December 01, 2015

By Stephen Puibello

Most people know that wearing a red ribbon is a sign of support for people living with HIV. Millions of people around the globe come together every year to raise awareness about the disease on Dec. 1, World AIDS Day.

What may be less well known is the green ribbon, which supports people living with mental illness. Mental health has its own observance for the month of May, Mental Health Month as well as in October for Mental Illness Awareness Week and World Mental Health Day.

All of these celebrations raise awareness, help to combat stigma and raise funds for the populations they honor. Between my Italian heritage and multiple diagnoses, red and green are important colors in my life.

In 1996, shortly after losing my mom to breast cancer, I was diagnosed with HIV and then with bipolar disorder. All of these events occurring on top of substance abuse issues led to me going through a very dark time, but I managed to climb out of the abyss. I put myself on the road to recovery by seeking therapy, finding the right medications and serving as an advocate and support to others going through similar experiences.

In the process, I realized that I am not alone. Researchers estimate that as many as 40 to 60% of the HIV-positive population will experience depression at some point. Another study looked at 200 adults living with HIV and found that 15% had bipolar disorder. Also, data shows that if you have a mental illness, your chance of having a substance use disorder is as high as 50%.

Any one of these issues can be incredibly difficult to manage—now imagine having two of them, or worse, all three. Talk about stigma.

Unfortunately, services for these disorders are often siloed. Many providers treat one or the other, but rarely do you see a brochure about mental health treatment in the waiting room where you get your HIV meds, or vice versa.

There are bright spots, such as Positive Impact in Atlanta, a nonprofit organization that recently celebrated 20 years in fighting HIV by promoting mental health. Callen-Lorde Community Health Center, in New York City's Chelsea neighborhood, recently received full licensing and now offers long-term mental health services for their HIV clients; the demand is so high, there's already a wait list to get in.

At the same time, when have you seen an AIDS and mental health ride, or an AIDS and mental health walk? When these disorders pile up, it can be incredibly isolating—and failing to address them together makes that road to recovery a long one that is often times rocky.

The year 2013 was special for me because I was named a Voice Awards Fellow by the federal Substance Abuse and Mental Health Services Administration (SAMHSA). I spent that year telling my story and spreading the message that if you face one or more of these struggles, you are not alone. If you have HIV and find yourself to be depressed, don't wait—talk to your health care provider so you can get the help you need. You have to be just as proactive about your mental health treatment as you are in caring for your HIV.

Have the courage to tell your story whenever you can. The more we talk about the fact that HIV, mental illness and substance use co-occur, the better the chance that service providers will ask the right questions and offer the right treatment. Hopefully we can chip away at the stigma that piles up as well. You can help—by wearing a green ribbon and a red one too, side by side.

Stephen Puibello is a HIV/AIDs, LGBT, and mental health advocate. More information about Stephen can be found on his website

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