Infertility and Depression

Depression and infertility can go hand in hand, particularly when the time it takes to bring home a baby is prolonged or it simply doesn’t happen.  

For Marissa and her husband Ben, the excitement of starting a family soon gave way to frustration, concern, anger, obsession, and full-blown depression as month after month went by without a positive pregnancy test. What was supposed to be the next joyous milestone in their relationship became a slippery slope that left Marissa crumpled in bed each time another friend or co-worker announced she was pregnant. “It felt like I was mourning something or someone I’d never even had,” shared Marissa, “Not having a baby overshadowed everything else in my life, and I just couldn’t seem to dig myself out.”

But Marissa is not alone.

Infertility depression is quite prevalent in women and their partners struggling to have a baby.  In one 18-month study of 174 women and 144 of their male partners who did not have a successful child-related outcome during the timeframe of the study, 39.1% of the women and 15.3% of the men met the criteria for a Major Depressive Disorder (MDD).

Why does infertility cause depression, what symptoms should you be looking for, and what are the treatment options?  We’ve got answers to all of these questions and more.

How is Infertility linked to Depression?

While both infertility and depression are formidable medical diagnoses on their own, the former can lead to the latter for a number of reasons.  

• High levels of stress & anxiety. Infertility can be among the most stressful experiences in a person’s life.  Researchers have compared the psychological distress associated with infertility to the stress experienced when receiving a heart disease, cancer, or HIV diagnosis. Several studies of psychological well-being and infertility have found that infertile women have increased anxiety and depressive symptoms.
• Some of the same medical conditions that put you at risk for infertility also increase your chances of depression. Certain medical issues, like Polycystic Ovarian Syndrome (PCOS) and autoimmune disease  can cause infertility, and may also increase your risk of depression. A 2010 study of women with PCOS found high rates of depression and anxiety. A Danish study found people who had been treated for autoimmune disease were 45% more likely to have developed a mood disorder than those without an autoimmune diagnosis.
• The emotional and physical toll of treatment is substantial. Anxiety and depression can worsen as treatment progresses. The length of treatment may also impact mental health in women. And when the cause of infertility is exclusively female, women experience higher levels of anxiety and general distress both before and during treatment.
• The side effects of hormones. Many fertility medications involve the use of hormones. Sometimes, the sudden drop and surge in hormone levels make susceptible women more likely to suffer from depression. 

Can Depression Cause Infertility?

Given all of the above, it’s clear that infertility can lead to depression, but can depression cause infertility? Some studies have shown that people who experience depression are more likely to have fertility problems , but other studies have not.

In women, the effects of SSRIs on fertility aren’t as conclusive, but there is some evidence that suggests a woman’s fertility is less affected than a man’s.  Several studies of people using assisted reproductive technology (ART) like in vitro fertilization (IVF) to conceive suggest SSRI use had no effect on hormone levels or the number and quality of eggs retrieved and embryos transferred.

Signs and Symptoms of Infertility-Based Depression

How do you know if infertility has hijacked your or your partner’s life?  Infertility depression has some clear signs and symptoms to look for:

• Infertility is the only thing you or your partner think or talk about. It finds its way into every conversation even when you’re not in the midst of a treatment cycle. You have difficulty concentrating or focusing on anything else.
• You feel guilty . . . for not being more fertile, or not trying to get pregnant sooner, or for physiological things that are beyond your control.  
• Your self-esteem (or lack thereof) is entirely based on your ability to have children. You worry your partner will love you less or even leave you if you can’t have a baby.  Infertility makes you feel defective and less than whole.
• You feel consistently sad.  Shedding tears after a failed treatment cycle or negative pregnancy test is completely normal, but feeling sad all the time no matter what’s happening is a clear sign that all is not well. Sadness you can’t shake or consistently feeling blue can be a symptom of depression, and it’s important to seek help.
• You’ve turned to food, drugs, or alcohol to numb the pain (none of which help your chances of getting pregnant)
• You’re sleeping too much or too little. This could be a result of hormones you’re taking or a symptom of depression
• You feel alone and lonely even when you’re around others, or you choose to be alone in an attempt to avoid seeing pregnant women and young families who make you feel even worse. Infertility can be isolating, that’s why it’s important to find support from others in the same boat or who have personal experience with infertility and can genuinely relate to what you’re feeling
• You’ve ditched many of the hobbies and activities you used to love because you now find little joy in them
• You frequently feel nervous, anxious, and worried about nothing and everything. Panic-mode seems to be your general state of being and the tension never subsides.
• You find you become easily frustrated and angry at your partner, co-workers, friends, family, and even strangers on the street (particularly pregnant women and young families). This misdirected anger is typically a symptom of the sadness you’re feeling.
• Your relationships with your partner and/or other friends and family are suffering. Stress has a way of bringing some couples closer and pulling others apart. Infertility can make you feel angry at the world, which can take a toll on all of your relationships. Couples counseling is a great place to start.
• You’ve forgotten that sex can be fun, not just for making babies. Sometimes the hormone roller-coaster can leave you feeling libido-less and sex for procreation can start to feel mechanical. This loss of intimacy can make you feel disconnected from your partner
• You’re struggling to find a reason to keep living. If you’re experiencing suicidal thoughts, it’s important to get immediate help and support. You can call the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Infertility Depression Support

Depression from infertility can sneak up on you. Make sure to speak with your doctor if you or your partner is experiencing symptoms that drag out. Treatment options range from anti-depressant medications to one-on-one or group therapy through specialized fertility support programs like the fertile spirit can be very helpful. Even things like yoga, acupuncture, meditation, and journaling can help you cope with stress. Your fertility doctor may need to adjust your medications and treatment protocol if they’re playing a role in your mood.

And remember, you are not alone. Infertility isn’t uncommon. Approximately 1 in 8 couples are affected by infertility. Odds are there’s someone you know who is struggling as well.

Infertility Depression Quotes – a unique way to gain perspective and cope with infertility based depression

I release my sadness and a new sense of hope begins.

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Emotions are temporary states of mind. Don’t let them permanently destroy you.

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SHE BELIEVED SHE COULD, BUT SHE WAS TIRED … so she rested and you know what?  The world went on and it was okay. She knew she could try again tomorrow.

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Life is a balance of holding on and letting go.

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With a baby or without, you are valuable, you are whole, and you matter.

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Sometimes it’s hard to see the rainbow when there are sheer endless days of rain.

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Feel what you need to feel and then let it go.

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Storms make trees take deeper roots.

  Dolly Parton

The Bottom Line about Infertility Depression

Remember Marissa and Ben? Thankfully Ben saw his wife was struggling. He shared his concerns with her and their fertility doctor who helped the couple find someone who specializes in the emotional aspect of infertility. Marissa also found a support group. It took her a while to open up, but once she did, it was a safe place where she could talk about her biggest fears, connect with others, and not worry about feeling judged.

And though it seems like the answer, a successful pregnancy isn’t always an effective cure for infertility depression. In fact, women who experience infertility are more likely to feel depressed during pregnancy and are more at risk for postpartum depression, so it’s important not to ignore your symptoms and seek help when needed.