Infertility and Mental Health

Infertility is a major source of stress, with emotional, physical, and financial ramifications; no wonder it can take a toll on our mental health! Today we are talking about why it’s common to experience anxiety and depression during infertility and how to cope.

Mental health is defined as “our emotional, psychological, and social well-being.” The stress and difficult emotions that tend to accompany infertility can have a significant impact on mental health.

Infertility is full of uncertainty, and it can be easy to feel alone while you are going through it. When these thoughts and feelings grow and multiply, it can cause people to feel anxious or depressed.

Symptoms of anxiety and depression are the most common mental health concerns reported by fertility patients. Oftentimes, mental health challenges during infertility can carry through into pregnancy and even postpartum.

How Common are Anxiety and Depression during Infertility? 

Research indicates a significantly higher prevalence of symptoms of anxiety and depression in the infertile population, compared to the fertile population. In one study, 44.8% of the infertile population experienced clinically significant depressive symptoms, as opposed to 24.2% of the fertile population. In addition, 39.6% of the infertile population displayed high levels of trait-anxiety, compared to 17.6% of the fertile population. This is consistent with other research studies.

These are pretty alarming numbers; there are a lot of people who are dealing with both infertility and anxiety or depression. If you are experiencing symptoms of anxiety or depression, know that you are not alone. We share these statistics to bring light to this issue and spread the awareness that mental health concerns during infertility are common.


Why Do People Often Experience Anxiety and Depression During Infertility?

The nature of anxiety and depression makes it difficult, if not impossible, to pinpoint the exact cause of these symptoms and disorders. In addition, experiences greatly vary from person to person. It may be the first time you have experienced anxiety or depression, or it may retrigger symptoms you have had in the past. 

With this being said, there are common themes of infertility that may explain why anxiety and depression are so common during this process. Infertility has emotional, physical, relational, and financial challenges. One of these, or the combination of all three at once, is likely to take a toll on your mental health. 


Emotional Challenges

In a recent survey, infertility was identified as the number one source of stress for most people who are pursuing fertility treatment. I’m guessing you would agree– infertility is stressful!! Each month that you try to conceive is a rollercoaster of emotions; hope, uncertainty, confusion, anger, sadness. When this repeats month after month, these emotions can become overwhelming, causing us to feel anxious or depressed. This is one of the reasons why it is important to frequently check-in with how you are feeling.

Rena Gower, a licensed clinical social worker, has a personal and professional insight into why anxiety and depression are so common among fertility warriors. On Fruitful’s podcast, Been There. Injected That, Rena explains that infertility is accompanied by feelings of loss. 

She states that infertility is “the loss of both our biological and innate right to conceive, then it’s the loss of whatever your vision was.” For women, it is common to feel that you have the innate right to naturally conceive a biological child. It is also common to have a “vision” of how and when you will grow your family. Men can also experience very similar feelings of loss. Any type of loss, including infertility, can bring up symptoms of anxiety and depression. 


Physical Challenges 

In addition to the loss and emotions that infertility brings up, there are also physical challenges of infertility and fertility treatment that may be connected to the development of anxiety and depression. 

One interesting fact is that regardless of fertility, epidemiological studies have shown that there is a higher prevalence of anxiety and depression in women than men. Scientists attribute this to several biological processes, including hormonal fluctuations necessary for various aspects of reproductive function. In addition, women who have polycystic ovary syndrome (PCOS) also have a significantly higher risk of developing mood disorders, including anxiety and depression.

Some fertility treatments may also play a role in the development of anxiety or depression. Certain medications and hormones, including clomiphene citrate (CC), human menopausal gonadotropin (hMG), and gonadotropin-releasing hormone (GnRH) agonists, dramatically alter estrogen and progesterone levels. Research has indicated that this can cause mood disturbance, due to estrogen and progesterone’s actions on serotonin

While it is less common for men to have dramatic hormone fluctuations or undergo fertility treatment, mental health challenges are still very relevant and common in males. Just as women grieve, not being able to naturally conceive, so do men. 


Relational + Financial Challenges

Relational and financial stress associated with infertility are also important to consider. Infertility puts stress on relationships; whether that’s pressure surrounding sex, the financial burden of pursuing fertility treatments or testing, or one partner having more obligations. Unmanaged, this stress can lead to symptoms of anxiety or depression. While these stressors may be unavoidable at times, one very important piece to managing stress is communicating with your partner. Be clear about your needs, feelings, and expectations– they can’t read your mind! This may be what you need to eliminate some of the stress that is causing you to feel anxious, down or upset. 


When to See a Mental Health Professional 

It is very important to both recognize when your mental health is compromised and take the necessary steps to work towards correcting it. Some fertility clinics have a licensed counselor or therapist that specializes in infertility, or you may have to look elsewhere. 

It is very common to not know when to seek professional help, or to think “it’s not bad enough.” Rena Gower encourages people to get help any time symptoms of anxiety or depression are detracting from their quality of life. 

In the podcast, Rena also identifies biological changes that would likely signify the diagnosis of clinical depression or anxiety. She states, “If you’re no longer able to do the things that you need to do every day, if you can’t get out of bed to go to work or you can’t get out of bed to do anything. If you have decreased appetite, increased appetite. You’re sleeping all the time or you’re not sleeping at all.”

It can be hard to put your guard down and reach out for help. But it is SO worth it. You deserve to feel empowered as you go through infertility. 


How to Cope with Symptoms of Anxiety and Depression  

In addition to seeing a mental health professional, there are also other things you can do to address and cope with symptoms of anxiety and depression:

  • Get social support from family, friends, a mentor
  • Get professional support from a therapist or mental health expert
  • Take care of your body: Sleep, nutrition, exercise 
  • Stress management: Journaling, meditation, acupuncture
  • Medication (consult your doctor)

If you or someone you know is in crisis, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) for free and confidential crisis counseling available 24 hours a day, 7 days a week. TTY: 1-800-799-4889.

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