Herpes and Depression: Coping After Diagnosis

Depression can be associated with herpes infection, but depression is not the same as simply feeling sad, embarrassed, or angry after receiving a herpes diagnosis. Most people will react to their diagnosis with a combination of complex feelings. These feelings can affect how you manage your day-to-day life and can even cause you to feel anxious or withdrawn.

You may be worried about what this incurable sexually transmitted infection (STI) means in terms of relationships and having kids. You may also be overcome with anxiety about having to disclose your status to not only your current sexual partner(s) but future ones as well.

Without support, these feelings can spiral out of control and undermine both your health and quality of life. For some people, a herpes diagnosis may even lead to depression.

This article starts by explaining what herpes is and what to expect if you've experienced a first outbreak. It then explores the signs and causes of depression, and what you can do to better cope with your diagnosis.

Herpes Impact and Management

If you have herpes, you are not alone. It is an incredibly common disease that affects more than one out of six people ages 14 to 49 in the United States. Many people living with herpes don't even realize they have it as the disease is often asymptomatic (without symptoms).

Genital herpes is most commonly caused by herpes simplex virus type 2 (HSV-2) but increasingly by herpes simplex virus type 1 (HSV-1). HSV-1, more commonly associated with cold sores, can be spread to the genitals by oral sex.

Herpes is neither a life-threatening illness nor one that will necessarily impact your life over the long term. For most people, the first outbreak will be the worst. After that, the frequency and severity will tend to taper off.

This is especially true if your first outbreak was caused by HSV-1. With a genital HSV-1 infection, recurrence is far less common, and, in some cases, the first outbreak may be your last.

Even if you have HSV-2, antiviral drugs like Valtrex (valacyclovir) and Zovirax (acyclovir) shorten the duration and severity of outbreaks. If needed, daily antivirals can be prescribed to keep the virus under control and reduce the risk of transmission to others.

Coping With a Herpes Diagnosis

Learning you have herpes can be stressful because of the stigma attached to the disease. But it is important to remember that herpes is simply a virus and that the vast majority of people with HSV do not have symptoms.

As such, you should not blame yourself for getting herpes or be accused of being "irresponsible." Similarly, you can't necessarily blame someone for giving you herpes. It may very well have been passed on to you by someone who didn't even realize they were infected.

Moreover, even with condoms, HSV can be passed through skin not covered by a condom.

While these facts may help ease any feelings of shame or anger, this doesn't mean that living with herpes is without challenges.

Among them, the very act of disclosing your status to a sexual partner can be extremely stressful. On the other hand, avoiding disclosure can have even greater consequences if transmission occurs.

This is where your healthcare provider can help. By bringing your partner with you to your healthcare provider's office, they can learn what herpes is, how the virus is transmitted, and ways to reduce their risk of infection.

Herpes and Depression

Research suggests there may be a link between herpes and depression. A 2018 study published in Psychiatry Research found that people with HSV-2 (the most common cause of genital herpes) were more commonly prescribed antidepressants than people with HSV-1 or hepatitis A.

A 2020 study found that there was also an association between HSV-1 and depression.

Some people with herpes are more prone to depression than others. This may be due to factors unassociated with herpes or those that compound the symptoms of depression, such as:

• Poor coping skills
  
• Isolation and a lack of social support
• Alcohol or drug use
• Secrecy
• A stressful lifestyle
• Insufficient treatment
  

What to Do

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

Here are some things you should do if you have difficulty coping with your herpes diagnosis:

• Recognize 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.
• Seek treatment: If you are experiencing signs of depression, seek medical help. The mainstay of treatment is usually medications (such as antidepressants), talk therapy (including cognitive behavioral therapy), or both.
• Build a support network: Isolation fuels depression and makes the symptoms worse. If you are unable or reluctant to reach out to friends or family, ask your healthcare provider about in-person or online support groups.
• Deal with substance abuse: This may include joining groups like Alcoholics Anonymous or Narcotics Anonymous, or getting help through an alcohol/substance treatment center.
• 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 what you will say. Consider all the possible responses and build a strategy to better cope with whatever response you receive.