No life is free from pain or suffering. Unfortunately, we will all experience difficult times at one point or another in our lives. While we may not be able to control the things that happen to us, we can control how we react to them. Fostering a sense of resilience is the way to go.
Psychologically defined as “the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress,” resilience allows us to be strong through even the most troubling periods. If you’re looking to boost this trait, there are plenty of small changes you can make. Take a look at our expert-backed advice.
Start looking at the bright side“It’s easy to fall into the trap of solely focusing on the negative aspects of a challenging situation; after all, our brains are hardwired to focus on the negative,” says Dr. Sharone Weltfreid, Ph.D., a licensed clinical psychologist. “So, what can we do instead? We can challenge ourselves to consider the upside of our situation. We make the choice to not allow our hardship to define us, overwhelm us, or completely colour our perspective.”
Practising reframing negative experiences daily can lead to low levels of pessimism, according to research published in the Journal of Consulting and Clinical Psychology. Whenever you experience something negative, take a moment to stop and notice the positive side of it. Slowly but surely, this habit will become a reflex.
Avoid catastrophizing situations“Catastrophizing is a cognitive distortion (i.e. faulty thinking) in which we predict the worst possible outcome for our situation and exaggerate its impact. For example, if you make a minor mistake at work, you may be convinced your boss will fire you.”
“Naming our experience allows us to gain distance from it and take perspective. We can then ask ourselves, ‘What is the likelihood of the worst-case scenario happening?’, ‘What is the best-case scenario?’, and ‘What is the most realistic scenario?’ You can also consider if there are any actions you can take to improve the situation,” explains Dr. Weltfreid.
Invest in your future selfThings may feel unstable right now. However, investing in yourself could help assure a happy and bright future. “When you are uncertain about what the future may hold, by investing in your future you can offer yourself some assurances,” says Dr. Christopher Ryan Jones, Psy.D., host of the Sex Therapy with Dr. Jones podcast.
“This could be learning a new skill, going back to college, investing money, or any number of things that are important to you. This way, regardless of what happens in the future, you are assured that one area of your life is taken care of.”
Savour everyday joys“Even in the midst of hardship, we can always find pleasure in everyday joys. When you identify something positive during your day, like taking a warm shower or receiving kind words from a friend, take the time to really revel in the positive feelings associated with the event,” says Dr. Weltfreid.
If you need a prompt to get you started, there’s a daily habit you can try. “One activity that can help you to savour the good in your everyday life is to write down 3-5 experiences of happiness at the end of each day. Knowing that you will be writing about your positive experiences can help you to scan your environment to find events that bring you joy.”
Get more sleep each nightWhen you’re feeling overwhelmed by worries, getting your 40 winks can be difficult. However, it’s in difficult times that quality sleep is most important. Research published by the American Psychological Association suggests that more sleep would make most people happier and healthier, while sleep deprivation has the opposite effect.
“When we sleep well, we boost our immunity, regulate our moods, heighten our brain functioning, and decrease our stress,” says Dr. Weltfreid. “To maximize our chances to get good sleep, we need to do what we can to ensure that our circadian rhythm stays balanced.”
Suggestions to do that include: “maintaining a consistent sleep schedule, having a sleep space that is dark and cool, avoiding bright lights, limiting caffeine intake in the afternoon, exercising in the early morning or afternoon, and getting morning sunlight for about 30 minutes. You also want to engage in activities before bed that help you wind down and relax such as meditation, a warm bath, and reading.”
Take pride in overcoming challengesNeedless to say, 2020 has presented all of us with challenges. When you’re trying to overcome the obstacles ahead of you, it’s hard to see the bigger picture. However, try to reframe this challenge as an essential task, and take pride in how you are managing it.
“There is a saying that today's troubles are tomorrow's testimonies,” says Dr. Jones. “By remembering that you have overcome hardships and adversity in the past, you can remind yourself of your resilience and ability to overcome things that may come in the future.”
Get in touch with natureIf you’re feeling overwhelmed by the strains of the modern world, take a break in the great outdoors. “Though nature has a way of capturing our attention and bringing us to the present, we can increase our connection to it via mindfulness,” says Dr. Weltfreid. “Try to immerse yourself fully in nature by engaging all of your senses.”
“Notice how the wind feels on your face, listen to the birds chirping, [and] observe the beauty and uniqueness of each tree. When we intentionally focus our attention on the beauty and wonder of nature, we allow ourselves the opportunity to get outside of ruminative or worrisome thoughts and experience joy, curiosity, connection, and gratitude.”
Use positive affirmationsIf you’re looking to boost your self-esteem and resilience, using positive affirmations could be the answer. You may want to write down positive statements that fill you with strength and leave them in visible places around your home. On the other hand, some people find that it is helpful to repeat affirmations to themselves as you might a mantra.
If you’re stuck in a negative thought cycle, you can even try using affirmations to change your mindset for the better. “This is a great way to combat negative thoughts,” says Dr. Jones. “Whenever a negative thought enters your mind, by offering a positive thought in its place you can combat being overwhelmed by negativity.”
Engage in mindful breathingHow you breathe can have a remarkable impact on your emotional well-being. “One of the foundational mindfulness meditations involves focusing your attention on your breath; appropriately, it’s called ‘mindfulness of breathing’,” explains Dr. Weltfreid.
“Find a comfortable position and close your eyes, or if it’s more comfortable, soften your gaze. Next, experience the sensation of your in-breath and out-breath without attempting to change it. When you notice that your mind has wandered, which is completely normal, gently redirect your attention to your breath—your anchor to the present moment. Continue redirecting your attention to your breathing each time you are distracted.”
Dr. Weltfreid also suggests using popular apps, such as Headspace or Calm, as well as guided meditations on YouTube, such as the ones by The Honest Guys.
Focus on physical exerciseWhile you may be feeling lethargic and unmotivated, engaging in physical exercise could be one of the best ways to boost your resilience. Not only does this activity give you something to focus on, but it will also improve your physical and emotional wellness.
“There are so many benefits to exercise, both physically and mentally,” says Dr. Jones. “Besides the hormonal releases inside of the body, the time spent running or participating in activities allows you to clear your mind and refocus on important things in your life.”
Try to be present in the momentMindfulness doesn’t have to be hard. “You can practise mindfulness informally by exercising non-judgmental present moment awareness during your everyday activities such as eating, listening to someone, or walking,” says Dr. Weltfreid.
“As you mindfully approach each activity, try to engage as many of your senses as possible. If you take a walk, try to view the details of your surroundings. When your mind wanders, gently bring it back to your surroundings. Know that you will feel less anxious and more centred, the more that you can keep your attention on the present moment.”
Speak to the people around youSometimes, all you need is a little help from your friends. “Resilient people rely on social support to help them through difficult times,” explains Dr. Weltfreid.
“Seek support from people who are empathic and understanding. If you do not currently have such people in your life, consider reaching out to people from your past, trying to befriend a co-worker or neighbour, or thinking creatively about developing connections. Speaking to people at this time can help you to feel less alone and isolated.”
Offer support to other peopleOne way to boost your resilience through difficult times is to offer support to those around you. In doing so, you can strengthen your social connections and experience the satisfaction of being able to help others through this period.
“We are social creatures and as such need to stay connected to each other. Reach out to people to check in with them about how they are doing,” says Dr. Weltfreid. “Be a good listener and offer your understanding and support. You can also try to make new connections by joining an outdoor exercise class or an online book club.”
Avoid compounding your problems“There are situations in life that are unavoidable. Dealing with them is difficult enough as it is. However, for some people, when they are exceptionally stressed, anxious, or nervous, they look for other situations that are not healthy to be a part of. I call this the ‘nuclear option,’” says Dr. Jones.
“It’s like they want to blow up everything in their life at once. I recommend, when people feel this way, to avoid [negative] situations and people who encourage these situations until you are clear-headed and capable of making positive and meaningful decisions.”
Remember that this won’t last foreverNothing is permanent. If you’re facing tough times, you may find it hard to believe that they will ever come to an end. However, you can use the knowledge that they will to embolden you and make you feel stronger through a difficult period.
“When we are suffering, it can be difficult to imagine that we will ever be free of suffering. We can counter our tendency to project our current suffering into the future by reminding ourselves of the popular adage, ‘this too shall pass’. Believing that there is a light at the end of the tunnel can help us persevere during these challenging times,” says Dr. Weltfreid.
Avoid ruminating on negative thoughtsAre you caught up in a vicious cycle? When your mindset is negative, your outlook will be too. “When we ruminate, we continuously replay the same negative thoughts about an upsetting situation,” explains Dr. Weltfreid. “We may repeatedly beat ourselves up for a mistake we made and consider all of the alternative ways we could have behaved.”
“Rumination keeps us living in our minds and prevents us from moving forward. It is a pathway to depression and anxiety and inhibits our ability to think more broadly. We can break out of this negative neural network by shifting our attention to a pleasant activity. For example, we can read a book, speak to friends or family, or listen to music.”
Practise self-loveDo you find yourself looking for validation from others? It’s time to stop. “Self-love is the foundation upon which we can create a happy and fulfilling life,” says Dr. Weltfreid. “When we love our true selves, we do not need external validation that we are worthy.”
“By not making our worth contingent on external factors, we experience more stable self-esteem. We live by our values and engage in the world from our core strengths. We also seek meaningful connections with people who have our best interest in mind.”
Enhance your self-care practiceThere has never been a more important time to practise self-care. Looking out for your baseline needs and ensuring you are happy and healthy could boost your resilience. The good news is that you can incorporate this practice into your daily routine.
There’s a lot of misinformation surrounding self-care, but it doesn’t have to be difficult to get started. Keep things simple. “Self-care practices include exercising, eating well, sleeping well, etc.,” says Dr. Weltfreid. “When we nourish our body, mind, and spirit, we send the message to ourselves that we are of value.”
Learn the art of forgivenessAre you holding grudges against people? When things get difficult, we often look for someone to blame. Engaging in forgiveness could lead to long-term happiness, according to research from the University of Leicester. This change may also help you become more resilient.
“I am a big advocate for forgiveness,” says Dr. Jones. “Failure to [forgive] often leads to bitterness and resentment. As a Jewish practitioner, I strongly believe in showing kindness to others. I believe that by doing acts of kindness, we bring joy into our own lives.”
Learn some self-compassionThe story you tell yourself dictates how you feel. If you’re constantly telling yourself that you’re not good enough or that you can’t cope, you will start to believe that narrative. Switch things up and speak to yourself as you would a good friend. By doing so, you can learn to practise self-compassion and give yourself some needed support.
“We also build self-love by offering ourselves self-compassion versus criticism when we are facing difficulties,” says Dr. Weltfreid. “For example, when we are facing challenges, we can provide reassuring words to ourselves, e.g. ‘It's okay, everyone makes mistakes’.”
Source: Expresso Communication
When Pfizer and BioNTech announced their astounding SARS-CoV-2 vaccine efficacy results in November, Arthur Reed was ecstatic.
“The global investment and coordination of billions of dollars enabling this unprecedented pace of scientific discovery is truly an incredible achievement,” he said.
But as a gay man in New York City living with HIV since the 1980s, he couldn’t help but wonder about the government and public response to SARS-CoV-2, the virus that causes COVID-19, compared to the early days of HIV/AIDS.
“Unfortunately, in both cases there has been immense stigma against minority communities,” Reed said. “Calling COVID-19 the ‘Chinese Virus,’ and the ensuing rise in anti-Asian scapegoating, feels eerily similar to when people labeled HIV as ‘gay-related immune deficiency’ and shunned us from society.”
What Reed finds especially triggering are the COVID-19 hospital policies that don’t allow visitors, and the patients having to die alone in isolated hospital beds. Media images of FaceTime farewells and sparsely populated funerals painfully remind him of an earlier decade, when patients with HIV/AIDS — many of whom were his closest friends — also died alone. This happened not only because of hospital policies, but because of discriminatory social dynamics and a vicious lack of acknowledgement of the deadly disease at the uppermost rungs of the federal government.
“I lost over 100 friends in the early days of HIV. And it was awful, because these people were like my family,” he said. “The worst part of it all was that it also took my partner’s life.”
The deep and reverberant trauma from these losses and his own fight against the virus have motivated him to keep up with the latest research on HIV. And while he has nothing but awe and praise for the scientists working on these viruses, he cannot help but wonder how a vaccine against SARS-CoV-2 was developed in less than a year — especially since developing new vaccines is a process that typically takes eight to 10 years — while there’s been nothing on the horizon for HIV in nearly four decades.
Reed’s not the only one wondering about this. On World AIDS Day, observed annually on Dec. 1 ― which this year fell only a few weeks after Pfizer’s announcement ― commenters on Twitter amplified the differences between SARS-CoV-2 and HIV vaccine development. Many offered conspiratorial “explanations” for the lack of an HIV vaccine.
Some theorized that the sole reason for this discrepancy is that HIV mostly affects trans people of color and men who have sex with men — marginalized groups without much political clout. Since SARS-CoV-2 is affecting all levels of society (even though the ultimate health outcomes are worse for ethnic minorities), they believe it has garnered quicker attention and unprecedented monetary investment, leading to a (thus far) successful vaccine.
Other commenters have falsely claimed that HIV is “money-making” for governments and pharmaceutical companies alike, and so vaccines have been strategically withheld.
It’s always hard to argue against more funding, since every step of the scientific discovery process is extremely resource-intensive. But it is worth noting that since 1982, federal funding for HIV has increased exponentially, to nearly $35 billion in 2019 alone. Additionally, private funders like the Bill & Melinda Gates Foundation have provided critical financial support over the decades.
To put this in the financial context of Operation Warp Speed ― a public-private partnership initiated by the United States government to facilitate SARS-CoV-2 vaccine discovery, therapeutics and diagnostics ― nearly $18 billion has been budgeted for the project.
“At the moment, I don’t think funding is necessarily the biggest bottleneck to an HIV vaccine breakthrough, although more funding never hurts,” said John Moore, a professor of microbiology and immunology at Weill Cornell Medicine in New York City who has been studying HIV vaccine development for over 20 years.
“At the end of the day, it’s the fundamental differences in the biology of HIV and SARS-CoV-2 that make developing a vaccine so difficult — not for a lack of trying,” Moore said. He dismissed the conspiracy theories as “absurd.”
“Some of these conspiracy theories have unfortunately been around for a while,” said Gregg Gonsalves, an assistant professor of epidemiology at the Yale School of Public Health and a renowned HIV activist. “Now more than ever, we have to continue meeting people where they’re at and identify trusted messengers within communities to dispel these myths.”
Why making a COVID-19 vaccine was faster
While it feels intuitive to compare the two viruses, there are only a few molecular-level similarities. The most prominent is that they both have “spike” proteins ― knob-like structures jutting out of their surfaces (though the structures on the two viruses differ in composition).
Both viruses use these spike proteins to bind to receptors, which are molecules that sit on the surfaces of human cells. In the case of SARS-CoV-2, the virus binds to cells with the ACE2 receptor found in the lungs, small intestine, blood vessels and many other parts of the body — which is why it is not surprising that COVID-19 affects so many different organs. HIV, however, binds to different receptors of immune system cells.
After entry into the cell, the two viruses do very different things. SARS-CoV-2 makes numerous copies of itself, which allows it to go on to infect more cells in the body.
HIV, on the other hand, has a much more sophisticated replication process. One of the most notable differences is that HIV particles have a way to replicate the virus’ genetic material so it becomes integrated into the human cell’s DNA. SARS-CoV-2 cannot emulate this mechanism.
So what does all of this mean for vaccines? What makes it so difficult to produce one for HIV?
“Among a whole host of factors, HIV has an extremely high mutation rate that impacts the architecture of the spike protein antibody recognition sites. And these mutations can happen daily, which is a significant challenge to HIV vaccine development,” Moore said. “On the other hand, the SARS-CoV-2 spike protein has been fairly static up until recently.” This gave scientists a chance to develop an effective vaccine, since that spike protein wasn’t changing too much.
SARS-CoV-2 mutants are now gaining traction. But there is little evidence so far to suggest that the currently available vaccines will be ineffective against these mutant strains. However, Moore said, “we cannot completely rule out the possibility of having to tweak the vaccines in the future to account for these mutations.”
Another critical difference between the two viruses is the topography of the receptor binding domains — areas on the spike proteins that, if strategically hindered by antibodies, can prevent the virus from attaching to its host cell altogether.
“In SARS-CoV-2, this region sticks out like a sore thumb, which makes it relatively targetable by antibodies,” Moore said. “But in HIV, the site is not only buried but also heavily coated with sugars.” This makes it difficult to prevent a fusion to a cell.
But decades of tedious HIV vaccine research have not been entirely futile.
“It is important that people — especially those spewing conspiracy theories —realize that a lot of the things we learned from years of grueling HIV research have paved the way to formulate vaccines and therapeutics against SARS-CoV-2,” said Kenneth Mayer, the medical research director and co-chair of the Fenway Institute in Boston and a professor in the department of global health and population at Harvard T.H. Chan School of Public Health.
As one example, the Moderna and Pfizer/BioNTech vaccines both deliver the SARS-CoV-2 spike protein through messenger RNA (or mRNA) technology. Immune cells sense the spike proteins and produce a huge reservoir of antibodies in response. If a vaccinated person comes in contact with the virus, they start making antibodies. Along with already-primed white blood cells, these antibodies kick in, neutralize the virus and prevent it from infecting a cell.
This approach originally emerged from better understanding the surface proteins of HIV and engineering antigens to elicit an immune response. But so far, this approach has been unsuccessful for HIV because of its high genetic diversity and rates of mutation.
As another example, the University of Oxford/AstraZeneca vaccine uses a weakened common-cold adenovirus to introduce the SARS-CoV-2 spike protein to generate antibodies. (Note: This isn’t the coronavirus that causes COVID-19, and it won’t make the recipient sick with the disease.)
“Again, this approach stems from HIV vaccine trials from the early 2000s, where weakened adenoviruses were used to deliver genes found in HIV,” Mayer said. While those initial trials yielded disappointing results, fine-tuning the underlying principle has led to successes with numerous other viruses, including SARS-CoV-2.
It is worth noting that the HIV research community hasn’t completely walked away from using these adenoviruses to advance trials. In fact, the same adenovirus currently being studied in a large Janssen HIV vaccine trial is also being used in their COVID-19 vaccine trial.
What’s next for HIV vaccine research
While the long-term effectiveness of vaccines against SARS-CoV-2 will continue to be monitored — especially in light of the new mutant strains — there are several ongoing and future directions for HIV vaccine development.
“Currently, one of the more promising avenues is the use of broadly neutralizing antibodies,” or bNabs, said Douglas Nixon, a professor of immunology in medicine at Weill Cornell Medicine.
These are specialized proteins that can bind to and neutralize a wide range of HIV subtypes, as opposed to non-broadly neutralizing antibodies, which can only nullify one strain of the virus. From studying individuals who seem to have an innate resistance to HIV infection, researchers can continue to identify how these bNabs are generated and, hopefully, test them out in clinical trials.
Another approach that scientists are working on is known as “kick-kill.” While there is still a lot more to learn, the idea here is to use one set of compounds that can “kick” HIV from its dormant state in cells, and another set to kill the freely circulating viruses.
Also, a question that’s on everyone’s mind is whether an mRNA vaccine, similar to what’s being used for SARS-CoV-2, will work for HIV. While there are no human trials yet, Moderna does have an ongoing investigation in monkeys, and the results have inspired cautious optimism. If the data continues to look promising, then human trials could well be on the horizon.
“But beyond the science alone, there are some critical ethical considerations when it comes to designing HIV vaccine trials,” Mayer said. “Since we still don’t know of any [preventative] medication for SARS-CoV-2, it’s easier to have a placebo arm. But that’s not the case for HIV, because we have medications like Truvada and Descovy that can be taken as pre-exposure prophylaxis that effectively stop the transmission of HIV.”
As a result, when recruiting people for HIV vaccine trials, the inclusion criteria get very tricky, which adds more time to the design and implementation of studies.
The other big barrier involves attracting talent to the U.S., given the “myopic immigration policies” of the past four years, Moore said. “Many of us investigators are having to deal with these consequences in our own labs, and having to figure out ways to recruit and retain these highly talented people.”
But with hopes of more inclusive immigration policies under the Biden administration ― and continued financial and scientific investments in HIV research ― great strides can be made in advancing this field.
“A huge collaborative momentum has already begun with Operation Warp Speed,” Nixon said. “Let’s keep it going with ‘Operation Warp Speed for HIV Too,’ or Operation HIVVAX, or Operation Hyperdrive, whatever you want to call it.”