you all posted.

Matt x.

[carousel]

Hi Matt

I'm not sure that I'm the one to give constructive advice as I am feeling pretty low myself.

I really admire the way that you have articulated the things that are going on your life.  It's a real gift.

I hope you sort the studying out, though the whole genealogical thing would not make me motivated.  One of the first things that went after my diagnosis was continuing my master's.  I couldn't study at all and just had to pull out.  That you have been able to continue shows a lot about your abilities.  I really regret not finishing the year.

When things do get on top of me, the problems often snowball.  Everything becomes a worry and before you know it, nothing in my life feels like it's working.  I try to do the things I know that I can do and not spend my time worrying about the things that I can't.  Try and take one thing at a time.  I find problems less overwhelming.  

That may be a bit lame for advice, but I hope it works out for you.  

[koi1]

Hi Matt,

I find myself taking this disease one day at a time. Yesterday was a very tough day for me. I am still dealing with ativan withdrawal, and yesterday I was feeling really anxious and couldn't snap out of it. So much so that I booked a flight for my ex to come back, and he had just left the day before. I just needed someone there telling ime that I was going to be okay. 

This disease makes me feel guilty for everything. After I felt like "Why did you do that. Can't you deal with this on your own. You got yourself into it. " I feel the pollution factor like you do. I feel different just for having this. I always worry. I think that this is will pass when I have been living with this for a while, but I just don't know.

So what you need to do is think of your bright future for now. I don't think that your boyfriend is the cause of everything right now. Don't concentrate too much on that. Do what you need to do to get your academics taken care of. You can deal with your boyfriend when you are in a more stable place emotionally. Remember that whenever a mood altering substance is in play, we are not ourselves. It's a double edged sword.  I hope that you will be able to live without the antidepressants one day. 

\Yes, it is easy to say that if you would not have had the break-up you would not have contracted this disease, but it is impossible to say with certainty. Don't blame yourself or anyone for having caught it, as it won't make any difference now. Trust me the same thing happened to me. I caught the HIV in one of my many break ups with my ex. It's not that simple. It never is.

rob

[penguin]

Matt - maybe focus on the right now, the things most important to get through each day. Easier said than done, perhaps, but if there are things people can do to help/make things simpler (even if it is just ironing that shirt, eh?)  - ask them (& then let them)

It does get better, calmer, easier even, with time. The past, it gets put in its place.
Keep your chin up, & be proud of all the stuff you've achieved…summer is just around the corner, they tell me 

Kate

ps - is there a special reason why mirtazapine..? Quite sedative/ de-energising…would it be worth looking into a (newer) alternative..?

[Moffie65]

Hi Matt,

Please find my answer that I promissed in this link.  http://forums.poz.com/index.php?topic=10936.0

I started another thread because I didn't want to load this one down.

I sure hope it helps, because it surely did for me.

Love,

[Central79]

Hey Tim

Thanks for your thoughts - I have contributed to the other thread you've started, as I think it's great to think about the wider view of things.

I'm really struggling to keep everything together. Today I got up late, not having slept and spent the day arguing with my bank, who have suddenly decided that they want some of the money they've lent me in the form of an overdraft back, 2 months away from the end of my course. Actually, they started just after Christmas. Bastards. So my card doesn't work, and I had to cycle across London to borrow some money from my other half.

And you know what? It was fun - I was dodging in and out of traffic, cycling like a mad thing. The weather in London today was lovely. I felt connected with my body in a way I haven't for a long time - could feel the air in my lungs, the strain in my legs. I think I've maybe been avoiding exercise because afterwards I feel this sense of loss. Almost like "so what if I can cycle, your body has this deadly virus in it". It's an attitude that is poisoning the rest of my life too - "so what if you're a doctor? You can't be a surgeon", or "so what if you eat well, all the organic food and veggies doesn't change the fact you've knocked 10 years plus off your life by getting HIV!". It's a horrible feeling of self-destructiveness - the urge to let everything go to hell so then I can say to myself: "See! You weren't wrong. HIV really did end your life". So I'm aware of that. I rationally know it's BS. But I'm still figuring out a way to combat it.

Just to pick up on what some other people have mentioned:

ROB - I hope you're stepping down off those ativan, and not going cold turkey anymore...

KATE - I'm taking mirtazapine on the recommendation of my Dean of medicine, who's also a shrink. I have tried fluoxetine (prozac) and citalopram in the past. Citalopram made my head feel very strange and fluoxetine didn't do much. I'm told mirtazapine is a good second line drug. I certainly is sedating, esp. initially so I tend to take it before bed when it doubles up as a sleeping pill. It also made me eat like a horse... Whatcha think?

Cheers,

Matt.

[fred40]

Thank you Matt for sharing this time in your life with us with such honesty.  I can truly understand how you feel, as I deal with much of the same issues.  You are definetly not alone.

I'll keep you in my thoughts and prayers that you pass through this soon.  You are an inspiration to me that you have continued to do something in life that is helpful not only to yourself, but so many others.  God bless.

[GSOgymrat]

Sorry to hear you are going through a rough patch. It is encouraging that you are doing things to help deal with this depression rather than just giving up and letting things get worse. You are obviously bright and insightful and recognize you need to let go of the negative thoughts that are draggin you down. I agree with other people's suggestion that exercise can really help. As you can see just being outdoors can help put problems into perspective.

[bravebuddharich]

Hi Matt,

You've gotten so many wonderful posts in response to your original post - thanks for sharing your story. Here is the one thing I would like to add for you to think about: please do yourself a favor and end things with this man. It will be the best thing you could ever do for yourself as far as valuing yourself highly and getting your best self back - figure out what YOU want. Clearly, you dont' want an open relationship (I simply refuse to consider open relationships, period). You sell yourself short by staying with someone who so clearly does not want what you want, and who treats you disrespectfully. We all deserve better, including you!

Metta,
Rich

[otherplaces]

Matt (and Keyite),

I just want to drop 2 cents on this, think what you may, but this is what I believe.

Sure...maybe you could've been more careful, and then yes maybe you wouldn't have gotten HIV....um, MAYBE.  Who the hell knows?  As humans we have sex, for good and bad reasons.  It's hard not to be human.  Look around at all the people you pass on the street today and tomorrow.  They ALL have sex.  I garuntee it.  And they've all taken a chance.  And alot of 'em got away with it, and will get away with it in the future.  But we got nailed...it's really the only difference.  EVERYONE I know has taken a chance with sex...EVERYONE (except maybe my parents).  So when it comes down to it you're blaming yourself for being a fallible human like everybody else.  Of course, the negs need to hear about safe sex, etc. and hopefully they'll be safe and won't end up poz.  But for you and I it's moot.  I'm human, you're human, and we did nothing wrong!

I've had "friends" tell me they forgive me for contracting HIV.  I've had "friends" tell me that I need to forgive myself.  When I knew damn well their sexual history was alot riskier than mine.  If I need to be forgiven so do they!  BTW, I'm not friends with them anymore.

The last person I told about my status immediately said, "You know you did nothing wrong".  And she gets mad props.  I was on that page, but it was nice to hear someone say it, especially as a first response.  So I'm saying to you right now.

You did nothing wrong.

...and you and I know what Milker said about the gym is true (I'm tryin' to take that advice myself....it'd be easier to run if it wasn't April and 30 degrees in Chicago....BLAH...but yeah it helps.)

much much love,
brian