The holidays can be the happiest time of the 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. Interactions with friends and family during a time of year that is supposed to be joyous can be difficult for several reasons. First, it may be a time when announcements are made, such as “we are 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. Second, family members can be intrusive. They may ask too many questions, give unsolicited advice, or criticize the infertility patient for not doing things differently. Finally, the holidays can mark the end of another year without a baby. The resulting pain for the infertility patient can be enormous.
Patients would be wise to remember 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. It’s also important to keep in mind that this brief period of time won’t last forever and caring for themselves now can make a big difference to their overall well-being.
It is commonly known that infertility can be a clinically depressing experience. We know that unsuccessful infertility patients can experience levels of depression similar to chemotherapy patients. 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 Elizabeth will restrain herself from asking, “so when will you two have children?” or that a sister-in-law will stop herself from sharing how easy it was to get pregnant.
So how does someone struggling with infertility deal with the emotions triggered during the holidays and stop from becoming inflamed 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 allow them to be direct with them about their feelings. A friend or family member may not always 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 hearing that while the pain of infertility makes attending a particular event painful, attending future events will be a pleasure.
When individuals or couples are struggling with infertility, it may seem unfair, or too strenuous, to make the effort to have these discussions with loved ones. However, in order to care for one’s emotions, it is important to remember that special relationships are worth preserving. Infertility treatment doesn’t last forever, but relationships with family and friends may last a lifetime.
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, and finding ways to have more control over pleasurable activities can help us feel more balanced. Fertility treatment can leave us feeling out of control, but activities such as taking a cooking class or learning how to knit can serve as evidence to our bodies that when we put effort into something, we can see a direct benefit. The experience can be very stabilizing.
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” or “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 to you but I want you to know that I care and I’m here any time you want to lean on me. I won’t be intrusive and ask you questions, but know 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 with loved ones. The holidays can be a good time for a trip to an adults-only resort. For patients who plan to stay in town, I encourage them to find something that they enjoy doing together, such as a movie or a show. Thoughts about the treatment may persist, but if the show is focused upon 20 percent of the evening, that is 20 percent not focused on treatment. It’s also good to get out of the house, even if we are not always initially 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 infertility discussions to 20 minutes per day, and then simply 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 their interactions with others, then the holiday season will be the best it can be under the circumstances, even if it may not be the most wonderful time of the year. Most importantly, emotional well-being and relationships will be kept intact so future holidays can be truly magnificent.