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Coping with stress and anxiety if you’re struggling to get pregnant

Fertility expert Dr Larisa Cora writes: If you're struggling to have a baby and are finding it difficult to cope, you're not alone. Research has shown that the psychological stress experienced by women with infertility is similar to that of women coping with long term illnesses such as cancer, HIV, and chronic pain.

Men are also at risk of anxiety, depression, experiencing physical aches and pains related to emotional distress, sexual dysfunction, and decreased self-esteem.

You may feel social pressure to have kids or feel judgment from well-meaning friends, family members, or even strangers. And then there’s the being told to “just relax” and it will all happen, which can be the most frustrating of all!

People often absorb a lot of judgement from the outside world, leading to feelings of shame and guilt, and almost inevitably they can end up comparing themselves to others, leading to even greater feelings of self doubt and anxiety.

Intimate relationships can often be put to the test and become strained and then there’s the actual process and pressure of trying to conceive which can often result in scheduled sex that neither partner enjoys, and can lead to problems with sexual performance for both men and women.

Added stress comes from the costs of any treatment and investigations that may be needed, and the pressure to do well in these, as well as facing the frustration of being declined treatment or unable to access it.

Feeling inadequate, empty, a failure and depressed is all normal, in particular if you’ve struggled to have a baby for a long time. In fact, a literature review has shown that up to 60% of people with infertility report some sort of psychiatric symptoms.

So, aside from realising that all of these feelings are very common, it’s also important to acknowledge what specific things are causing you the distress. This may not always be easy and in fact, though a lot of people may, for example, relate to feeling angry, what’s important here is to identify the trigger for this, because this will help you to deal with the emotion and its root cause.

We used techniques such as yoga, reiki, crystal healing and shamanic healing for our couples undergoing The Conception Plan, because all have been shown to be helpful in encouraging a person to reconnect with their emotions, and to offer clues and guidance on how to deal with the issues identified. People will have different responses to different treatments, but there is a whole range available to help with this, such as acupuncture, reflexology, hypnosis, massage, etc, so there is something to suit everyone. The other benefit of this treatment is that it’s stress relieving and quite often cathartic.

There is no doubt that people facing infertility carry a lot of stress engendered by their diagnosis. Multiple studies show this. But what is more difficult to prove is whether the stress itself has an impact on fertility, hence propagating a vicious circle where if you’re stressed, you may struggle to conceive, and by struggling to conceive, you become more stressed. Stress is incredibly subjective and difficult to measure, in addition to which it can often be associated with other unhealthy behaviours, such as drinking too much alcohol or smoking, and these in themselves could therefore be accountable for the difficulty in conceiving.

If we consider this logically, stress is part of our inbuilt fight or flight response. It’s there to protect us from danger. It leads to an increase in cortisol, the stress hormone, which then triggers a cascade of events that lead to priming the body ready to escape or defend itself. In this situation, stress is useful. But not if you’re trying to have a baby, where the excess cortisol can end up having negative effects around the body, such as reducing progesterone production and increasing oestrogen dominance in the body, which in itself can increase inflammation and create an unfavourable environment for fertility.

A recent study found that women with high levels of alpha-amylase, an enzyme that correlates with stress, have a harder time getting pregnant. Saliva samples taken from 274 women over six menstrual cycles (or until they got pregnant) revealed that those with the highest enzyme concentrations during the first cycle were 12 percent less likely to conceive than were women with the lowest levels.

What can you do to cope

Reconnect with your partner. Research shows that women handle infertility-related stress differently from men. Women more often seek social support whereas men lean towards problem-solving. That disconnect can strain the relationship, and it’s important to be open and honest and communicate what you’re feeling and what your needs are to your partner. You can try counselling individually or together to help you to deal with these emotions. And then focus on dating again. Set aside time during the week to go to a movie. Take a dance class together. And put a time limit on how long you discuss any fertility related issues, which can leave you both feeling drained and inadequate.

Rethink your thoughts. Recognise when you’re feeling low or pessimistic and instead of allowing yourself to pursue those thoughts, practice a positive affirmation of where you’re at and what you’re doing. This will be difficult at first, but it’s so important to keep your thoughts positive and motivational, as your thoughts become your actions, and your actions become your behaviour, which then becomes your habit. In other words, thoughts have far reaching consequences, so practice mindfulness which is the act of paying attention to the thoughts you have.

Try journaling. Writing down how you feel each day can help you to process and relieve some of the stress you’re experiencing. Sometimes you may not write much, other times you may write pages. You can even shred or burn the pages is that gives you catharsis, as sometimes the physical act of doing this is powerful in itself.

Have hobbies. Make sure you still continue to do things which bring you pleasure. So many people I see only focus on what they don’t yet have, and that’s a baby, but they forget that this time spent building up to that is precious and should be full of activities and occasions that give you pleasure, allowing you to grow and invest on what’s inside of you, which you may not get the chance to do again once you have a baby. Focus on hobbies you enjoy and give you a sense of purpose, reminding you that you have an identity outside of the fertility sector. Buy clothes that make you feel great and go and watch a movie that releases the feel good hormones. It’s all part of nurturing and honouring yourself, that can often get neglected in the whole struggle to have a baby.

Work on relaxation. Spend time once or twice a day slowing down your breathing and coaxing your body into a state of relaxation. Take five minutes or so to close your eyes and transport yourself to a far-off destination, a mini-mental vacation. Allow yourself to experience all the senses of your surroundings and your body will respond as if you are actually there. This will help to reduce stress hormone levels and also give you a little boost. Meditation and yoga are powerful ways to do this too.

Exercise. This is really important as not only will it help you to keep slim and improve blood flow to your womb and ovaries, but it will also lead to the release of serotonin, which is the feel good hormone, increase libido, motivation and improve concentration. However, too much exercise for women who are already stressed can make matters worse, since exertion triggers the release of cortisol, so be careful not to overdo it, see my blog on Exercise for The Conception Plan.

Get help through counselling or group support. It’s really important to have an outlet for feelings of confusion, sadness, pain and anger and to reduce feelings of isolation. A counsellor or support group can help you to deal with this. Also, find your tribe on social media and forums where there is no judgement, but instead support and help from people who’ve had similar experiences and want to help one another. There is a lot of help out there, please don’t ever suffer in silence but instead reach out and connect with people who love you and will help to guide you.

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