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Psychological and psychosexual implications of herpes simplex virus infections

Psychological and psychosexual implications of herpes simplex virus infections

Genital herpes causes considerable psychological and psychosexual morbidity. The most common emotional responses are depression, anguish, anger, diminution in self-esteem and hostility towards the person believed to be the source of the infection. These emotional problems appear to be worse in women than in men. The psychological morbidity in patients with first episode genital herpes is statistically significantly greater than that occurring in non-herpes patients attending sexually transmitted disease clinics. It was previously believed that stressful life events could precipitate recurrences. However, recent studies suggest that ongoing recurrences cause the emotional stress rather than vice versa. There is some evidence that premorbid personality may effect recurrence rates, but an equally plausible explanation is that frequent recurrences adversely affect personality. Long-term aciclovir suppression significantly reduces the psychological morbidity associated with recurrent genital herpes, over at least the period of treatment. Cognitive coping strategies and social support from a partner appear to assist with adjustment. Improving a patient's problem-solving skills, and long-term aciclovir therapy should form an integral part of the long-term management of recurrent genital herpes.

It is not uncommon to experience depression after receiving a herpes diagnosis. Not only are you faced with a condition you have to tell your sexual partners about, but you may be awash in feelings of guilt, anger, shame, sadness, anxiety, or fear that you simply cannot shake. All of these emotions are normal.

As with any health condition, you will eventually learn to adapt and come to terms with the diagnosis. But, if you can't and find yourself struggling with depression because you have herpes, you need to seek professional help.

Coping With the Diagnosis

Although learning you have herpes can be stressful because of the stigma associated with the disease, herpes is simply a virus like any other. A herpes diagnosis says nothing about how you live your life. It says nothing about who you are.

As hard as it may be to believe, people with herpes can date and have happy and fulfilling sexual lives with herpes. This is not to suggest you won't encounter challenges or need time to adjust.

The very act of disclosing your status to a sexual partner can be extremely stressful; not disclosing it can be even worse. There is a chance you may be rejected if your partner finds out or that you may pass the infection to others even if you use condoms.

But, it's important that attitude to herpes is fast-changing. The public is better appraised about how the virus is spread and what you can do to protect yourself against not only herpes but a host of the common STDs like chlamydia, gonorrhea, syphilis, and HIV.

Herpes and Depression

There is a lot of anecdotal evidence linking depression to a herpes diagnosis, but relatively little published data. With that said, a national study conducted in 2012 found that adults infected with HSV-2 were twice as likely to be depressed as adults who were not.2

It is unclear from the study which factors were linked to the risk of depression, including whether depression was a pre-existing condition for some. There is plenty of evidence that depression increases a person's vulnerability to STDs given the increased likelihood of alcohol abuse, drug use, and sexual risk-taking.3

On the other hand, some people may simply be able to cope better with health adversity than others. The inability to cope is not something you should be ashamed about; it simply suggests that you may need help coming to terms with a herpes diagnosis.

Doing nothing will only make things worse. Numerous studies have linked stress to more frequent or severe genital herpes outbreaks.4 Moreover, depression undermines the quality of your life, your relationships with others, and your very health.

What to Do

Depression is a disease not unlike others you may have. You can't wish it away or pretend that it isn't there. Whatever the cause, it can benefit from treatment which may include counseling, medications, or self-help therapies. The first step is recognizing there is a problem.

Among the things you should do if faced with overwhelming emotions after a herpes diagnosis.

  • Be aware of the signs of depression. These include persistent feelings of sadness or a loss of interest in things you otherwise enjoy. There may be changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem.

  • Call a healthcare provider. If you are experiencing symptoms of depression, seek medical help. The mainstay of treatment is usually medications (such as antidepressant), talk therapy (including cognitive behavioral therapy), or a combination of the two.

  • Deal with substance abuse issues. This may include groups like Alcoholics Anonymous or Narcotics Anonymous or alcohol/substance treatment centers.

  • Learn about herpes. If herpes is specific to your depression diagnosis, it is important to learn what the disease is, how it is spread, and how it can be prevented. By answering all of the "what ifs" surrounding the disease, you can become a master of your illness rather than the other way around.

  • Practice disclosure. If you need to disclose your status to a sexual partner, sit down with your healthcare provider, a counselor, or a trusted family member to practice. Consider all the possible responses and build a strategy to better cope with whatever response you receive.


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