Anxiety and Infertility

1 in 8 couples struggle with infertility. Infertility is a disease that carries a lot of stigma. If you are going through infertility, it is common that you may be feeling: shame, loss of control, detached from your body, sad, angry, emotional, depressed, and even anxious.

Anxiety is common when going through infertility.

In Rewiring your Anxious Brain, by Catherine M. Pittman, PHD and Elizabeth M. Karle, MILS, you learn that anxiety can come from the cortex or the amygdala. The anxiety that develops in the cortex, is the anxiety that you interpret; the “what ifs”. What if you never get pregnant? What if you never become a parent? What if you do get pregnant and lose the baby? What if infertility ruins your relationship?

In addition, these thoughts are usually accompanied by physiological symptoms. This is anxiety that comes from the amygdala. Anxiety that comes from the amygdala is the physical sensations and anxiety of past experiences. This type of anxiety contains the triggers and associations. Examples include feeling anxious every time you see a pregnancy test because it was negative before and that caused anxiety. Also, anxiety about going to the doctors office because the last time you were there you got bad news.

Anxiety symptoms can include, but are not limited to, racing thoughts, rapid heartbeat, sweaty or clammy hands, upset stomach or butterflies, tight muscles, inability to focus, feeling lightheaded, and dizziness. Everyone experiences anxiety, as it is our body’s coping mechanism for danger. It is when there is no danger and our body still goes into the fight/flight/freeze mode that it starts impacting our functioning in life and becomes an anxiety disorder.

Stress is a common trigger for anxiety. If you are going through infertility this can be a stressful time in your life. Infertility treatments can also be emotionally and physically stressful. If you are feeling anxious you do not have to let it control you.

Here are some ways to deal with your anxiety:

1. Exercise - When you exercise you can lower the baseline for your anxiety so that it doesn’t peak every time you start to notice your symptoms of anxiety. Exercise is also great when you are feeling anxious. When your body goes into fight, flight or freeze mode your body sends energy to the parts of the body that you need to either fight or flee, when you exercise you can use up that excess energy allowing your body to get the message that you are no longer in danger.

2. Breath - If you are feeling anxious one of the best things that you can do is start to take some deep breaths and start to notice your breath. When your body is in the fight or flight mode our breathing becomes quicker to get more oxygen into the parts of our body preparing to fight or flee. When you start to slow down your breath your body gets the message that you are no longer in danger.

3. Take charge of what you are in control of - If you are going through infertility, it can be easy to feel out of control. Write down your anxious thoughts. In one column, put those thoughts that you have control over. In the other column, put those thoughts that you do not have control over. Take the list that you have control over and work on those things. Rip up the other list.

4. Say no - It can be very difficult some days to be facing infertility. You do not have to go to every baby shower or every kid’s birthday party. You do not have to join in on every holiday. You get to decide what you can handle that day. You do not have to listen to people’s advice or tips on how they got pregnant. It is okay to say no and to set boundaries.

5. Be kind to yourself - Going through infertility is not easy. It is very important that you treat yourself kindly through the process-self affirmations, self care, mediation, support groups, counseling. These are all great ways to show yourself kindness through this difficult journey.

   If you are struggling with infertility and anxiety you are not alone. Please contact Kull Counseling, LLC to learn more about coping with anxiety during infertility. 608.239.4807 or julie@kullcounselingmadison.com

Best practices for helping women after a miscarriage.

A miscarriage is pregnancy loss before twenty weeks. Early pregnancy loss is estimated to occur in 1 out of 4 women. Most miscarriages happen between 6-12 weeks gestation. Early pregnancy loss is considered a loss but also a trauma. I recently was asked by Kat Schuknecht to give a presentation to the Madison Postpartum collective on best practices in helping people through early pregnancy loss. Here is a summary of my presentation.

Miscarriage is an invisible loss. It is the loss of your baby but also the loss of your dreams to come. Many people wait until the second trimester to share pregnancy news. When pregnancy is unknown by others it can feel invisible to the couple that is grieving. There is no one asking how you are doing or checking in with you. It can be difficult to share your news with others because of the sense of shame and guilt that surrounds the stigma of miscarriage. Many women blame themselves even though it is not their fault. In most cultures there are no rituals or ceremonies to help people grieve. It is normal to grieve with others, you may grieve miscarriage alone or with only a few people and you may feel very isolated.  It can also feel very abstract. If you do decide to share the news of a miscarriage it can feel abstract to the people you are sharing it with. It can even feel this way for your partner. Women tend to connect with their pregnancy and baby early on while partners often connect later in the pregnancy or once the baby is born. This type of loss can feel very uncomfortable for people and you may find them shying away or not knowing what to say.

If you have had a miscarriage you have experienced a major loss. An earlier loss does not equal less grief. Grief does not go away, it becomes part of a new normal that you carry with you. Grief is not linear it is actually quite messy and make look different every day. Grief is different for each person. You have a right to your grief. Your partner's grief will be different from your own.

Miscarriage can lead to feelings of shame, guilt, anxiety, depression, isolation, emptiness, failure, feeling disconnected from your body and sadness. No two people feel the same way. We cannot assume that we know how someone is feeling.

Miscarriage can lead to women feeling disconnected from their bodies. It may lead to difficulties with intimacy. Because women may be feeling disconnected they can be unaware that they are holding trauma in there body. It is important if you do bodywork with people that you are taking a trauma informed approach.

A miscarriage is a loss but also a trauma. Having a miscarriage can trigger post traumatic stress disorder. Symptoms of PTSD to look for our: fatigue, trouble sleeping, hyperarousal, nightmares, lack of concentration, anxiety, depression, loss of appetite and frequent crying. Pregnancy after a loss can be triggering for people.

Women who experience a miscarriage can have postpartum depression or anxiety. Anytime a woman goes from pregnant to not pregnant there is a shift in hormones that can affect brain chemistry.  It can be difficult to identify what is grief and what is anxiety or depression.

How Can Professionals Help

Holding Space - Professionals can help by holding space for clients. Holding space is being present with clients. Starting where a client is and remaining non judgmental. It is providing an environment that honors your clients needs.

Communication - How we communicate with people about early pregnancy loss can greatly impact our work. By opening dialogue about early pregnancy loss we can normalize and help reduce stigma. Ask. Include questions about early pregnancy loss in your assessment.  Take cues from clients when addressing early pregnancy loss. Refer to it as your client does. Whether they call it a pregnancy, a baby or even a name. If you meet with couples acknowledging a partner's grief.

Advocacy - Advocate for your client's needs on different level. At a micro level address their needs within your office. Are there pictures you may want to take down in your office or waiting room? Does this client have to wait in a room full of pregnant women? Is it possible for them to wait in the office? If you have someone that needs support validating and normalizing that it is okay to need support. Connect them to resources in the community. Therapy and Support groups are a few sources of support.

What do clients want us to know? I surveyed a group of women that had experienced early pregnancy loss and this is what they wanted providers to know.  They wanted providers to:

• Be present with the client and loss

• To listen

• To validate

• To understand that grief is a lifelong process

• To be told they are a mom

If you are a provider or someone that has experienced miscarriage and our looking for resources Kull Counseling provides therapy and a free monthly miscarriage support group. Contact Julie at 608.239.4807 for a free 15-minute consultation.

The guilt of miscarriage

It is estimated that 1 in 4 women will experience a miscarriage.  For many, having a miscarriage is a devastating loss that leads to a roller coaster of emotions. One common emotion many women hesitate to talk about is guilt. When you have a miscarriage there is a large amount of guilt associated with it because you feel like you did something wrong.  

Different types of guilt with a miscarriage:

1. The Guilt of It was my job. You may feel that that having a baby is part of your role as a woman and a wife. You might feel guilty that this is your job and since this is your job and you did not give birth to a healthy baby you have failed your job. You might have been taught that pregnancy and motherhood come naturally (and easily might I add) so when you are not able to maintain a healthy pregnancy there are strong feelings of guilt.

2. The Guilt of I did something wrong. If you believe #1, that it was your job to get pregnant and have a baby, than this is usually where the second layer of guilt sets in. If you could not do "your job" than you must have done something wrong. Did I drink too much caffeine? Was I exercising too much or not enough? Was it that glass of wine I had before I knew I was pregnant? You probably have come up with a dozen things that might have caused your miscarriage and concluded that is was your fault. 

3. The Guilt of what if I can't get pregnant again. If it was your job and you did something wrong than you might be feeling it is quite possible that you cannot get pregnant again. You may fear that you have already lost a baby and now you feel the guilt of what if I already lost one baby and I will never be able to have another. You might feel that this was your only chance and you did something wrong to cause this. You might feel that this is punishment for something else that happened in your life.

Guilt is an intense emotion and a very real part of the healing process of losing a baby in early pregnancy. There is help working to challenge these negative thoughts and normalize these feelings. If you have experienced early pregnancy loss it is not your fault, and  you are not alone. To learn more about guilt and other common feelings after a miscarriage or more information about the free monthly miscarriage support group please contact Julie at 608.239.4807 or julie@kullcounselingmadison.com