Decrease Chronic Pain with HIV Infection with Mindfulness

Decrease Chronic Pain with HIV Infection with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When it came to processing my HIV diagnosis, meditation offered me a framework for reflection, self-forgiveness, forgiving others and moving toward a place of acceptance.” – Seb Stuart

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20-year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include chronic pain, muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV.

 

Mindfulness training has been found to be effective in treating chronic pain conditions. In addition, mindfulness training has been shown to improve psychological well-being, lower depression and strengthen the immune system of patients with HIV infection. Hence it makes sense to examine the ability of mindfulness training to help relieve the chronic pain associated with HIV infection.

 

In today’s Research News article “A Mixed-Methods Pilot Study of Mindfulness Based Stress Reduction for HIV-Associated Chronic Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005203/ ), George and colleagues recruited  HIV-infected adults who had been experiencing neuropathic and/or musculoskeletal pain for at least 3 months. They were randomly assigned to receive either an 8-week program of Mindfulness-Based Stress Reduction (MBSR) or health education. The MBSR program was comprised of guided meditations, gentle movement exercises, and group discussion. Health education concerned HIV-related pain topics. The participants were measured before and after training and 3 months later for pain intensity, pain interference with activities, HIV symptoms, perceived stress, and autonomic nervous system function.

 

They found that both groups improved modestly on all measures after training. But at the 3-month follow-up the Mindfulness-Based Stress Reduction (MBSR) had a further significant decline in pain intensity while the health education group reverted to pretreatment levels. At the follow-up 79% of the MBSR patients were still practicing which may account for the continued improvements. MBSR is composed of an array of different practices and it cannot be determined here which or which combination of components were necessary and sufficient for the benefits.

Regardless, MBSR appears to help in all areas of HIV symptoms but particularly with HIV-related pain and it is not only lasting but appears to continue producing reductions in pain intensity over time. This is a blessing for the patients as the torment of the pain produces suffering and reduces the quality of their lives.

 

So, decrease chronic pain with HIV infection with mindfulness.

 

“Given the stress-reduction benefits of mindfulness meditation training, these findings indicate there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – David Creswell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

George, M. C., Wongmek, A., Kaku, M., Nmashie, A., & Robinson-Papp, J. (2017). A Mixed-Methods Pilot Study of Mindfulness Based Stress Reduction for HIV-Associated Chronic Pain. Behavioral Medicine (Washington, D.C.), 43(2), 108–119. http://doi.org/10.1080/08964289.2015.1107525

 

Abstract

Treatment guidelines for chronic pain recommend non-pharmacologic modalities as part of a comprehensive management plan. Chronic pain is common among people living with HIV/AIDS, but there is little data to guide the choice of non-pharmacologic therapies in this complex population. We performed a mixed-methods feasibility study of Mindfulness Based Stress Reduction (MBSR) versus health education control with 32 inner city, HIV-infected participants. Outcome measures included: the Brief Pain Inventory, Perceived Stress Scale, HIV Symptoms Index, autonomic function testing, and audiotaped focus groups. Post-intervention, participants reported modest improvements in pain measures and perceived stress, but no effect of group assignment was observed. At 3-month follow-up, 79% of MBSR participants were still practicing, and pain intensity was improved, whereas in the control group pain intensity had worsened. Qualitative analysis revealed a strong sense of community in both groups, but only MBSR was perceived as useful for relaxation and pain relief.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6005203/

 

Improve the Physical and Psychological State of HIV-Infected Youth with Mindfulness

Improve the Physical and Psychological State of HIV-Infected Youth with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Even in the midst of this stressful experience of testing positive for HIV, coaching people to feel happy, calm and satisfied — what we call positive affect — appears to influence important health outcomes,” – Judith Moskowitz

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. HIV is a virus that gradually attacks the immune system. It destroys a type of white blood cell called a T-helper cell (CD4 Cell). This isn’t a problem unto itself, but the immune system is our body’s natural defense against illness. Hence, HIV infection makes it harder to combat other infections and diseases. If HIV is untreated, these secondary infections produce chronic illness and eventually death. It is important, then, in treating HIV infection to strengthen the immune system and increase the levels of CD4 in the blood to fight off disease.

 

In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people. People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.

 

Mindfulness has been shown to strengthen the immune system. It also improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Hence, it makes sense to further study the ability of mindfulness training as a treatment for the physical and psychological issues associated with living with HIV.

 

In today’s Research News article “Mindfulness instruction for HIV-infected youth: a randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987527/ ), Webb and colleagues recruited HIV infected youths 14-22 aged years who were being treated with drugs. They were randomly assigned to receive a Mindfulness-Based Stress Reduction (MBSR) program or health education program. Both the MBSR and health education programs were presented for 2.5 hours, once a week, for 8 weeks. MBSR consisted of discussion and meditation, body scan, and yoga practices and included 30-minute daily home practice. They were measured before and after training and 3-months later for mindfulness, perceived stress, cognitive self-regulation, emotional attention, coping, life satisfaction, problem solving, aggression, HIV drug regimen adherence, HIV viral load, and CD4 counts.

 

At the 3-month follow-up, the youths who received the MBSR program had significantly higher levels of mindfulness, life satisfaction, problem solving, and lower levels of aggression. MBSR participants were significantly more likely to have markedly improved HIV viral loads after treatment. These results are potentially very important and demonstrate that mindfulness training improves the psychological state of HIV infected youths. But significantly appeared to also improve their physiological state, lowing the levels of virus in their blood.

 

This suggests that the Mindfulness-Based Stress Reduction (MBSR) program may be an effective treatment for HIV infected youths. MBSR was designed to and has been repeatedly been shown to improve the individual’s ability to cope with the physiological and psychological effect of stress. Since stress is known to worsen the symptoms of HIV, it would seem reasonable to speculate that the improved stress coping underlies the ability of MBSR to improve the physical and psychological state of HIV sufferers.

 

So, improve the physical and psychological state of HIV-infected youth with mindfulness.

 

“mindfulness meditation stress-management training can have a direct impact on slowing HIV disease progression. . . . it’s possible that such training can be used as a powerful complementary treatment for HIV disease, alongside medications.” – David Creswell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Webb, L., Perry-Parrish, C., Ellen, J., & Sibinga, E. (2018). Mindfulness instruction for HIV-infected youth: a randomized controlled trial. AIDS Care, 30(6), 688–695. http://doi.org/10.1080/09540121.2017.1394434

 

Abstract

HIV-infected youth experience many stressors, including stress related to their illness, which can negatively impact their mental and physical health. Therefore, there is a significant need to identify potentially effective interventions to improve stress management, coping, and self-regulation. The object of the study was to assess the effect of a mindfulness-based stress reduction (MBSR) program compared to an active control group on psychological symptoms and HIV disease management in youth utilizing a randomized controlled trial. Seventy-two HIV-infected adolescents, ages 14–22 (mean age 18.71 years), were enrolled from two urban clinics and randomized to MBSR or an active control. Data were collected on mindfulness, stress, self-regulation, psychological symptoms, medication adherence, and cognitive flexibility at baseline, post-program, and 3-month follow-up. CD4+ T lymphocyte and HIV viral load (HIV VL) counts were also pulled from medical records. HIV-infected youth in the MBSR group reported higher levels of mindfulness (P = .03), problem-solving coping (P = .03), and life satisfaction (P = .047), and lower aggression (P = .002) than those in the control group at the 3-month follow-up. At post-program, MBSR participants had higher cognitive accuracy when faced with negative emotion stimuli (P = .02). Also, those in the MBSR study arm were more likely to have or maintain reductions in HIV VL at 3-month follow-up than those in the control group (P = .04). In our sample, MBSR instruction proved beneficial for important psychological and HIV-disease outcomes, even when compared with an active control condition. Lower HIV VL levels suggest improved HIV disease control, possibly due to higher levels of HIV medication adherence, which is of great significance in both HIV treatment and prevention. Additional research is needed to explore further the role of MBSR for improving the psychological and physical health of HIV-positive youth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5987527/

 

Improve Loneliness and Quality of Life with Women with HIV with Mindfulness

Improve Loneliness and Quality of Life with Women with HIV with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-Based Therapies had a long-term effect on stress and both a short- and long-term effect on depression in people living with an HIV infection.” – Yang Yang

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development, a 20-year-old individual, infected with HIV, can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, loneliness, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice is a mindfulness practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to reduce anxiety and depression in in patients with HIV infection. So, it would stand to reason that other mindfulness practices would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV.” See summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319288/

Samhkaniyan and colleagues recruited women infected with HIV and randomly assigned them to a no-treatment control or to receive 8 weeks of Mindfulness-Based Cognitive Therapy (MBCT), administered once weekly for 2 hours. They were measured before and after the 8-week intervention for loneliness and quality of life, including body health, emotional care, community relationships, and environmental health.

 

They found that the Mindfulness-Based Cognitive Therapy (MBCT) group had significant improvements in all measure in comparison to baseline and the control group, with significant improvements in loneliness, overall quality of life and each quality of life component, body health, emotional care, community relationships, and environmental health. Hence, MBCT appears to be an effective treatment for the psychological issues of loneliness and perceived quality of life in women diagnosed with HIV.

 

MBCT contains both mindfulness practice and also cognitive therapy that is designed to change faulty thought processes. Mindfulness training has been shown to relieve loneliness and lead to improvement in quality of life with a myriad of different conditions. Also, loneliness is an interpretation of the environmental conditions and the altered thinking produced by MBCT may well be responsible for the effect. A more mundane explanation is that the social contacts involved in receiving MBCT by themselves relieve loneliness and improve quality of life. A randomized controlled clinical trial with an active control group is needed to distinguish between these alternative explanations.

 

So, improve loneliness and quality of life with women with HIV with mindfulness.

 

“Given the stress-reduction benefits of mindfulness meditation training, there can be health protective effects not just in people with HIV but in folks who suffer from daily stress,” – David Creswell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

Samhkaniyan, E., Mahdavi, A., Mohamadpour, S., & Rahmani, S. (2015). The effectiveness of mindfulness-based cognitive therapy on quality of life and loneliness of women with HIV . Journal of Medicine and Life, 8(Spec Iss 4), 107–113.

 

Abstract

Objective: The present study investigated the performance of Mindfulness according to the Cognitive approach on the Quality of Life and Loneliness of women with HIV.

Methods: This research is a semi-experimental with pretest-posttest and check team, which was conducted in winter, 2014. In this research, 24 positive HIV women in Tehran were selected by volunteers sampling method and were stochastically related to either the control team (n = 12) or the MBCT groups (n = 12) and, the World Health Organization quality of life survey and the University of California Los Angeles loneliness scale were administrated as pretest. The MBCT team got eight sessions of mindfulness according to the cognitive theory and the check team got no intervention. At the end, the post-test was administrated to two groups and, covariance method was used for data analysis by SPSS-20 software.

Findings: The results of the present study indicated that there were clear variations among the test groups check group and MBCT (p < 0.001). Therefore, Mindfulness-based Cognitive theory increased the mean quality of life and decreased loneliness.

Conclusion: The findings indicated that the Mindfulness-based Cognitive therapy increased the quality of life and decreased loneliness in positive HIV women. Therefore, in order to modify the quality of life and loneliness in these cases, attention to these variables during clinical trials with the goal of an appropriate intervention, will be beneficial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319288/

 

Improve Psychological and Physical Effects of HIV with Yoga

By John M. de Castro, Ph.D.

 

“Yoga is not just about the physical side, it’s also about the mind-body connection. I think having that awareness and accepting their condition can help them when they go out into the world, and lift up their self-esteem. Life is fast – yoga can help them be calm and still.” – Surang Sengsamran

 

HIV is a virus that gradually attacks the immune system. It destroys a type of white blood cell called a T-helper cell (CD4 Cell). This isn’t a problem unto itself, but the immune system is our body’s natural defense against illness. Hence, HIV infection makes it harder to combat other infections and diseases. If HIV is untreated, these secondary infections produce chronic illness and eventually death. It is important, then, in treating HIV infection to strengthen the immune system and increase the levels of CD4 in the blood to fight off disease.

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year-old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, anxiety, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence, patients with HIV infection, even when controlled with drugs, have a reduction in their quality of life.  There is thus a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to strengthen the immune system. It also improve psychological and physical well-being in people suffering from a wide range of disorders including depression and anxiety. It has also been shown that mindfulness is associated with psychological well-being and lower depression in patients with HIV infection. Integrated Yoga is a contemplative practice that includes postures, breathing practices, relaxation techniques, and meditation. It has been shown to increase mindfulness, and reduce anxiety and depression. So, it would stand to reason that Integrated Yoga would be beneficial for people who are living with HIV infection.

 

In today’s Research News article “Effect of Integrated Yoga (IY) on psychological states and CD4 counts of HIV-1 infected patients: A randomized controlled pilot study”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1183625434994714/?type=3&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4728960/

Naoroibam and colleagues randomly assigned patients with HIV infection to either a one-hour per day, six-days per week Integrated Yoga practice for one-month or to a treatment as usual condition. Compared to before treatment and the control group, they found that the Integrated Yoga practice produced a significant reduction in anxiety and depression levels and an increase in T-helper cell (CD4 Cell) counts in the blood. It should be kept in mind that there was not an active control condition. So, it is unclear if the effectiveness of Integrated Yoga practice was due to exercise effects or perhaps to expectancy effects, researcher bias effects, etc. It will remain for future research to sort out exactly what is responsible to the improvement in the HIV patients.

 

Regardless, these are exciting and potentially important results suggesting that Integrated Yoga practice may not only improve the psychological well-being of HIV infected patients but also strengthen the immune system. This would make them better able to combat other infections and diseases.

 

So, improve psychological and physical effects of HIV with yoga.

 

“As you become more adept at yoga, you learn which poses can help you, depending on how you are feeling physically. There are certain poses that assist in relieving fatigue, diarrhea, anxiety, depression. You do learn about the nature of self, but you also learn that so much is beyond your control. It helps you realize, somehow, to trust in a higher being.” – Steve McCeney

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

 

Improve Well-being with HIV with Mindfulness

People wait in line to see me, saying there’s plenty of living to be done even if you have an HIV diagnosis. People say they are 10- or 15-year survivors and still moving forward. – Greg Louganis

 

More than 35 million people worldwide and 1.2 million people in the United States are living with HIV infection. In 1996, the advent of the protease inhibitor and the so-called cocktail changed the prognosis for HIV. Since this development a 20 year old infected with HIV can now expect to live on average to age 69. Hence, living with HIV is a long-term reality for a very large group of people.

 

People living with HIV infection experience a wide array of physical and psychological symptoms which decrease their perceived quality of life. The symptoms include muscle aches, depression, weakness, fear/worries, difficulty with concentration, concerns regarding the need to interact with a complex healthcare system, stigma, and the challenge to come to terms with a new identity as someone living with HIV. Hence there is a need to find methods to improve the quality of life in people who are living with HIV infection.

 

Mindfulness has been shown to improve psychological and physical well-being in people suffering from a wide range of disorders (see http://contemplative-studies.org/wp/index.php/2015/07/17/why-is-mindfulness-so-beneficial/ and http://contemplative-studies.org/wp/index.php/2015/07/17/how-do-mindfulness-based-interventions-improve-mental-health/). So, it would stand to reason that mindfulness would also be beneficial for people who are living with HIV infection.

 

In today’s Research News article “Dispositional mindfulness in people with HIV: Associations with psychological and physical health”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1107732272584031/?type=3&theater

Moskowitz and colleagues investigated the mindfulness, appraisal, positive and negative affect, coping, and indicators of psychological well-being and physical health of a group of primarily male HIV positive individuals. They found that mindfulness has significantly associated with a number of positive indicators of psychological well-being. HIV infected individuals who were high in mindfulness were found to have lower depression, lower perceived stress, fewer hassles, less negative affect, less escape-avoidance and self-blame forms of coping and more positive affect.

 

There are a number of potential explanations for the association of mindfulness with improved psychological well-being. The study demonstrated that the association between mindfulness and lower depression was mediated by lower perceived stress and negative emotions. This makes sense as mindfulness has been shown to reduce both the physical and psychological responses to stress (see http://contemplative-studies.org/wp/index.php/2015/07/17/destress-with-mindfulness/) and it is also known to improve emotion regulation (see http://contemplative-studies.org/wp/index.php/2015/09/10/take-command-and-control-of-your-emotions/) and stress reduction and emotion regulation are helpful in relieving depression. In addition, since mindful individuals are more attuned to the present moment they may be better able to deal with whatever symptoms are present and not worry and catastrophize about the future.

The results are impressive. They are, however, only associations and it cannot be concluded that there is a causal link between mindfulness and the improved psychological well-being. A trial where mindfulness training is actively manipulated is needed to resolve this issue. Nevertheless, these results are suggestive that mindfulness training may be a way to help the vast numbers of people living with HIV infection adapt and cope with the physical and psychological issues associated with living with infection.

 

So, be mindful of HIV

 

I’m not cured, but the HIV is asleep deep in my body.”- Magic Johnson

 

CMCS – Center for Mindfulness and Contemplative Studies