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Sunday, July 20, 2014

I've Battled Depression all My Life

Katerina age 32, diagnosed HIV in 2010

I've battled depression all my life. I'm a survivor of multiple suicide attempts, survivor of abuse, I was a cutter, I'm a recovering addict, been on multiple psych med's, diagnosed with multiple problems over the years, and I made a decision in 2012 to overcome depression and not let my life be dictated in-by negativity.

It hasn't been easy, however today depression does not consume me. My life was saved when I checked myself into an outpatient program at Langley Porter. While I use to teach CBT and meditation I never lived it. DBT (Dialectical Behavior Therapy) and CBT (Cognitive Behavior Therapy) gave me the vehicle I needed to be living the life I needed, I wanted, and one I deserve. Through therapy, working on my issues, and with my determination, we incorporated these skills into my psychiatry and therapy; by working with my health and mental health teams, I've been able to get off psych med's including lithium. I have handlers, three sponsors, and my support systems that I check in with regularly. And DBT is just as important as working my recovery program, while being instrumental in reducing stress and living a wonderful quality of life I thought was unimaginable. I'm not saying I never feel depressed, I just have a better way of dealing and coping with things and I am stronger in all aspects of my life as a person because of it.

I love myself today, I know I am beautiful, I am worth it, and I deserve the quality of life I believe I deserve, and I and determined through hard work and perseverance to manifest these things. Today I'm happy to the point it's sickening lol and I wouldn't have it any other way. I am sober and I found redemption in a new life where I was once broken and shattered. For me I'm a mighty oak and will withstand all things. I've been through hell and back and there is nothing that is worth or is an excuse to relapse. Self sabotage no longer has a place, and I'm the first person to call myself out on my bullshit, thanks to the rooms of CMA, AA, NA, CODA, and Alanon.


DBT Self-Help

Wikipedia, DBT defined.

Wikipedia, CBT defined.







Monday, July 7, 2014

In the News July 2014

New HIV Cases Decline in DC

"At the end of 2012, 16,072 people were living with HIV in D.C. That represents 2.5 percent of D.C.'s population, a level still well above the World Health Organization's 1 percent definition of an epidemic. Of the over 16,000 people living with HIV, the majority are men (72.7 percent) and black (75 percent total, 68.5 percent men). The age groups most affected are people in their 40s (31.1 percent) and 50s (29.4 percent)"

"Interventions Crafted for Those Struggling With Mental Health and HIV Adherence Show Promise, Report States " 

"A clinical review published in the peer-reviewed journal LGBT Health in early June by Jaclyn M. White, M.P.H., Janna R. Gordon, and Matthew J. Mimiaga, Sc.D., M.P.H., from Harvard and the Fenway Institute in Massachusetts, indicates that there may be relief at hand for HIV-positive gay men struggling with added mental health and substance abuse issues that can add difficulty to sticking to an HIV medication regimen. White et al concluded that interventions that combine both adherence counseling with standard cognitive behavioral therapy have made some headway with participants in several recent intervention trials"

"Aging with HIV and AIDS: A growing social issue"

" the first people with HIV grow old, a new study from St. Michael's Hospital questions whether the health care system and other government policies are prepared to meet their complex medical and social needs.
In high-income countries such as Canada, 30 per cent of people living with HIV are 50 or older, and many are living into their 60s and 70s. In San Francisco, more than half the people with HIV are over 50."

"LGBT people living with mental illness face double stigma"

" uly is National Minority Mental Health Awareness Month, and in Atlanta, the Health Initiative is teaming up with the DeKalb County chapter of the National Alliance on Mental Illness to bring awareness to LGBT people about resources available.
LGBT people with bipolar disorder, post traumatic stress disorder or chronic depression not only face stigma not only because of their sexual orientation and gender identity, but also because of their mental illness.
“The double stigma of being GLBT and having a mental illness limits our access to resources and support. Not many can provide specialized care I think our community needs and this is a great disservice,” says Alisa Porter, marketing director of NAMI DeKalb.."

For a comprehensive listing of HIV and mental health resources visit:

Tuesday, July 1, 2014

Mental Bottleneck and it's crippling of my ability to make friends

For me of late, like the last decade of my bipolar diagnoses, my different ability has me choked up to the point of being afraid.  Afraid of what, my ability to get back out into the World amongst my peers, people who minds are sharp, stimulated, creative and intelligent. Possible this is you also, stuck at the neck of a bottle.

Within my writings I refer to my bipolar disability not as a disability but a different ability managing my mania...putting it to good use on projects.  I used projects throughout my youth before I was diagnosed to establish friendships, I mentored others with their projects, watching them flourish, move on while I'm held back.

Fear is something many people have a hard time with.  For myself the fear is in front of me morning, noon and night, it often goes to sleep with me.  I can reach out and touch it, that's how crippling fear is to me, more then a word in a dictionary.  Fear leads to anxiety and panic attacks,  symptoms of my bipolar.

For this past decade it's my disability and the stigma of that has robbed me of new friendships and possible relationships as I shunned away from people, those knowing me, would never think this.

I haven't conquered this fear 100%, but I'm certainly making progress, with a part-time job, my own project on mental illness and HIV and my very bumpy road to recovery I'm now seeing a transformation of hope rather then hopelessness.  I owe this to many wonderful new people in my life, most of them halfway across the country, others in different parts of the World via social media and emails from readers who write me.

Others are my Therapist who I meet with weekly and my Psychiatrist as the medications prescribed for my mental well being, a second cocktail for my HIV  for my physical well being are what keep me going.

I can remember a neighbor from Boston Sharon who in those first few months after being inside my home  for over 54 days in shock from my dual diagnoses telling me, "baby steps."  

There's new fears now as I turn 55 1/2 years old, these are not of the mind, but of my physical well being, but unlike the mind, the physical aliments of aging with two chronic illnesses  bipolar and HIV are starting to send postcards. 

I love postcards, but these postcards I'm working at returning to sender.

Resources for Returning Postcards to Sender:

Sunday, June 29, 2014

Happy Gay Pride 2014.....The Even Harder Coming Out

Happy Gay Pride 2014 

Reprint from 2012 gay pride post.

Thanks to a dear friend I've been sitting here in one of the first three cities to hold the first gay pride parade, in this city San Francisco it was a referred to a the gay sit in. So thanks Virgil for this trip which inspired this article about Coming out, not once, not twice, but for a third time.

Coming out or coming out of the closet is a gay persons right of passage, their journey, their choice to no longer feel the need to keep their sexuality private.  For me it was on Mt. Katahdin, located in Maine. I was a freshman at Unity College and my lesbian cousin drove up to visit me and she popped the question, she was the first person I told, the year was 1978.

My next coming outs plural was in 1996 when I diagnosed HIV positive and also Bipolar, the first one that hit me the hardest was human immunodeficiency virus infection , HIV.  I felt stained, I myself was unable to reach out for help at first as I was crippled, I stayed indoors for close to two months, minus the treatments I would go for, labs (blood work) to see how weak or how healthy my immune system was. I'm happy to say that thanks to new class of medications I've been healthy, good numbers, but the trauma of all this and the stigma of it all set me back.

You see I was a volunteer in the gay community around AIDS, HIV as a negative gay man.   So I've asked it, and I'm sure others ask it, if I/he volunteered in his community on prevention, on a help line, fundraising for AIDS walks and later AIDS rides, then how did I/he contract the HIV virus, the answer was the other diagnoses of Bipolar-manic depression

All my life I felt different, I felt charged, lots of energy, required little sleep, able to do so many things at once, and then I would crash into a wall and into a deep depression and not knowing why, and not on the medications I'm on today, I was self-medicating  due to psychological trauma that I got addicted to drugs and in that time period I contracted the HIV virus.

This isn't the same journey for everyone but for myself it was mine and I went back to connect all the pieces which brought me to my third and even harder coming out, that being an out spoken Consumer Advocate for both HIV and Mental Illness.  It's my choice, it's easy when writing, when speaking out, but it is very hard do to the double stigma from the very community I've embraced and continue to embrace, my community, the Gay Community.

So yes coming out a third time is the even harder coming out for me and I'm certain for many others living with HIV as today one in five HIV+ person is dealing with depression or like me a mental illness.  I'm the lowest in the hierarchy of the GLBT community, but it's progressing like everything else in the gay community, gay liberation, AIDS/HIV and the very much needed activism that opened the doors for generations down the road like me who are living with HIV/AIDS and today as I write this, 49 GLBT Community Centers offer Mental Health short-term care, support groups, and it's getting better as very soon in Manhattan long term mental health care will be offered, a trend I predict will continue as there is a need.

P2P, you are not alone, me the Bi Polar Bear wishes every one a very Happy Gay Pride.  I can be found wearing my Bi Polar Bear T-shirt (seen on my homepage) tomorrow at the San Francisco Pride Parade/March. 

Additional Resources:


Depression and Bipolar Support Alliance

CDC on Mental Health and MSM

Tuesday, June 17, 2014

Common Red Flags for Bipolar Disorder Relapse

Thanks to the many of you who know me and have been checking in, prior to my trip and after my trip a period of almost seven weeks I've been in and out of severe depression.  Signs of this are:

       1.  I stop cooking meals.
       2.  I shun, stay away from people.
       3.  I caving sweets.
       4.  I don't care about anybody else.
       5.  Short tempered, people bother me.
       6.  Biggest for me, requiring more sleep, especially naps. I see blue skies but have
            no interest.
       7.  I stay at home long periods, phone off as many as six days

If you are diagnosed Bipolar and are experience some of these, notify your therapist, seek help, also alert your friends and family, support network.   I'm on my own, as a gay man with no children, soon to be 56 years old, living with HIV, it's very hard, don't kid yourself.  Add to this regular health concerns, lack of 100% health insurance, trust me it is very hard.

I want to share my biggest aide, that being the ability to call a friend, letting him know I don't feel safe and asking if you can spend the night, I try very hard not to call 911, but if you don't have a friend or family member, call 911 or have a plan.  My plan taxi service, having credit card and also have cash to cover a cab ride.

Don't ever feel ashamed to call a friend, share with them that you are bipolar, it's important that your family or closest friends know, therapist aren't available around the clock.  

Other resource is a suicide prevention hotline:

Related Resources and Articles:

There may never be a last relapse

Early warning signs of Bipolar relaspe

Bipolar disorder: How to avoid a relapse

Tuesday, May 27, 2014

AIDS Life Cycle 2014, I Highly Recommend you do this event at least Once

A must see video about the event

The history of AIDS Life Cycle the 7 day, 545 mile event which I first cycled in 2007 was the reason I started my website  The rides prior all less the 150 cyclist I wasn't connecting with other like myself who were dual diagnosed.   AIDS life cycle or ALC with it's over 3.000 cyclist the odds of me finding others who were dual diagnosed.  Today I just arrived at one of my newest and oldest friends whom I met that very first year, Virgil Parrett.   Thanks to Virgil and several others I'm able to afford participating as they host me in their homes.

I've come a long way since the my first year of cycling, today I'm a consumer advocate, educator, certified peer specialist for both mental health and HIV since 2004.  Today my recoveries plural are in check, I owe a great deal to all folks I've met along the way since I was diagnosed, the long bumpy road was not an easy one, it was very hard due to my not fitting in from the bipolar diagnoses.

So here I am again, just off my flight from Newark, friends out doing errands and me well. I wanted to share with you all the history of my participation on AIDS life cycle once again, this my sixth year.

Thanks to everyone who donated, I left New Jersey this morning, turned on my cell and during my flight another $150 was donated.  If you wish to support me with a tax deductible donation please click here ---------->

Thank You

Previous Post on my AIDS Life Cycle experience.

Sunday, May 18, 2014

Wearing Red and Green, One Year Later

                                                       BP Magazine  Photo by Peter Johnansky

On May 8th I wrote about May being Mental health awareness month please read.

Last year I published my Op-Ed title Wearing Red and Green, this is my first year anniversary of that article and the start of my newly created red and green ribbon that identifies both HIV/AIDS and mental health.

I'd like to reprint source that article here now, and ask that you wear a red and green ribbon, thank you.

Dual Diagnosed HIV+ and Bipolar, wear a Red & Green Ribbon during May

Celebrate both HIV/AIDS and Mental Health 
Awareness each May by wearing a 
Red and Green Ribbon

Reprint from
May 3rd, 2013
Wearing Red and Green
by Stephen Puibello

An HIV-positive advocate reminds us about the need for mental health services.

Stephen Puibello
Stephen Puibello
Everyone knows that wearing a red ribbon is a sign of support for people living with HIV, and millions around the globe come together every year to raise awareness about the disease on World AIDS Day, December 1. Less well-known is the green ribbon, which supports people living with mental illness, and has its own observance each May, which is Mental Health Month. Both celebrations raise awareness, help to combat stigma, and raise funds for the populations they honor. Whether you attribute it to my brain chemistry or my Italian heritage, both the red and the green colors of the ribbons and the Italian flag apply to me.

My story begins in 1996, when I lost my mom to breast cancer and shortly thereafter was diagnosed with HIV, and then with bipolar disorder. I went through a very dark time—add substance use to the list of challenges—but 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 percent of the HIV-positive population will experience depression at some point. That's right—half. Another study looked at 200 adults living with HIV and found that 15 percent had bipolar disorder. And whether you are HIV positive, have a mental illness or both, it's quite likely you have a substance use problem as well; data shows that if you have a mental illness, your chance of having a substance use disorder also is as high as 50 percent. Any one of these issues can be incredibly difficult to manage—now imagine having two of them, or worse, all three. Talk about stigma.

Sadly, though, 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. But 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 oftentimes rocky.

But it is a road that can inspire others. This year is special for me, as I was named a Voice Awards Fellow by the federal Substance Abuse and Mental Health Services Administration (SAMHSA). I am spending 2013 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 depressed, don't wait—talk to your health care provider so you can get the help you need. Visit my site at and check out the resources I've compiled to help. You have to be just as proactive about your mental health treatment as you are in caring for your HIV.

Last, look for 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. This May, you can help—by wearing a green ribbon and a red one too, side by side.

Stephen Puibello is an HIV/AIDS and mental health advocate. Go to for more information