The holidays can be the happiest time of year… or the saddest. According to the National Institutes of Health, there is a high incidence of depression during December’s holiday season. Hospitals report an increase in the number of suicides or attempted suicides during this time of year. Mental health professionals report a significant increase in their patients’ symptoms of depression and anxiety.
Infertility patients often face added sadness during the holiday season. Lisa Schuman, LCSW, the Director of Mental Health Services at Reproductive Medicine Associates of Connecticut, witnesses patients struggle each year. They are faced with both the pain of infertility and a myriad of hurtful experiences that arise when interacting with family and friends over the holidays.
Schuman has worked with infertility patients for almost two decades. She is also the Chair of the Oocyte Cryopreservation Task Force for the Mental Health Group of the American Society for Reproductive Medicine (ASRM). Schuman has received several awards for research at the ASRM and the Pacific Coast Reproductive Society’s annual meetings.
What Makes the Holidays More Difficult Than Other Times of the Year?
Interactions with friends and family during a time of year that is supposed to be joyous can be difficult for several reasons. First, families and friends are often together during the holidays, making it a common time for announcements, such as “We’re pregnant!” Even if the infertility patient feels happy for a relative or friend who makes such an announcement, it is only natural that she would feel badly about her own misfortune. Further, family members can be intrusive by asking too many questions, giving unsolicited advice, or criticizing. Finally, the holidays can mark the end of another year without a baby. The resulting pain can be enormous.
What Can Infertility Patients Do To Help Themselves Get Through This Tough Season?
Patients would be wise to appreciate how upsetting these interactions can be. They can preserve their relationships and take care of themselves by considering that this time in their life is extremely stressful, but it won’t last forever.
It is commonly known that infertility can be a clinically depressing experience. We know that infertility patients who are unsuccessful at obtaining a pregnancy can experience levels of depression that are similar to chemotherapy patients. Patients who are having trouble getting pregnant may truly have the same level of depression as patients fighting for their lives. Friends and family rarely understand this, and therefore cannot be expected say or do “the right thing.” It’s unlikely that baby announcements will be postponed, that sweet aunt Ethel will refrain herself from asking, “So when will you two have children?” or that a sister-in-law will hold back from boasting about how easy it was to get pregnant.
So how does someone struggling with infertility deal with the emotions triggered during the holidays and possibly enflamed by the reactions of others? The answer is in the planning. Understanding that the holidays may bring added stress can help patients either minimize their interactions with friends and family or be prepared to be direct with them about their feelings. A friend or family member may not understand if their beloved relative doesn’t attend every family event, but missing a few events can usually be tolerated.
If being direct is an option, friends and family often respond well to that approach. While infertility makes attending a particular event painful, and missing the event will be upsetting, attending future events will be a pleasure once your feelings are made known to family members.
The importance of taking time to nurture a partnership as well as the body and spirit cannot be overestimated. It may not be possible to control the medical treatment, but it is possible to take control over one’s health and well-being. Acupuncture, psychotherapy, massage, yoga, or just taking some time off can be rejuvenating. It can also be helpful to feel balanced by having more control over other aspects of one’s life. For example, taking a cooking class or learning how to knit can feel incredibly stabilizing because effort is put into something and there is an immediate benefit. Activities such as these can actually counteract some of the “out of control” feelings of infertility treatment.
What Can Family Members Say or Do?
Friends and family need to understand that infertility is a medical condition and the pain of infertility can lead to depression, self-blame, and diminished self-esteem. Phrases such as “just relax” and “look on the bright side” can leave one feeling criticized and uncared for.
My advice to friends and family is to take your cues from the patient. If it is unclear what the patient wants, ask them. It can be helpful to start the conversation with a statement such as, “I know you are going through a rough time. I’m not sure how to respond, but I want you to know I care and I am here any time you want to lean on me. I won’t be intrusive and ask you questions but understand that I always want to know how you are doing.”
What Can Patients Do To Help Their Relationship With Their Partner?
To help maintain a good relationship and give patients something positive to look forward to, I encourage them to plan time together. The holidays can be a good time for a trip to an adult-only resort. For patients who plan to stay in town, I encourage them to find something that they enjoy doing together, such as going to a movie or show. Thoughts about the treatment may persist but if the patient focuses on the show even 50 percent, that’s 50 percent not focused on treatment. It’s also good to get out of the house, even if we are not always up to it.
There may be a lot to discuss, but it is important not to allow infertility treatment to consume every discussion. I suggest patients limit their infertility discussions to 20 minutes per day, and then put it to rest. If anything else comes up, write it down for later. Tomorrow will come.
It may be hard to imagine that one day all the pain of infertility will diminish and eventually fade, but it will. If patients can take the time to care for themselves and plan for their interactions with others, the holiday season will be the best it can be under the circumstances. Most importantly, emotional well-being and relationships will be kept intact so that future holidays can be truly wonderful.
Dr. Spencer Richlin, is the Surgical Director and a Fertility Specialist in reproductive endocrinology at Reproductive Medicine Associates of Connecticut (RMACT). Richlin also holds the title, Chief of Reproductive Endocrinology and Infertility (REI), in the Department of Obstetrics and Gynecology at Norwalk Hospital. He is Board Certified in Reproductive Endocrinology and Infertility as well as Obstetrics and Gynecology.