Dr. Abayomi Ajayi
Infertility and depression frequently go together. You should know that infertility can lead to depression, and that people who experience depression are more likely to have fertility problems.
It is a fact that depression during pregnancy and after pregnancy is more common in women who have struggled with conception. This is a good reason why depression should not be ignored or left untreated. It’s quite normal to feel a sense of sadness when dealing with infertility.
You may feel unhappy when your menstrual period comes, when a fertility test result is not what was expected, when treatments fail, or upon diagnosis of infertility.
You may also feel sadness when reminded of your fertility struggles, like when there’s a baby shower or your friends have new babies. But it is essential to talk about what you are feeling. It is essential to break the silence even though despite many efforts to break the silence on infertility and pregnancy loss, fertility and miscarriage largely remain forbidden subjects.
Many couples that are suffering don’t share their experiences with others. Non-members of the infertility-and-loss club don’t know how to react or what to do when they are told of a friend’s struggle. Some persons honestly are uncomfortable hearing about it at all. The stigma is strong even with up to 25 per cent of pregnancies ending in miscarriage; it’s still uncomfortable discussing these relatively common life events.
The study of stress and infertility is important and controversial. Any time a new study on stress and fertility comes out, you’ll see headlines that tell you stress is the reason you can’t get pregnant, even if the study didn’t truly indicate that stress causes infertility.
If you’re experiencing fertility challenges, you may be worried about stress. Infertility itself causes distress and emotional turmoil and the stress of infertility could make your situation even worse.
As fertility experts, we are curious about the stress-fertility connection. Stress could be the missing clue when a cause for infertility is unexplained or when treatments fail for unknown reasons. If you feel like your entire life is focused on infertility, it could be an indication of depression. Do you go to sleep and wake up thinking about getting pregnant? You may be experiencing infertility-related depression or anxiety and infertility may have hijacked your life. Infertility is emotionally and physically exhausting.
When you are out with friends, do you find your thoughts drifting back to your fertility issues? Are you struggling to find things to talk about with your partner (or friends) besides infertility? When you try to concentrate or enjoy other parts of your life, do you feel like infertility always manages to sneak in and break your concentration? These could be symptoms of depression.
Sadness is a normal reaction to unfortunate events. If you find yourself in tears when a treatment fails, a fertility test comes back with bad results, or a pregnancy test is negative, that’s normal. But you may be dealing with depression if your sadness seems to rarely lift and you find your days are greyer than being bright and you feel sad for weeks and weeks.
It’s established that infertile couples are more likely to struggle with depression, which is loosely defined as sadness that you can’t shake, or sadness that lasts for extended periods of time, and interferes with your daily life.
If you feel sad most of the time – even when you don’t really understand why you’re feeling sad – you may be dealing with more than normal sadness and it could be depression. A marked difference between sadness and depression is that sadness lifts after some time while depression lingers, involves other symptoms, and interferes with your life.
Like I pointed out above, common signs of depression include sadness that lasts for weeks or months, feelings of hopelessness and helplessness, frequent crying, irritation or intolerance of others around you; specifically people who you used to enjoy being around.
Other signs include lack of motivation, struggling to get work done at the office or around the home, difficulty sleeping, difficulty with eating, and struggling with experiencing pleasure in life, including a low interest in sex.
If what you’re dealing with seems like “just the blues,” and not full-blown depression, don’t let that stop you from seeking help.
Many things that help those with depression, like counselling, support groups, and mind-body therapies, can also help with the infertility blues. It is no secret that infertility is a stressful condition, having a strong impact on sex life, relationship, sense of self-worth, and daily life.
If you have experienced it, you’ll know that in the midst of testing and treatments, infertility may literally feel like it has become your entire life, as you go to and come from appointments with doctors.
All of this stress can potentially contribute to the development of depression. From clinical experience, depression is more common among fertility-challenged people who have a family history of depression, who experienced depression before their fertility struggles, or who lack a support network.
Although infertility frequently causes feelings of shame, which may make it more difficult for you to talk to friends and family about your struggles, the isolation makes depression much more likely. As fertility experts, we know some hormonal imbalances that cause infertility may also contribute to mood symptoms and vulnerability to depression.
If you’re experiencing any feelings of a low mood, it is good to talk to your doctor as it may help diagnose your infertility and manage your overall care. No one can definitely know whether depression itself can cause infertility, though some studies have found a correlation between depression and increased rates of infertility. There are theories that this may be due to an overlap in some of the hormonal issues involved in both conditions.
But it is true that if you’re depressed, it may lead to lifestyle habits that can negatively impact your fertility. Depression may cause you to overeat or to lack appetite, it could also cause you to become overweight or underweight, which can be the cause of infertility. If you are depressed, you are also more likely to smoke or drink, which can also hurt your fertility.
There have been considerations on whether pregnancy will cure depression. The point really is that if not getting pregnant is contributing to depression, achieving pregnancy would likely cure depression.
However, this isn’t always the case. If you’re experiencing infertility or have experienced infertility, you are more likely to feel depression during pregnancy and at an increased risk of postpartum depression.
Not achieving pregnancy or failing to have children does automatically mean you’ll feel depressed the rest of your life. However, if depression has taken hold, it’s unlikely to resolve on its own.
Quite often, after a failed IVF, an affected couple could still be grieving up to three years later. Counselling can help you get through such grieving process and take back your life after infertility. It’s not unusual to hesitate to get treatment for depression, because you may be thinking that antidepressants can’t be taken when trying to conceive.
Actually, while some antidepressants may negatively impact your fertility, not all do. Treating depression with counselling and antidepressants together increase pregnancy success.
That said, for milder depression, antidepressant medications are just one of many treatment options. Depression can also be treated with talk therapy, support groups, and mind-body therapies.
It is best to speak to a specialist if you’re experiencing depression while going through infertility. Get fertility doctors to help you adjust to your fertility medications, ensuring the situation is less likely to affect your mood, since fertility drugs can aggravate depression and cause mood swings.
Look for a fertility clinic that also offers acupuncture services to further help you with relaxation to reduce the stress associated with IVF treatment.
If medication for depression is needed, your fertility doctor and mental health doctor should work together to help you decide the safest and most effective treatments while you try to conceive.
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