Infertility and depression: Symptoms and coping
In this article, learn more about infertility and depression, as well as the symptoms and treatment options.
How is infertility linked to depression?
People with infertility may be at risk of depression.
While doctors have long understood that infertility is a medical problem, shame and secrecy remain prevalent among people with infertility. This can make it difficult to seek help from friends and family.
Not getting pregnant after trying for a prolonged period can be profoundly disappointing and frustrating, especially without support from loved ones.
Research from 2010 found that depression may prevent people from seeking treatment for infertility.
Though many people with fertility issues can have a child after treatment, such as in vitro fertilization (IVF), anxiety about whether the treatment will work can also undermine a person's mental health.
Some of the reasons people with infertility struggle with depression include:
- Stress. Infertility can be a stressful experience, particularly where there is a lot of pressure on someone to get pregnant.
- Medical conditions. Several medical issues that can cause infertility, such as polycystic ovary syndrome (PCOS), may also increase the risk of depression. A 2010 study found higher rates of depression and anxiety in women with PCOS.
- The emotional and physical challenges of treatment. A small 2014 trial of women seeking infertility treatment or fertility-preserving services found that their anxiety and depression worsened as treatment progressed.
- Treatment side effects. Many fertility medications involve the use of hormones. Sometimes, these hormones can affect a person's mood, increasing the risk of depression.
Anyone can experience depression because of infertility.
Depression can cause changes to sleeping habits.
It is not unusual to feel sad or even depressed occasionally. However, when these feelings persist over time and affect a person's quality of life, they may be experiencing depression.
A person may receive a diagnosis for depression when they have five or more of the following symptoms:
- depressed mood for most of the day on most days
- loss of interest in most activities, even those a person once enjoyed
- weight loss or gain not due to deliberate dieting or a health condition
- sleeping too much or too little
- feeling physically agitated or slow most days
- having low energy most days
- feeling worthless, guilty, or ashamed
- trouble thinking clearly or concentrating
- frequent thoughts of death or suicide
For a doctor to diagnose depression, a person's symptoms must not be due to medication or substance abuse. A doctor should also assess someone for other mental health conditions.
If another condition more accurately explains a person's symptoms, then a doctor may diagnose them with that condition rather than depression.
When to see a doctor
People with infertility who experience depression should seek treatment for both conditions. Although infertility might be the cause of depression, it is essential to treat the mental health problems as well.
According to the Centers for Disease Control and Prevention (CDC), people unable to get pregnant after trying for 12 months or longer should consider talking to a doctor about infertility.
However, women over the age of 35 should see a doctor if they have been unable to get pregnant after 6 months of trying. Couples with a history of infertility, women with irregular periods, and people with chronic medical issues, such as diabetes, should see a doctor before they begin trying to get pregnant.
A family doctor may refer men to a urologist and women to a gynecologist. Sometimes, a doctor will refer someone to a reproductive endocrinologist or another infertility specialist.
If symptoms of depression make it difficult for a person to function at home, work, or school, or make seeking treatment for infertility seem impossible, they should get help.
The hopelessness of depression can make people think that treatment will not work. However, this may also be a symptom of depression. Treatment can and often does alleviate symptoms of depression and improve a person's quality of life.
Counseling may help treat depression related to infertility.
There are many medications available that can treat depression. Antidepressants come in many forms, including selective serotonin reuptake inhibitors (SSRI), tricyclic antidepressants, serotonin modulators, and monoamine oxidase inhibitors.
Some people may need to try several different medications before they find one that works well for them. Being honest with a doctor about any side effects is essential as the doctor may be able to change the dose or type of medication.
Therapy is also an effective way to treat depression. When a person is in therapy, they may discuss their feelings about infertility, set goals, and identify strategies for improving their relationship. Some couples find that infertility harms their relationship, so attending counseling together may also help.
For most people, medication and therapy together offer the best treatment outcomes. A healthful lifestyle, such as eating a nutritious diet and getting regular exercise, is also important.
Some couples find that a new hobby or shared activity can help. When dealing with fertility issues, it is easy to focus solely on getting pregnant and neglect other aspects of the relationship.
Trying new activities, having new things to look forward to, and building on shared interests can help re-balance a couple's life.
Although infertility is common, it can feel isolating. According to the CDC, about 6 percent of women ages 15–44 do not get pregnant after 1 year of trying. However, infertility does not have to last forever, and treatment allows many people to go on to have healthy babies.
Finding support from other people with similar experiences can be helpful. They can offer resources for managing stress, keeping a relationship functioning well, and reassure individuals that they are not alone.
RESOLVE, the National Infertility Association, can help people find a local support group. Online groups, such as private Facebook groups and fertility message boards, can also offer support.