Anxiety & Depression: The Psychology of Infertility

Erin O’Neill, LCSW-R

infertility-depressionApril 19-25 is National Infertility Awareness Week and we at Capital Counseling felt it was important to share information about some of the stressors that persons with Infertility might experience. With 1 in 8 couples (or 12% of married women) having trouble getting pregnant or sustaining a pregnancy, infertility is not uncommon. Moreover, studies have shown that more than half (53.8%) of women experiencing infertile issues also had depression.

One study of 200 couples seen consecutively at a fertility clinic, for example, found that half of the women and 15% of the men said that infertility was the most upsetting experience of their lives. Another study of 488 American women who filled out a standard psychological questionnaire before undergoing a stress reduction program concluded that women with infertility felt as anxious or depressed as those diagnosed with cancer, hypertension, or recovering from a heart attack

By simple definition, Infertility is the inability to become pregnant, usually experienced by an otherwise healthy couple. The cause of Infertility may be related to a medical problem within the man or the woman or both. The ability to conceive a child is typically seen as natural, a part of “The American Dream” and an expectation of the physical aspect of our nature, that is, to procreate as a species.

In most situations the couple has already been shockingly surprised that becoming pregnant is not as easy as they were lead to believe. This is the time that the onslaught of advice from well-intended relatives and friends makes its appearance. Words of encouragement such as, “Just relax,” “Have a glass of wine before bed,” “Don’t worry,” “Pray,” “Have sex when the Yankees win a double header” are freely offered. Fortunately, couples quickly tire of this mythology and seek medical consultation.

It is in this phase that the couple is introduced to a variety of medical procedures designed to discover why pregnancy has not been achieved. These may include medical/family history, blood work, injections to increase ovulation, ultra-sounds, and obtaining sperm samples. Having support from a trained professional at this juncture is recommended to help address the sadness, loss of a dream, other grief manifestations, and to modify the inevitable “Blame Game.”

Down the road, once a diagnosis of Infertility has been established, these various Assisted Reproduction Techniques may be explored: in vitro fertilization, egg donor, sperm donor, surrogacy, post-miscarriage analysis, etc. Accompanying this phase is work with a counselor to address familial and cultural pressures to attend baby showers, answer questions like, “When are you going to have a baby?”, “I want a grandchild.” Both partners are forced to face insensitive comments regarding who is “at fault.”

As an international example of “Baby Contagion,” Psychology Today, April 2015, cites data from a report by Advances in Life Course Research. The findings indicate that of 30,000 employed women in Germany, the rate at which they planned to have their first baby doubled in the year after a co-worker gave birth.

At an advanced stage during Infertility treatment, the couple unknowingly faces the revisiting of past losses, whether resolved or unresolved, a sense of urgency pertaining to age, i.e., “The clock is ticking,” and anger at their bodies for letting them down. The process of treating Infertility is expensive and can be grueling while taxing each partner’s commitment to the treatment, willingness to continue and relies upon the previous mental health status of the couple. In other words, these internal and external pressures often result in depression and/or anxiety which can be treated by a trained EAP counselor.

To summarize, having a baby is not always easy for every couple who wants to become pregnant. Infertility as a diagnosis is extremely frustrating and can be a prolonged period of testing and treatments. During this process it is normal for the couple to feel isolated, different, sad, angry and hopeless. To “survive” Infertility the partners need to communicate well with one another and support each other in making difficult decisions. Depending upon the outcome of Infertility, the couple may choose to remain childless, do foster care or adopt.

Finally, Infertility treatments may cause anxiety and depression which occasionally impact an employee’s job performance or attendance. If you are or someone you know is struggling with anxiety or depression, be sure to refer them to Capital EAP, Your Lifeline to Better Mental Health!