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Worrying can feel so overwhelming during infertility. It can be so hard to get yourself out of your head and away from all of these worrying thoughts. One little trick that I encourage my clients to do is to have worry o’clock, actually just almost setting a time aside later in the day to say “I’m going to worry about it then”. Then at that time having some dedicated time to look through your worries if you’ve written them down during the day or really think around those. And to start questioning and challenging some of those thoughts that you might be having, to say are they rational? Are they true? Are they healthy or helping me? If they’re not those things maybe just becoming aware of that can be really important in helping you drive change in how you’re thinking. This is what’s really important in this area – it’s that we can’t change, infertility, unfortunately, but we can change your response to it, and that is where the power lies in changing that response. I would really encourage you to start journaling some of those thoughts and potentially having worry o’clock. However, it’s going to work for you, but just becoming aware of some of those thoughts can really be the point of change.
Another great tool to use is gratitude. Going through infertility, often our focus is about the lack of the thing that we don’t have, so we lose focus on the things that we do have, and the things that we can be grateful for. If you shift your focus just before bed, writing down three things that you’re really grateful for that happened that day, it’s almost as if that area starts to expand. Your focus goes there during the day to think “I can write that down at night, I’m grateful for this”, or this beautiful moment that you have with your partner or a friend, and to start expanding on the areas that you do have, it really starts to decrease the thinking on some of the other areas.
I want you to know that there is support out there and it’s really important to get the support when you do find the worrying is becoming very overwhelming, so either through a fertility coach or counselor, or through your doctor to see a psychologist. This area is very serious, it can become – it can translate later down the line into stress, anxiety, and depression, so it’s really important that you get the support that you need with worrying and feeling those anxious thoughts an having a look at anxiety and stress reduction tools such as relaxation practices to really help you manage and cope better with all of the stresses and strains of infertility.
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The first step in managing emotions is to identify them correctly.
Anxiety is a physical, cognitive and emotional state, which can develop symptomatology giving greater weight to one component or the other. The first thing to do is to identify what it is that we perceive when we feel anxious and from there begin to use strategies to manage it.
It is very common for women to feel a lot of cognitive anxiety, that is to say that they identify themselves as continuously worried about how the cycle will go, what will happen, whether they will get pregnant or not. Given that treatments are made up of different steps, it is very easy when you are anxious to be worried about so many things and to negatively anticipate so many issues that sometimes you become overwhelmed.
After identifying the thoughts, we can start working on what to do with them and when they are relevant or not. Something that helps patients a lot is to focus their thoughts on the present moment.
On other occasions the anxiety that is identified is physiological, symptoms of which are digestive discomfort, rapid and shallow breathing, palpitations, rapid pulse, sweating, dry mouth, among others. In these cases, it is important to learn deactivation techniques to manage it, such as diaphragmatic breathing or visualisation.
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One of the things that I missed when I was trying to conceive 15 years ago when I knew that IVF was my only way was what I have today with you, with social media. Technology has been advancing so much that today there is a huge community in our world, women, and men all over the world that are ready to support you, that have gone through what you are going through now, so it’s very important to have someone close to us that can listen. Sometimes we don’t even need to hear a piece of advice or something but just someone to listen to, why? Because it’s a way to get out all our feelings, and then make sure – make sure that if you are going through infertility and the clinic that you are going… that is a big thing in how anxiety and worry play a role in our journey, because if you know that you have a great RE that has a wonderful team of nurses that are kind and compassionate, and are somehow also encouraging you to move on with the process and to put the best of you to a positive outcome, that is a huge help in our anxiety. The clinic and endocrinologists, you know the reproductive endocrinologist play a big role in that anxiety. If you have a good team around you, you need to be grateful for that.
Number two, make sure that whatever the clinic you are choosing has a good rate in live births, not in positive tests, but the number of live births they have because that is more important. When you have all these tools and then you add to it the emotional support. Today clinics are starting to work with you then you have basically 90% of all that is needed to help you have that positive outcome.
Today fertility coaching is really a very important tool for you because clinics, even though they have a good team, and even though they are kind, they have patients all the time and they don’t have the time to help you with the emotional support so you can turn to a coach. Many times I have seen cases of couples of unexplained infertility, that use a coach, and suddenly after using the coach they just get pregnant naturally.
Let’s face it, in a lot of couples everything is okay but for some reason, they don’t get pregnant, they choose IVF IUI, they make it even worse and more stressful for them and then suddenly they find a coach for emotional support, do little changes, and they get pregnant naturally. So having someone to listen to you, having that emotional support combined with the support of your clinic is very important to handle that part of anxiety and worry during the journey.
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Human beings have this amazing ability to think about future events and this thinking ahead means that we can anticipate obstacles or problems. It gives us the opportunity to plan for solutions for those problems and when it helps us achieve our goals, thinking ahead can actually be very useful and very helpful. However, worrying or anxiety is a way of thinking ahead that usually leaves us feeling anxious, apprehensive about the future. Worrying excessively often makes us think about the worst case scenario. It can make us feel like we won’t be able to cope.
What does it feel like? It feels like a chain of thoughts and images in our heads that can progress and become increasingly catastrophic and even unlikely to happen. You might be thinking “I have my period so that means I haven’t gotten pregnant during this cycle. Maybe I will never be able to get pregnant. Maybe my partner is going to leave me because I’m never going to get pregnant. Maybe I’m going to die all alone and without a child” – so that’s the chain of thoughts and of events that can happen in our head that can lead to increased worry or anxiety. In terms of physical symptoms, we might be feeling some muscle tension, aches and pains, restlessness and inability to relax; maybe you find it difficult to fall asleep or stay asleep or you might be finding it difficult to concentrate or you might be feeling tired all the time. If you are feeling worried or anxious when trying to conceive, know that you are not alone. It happens to a lot of people.
Why does it happen? It’s because all the situations that are ambiguous, that are new or that are unpredictable are known to cause worry and anxiety and if we think about fertility and fertility treatment, it’s usually a situation that is ambiguous, it’s open to different interpretations, you may or may not have a diagnosis, you may or may not know what the outcome of treatment is going to be or what treatment you might want to have. It’s also usually a new situation so you don’t have any experience to fall back on. It’s also unpredictable because it can be very unclear how things are going to turn out. Know that if you feel worried or anxious, it’s absolutely normal to feel that way.
There are two types of worry that you need to remember: the first one is a real problem, worry or anxiety where we’re looking at actual problems that have solutions right now. However, most of the time we are getting worried or anxious about hypothetical worries. These are worries that only exist in our minds and situations that haven’t happened yet, that doesn’t have an actual solution right now so if you don’t have a solution right now, it’s very much likely that you are thinking about the future, about the worst-case scenario and that is going to be a hypothetical worry. It’s good to know as well that there isn’t a right amount of worry. Everything is different for everyone and it’s almost like a scale between normal worry and excessive worry and everything in between is allowed. Normal worry would be a worry that helps you get what you want, helps you achieve your goals. An excessive worry would be one where you’re feeling demoralized, upset, or exhausted. You need to ask yourself – is the worry and anxiety that I’m feeling normal worry that is helping me achieve my fertility goals or is my worry and anxiety excessive worry that is leaving me demoralized, upset or and/or exhausted? Is the worry that I’m feeling a real problem or that has a solution or is it a hypothetical worry that doesn’t have a solution.
That leads me to what can we do about it. The number one thing that I would say is to get a work-life balance, to find balance in your life, make sure that you have space in your life to do things that bring you joy, things that give you absolute pleasure. Secondly, doing things that give you a sense of achievement, a sense that you’re moving forward with your life, maybe doing some housework, decorating, doing some gardening. The third one would be to do activities that give you a sense of connection, either through social media, calling a friend, making a video call. After you’ve found some balance, it’s still likely that you will be worried or anxious from time to time so as soon as you feel that worrying thought in your brain, try to catch it and try to check if it is a real problem worry or is it a hypothetical worry. Ask yourself what am I worried about, is this something that I can do something about; if not I’m going to let go and I’m going to focus on important things to me right now, things that I can do something about. If this is a real problem worry but it’s not a problem right now, maybe it’s a problem in the future, we can plan what we can do and when we will do it. That will let you soften the levels of worry and anxiety.
Another tip that I think is really helpful, the third tip, is to speak to yourself with compassion. Think about all the things that you tell yourself, the self-blame, the guilt and try to think about everything that you are, everything that you do with a sense of love and self-compassion, think about the situations you’re involved, acknowledge that your emotions are absolutely normal and you are human, notice those automatic thoughts that come in your head and challenge them, choose a compassionate response to your thoughts.
