So what is it that does our heads in? Is it the drugs? Is it the stigma? Is it the virus itself? I don?t think I know of one person who is HIV positive who doesn?t have some sort of issues. Many of us are depressed. Many of us are chronically anxious. Some of us are in denial. Most of us harbour deep fears for the future, even if we can?t, even if we won?t admit it ? not even to ourselves.

I seem to know more positive people who are on psychoactive drugs than off. It?s common. It?s common as muck and muck it is because it doesn?t have to be this way. We are thrown in at the deep end and left to sink or swim. Sure, for most of us, our bodies are monitored and our CD4s regularly scrutinized. But what about the bit that makes us who we are? The doctors are concerned but they don?t really want to know. They just don?t have the time. There?s too many of us for the specialists and the GPs don?t understand. They reach with relief for the prescription pad and write up another pill. And we take it and we push it down; we swallow our feelings with our daily dose of antidepressants and we rest at night through the magic of sleeping pills. It?s another way that pharmaceutical science has transformed HIV into a ?manageable? illness. Our innermost feelings are chemically managed along with our blood cells; inner demons are chemically bludgeoned alongside HIV.

But is the management team always up to snuff? Are we managing nothing more than a mess?

A newly diagnosed person becomes an instant initiate into a secret society of one and millions. We knew about this society but we preferred to smile politely and turn the other cheek, as though smacked in the face with mortality. We never thought it would be us, even when we expected it. It didn?t concern us. It was? other. It was them. Suddenly, we are other. We are them and we are alien to ourselves. To be newly diagnosed with HIV is to be lost and alone and in free-fall like a child?s nightmare when you woke mid-fall - but this time you do not seem to be waking up?

One of the major themes I?ve seen in newly diagnosed people ? myself included at one time - is emotional isolation. We?re thrust into this free-fall nightmare totally alone with our frightening thoughts and there seems to be very little effort being made to address this issue. The people we see on the AIDSmeds Forums are just the tip of a very large iceberg and the thought of those who go through their first year completely on their own, without emotional support, sends chills down my spine. I firmly believe this lack of attention to our emotional state is something that helps to increase the rate of new infections and I believe it has a lot to do with whether we thrive or dive with HIV.

The mental health aspect of HIV infection is a subject I am drawn to again and again. It touches so many areas of our lives with HIV and I am at a loss to understand why it is a subject most often ignored completely, acknowledged but brushed aside or at best, medicated. What would make more sense to me is a more pro-active mental health approach from the medical establishment from the point of diagnosis onward. In the coming weeks I hope to be able to research this more closely and come up with some ideas of how this problem might be tackled. As regular readers will know, I feel I should be doing more for the positive community and maybe this is my calling.

If any of you have stories about how your mental health needs were managed as a newly diagnosed person ? good or bad ? I?d love to hear from you in the Comment on the HIV Blogs Forum.