Whether you’re TTC, undergoing IVF or considering egg freezing, too often the journey can feel long, confusing and come with a host of unknown challenges.
The emotional roller coaster that ensues is enough to mean even the most well adjusted person can face a cocktail of complicated emotions.
Common depression and anxiety crop up when people are experiencing fertility struggles is something that is widely discussed But what are the signs to be aware of, and how can you manage going through this experience with support and self care?
What this article covers:
How common it is to experience depressive symptoms alongside fertility struggles
Symptoms of depression to look out for
Reasons behind fertility's emotional health impact
Treatment and support options to consider
1. Depression and fertility struggles: how common is it?
One UK survey found that 90% of people struggling with fertility say they experienced depression symptoms of some kind, and 42% report suicidal thoughts.
Meanwhile, the World Health Organization reports that roughly 5.1% of women and 3.6% of men worldwide face clinically diagnosed depression as a result of infertility.
It’s difficult to pinpoint exact figures, as many people suffer in silence, but what we do know is that emotional turmoil common enough that it should be something to be prepared for, so you can manage your mental wellbeing as smoothly as possible in the face of treatment.
Planning to become a parent is one of the major life events that many adults dream about and look forward to for many years.
But what if that reality is not as easy and simple to have as they expect it to be?
For 1 out of 5 couples, this is the unfortunate reality.
To put things in perspective, in the US, there are 4 million babies born every year, and yet 6.1 million people struggle with infertility - making it more common than most people ever hear about.
The stress associated of family plans not becoming a reality can lead to feelings of anger, anxiety and resentment
What’s more, stigma and shame (though things are shifting these still exist) can cause many people to retreat into social isolation, getting cut off from potential sources of support, and relationships and marriages are all too often placed under great strain.
Infertility is often a silent struggle. Patients who are struggling to conceive often report feelings of depression, anxiety, isolation, and they often feel as if they are no longer in control.
Depression not only has an impact on our overall health but can very easily have an impact on the process of trying to conceive, too - leading to lifestyle changes like less frequent sex, sleep issues, higher stress and the potential for coping mechanisms like smoking or eating junk food.
What are some of the symptoms of depression?
Lack of motivation
Difficulty making decisions
Low self - esteem
Guilt
Irritability
Anxiety
Suicidal thoughts
Changes to your menstrual cycle
Disturbed sleep
Physical pain
2. Why is depression and anxiety so prevalent for people with infertility struggles?
It may not come as a surprise that a number of studies have found that the incidence of depression in infertile couples is significantly higher than in those that are not.
50% of people undergoing fertility treatment have called it “the worst experience of their entire lives.”
Studies also show that the emotional impact of an infertility diagnosis is the same as a diagnosis of cancer.
But why is infertility such a psychological burden? The answer is far more complex and subsconscious than you may think.
All through childhood and adolescence girls and women receive the message that it is important to have children of their own.
Little girls play with dolls and newborn dolls and are very accustomed to the identity of being ‘a mother’. Feeling unable to meet engrained societal and intergenerational expectations can be a difficult thing to bear.
Some researchers found that women who later in life face infertility challenges say they experienced feelings of incompetence, as well as loss of identity.
Sometimes this type of depression is camouflaged and may lead to the conscious and subconscious sabotage of your attempts at conceiving to limit the chance of disappointment.
For example, you may some women say they found themselves intentionally avoiding having intercource durning your fertile window to avoid the disappointment when your period starts.
For women, pregnancy and motherhood are part of the milestones that have been emphasized by cultures globally.
When their attempts to have a baby and start a family don’t work out smoothly, grief and disappointment can manifest as a sense of personal failure.
Women who experience infertility may often find themselves feeling guilty and even questioning their worthiness as a women, wife and potential mum.
Some people also say they struggle with feeling like they let down their family or partner - making it doubly difficult to ask for help.
“So when am I going to be a Grandma/Grandpa?” are loving, hopeful words, that can quickly start to feel painful.
Although this might seem like a very innocent question to ask, it can often make people feel as if they are letting your parents, or your partner's parents down.
The sense of isolation can take root and grow even within couples: often when couples do undergo fertility testing and a medical basis for infertility is discovered, the partner diagnosed with infertility can feel a sense of guilt that they are the reason for their partner not being able to have children.
Depression or low mood might coincide with the phase of a fertility treatment cycle, a round of IVF or IUI and be exacerbated by high hormone levels.
It could also be triggered an upcoming event such as a family holiday or the announcement of a friend or family member's pregnancy.
Fortunately for most people, these sorts of emotional struggles are short lived, but what if they aren’t?
If you are facing chronically low or erratic mood, or finding yourself with little motivation, this can start to have an impact on other areas of your life - beyond health and relationships, for some people it can even start to affect performance at work.
Existing depression may also be a cause of infertility - often emotional distress has been associated with physical changes.
A study conducted has found a link between factors that cause infertility and high levels of continued stress, depression as well as anxiety.
A Harvard study even found that long term depression may in fact be associated with the decline of ovarian function.
3. How do I know if I am part of this statistic?
Do you find yourself constantly thinking about your fertility journey?
Do you wake up in the mornings and go to bed at night with the same intrusive thoughts?
Although starting a family and battling infertility or experiencing fertility challenges might seem all encapsulating – it is important to prioritize your mental wellbeing.
Let that sink in. Your feelings are valid, do not sell your feelings short and do not bottle them up or dismiss them.
As society it is important that we start conversations around infertility, depression as a result of infertility is more common than we would like to admit.
Infertility is constantly on my mind
In the midst of countless blood tests, ultrasounds, doctor visits, injections and tracking basal body temperature, you might ask yourself ‘how can I not constantly think about it?’
Even though the thought is constantly on your mind, be careful of your fertility journey becoming who and what you are.
You constantly feel guilty
As women, we are often told that we are here to procreate. “All I want is to be a mum”. You are more than a medical diagnosis.
We often hear women say that ‘it is my fault I am struggling to have a baby’. This can not be more untrue!
Let’s clear the air – feeling guilty should be an emotion left for individuals who KNOWINGLY did something wrong. Stop thinking about the ‘what ifs.
What if I didn’t wait so long?
What if I saw a fertility specialist earlier?
What if I never started smoking?
Guilt is often one of the emotions women struggle with the most through fertility treatment. BUT for the sake of your mental and physical health – you shouldn’t feel guilty.
The feelings of guilt implies that you knew and understood that your actions were wrong, that you were fully aware of what the consequences would be but still you choose to do it.
We are willing to bet that this is not the case. There are very few occasions where a choice was ‘wrong’ when it comes to your fertility.
Waiting to start a family isn’t ‘wrong’
Waiting for that raise isn’t ‘wrong’
Not freezing your eggs in your 20s isn’t ‘wrong’
4. You feel ashamed about your fertility struggle
YOU ARE MORE THAN YOUR DIAGNOSIS – when it comes to fertility diagnosis, this statement does not ring truer.
Many women who have a fertility challenge find themselves feeling broken or damaged.
Do not let your diagnosis define you as a person, you are so much more.
Facing fertility struggles is by no means a walk in the park, it is difficult to live with, BUT sometimes we make things harder on ourselves.
Of course, this is not done intentionally – sometimes you may not even know that you are making things harder for yourself.
Before you decided to try and start a family, before you knew your fertility diagnosis, we are almost certain that you felt different about yourself – how you thought of yourself was most likely in a much more positive light.
Always remember that ‘that you’ is still there! YOU have not become a different person.
If you were awesome and lovable before infertility, then you're just as awesome and lovable after.
If you doubt this, think about what you'd say to a friend who told you they felt ashamed and worthless because of their infertility. You probably wouldn't say to them, "Yep, you're right. You're worthless!" No way
5. What treatment options are available?
Just as your fertility diagnosis, depression is not a permanent diagnosis. There are many treatment options available, some pharmacological such as antidepressants, but also a host of talking therapies and self-care options:
Eat a balanced diet
Get enough sleep
Get your hair done
Treat yourself to a spa day
The most important thing to speak to your doctor or health care provider as soon as possible to have a frank discussion about whatever you are experiencing: trained specialists are on hand on help you feel better and some medications are available even as diagnosis or treatment continues.
Therapy is also an effective treatment method. Your therapist will help you talk about your feelings, set goals as well as identify strategies to improve your current relationships.
If you find that your relationship with your partner has been affected, it might be helpful to attend therapy together.
For some people experiencing severe or clinical symptoms of depression, medication and therapy together offer the best treatment outcomes.
But for many people who are stressed, overwhelmed, or experiencing low mood a fantastic place to start is by creating a healthful lifestyle, such as eating a nutritious diet and getting regular exercise and good quality sleep, as well as curating a strong support system with people you can talk to and feel you can be open with.
Seeking support
Although infertility is a common diagnosis, it more often than not, it can feel very isolating.
Though you may feel alone, though it may seem you're the only infertile couple among all your friends, you are not alone in this big world. One in eight experience fertility problems at some point in their lives.
There's a good chance someone you know has struggled with trying to conceive, but like you, they are keeping it secret.
Being brave and breaking the silence can be a first step to things feeling more manageable - either with a loved one, or a source of professional help. You have more opportunities for support than you realize.
Infertility, more often than not, is not a permanent diagnosis, and with the help of health care practitioners, many people do go on to having happy and healthy babies.
Whatever the journey holds, having a support structure can positively benefit your life and your relationships in more ways than you might think.