Haute MD: How does struggling with infertility impact the mental health of a couple or woman trying to conceive, especially around the holidays?
For those who are struggling with infertility, this is a tough time of the year. The days are getting shorter, the temperature is dropping, and family gatherings (in a time outside of COVID-19) seem to only revolve around holiday celebrations, and every holiday card seems to spotlight families and children. For many, the family events and holiday parties are incredibly difficult because the perennial question seems to pop-up at the least expected time, “So, when are you thinking about starting a family?”
In a powerful 2010 Scandinavian nationwide study (Klemetti et al) that is still relevant today, childless women with infertility had a significant risk of developing dysthymia (a mild but long-term form of depression) and anxiety disorders compared to women who had not experienced infertility. Women with secondary infertility (which means they already have a child but are trying for another child) had an increased risk for panic disorders. Men with infertility also had a significantly poorer quality of life compared to men without infertility.
Taken together, infertility commonly creates an emotional tinderbox, and the holidays seem to be the spark that sets the emotions ablaze.
Haute MD: What can couples or individuals do during this time to remain positive?
With that said, just because it is pumpkin spiced latte season and a person or couple is dealing with infertility, it does not mean they need to isolate from society and turn off all forms of social media. First and foremost, confide in your doctor or treatment team. Given how incredibly common mental health conditions are among infertility patients, many providers have resources available at their fingertips. Frequently we will refer patients/couples to psychologists, social workers, psychiatrists, group-based resources, and during the COVID-19 pandemic, we have frequently referred patients to online app-based resources.
With respect to the holidays themselves, it is still possible to enjoy them while enduring infertility. Some helpful strategies that have been shared by patients include:
- Making a holiday card, even if it’s just one or two of you! You do not need to have children to spread holiday cheer.
- Develop a game-plan for when you want to open holiday cards. Instead of having daily reminders of the difficulty of your journey, set one day every few weeks to open the cards.
- Do not overshare. It is natural to want to look towards family and friends for comfort and support during a trying time, but you may not get the response you are anticipating depending on when/where you share your struggle. Instead, come up with a strategy or a few lines of what you want to say and how you want to say it. It’s OK to have a canned response of, “We’re hoping to have good news to share next year at this time; it’s been a tough couple of months for us as we struggle with infertility.”
- Celebrate you! If 2020 has taught us anything, life is short and precious. Be thankful for what you do have and spoil yourself with either a new piece of exercise equipment, a new luxurious coat, or maybe an Instagram-worthy bottle of wine.
Haute MD: What can couples or individuals do to maintain physical health during the holiday season/colder months if they are struggling to conceive?
My most important advice to patients during this holiday season is not to overindulge! It’s easy to shy away from exercise, let the diets slip, have some extra cookies, and just lounge around in snuggly pajamas. If you start to gain weight and feel sluggish, the weight of the holidays and that of infertility will feel exponentially greater. With that said, battling infertility is like running a marathon. It requires hard work, discipline, and training. If you’re going to take part in consuming extra holiday calories, make a strategy to increase your exercise plan, with the approval of your treatment team. In fact, while winter and holidays might get you down, exercise has been shown to reduce the negative effects of stress by elevating your endorphins which can elevate your mood and essentially becomes a meditation in motion!