Ask an Expert: How Can I Protect My Mental Health During Fertility Treatment?

Fertility treatments help many women who want to have a baby. While these treatments offer hope to women, they can also bring a mix of emotional stress, financial pressure, and hormonal side effects. ADAA spoke to Dr. Julia Riddle MD, a reproductive psychiatrist and Assistant Professor at the Center for Women's Mood Disorder Center at the University of North Carolina’s Chapel Hill School of Medicine to learn more about how women can take care of their feelings and mental health during this emotional rollercoaster.

Fertility Treatments Can Be Tough on Your Mental Health

Infertility is more common than many people think. Dr. Riddle explains that women going through treatment “are carrying it all the time—it can feel like a full-time job layered on top of the other daily demands of life. Because they are mentally carrying the unknown while also undergoing physical procedures, their mind-body connection is impacted. At times, they may feel like they have a broken part.” This constant stress can affect how women feel in their bodies and their sense of identity.

Fertility treatment can be a long and overwhelming process. In reproductive medicine, if one thing does not work, there is usually something else to try. Before you know it, it can feel like a full year has flown by. That is why Dr. Riddle recommends taking breaks to rebuild your strength and refill your resiliency cup. Try taking a short trip or just taking some time to rest. These pauses can help you stay grounded and protect your emotional well-being.

How Your Mental Health is Impacted

Fertility treatments can be really tough on both your body and your mind. The medications used to help stimulate your ovaries and support pregnancy can cause side effects. Dr. Riddle says, “We are putting the body and mind through a spin cycle continuously.” Some common mental health effects include:

• Mood changes like feeling irritable, emotional, or extra sensitive
• Feeling more anxious or stressed
• Trouble sleeping
• Losing interest or joy in things you normally enjoy
• Using substances such as alcohol or cannabis more often to be able to relax

These can be signs that your mental health needs some extra care and support.

What If My Fertility Treatments Do Not Work?

It is natural to want to stay hopeful by avoiding thoughts of “What if this doesn’t work?”, but sometimes avoidance can actually make the fear more powerful. Dr. Riddle encourages women to face these possibilities head-on by asking themselves, “Is there a point where we do something else? What if this all fails?” Sometimes talking through the biggest fear with your partner, trusted family member/friend, or therapist can help. You are not giving up; you are just facing the fear head-on, which often makes it less powerful.

If treatment does not lead to the outcome you hoped for, know that grief is a normal and expected part of that experience. It does not mean you made the wrong choices or that you failed. Creating a memorial to this experience can help you honor what you went through and mark the meaning of that chapter. When you are ready, you can find hope in a new direction.

How to Navigate Feelings & Set Boundaries

Fertility treatments can feel overwhelming. They can come with pressure to follow advice perfectly, but it is important to give yourself grace. Also, protecting your mental health may mean setting boundaries with even the people who care about you most. Dr. Riddle suggests ways to manage guilt, protect your mental health, and set healthy boundaries:

• Take breaks when needed. If fertility feels like it is taking over your life, listen to your body and pause.
• Let go of guilt. You do not have to follow every diet or health tip perfectly. It is human nature to give your mind a reason why something is going wrong, but those reasons might not be true.
• Watch your thoughts. Infertility is commonly a time with uncertainty plaguing your mind. Questions like “Why is this happening?” and “Why didn’t that procedure work?” may make you find yourself with a lot of self-blame thoughts. This is a normal response to uncertainty—try to remember that it doesn’t make the thought come true.
• Consider shutting down social media. It can feel overwhelming to see other folks announcing pregnancies or with their children. It is OK to take a break from that.
• Give your community explicit instructions about how to care for you. You can provide guidance that you will give updates when you feel comfortable and request people not to inquire otherwise. On the other hand, you might want to have a person check in on you weekly for a phone or coffee date.

Ways to Get Support and Cope

Dr. Riddle says you should think about getting preventative mental health support at the beginning of your fertility journey. It is a good idea to engage with someone monthly and speak to them along the process so they are up to speed and can remain part of your support system. It is never too late to find help. If at any point in your journey you need support, your infertility center may have resources, or you can look for women’s mental health specialists near you.

There are many therapies and support systems available:

• CBT and mindfulness therapies work the best.
• Acceptance and compassion therapy can also provide relief.
• Couples therapy is helpful to nurture your relationship and explore the unique experience of the carrying partner.
• Medications, including SSRIs, can be helpful depending on your medical history.
• Find a support group via your local hospital or IVF practice. You can also check out Postpartum Support International, Compassionate Friends, and Return to Zero for dealing with losses.
• It might be helpful to have someone go along with you on your appointments. Dr. Riddle explains, “When the brain is stressed or overwhelmed, it is really hard to remember what someone said. A friend or spouse can take notes and advocate for any questions you have.”

Fertility treatment is not just a medical journey; it is also an emotional one. Taking care of your mind is just as important as caring for your body. Be kind to yourself and reach out for support when you need it.