The Write Action
Photo by Hugo Jehanne on Unsplash - Oeschinen Lake, Kandersteg, Switzerland
First published on Hepatitis Australia's website in March 2020
"Having HBV is only a small facet of who you are, and not a reason to give up on a loving relationship. A partner who accepts you as you are and wants the best for you is someone who will not see HBV as a barrier to getting to know you.”
Although most people get hepatitis B at birth, it can be transmitted in other ways including sex. This article contains information about how it is spreads, and how you can keep your partner safe.
How Hepatitis B is spread through sex
Hepatitis B contained in blood, semen or other fluids can be spread through unprotected vaginal, anal or oral sex. As it is very infectious, it transmits easily through breaks in the skin or mucous membranes (the lining of the nose, mouth, eyes and other soft tissues) .
We also need to remember that hepatitis B infection can occur through non-sexual contact such as sharing toothbrushes, razors or contact with an infected open wound.
However, it is not spread through normal hugging or kissing, or sharing meals, showers or toilets with someone who has hepatitis B .
How can we prevent the spread of hepatitis B?
The best way to prevent hepatitis B infection, is to get vaccinated. Given hepatitis B can be spread in many different ways, it is strongly advised that all household contacts and sexual partners should be vaccinated, as well as using condoms with sexual partners . By the way, vaccination is usually free for the above groups .
If you are concerned you may have been put at risk of hepatitis B, or that you may have put someone else at risk, contact your GP or local sexual health clinic straight away. Your doctor can also contact a sexual partner for you, without including your details if you wish to stay anonymous.
Telling others about your diagnosis
After you have had time to come to terms with your diagnosis , you may wish to start thinking about disclosing your condition to others.There are many possible reasons for disclosure, such as:
Knowing when and how to disclose can be difficult. Some people may be supportive, whereas others may withdraw or even be angry. Often this is due to their lack of knowledge about the condition. Be prepared that a relationship may change or even end.
Here are some tips that may help with the process :
Finally, you may find these insights help you to negotiate your own relationships and communicate your diagnosis.
“My personal philosophy and method is to be selective about the people I choose to date. To me, it is important if the potential date has common sense and good character. Once I feel this person is worthy of my time and attention, I have the talk about my hepatitis B, and that HBV is vaccine preventable. If they are interested in continuing a romantic relationship with me, they need to be vaccinated to protect against HBV. Some may have already been vaccinated, and if so, HBV is no longer an issue.”
“You need to approach dating, not as who will ‘accept’ you, but rather who ‘deserves’ you. Perspective is everything. If you see a health issue like HBV as a unique barrier to intimacy others will not understand and might reject you for, you will create self-defeating thoughts that not only limit your happiness, but are inaccurate. Everyone has issues. Whether it is health, mental, social or financial, we all feel alone at times and want a connection with another soul.”
If you think this article might help someone else too, please like and share
First published in Bipolar Life's newsletter in February 2020
It is so important to remember that you are not defined by your illness. Though bipolar disorder is thought to be biological in origin, with changes in genes accounting for maybe 60-70% of BPAD , it is also believed that the other factors are environmental, meaning there is so much that you can do to get better and stay well.
Making use of the medical model
The medical model emphasises regular monitoring, medications and psychotherapy to treat the condition in the acute and maintenance phase. Side effects such as weight gain or tremor from medications may need to be addressed in a collaborative manner with your doctor. Regular testing for medication levels, organ health (like kidney and liver function, cholesterol and sugar may also be necessary, especially as it has been found that there are higher rates of diabetes and cardiovascular disease in people with bipolar disorder .
Your team may include a psychiatrist, GP, psychologist, dietician, exercise physiologist and more. It’s important to find the right health care professionals so that you can feel comfortable and confident working with them towards your health goals. This article  might help you with some ideas on what to look for in your healthcare provider.
In addition to talking therapy with your psychiatrist and one-to-one sessions with a psychologist, therapy may be available in the form of inpatient or outpatient group programs. Depending on where you live in relation to public and private psychiatric facilities, available programs might include: Cognitive Behavioural Therapy (CBT), Mindfulness, Schema therapy, Acceptance and Commitment Therapy (ACT), Interpersonal therapy, Art and Music therapy to name a few. Many people have found such courses invaluable, not just because they are taught in a kind, supportive environment but also because the benefits of these tools can last a lifetime. Ask your psychiatrist about these if you are interested.
You can also speak to your GP about the following Care Plans, which can help eligible persons with allied health costs:
Bringing in a wellness and recovery focus
A more person-centred, holistic approach complements your other treatments by strongly encouraging appropriate lifestyle modifications and personal strategies.
Some of these personal stories  on the Depression and Bipolar Support Alliance (DBSA) website by people with lived experience of bipolar disorder may inspire you further on your own journey. Here are some of their experiences:
Remember you are not alone – a helpful exercise might be to write down the people who are in your support network. This might include a partner, peers from a local group (or online forum), friends, family, doctor or psychologist. These people can offer not only a listening ear but can also help you reach your goals.
Dr.Holly Swartz, Professor of Psychiatry at University of Pittsburgh School of Medicine, U.S.A. highly recommends optimising lifestyle factors given bipolar disorder doubles the rate of cardiovascular disease and medications exacerbate it. Healthy schedules, routine and sleep are all therefore needed to support bipolar disorder recovery and to achieve goals .
The Quality of Life Tool (QoL) tool  was produced by The Collaborative RESearch Team to study psychosocial issues in Bipolar Disorder. It is a free online resource for a user to intermittently fill in a simple questionnaire where they can rate satisfaction levels for energy, mood, sleep, work, money, relationships and other domains. The tool then displays the data as a graph and table where the user can easily see where they’ve progressed, and where they might want to focus more attention.
You can find some tips in our October  newsletter on Routine, Goal Setting and Values and the DBSA has some useful information here too .
Check the BipolarLife newsletter for the next monthly support group meeting.in your area.
If you think this article might help someone else too, please like and share
Dr Alice Lam
I'm a doctor who is passionate about writing quality health content.