Tag Archives: mental health

Building a Village

25 Tuesday Feb 2020

Posted by in Infertility Education

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sydney-rae-geM5lzDj4Iw-unsplashInfertility can be a very lonely place. Getting the right kind of support at the right time can make a world of difference when you feel like you are drowning in it. What is the right kind of support?

Sometimes it’s a kind friend who just listens, even if she has never been in the same situation.  Sometimes it’s a partner who holds you while you cry on their shoulder. Sometimes it’s a group of friends who distract you with a fun night out and never say a word about fertility or the lack thereof. Sometimes it’s a group of women on social media that you’ve never met in real life, but they understand the pain of another failed transfer like no one else in your life can.

Sometimes we need to vent, to feel understood, or to get advice from someone with shared experience. Sometimes we need someone brave enough to sit with us in our sadness without saying a word. Sometimes we need someone who can ask the hard questions. At different times we need different things. And the reality is, we need different people for these different things. Expecting one person to fulfill all our support needs is setting us (and them) up for failure. Why? Because each person brings a unique set of skills and life experiences to the table. And that’s fine, because we have lots of options out there to build our support system.

You may have family and friends that serve certain rolls in your support arsenal. That face-to-face contact is vital. Then there are online communities for solidarity and shared experience. These can be even more helpful when you find groups that are facing similar challenges as you, whether than be diagnostic issues or age-specific groups. I can’t tell you how much I learned from an IVF group for women 40 years and older. I’ve even developed friendships with women that I’ve met in these groups that have endured past IVF outcomes and births.

Through the process of it all, I found a couple more resources to add to my team; and I want to share those with you because it look me longer to find them and they can serve different roles than the rest.

The first is Fruitful Fertility. Fruitful Fertility is a unique mentorship program. It matches people who are experiencing infertility with “mentors” who have been there done that.  It’s free to join, and you submit information about your background, experiences, and values. Then they match you with a mentor based on a variety of factors, which could include age, diagnosis, primary vs. secondary infertility, treatments, geographic location, or other information. You’ll receive an email or notification in the app when you have been “matched” along with info about the other person and preferred way to contact (e.g., email, text). I like Fruitful Fertility because it takes the invaluable support you can get from someone who has shared experiences and facilitates a more personal one-on-one relationship, which is often lacking in online support communities. I didn’t find Fruitful Fertility until I was at the end of my IVF journey. So I became a mentor and have had the honor of working with four mentees over the past two years. Sometimes online infertility groups can become overwhelming. Fruitful Fertility helps you connect with someone similar to you, without all the distractions or drama.

 

The second resource I’d like to share is an app called Fertility Answers created by MedAnswers, Inc.This app gives you free access to fertility specialists. You can submit anonymous questions privately that will be answered by specialists in a variety of fertility-related disciplines, including RE’s, embryologists, psychologists, genetic counselors, acupuncturists, pharmacists and more. Got diet and nutrition questions – there’s an expert for that. Got questions about egg quality – there’s an expert for that. Need help with stress related to infertility – there’s an expert for that. It’s a great way to get a second, third, or even fourth (because let’s face it, we want all the info we can get) opinion on any of your fertility related questions. You can even schedule phone or in-person consultations with an expert that you connect with. I like the convenience of submitting private questions anytime, anywhere and getting knowledgeable responses. One of the things I found pretty amazing about Fertility Answers is that the app is the brain child of Alice Crisci, who is a cancer survivor and fertility activist. Through her hard work, entrepreneurship, and her own personal experience with fertility challenges, she created has created a one of a kind resource to support you in your journey. I’m passionate about infertility advocacy and as a way to give back to the community that provided me with so much support when I needed it, I volunteer as a psychologist for Fertility Answers.

If you’re interested in expanding your support team, I hope you check out Fruitful Fertility and Fertility Answers. We all need a village!

 

Life After IVF

26 Wednesday Jun 2019

Posted by in Life After IVF

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art blur bright burn

Am I stuck in low-grade reaction mode?

I was reading a post recently by herbalist extraordinaire Maria Toll titled, “Reaction Mode, Yikes! Sit, Sip, Breathe.” She explains that in our fast paced modern life, where we operate under a multitude of pressures, it’s easy for our bodies to get stuck in a low-grade reaction mode. This reaction mode stems from the hard-wired fight-or-flight response (or more accurately called the fight-flight-or freeze response) controlled by our sympathetic nervous system. Basically, this response is how our bodies are built to react to significant stressors.  Like a lion attack. This nervous system response allows our bodies to shut down “unnecessary” functions and respond to the immediate threat in front of us. It’s what helped our ancestors survive.

It’s what helps us survive modern day traumas too, like rape, war, car crashes, fires. Like IVF. Because IVF and pregnancy loss are traumatic. This flight-fright-or freeze response helps us get through the pain as best as we can in the heat of it all. But what happens when the traumatic event isn’t an isolated incident? What happens when we deal with this stress day in and day out, for years?  That kind of prolonged stress response has a big impact on our bodies and emotions.

Now I’m on the other side of infertility. I have two daughters that are IVF miracles. I’m done. No more baby making for me. No. More. IVF. EVER. I’m lucky I made it to the other side. I exhale and think that everything is fine. Finally.

But as I was reading Ms. Toll’s post, I began to think…what if I am still stuck in low-grade reaction mode? As a psychologist, I know that that kind of prolonged stress does not simply vanish when you remove the person from the stressor. On the most severe end of the spectrum, people can develop Post-Traumatic Stress Disorder (PTSD) from their battle with infertility. Others may become depressed, anxious, or have other reactions. It changes us. We all walk away from IVF with a unique reaction, shaped in part by our own stories, outcomes, support system, and experiences. But without a doubt, all of us have been living under the pressure of isolating, heart-wrenching prolonged stress.

I still catch myself holding my breath. Tense and waiting for what will come. I’m still trying to find my way back to myself. I find my moments of calm – when I’m nursing my perfect baby and it’s just the two of us, when I light a candle and sip tea, when I walk barefoot in the grass, when I listen to the birds as I stroll my baby. These moments give my body a break from the tension that seems to hide in the background. In those moments I breathe deeply and exhale.

Therapy? Who me?

15 Friday Mar 2019

Posted by in Uncategorized

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heather-ford-493955-unsplashI want to talk about mental health and infertility.

I remember my very first IVF cycle 5 years ago. I was sitting in my Reproductive Endocrinologist’s (RE) office talking about what was to come. At this point I had already been through the usual – countless tests, gateway drugs (you know, clomid and femara), IUI, surgeries – and racked up more failed cycles than I care to think about. I was desperate, lonely, and afraid. My RE asked how I was doing, and I made some off handed joke about medication-induced mood swings. Instead of laughing with me, he got serious. “Don’t do that. You’re a psychologist and I know you know the emotional impact infertility has on people. It’s not the medications – it’s infertility. It’s painful.”

And he was right. I did know. Sure, all of us who have ever fought in the infertility trenches know intimately the roller coaster ride that these medications force us to ride. Sometimes the side effects from these medications are so strong we feel like we don’t have any control. Maybe we hide in the bathroom and cry at the smallest slight. Maybe we turn into a raging infertile Godzilla. But even if we took all the meds away, we would still be left with the pain. The pain is a part of infertility.

My first battle with infertility was raw and scary. I was charting unknown waters. I was afraid that I would never become a mom. That fear was all consuming. Being a psychologist myself, I tended to hang out with other mental health professionals. One of my good friends, who also happened to be a psychologist, was an invaluable support person. He wasn’t doing therapy with me, that would be unethical as you can’t be your friend’s therapist, he was just being a good friend who always said the right thing. He wasn’t afraid to ask or sit with my emotions. While this helped me tremendously during my IVF cycle, I wasn’t prepared for what was to come after I got that BFP (big fat positive – aka positive pregnancy test).

What came next was joy, relief, excitement, as well as fear and anxiety that were so strong I had difficulty truly embracing my growing baby. And it didn’t stop there. After my miracle baby was born, the trauma from infertility was still present. It was an unspoken trauma, because who wants to talk about still not feeling right after you “won the battle with infertility”. But there it was. And it impacted my ability to bond with my baby after her birth. Sure there were other factors at play – a traumatic birth and difficult temperament baby – but the pain of infertility wasn’t easy to shake even afterwards. It took me a long time to recognize that carry over effect and move through it.

Then came my second run in with infertility. This time around I was 40 years old so we had to pile egg quality issues on top of my regularly scheduled infertility programming. It was a hard battle. I did another 5 IVF cycles and 2 additional frozen embryo transfers. It was a very different experience from the first time around. No matter what the outcome, it wouldn’t change the fact that I was a mother. But that reality also didn’t negate how badly I desired another child. How badly I wanted to give my daughter the sibling she so desired. If someone had told me in the beginning how many IVF cycles I’d do, I would have adamantly disagreed. It’s hard to imagine going through it so many times…before you have. This time around though, I was more prepared for what was to come – or at least what I thought might come. I took preventative measures by arming myself with a variety of coping strategies that I knew resonated with me. Starting this blog was one of them, and reflective writing has been invaluable.

Still it wasn’t enough.

I remember at one point, I think it was after a cycle where none of my embryos made it to blast, thus we had nothing to test or transfer. I was devastated. I was also starting to notice myself snapping at my daughter, and being irritable toward my husband. It was more so than what I would normally experience on the medication roller coaster. I realized that I had exhausted my coping skills and I didn’t want to be this person. I realized I needed professional help. And so this psychologist sought out a psychologist for therapy.

I live in a small enough town where the mental health community is relatively small, so I had to find someone that I didn’t already have connections with and that I could truly trust with my confidentiality. At first I felt awkward being on the other side of the couch, so to speak. But I found someone who came highly recommended, although he didn’t have much experience with infertility. Given my limited options, I decided that his therapy skills would make up for his lack of infertility knowledge, and I could educate him on the latter. And so we began our therapeutic relationship. He helped me work through my fears and anxieties, challenging my assumptions and helping me adjust my view to see the whole picture. We also worked through some of my feelings of inadequacy as a mother, which were partially impacted by infertility and partly due to my own, ahem, perfectionism and expectations. I was able to gradually see some things in a new light, and most importantly, I was able to come to a place where I knew I would be okay regardless of the outcome of IVF. Not that a bad outcome would be easy or painless, but that I would be able to survive it and find myself whole at the end.

We actually ended therapy during the preparation for a frozen embryo transfer (FET). I knew that I could return if I needed it. But at that point, I recognized myself again. I was more connected to my loved ones around me. I saw the end of our infertility treatments, and I felt confident about when we would stop treatment. And I knew that if we did stop, I hadn’t left anything on the table. It would be okay. So we parted ways.

And then my unlikely FET worked. This time around, while I still had some level of anxiety about miscarriage, I was eventually better able to enjoy my pregnancy. I believe that being in a better headspace with the emotional affects of infertility not only helped me with that, but also set the stage to bond better with my baby after her arrival. I’ve written before about how hurtful the carryover affects of infertility can be when it comes to parenting. It’s something few people talk about because, in part, we worry we are being ungrateful and selfish. I’m thankful that therapy during my infertility treatments helped change this for me.

So why did I want to talk about mental health and infertility? Because I want to say that there’s no shame in getting some professional help. Infertility is hard. No matter how well put together we are, how independent we are, how smart we are, how strong we are, it’s still hard. If you are just starting out on this road, or even already in deep, I encourage you to do some soul searching and write out what things might look like if you weren’t doing well emotionally. Make a list. For me, I knew that being short tempered with my daughter and husband were on that list. Maybe you think you can handle IVF, and maybe you can, but how would you know if you were struggling? What would it look like? Maybe you’ve struggled with something in the past. Maybe you know what depression, anxiety, and consuming anger feel like first hand. What are the signs for you that would let you know you are headed there again? Then tuck this list away. Sometime when you are in the heat of a cycle or trying to deal with a loss or negative test, bring out the list. Or maybe when you write it, you may realize that you are already there.

Then consider seeking some professional help. There are many choices out there – psychologists, social workers, marriage and family therapists, etc. If you have insurance, see who is covered. Ask people for recommendations in your community. Google or call to find out which have experience working with people struggling with infertility. Your RE or nurse may even have suggestions for providers in your area that specialize in infertility. Then call one or more of them and interview them! As a psychologist I know that one of the most important aspects of a successful therapy outcome is the goodness of fit between the therapist and client. It’s important that you feel comfortable with the therapist and that you have a good working relationship. So ask them questions before you sign up for a session. Some questions to ask could include:

  • What’s your experience working with people with infertility?
  • Describe your therapy style? What treatments do you use?
  • Do you offer a free or reduced rate first session to see if we are a good fit? (Yes, many offer this and it’s okay to ask.)
  • Do you have a sliding fee scale? (Important if you don’t have insurance coverage.)
  • Ask about any religious/spiritual or cultural experience that may be important to you. (For example, some people may prefer a therapist with a similar religious background as them.)

At your first session, see how you feel with the person. Is this someone you think you jive with? Still, understand that it’s hard to get to know someone in one session and trust takes time to develop. Rarely do people feel comfortable enough to emotionally expose themselves in one session. But can you feel some potential there? Does the therapist seem like they care – are they present and attentive during session? Do they keep personal talk about themselves to a minimum? (This is about you, not a time for a therapist to make it all about them. Yes, there are bad therapists out there, just like in every profession.) If something feels really off, then try a different therapist. Some people  try out one therapist and then, when they have a bad experience, completely write off therapy for good. But just like any relationship, not all are meant to be. It may take more than one try to find the therapist you like. Don’t let one bad apply spoil the bunch.

There is no shame in seeking mental health help. Quite the contrary, sometimes getting help is the strongest thing you can do. Did I mention infertility is hard? Yes. And none of us are immune to that.