Anxiety and Infertility: How to Cope

An interview with clinical psychologist and anxiety specialist, Dr. Douglas Mennin

Many people feel scared, sad, or nervous along the unpredictable path of the fertility journey, and it’s sometimes hard to know how to manage these emotions.

Dr. Douglas Mennin, Professor of Clinical Psychology at CUNY Hunter College runs a New York-based practice to help people specifically with chronic worry, stress, and depression. Here he shares some thoughts on how to cope with the inevitable feelings of anxiety so that you’re not ignoring your feelings – or consumed by them either.

How normal is it to feel anxious when you’re going through infertility and/or fertility treatments?
Anything that has high risk and high value, like starting a family, will create anxiety in many people.

We know that anticipation is at the root of a lot of anxiety, when things are unknown and ambiguous. There’s a good reason that we feel this way. We’ve evolved to have preparedness for potential threats, and there’s certainly potential threat and loss in this experience, so it’s expected that anyone going through it feels the raised stakes. Of course fertility treatments or infertility will make people anxious.

Are we all predisposed, then, to experience anxiety?
Some people come in more anxious at baseline. People may bring in prior anxiety and/or depression, and this will exacerbate that and may stress these individuals more.  
People who have been depressed before may react more strongly (to infertility) as they would any stressor. We know that having a previous episode of depression increases the likelihood of having another episode in the face of a stressor. So, if someone knows that she has had this difficulty, anchoring herself in the coping tools that have previously worked before, prior to beginning the fertility process, could be beneficial. This may be a mindfulness or mediation practice, an exercise regimen, and/or ways of talking to oneself that help promote grounding and seeing things in perspective. Those who are expecting a hard time can also see a professional counselor to help them develop these coping tools before beginning the fertility process.

What are ways someone experiencing anxiety can handle it?
There are strategies to cope with it.  Here are a few:
Take some deep breaths and focus on your environment, to be in the present moment.

Think about this: Can you notice where you are? Can you notice your surroundings?  Can you notice things that feel nice and things that don’t? Can you notice both of these things at once? For example, can you notice the sadness and disappointment and the excitement and potential in this moment?

Try an allowance practice.

Consider: Can you let that feeling be there? So, instead of trying to push out something that’s bad, can you let it be in your mind and observe it? Can you say the words “Just allow” or “Pause” to allow yourself to slow down and be in the experience you’re in?

People often don’t want to feel these feelings because it’s so important. But, can you let in the fear or pain?

Think of a kind, courageous statement that you can say to yourself.

It’s important to clarify that this is not resignation; it’s just allowing your feelings to be present.

Create some mental distance.

Can you get some perspective by visualizing your fear and your hopes? Maybe the fear looks like a monster and the hope looks like a cute character.  Can you let both in?

Create a statement that feels honest and courageous.

Think of a kind, courageous statement that you can say to yourself. For example, “I’m frightened but I have the strength to handle it,” or, “I’ve been through hard times before, so I can handle this one.”

Come up with a phrase that resonates for you.

Write this phrase down on a piece of paper and put it in your pocket. Tap your pocket to remember the statement.

If your partner is experiencing anxiety during infertility or fertility treatments, how can you help him or her? I think it’s good to think about the ways that both of you cope with uncertain situations.  Consider having a sit down where you share what you know about the way the other person is coping and what you can do to alleviate that source of stress. Ask her if you’re correct. Suggest something you can do for her and let her offer something to you, rather than trying to get her to gratify what you need from her. Open your mind to what she needs, and vice-versa.

Why is anxiety more pronounced at night?

In the past we were in caves, and we’ve evolved to be vigilant at night because we were vulnerable then.

We’re still vulnerable at night. We close our eyes and release control. We’re often alone. Even if we’re not living alone, we may be alone at night and subject to our dreams, which can please or haunt us, and we don’t have the ability to go somewhere to escape it.

How can one cope during this kind of anxiety episode and/or the insomnia that ensues?

I would suggest trying not to lie in bed. Get up and go to a couch and start reading something that has interest, but that is not on this topic. Read material that is not stressful, like work, but mildly engaging. Read until you get very tired. Then try to go back to bed.

If you don’t get tired, it’s okay; you can survive it the next day.

Ultimately, Dr. Mennin says that especially with infertility, all of the information that we try to absorb to make sure we’re on the right path may be overwhelming and induce more anxiety. So, the night before a treatment or doctor appointment, he recommends:  “No looking on the internet about percentages and rates and data about this. No discussions. And nothing in bed like looking on your phone, obsessively reading message boards.”

It’s a tough exercise because the web is full of information; but it seems that the best way to cope with anxiety during the baby-making process is to be present in the moment, to allow yourself to feel what you’re experiencing, without getting stuck, and to be kind to yourself.

Remind yourself that it’s normal to feel anxious when the stakes are high; but that ultimately, you will be okay.