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Mood Stability While Facing Infertility

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EXPLAINED BY REPRODUCTIVE PSYCHIATRIST, DR. CARLY SNYDER

Dr. Carly Snyder is one of a small cohort of medical physicians specializing in reproductive psychiatry. Her approach combines traditional psychiatric treatment and integrative medicine-based treatments to optimize the body and mind. Dr. Snyder is in a private practice in NYC, and is on staff at Weill-Cornell in the Payne Whitney Women’s Program.

Dr. Snyder joined us for Speak Your Truth at Hatch as part of our Beyond Mother’s Day campaign. She was part of an important discussion surrounding fertility, pregnancy, and loss. Below, Dr. Snyder shares her advice on how to keep your mood stable when facing infertility.

As little girls, many of us imagined motherhood and it all seems easy and fun. When reality counters this childhood fantasy, there is a sense of loss, anxiety, disappointment and even anger. These are normal emotions, but sometimes the fertility process can become a tidal wave, threatening to take over one’s life.

Should the process of getting pregnant be easy and fun? Why am I feeling more stressed than optimistic?

Trying to conceive is different for each woman and often changes with each child. For some women, the process is seamless, quick and painless. For others, it can take months or even years to successfully get or to remain pregnant. With each passing month, the sense of urgency often builds along with frustration. The longer it takes to conceive, the more getting pregnant can feel like a job (and not the fun type).

Women tend to feel responsible for the fertility journey and when the road is rocky, women often take it as a personal failure even though it is never anyone’s fault. Each month becomes a roller coaster of emotions between anticipation, excitement and then disappointment to despair. Bearing the burden of being the one to get and stay pregnant, to bring a baby into the family is a heavy weight to walk around with, and this breeds anxiety and sometimes unwarranted guilt.

Many women express feelings of being out of control of their lives in a way they’ve never experienced before. In every other aspect of our lives we can dictate change – want a new job, go network and find one; want to lose five pounds, exercise and cut back on dessert, and so forth. But, getting pregnant is something where even when we do everything right, what we want can still be elusive, which is profoundly disempowering.

There is an understandable drive in the face of feeling so helpless to regain some sense of control. Women resort to buying every fertility related product available, changing and restricting their diets, spending a veritable fortune on supplements and some even forgo their favorite spirits and caffeinated beverages (even during their non-fertile days). Many of these measures are futile and just make life less enjoyable, but don’t do any actual harm.

The problem lies when women actually inadvertently hurt themselves. Sometimes women will forgo necessary medications such as antidepressants due to an unwarranted fear that these treatments may hinder conception. In fact, remaining stable is important and some research suggests that the better your mood, the more likely you are to conceive. While controversial, there is data indicating that women who are more anxious or depressed while trying to get pregnant are less likely to conceive as compared to women who are feeling more emotionally stable. The important message is that stopping medication cold turkey is never a good idea and any treatment decision should be made after a comprehensive discussion of risks, benefits and alternatives with your personal psychiatrist (googling and reading things online definitely doesn’t count!).

Trying to improve the odds of getting and staying pregnant is completely understandable, but it’s important to remember that most ‘fertility enhancing agents’ are bogus at best, and may be detrimental at worst. Similarly, while making healthy life changes never hurts, cutting out foods you enjoy, abstaining from things like caffeine or a glass of wine on occasion just makes life feel like purgatory. Remember you did nothing wrong – you do not need to punish yourself by withholding things you enjoy. For better or worse, when it comes to conception, nothing you do or don’t do makes as big a difference as having sex around the time of ovulation and / or relying on the magic of modern medicine.

What can I do to feel better?

No one can make the infertility process easy, but here are a few suggestions to make things easier and more manageable along the way:

Share Your Feelings: Many women opt to keep their difficulties getting or staying pregnant a secret often due to unnecessary shame or guilt. This leads to a frequently reported sense of isolation and loneliness while trying to conceive and when undergoing fertility treatments. The irony is that it is actually common for people to have a harder time conceiving than expected, with 10-15% of couples facing infertility. When women start opening up to others about their journey, it’s inspiring and heartening how many people commiserate and are there to be supportive and encouraging. Rather than feeling alone, women find they have a ready-made community at their fingertips once they open up and let others know what’s going on. So, share how you’re feeling, talk to friends, relatives and your partner – don’t keep your feelings inside – allow people to support you through the process. People often want to help, but you must give them the opportunity to do so.

Take Care of Your Body: Exercising, eating healthy foods, staying hydrated and getting adequate sleep are all good for your body and mind. These things will not inherently get or keep you pregnant, but being your healthiest self and feeling your best will make the process smoother, better and can only help.

Socialize: Sometimes it feels easier to stay home rather than engage with others, especially during the two weeks before taking a pregnancy test. However, the drive to bury one’s head in the sand is detrimental to well being and leads to further isolation and loneliness. It’s important to fight these urges and go out anyway – make plans with friends in advance and stick with them. Take walks outside to get fresh air, go to the movies, museums or try new restaurants with your partner. The best way to pass the time is by being active and engaged with life, not by watching the clock in an empty house or apartment.

Protect Yourself: The caveat to getting out is that it’s also imperative that you be self protective during this time – it’s not uncommon while trying to conceive that friends will be pregnant and will have baby showers, baby namings and other celebrations. It’s perfectly ok to pass on these gatherings if attending will be too difficult – send a note with congratulations and briefly explain that you are unable to attend but can’t wait to meet the baby in the future. It’s far better to bow out gracefully than to attend and be quietly heartbroken.

Connect With Your Partner: Don’t forget that you were a couple before you began this journey to parenthood and you will remain a couple once you add a baby to the mix. It is incredibly important for the sake of your relationship that you focus on one another separate from baby making and in the future, after baby arrives, that you also focus on one another as adults, not just as co-parents. You were lovers and friends before the idea of parenthood emerged, and while it is tempting to focus only on fertility, don’t. Take mini trips, go on dates and make a point to discuss things beyond making babies. At the same time, it is also important to set aside time to discuss the fertility process openly and how you are each experiencing it. Remember to check in on one another; give your partner space to share his or her emotions and share your feelings as well. You will get through this time together stronger and closer as a couple if you proceed as a team, united with a common goal.

Ask For Support From A Professional If Needed: If the process of trying to build a family is taking over your life and you’re feeling overwhelmed and anxious, depressed or very out of control more often than not and you aren’t able to function or enjoy life as you normally do, then it is a good idea to reach out for professional help. Psychotherapy can be incredibly helpful as can medication if indicated. Establishing a relationship with a therapist and/or a psychiatrist now can also be very useful to offer support and guidance as you navigate through pregnancy and the postpartum period in the future. You deserve to feel as good as possible and to enjoy every step in the journey towards and in motherhood, and if you are struggling then reaching out for help is not only good for you, but it is good for your future baby. WeAreRobyn.com is an invaluable resource because it provides a curated network of mental health providers who are trained to help women dealing with fertility struggles.

Dr. Carly Snyder