Reclaiming self-esteem after an STD diagnosis

March 1999

After finding out you have a chronic sexually transmitted disease (STD), it's not unusual to experience feelings of shame and a negative body image. Here are some ways to restore self-esteem.

According to two American Social Health Association (ASHA) surveys, most people who had been diagnosed with herpes and human papillomavirus (HPV)—two chronic sexually transmitted diseases—experienced depression and feared rejection from future partners. Can a person with one of these diseases ever learn to adjust?

After the initial shock of her HPV diagnosis had passed, Sarah faced some hard emotional work: overcoming her sense of shame and adjusting to her new body image. Because HPV is a virus, she quickly learned that she would have her sexually transmitted disease forever. Only 24 years old at the time, she felt "used-up and unclean."

Sarah is not alone in her emotional reaction to her diagnosis of chronic STD. Psychologist and sex therapist Jill W. Bly, PhD, says that in her experience counseling people with STDs, "The first reaction of people is usually pretty overwhelming. They think their sex life is over."

Fortunately, these feelings pass. Just like people who learn to deal with other unpleasant surprises in life, people also eventually learn to adjust to HPV and herpes. Indeed, when one ASHA survey asked people how they felt about herpes recently, compared to when they were first diagnosed, fewer people had as low a self-image this time around.

Still, the question remains: How do you reclaim self-esteem? The answer seems to lie in the words of psychologist and marriage and family therapist Joy Davidson, PhD: "Avoid being a passive victim of your own disease." In other words, by gathering knowledge about the disease and how it affects your body, you can gather strength.

Know your disease

"Education is definitely the first step to restoring self-esteem," Bly says. Davidson couldn't agree more. "Get as much information as you can about ways of coping with the disease, both medically and psychologically."

Myths surrounding STDs contribute to feelings of shame, and fact-finding missions often succeed in debunking them. One common fallacy, for instance, assumes that a person who has HPV or herpes inhabits a small, ostracized colony. Not so. As a matter of fact, ASHA estimates that 24 million people have HPV and more than 40 million carry herpes.

Learning the best ways to cope with a disease also helps you regain a sense of control over your body. New insights into the transmission and treatment of HPV and herpes are being discovered all the time. However, staying on top of research usually involves more than a trip to the doctor's office. "Don't rely on your physician to give you all the facts. If it's not their area of specialty they sometimes pass on the same myths that a lay person
is likely to have picked up," Bly cautions. Davidson agrees. (See "Resources" below for current information outlets.)

Know your body

For some wisdom, you need look no further than your own body. If you're experiencing genital warts and herpes blisters, simply observing the timing of the outbreaks may give you a greater sense of control over your disease, and an acceptance of your body's changes.

For instance, one ASHA survey revealed that seven in 10 people with herpes cite stress as an outbreak trigger, though little research has attempted to prove this. People with herpes have also listed menstruation, poor nutrition and lack of exercise as outbreak triggers. Based on these experiences, noting the timing of outbreaks and what might have inspired them may help curb the disease's influence on your body.

Something as simple as looking at your outbreaks of herpes and HPV can ease the adjustment to your new body image, according to Bly. Of course, some people aren't comfortable looking at their genitals in a healthy state, not to mention observing them when blisters or warts adorn the area. Still, Bly recommends, "Become more genital friendly. With men that's not so hard; they're usually pretty friendly with their genitals. With women, though, it usually takes work on their part. A woman should get out a hand mirror and look at her genitals when they're in a healthy state and look at them again during an outbreak. Then she can become more accepting of the disease and the affects that it has on her body."

While the above recommendations are helpful, studies have shown that social support is crucial to STD adjustment. Fortunately, there are many forms of support from which to choose.

Friends and lovers

Over half the people surveyed by ASHA had told a friend about having HPV. But support from a lover, according to one study, may aid adjustment more than support from any other source.

Support groups

Keep in mind that support groups should provide growth and not simply commiseration. Certified sex educator Jan Swanson, RN, advises that a support group should include people at all levels of adjustment, particularly those "who have adjusted and are carrying on with their normal lives."

Signs of health

Even if you've done all of the above—gathered information, told a lover, and even engaged in a respectable amount of genital-gazing—how can you tell that you're truly adjusting?

Bly advises, "I tell people to be patient with themselves and take the time to adjust to their new body image and the new beliefs about themselves as people. You also must learn to accept rejection from a potential partner without thinking that you're a terrible person. If someone can get to that point, they're usually doing pretty well." (For tips on how to tell a partner, as well as information on regaining intimacy, see Couples Coping with a Chronic Sexually Transmitted Disease)

Meanwhile, Davidson recommends, "You absolutely have to be an active participant in coping with a disease...and make decisions about how you want to work with it on a physical, emotional and spiritual level. I think that kind of action orientation is empowering, and that it can have a counter effect to the shame or the pain of having contracted an STD in the first place."