Mental Health Is Key

We Need to Address Our Psychological Well Being

by John Francis Leonard

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Life is tough, we all face challenges—some people seem to have more than their share. I’m writing this month’s column just a few weeks after National Suicide Prevention Week, and I took that opportunity to reflect on the problem of suicide within the LGBT community, the HIV community, as well as my own history with it.

Suicide rates among the LGBT community have always been higher than other communities. I read several pieces recently stating that fifty percent of trans men have attempted suicide. Suicide rates among our LGBT youth are much higher than the general youth population as well. It’s easy to think that growing up gay, bi, trans, or gender fluid is less problematic than it was in decades past, but our youth still face ostracism and stigma. I myself remember my own suicide attempts as a teenager, my first at thirteen. I had no problem with being gay; it was other people’s problems with it that drove me to despair. That and an abusive home life were a recipe for disaster—I saw no other way out. Fortunately, I was under the mistaken impression that it was easy to kill oneself by taking an overdose of Tylenol. It can land you in the hospital, as it did me, but it did no lasting damage.

This brings me to what I’ve really been thinking about, what increased chance of suicide must there be for those of us who are HIV-positive, gay or straight, cis or trans? I decided to read some studies and what they told me was disheartening. First of all, according to the NIH, mental health conditions such as depression and anxiety which can exacerbate suicidal ideation are more common among individuals living with HIV. The suicide attempt rate among those who are living with HIV are 7.4 times higher than the general population per the NIH. One ART medication, efavirenz, actually can cause psychiatric side effects in the first month of treatment, increasing the likelihood of suicide attempts. Public Health England recently finished a fifteen year study which showed that HIV-positive men are twice as likely to die from suicide than the general population. There was no increased rate among HIV-positive women and it does not give numbers for HIV-positive trans individuals.

My own experiences with suicide, unfortunately, did not end as a teenager. After my diagnosis as positive at thirty-three as well as being diagnosed bipolar soon after, I moved back to the city of my birth from a stressful, harried life in L.A. I was under psychiatric care, but it took some years of adjusting and changing my medications to even out the extreme highs and lows of my condition. The lows were particularly rough and there were several suicide attempts that landed me in in-patient psychiatric care. It’s hard to separate and quantify the causes of my attempts—there were many factors at play. The two biggest had to be the crippling depression and one of the major reasons that I felt so depressed was due to life as an individual living with HIV. My experiences early on were long before U=U and my earliest experiences in dating and even just hooking up were those of rejection and alienation by my peers. There is no community of positive gay men or women in my area that I can relate to and the feelings of isolation and loneliness were disheartening to say the least. There were days at a time where I just couldn’t get out of bed. My career in business was over, I’d left another failed relationship behind me and I just couldn’t look to the future with hope.

It did get better. After a final attempt at suicide ended in a month-long coma due to a burst aneurysm caused by an overdose, I finally started responding to a new mood stabilizer that had initially been prescribed as an anti-seizure medication. The change was prolific, and I began having some control. Certainly, even under medication, I still have periods of more tempered highs and lows, but they’re manageable. Even in my blackest moods, suicide is just something I don’t think about seriously. I am very lucky and cautiously optimistic. Should I need it, the help and counsel of two talented clinicians that I have great relationships with are just a phone call away.

I’d be remiss if I didn’t mention one more factor in my suicide attempts that resonates with many in the LGBT and HIV communities and that’s addiction. LGBT and positive individuals are much more likely to abuse drugs and alcohol, and I was no exception. My drugs of choice at the time were the addictive prescription medications that doctors had been prescribing me for years. I don’t mean standard psychiatric drugs—what I mean are powerful narcotics like benzodiazepines, Adderall and various sleeping medications. Now, I share full culpability and responsibility for this addiction—but it was obvious that I had a serious problem with these medications and I wish just one in a series of physicians had cut me off. Nonetheless, with the full support of a wonderful psychiatrist who steered me in the right direction, I cut them all out of my regimen one by one. Things are hardly perfect now, but whose life is? But I’m healthy, happy and well adjusted and the most challenging years of my life seem far behind me.

Here are some hotlines that can help: The National Suicide Prevention Hotline: 1 (800) 273-8255; The Trevor Project (LGBT youth): 1 (866) 488-7386; GMHC: 1 (800) 243-7692.


John Francis Leonard is an advocate and writer, as well as a voracious reader of literature, which helps to feed his love of the English language. He has been living with HIV for fifteen years and he is currently at work on his first novel, Fools Rush In. His fiction has been published in the ImageOutWrite literary journal and is a literary critic for Lambda Literary. Follow him on Twitter @JohnFrancisleo2.