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Spirit Stronger Than Disease

By Daniel J. DeNoon
WebMD Health News

April 3, 2002 -- Even life-threatening disease doesn't destroy the human spirit. Far from being devastated by their HIV infection -- and their poverty -- three out of four women report positive changes in their lives.

The finding comes from interviews with 189 low-income women living with HIV. Conducted by UCLA researcher John A. Updegraff and colleagues, the study appears in the April issue of Personality and Social Psychology Bulletin.

The women don't deny their suffering. Yet they say that facing death has made them stronger, wiser, less involved with drugs, and more understanding. It's helped them focus on what's really important: family, helping others, and living life to the fullest. Updegraff says that other researchers have seen the same thing in patients with cancer and other chronic diseases.

"These kinds of growth processes seem to happen naturally for a lot of different stresses and it does help people to cope," he tells WebMD. "This shows it is not just a denial of reality for people to use their chronic disease as something that will create a positive change in their life."

It doesn't happen overnight. The women Updegraff studied had lived with HIV for more than four years.

"Chronic diseases are devastating and no doubt change people's lives for the worse, but there are ways that many people reinterpret their situations that lead to growth and positive change," he says. "You can't say that once someone is told they have HIV or cancer they will change for the better. It does take time, and is most adaptive when it is allowed to develop naturally. It is not something you can force on people."

People who are told they have a terrible illness first spend their energy searching and hoping for a cure, says Martha H. Lansing, MD. Lansing is co-author of the book Treating People with Chronic Disease: A Psychological Guide. She is director of the family health center and director of the family practice residency program at New Jersey's Robert Wood Johnson Medical School.

"You ultimately accept your limitation, you struggle with your disease, and eventually you adjust to it," Lansing tells WebMD. A lot of people get stuck in the stage of just wishing for the cure. That group of people doesn't do well. They tend to get over-treated; their bodies and souls get more and more out of balance. The HIV positive women in this study have learned how to live well with this disease. There is more than just the disease in their lives. They have learned how to make things work and how to get back in balance."

Lansing says that people who make this adjustment don't just feel more at peace -- they actually do physically better. Indeed, Updegraff showed that women who reported more positive than negative changes had less depression and anxiety. Both of these problems mean worse health.

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