“After I started keeping a journal, I noticed that my symptoms were worse when I was sleep-deprived,” Andrea said. “I guess I just didn’t make the connection until I saw how often I wrote that I was overtired and that my blood sugar levels were much more out of whack than usual.”

James Pennebaker, Ph.D., a research psychologist at the University of Texas at Austin, has conducted numerous studies on the physical benefits of journal writing. His 1997 book Opening Up: The Healing Power of Expressing Emotion, details numerous studies showing that people who write about traumatic experiences feel better emotionally and physically. He found that after writing about difficult emotions study participants had stronger immune function and fewer doctor visits than those who only wrote about their everyday lives.

A groundbreaking 1999 study detailed the effect of writing about stressful events for the chronically ill. Researchers at the State University of New York at Stony Brook asked 112 patients with asthma or rheumatoid arthritis to write 20 minutes a day for three days. Some were told to write about the most stressful event of their lives; others were asked to write about their plans for the day.

After four months, asthma patients who wrote about stressful events showed a 19 percent improvement in lung function, and rheumatoid arthritis sufferers had a 28 percent improvement in overall symptoms. There was no change in those who had only written about daily plans. (Journ. Amer. Med. Assoc., April 1999, 281:14)

Emptying your brain on paper can also help with stress relief and improve sleep problems. Kathleen Adams, founder/director of the Center for Journal Therapy and author of Journal to the Self and The Way of the Journal, refers to this as containment. “Use your journal book literally as a container,” she advises. “…When you write, you are moving thoughts, feelings and energy out of your mind and body and into a neutral, receptive place where they will be stored safely for you.” Even this seemingly simple act can do wonders for your stress and anxiety levels.

The authors of “Unsung Lullabies: Understanding and Coping with Infertility” are personally familiar with infertility. Each of them has their own story of how infertility came calling and all are psychologists who work with others who are experiencing infertility. They offer real advice for understanding why infertility is so emotionally pervasive. The authors get to the core of the reason infertility is so painful–losing the ability to have a baby at will is also losing a part of our reproductive story.

From our earliest days we start to build a story about what our lives wil be like and what kind of parents we will be. Infertility strikes at more than the chronology of when we can expect a baby–it can make us feel vulnerable, alone and out of control. It can even change our core idea of who we are.

This is a must read for anyone who is coping with the pain of infertility. Even if you are still in the journey, this book can help you understand your reactions to this overwhelming condition.

Unsung Lullabies: Understanding and Coping with Infertility

Alice Domar, who has done a great deal of research on the mind-body issues of infertility, found in one study that women with infertility were more likely to suffer from depression than many other groups. Women with infertility were found to be more depressed than even women with cancer. The only group in Domar’s study who had higher rates of depression were those suffering from chronic pain.

Major depressive disorder, the clinical name for severe or prolonged depression, is more common than most people realize. The symptoms as defined by the psychiatric reference book Diagnostic and Statistical Manual IV (DSM-IV), include depressed mood or loss of interest or pleasure combined with at least four of the following: sleep disturbances, weight loss, changes in appetite, psychomotor agitation, feelings of worthlessness or excessive guilt, impaired cognition or concentration and recurrent thoughts of death. Generally these symptoms must persist for two or more weeks to be diagnosed as clinical depression.

In addition to the depression issues stemming from infertility, the reason you are infertile can play a role in depression. Women suffering from PCOS (a common cause of infertility) are more likely to suffer from depression than women without the disorder, according to a study in the May 2003 issue of Journal of Affective Disorders (Rasgon N, et al.). The study showed that women with PCOS are depressed not only because of the symptoms but also because of the underlying biology of PCOS.

Numerous studies have shown that exercise is of great benefit in reducing the severity of depression. A brisk 30-minute walk or jog three times a week may be just as effective in relieving the symptoms of major depression as the standard anti-depressant medications, according to an article from the American Council on Exercise reporting the results of a study done at the Duke University Medical Center. Lead researcher James Blumenthal suggested that exercise may be beneficial because patients are actually taking an active role in trying to get better.

“Simply taking a pill is very passive,” he said. “Patients who exercised may have felt a greater sense of mastery over their condition and gained a greater sense of accomplishment. They felt more self-confident and had better self-esteem because they were able to do it themselves, and attributed their improvement to their ability to exercise.”

In addition, anti-depressants simply don’t work for some people. According to a 2000 New England Journal of Medicine study the medications fail to help one-third of people suffering from mild to moderate depression and half of those suffering from chronic depression.

Light therapy may help with seasonal depression, such as Seasonal Affective Disorder (SAD). Sufferers of SAD find that they become depressed when the days are shorter, they are indoors for too much of the day, or when they are subject to long-periods of cloudy weather.

Clearly, if you are suffering from severe depression you won’t want to wait for relief and should seek out competent medical care as quickly as possible. But, if you are suffering from mild depression, or you are already under treatment, exercise is a good option with few negative side effects. Other successful treatments for depression include herbs, psychotherapy, prayer, and acupuncture.

Most of the world’s religions teach that family matters. When you can not have a child it can make you feel as if you are breaking a chain. Does your family tree end with you? How can you pass along the faith of your fathers or the wisdom of your ancestors without children? How can you leave a legacy without a child who will one day have children of their own? Infertility can leave you feeling lonely and alone.

One way to counter this feeling of aloneness is to volunteer. Working with children may be too painful for you, but you can always find a place where your time and talents will make a difference in the world. This can help you to find meaning and take you outside of yourself to ease the pain. If you can handle working with children, or on their behalf through a foundation or other charity, you may find that this helps to give you a sense of accomplishment.

For many couples facing infertility, it can be difficult to maintain regular attendance at religious meetings. This can make the feeling of aloneness even more profound. Whether you meet in a mosque, a synagogue or a church, chances are you’ll feel out of place without children of your own. You may be able to locate a local or online group of women who are of your faith who also deal with infertility. This can be tremendously comforting to find this kind of support.

It is easy to feel that infertility is some kind of punishment from God. We need not look far in the scriptures to find references to children as a gift from God. However, we can also look to the scriptures for reassurance that we are not alone in this painful path of infertility. Abraham and Sarah, Rachel, Hannah and others suffered from infertility, even as the scriptures outline their faith. Through their stories we can know that infertility is not a punishment and that we should not give up hope.

When the spectre of infertility weighs heavily on my heart I comfort myself with these thoughts:

“Only God can know the full plan for my life. Only by trusting in Him can I reach my potential. I do not know what miracles I may be a part of in this part of my life that would not be possible if I were raising a child right now. In due time that child may come. If not, I will know that I have done all I can to welcome that child and all I can to follow His plan.”

The following books may of value to you on your journey:

From a Christian perspective:

From a Jewish perspective:

Whether the “missing” baby is your first or a second or even third or more, it is still painful when you desire a baby and you are not able to conceive. The problem is, once you have a baby those who do not understand infertility assume that the pain goes away. Wanting a baby you can’t have always hurts. No matter how many children you have, when that choice is taken from you, the pain is still there.

My daughter was born almost a year ago, and after many months of trying to conceive a second child, I realized that this second baby is not going to come as easily as I had hoped. When we were surprised by our little miracle baby’s conception, I dreamed that my fertility problems were over. Almost as soon as I had recovered from child birth, we were trying for baby number two. I was hopeful that by starting again so soon, we’d catch the positive hormones from the pregnancy and I would get pregnant easily.

Now, as my daughter’s first birthday is just weeks away and my own 38th birthday looms, I am back on the infertility rollercoaster. I hate rollercoasters. Especially those with no clear end in sight.

Due to my age and history, we decided to start off with more aggressive tactics in addition to the natural ones that brought us Eva. So, with some polite persistance, I managed to get an appointment with my doctor within a couple of weeks instead of several months as we were first told. I just started a round of Clomid and I am planning what natural treatments I am going to add to the medical ones (never, ever mix herbs and fertility drugs!).

The good news with secondary infertility is that at least you start knowing that a baby is possible – that is very comforting after so many years of wondering if I would ever have a baby at all. But the worries are just as strong. Will my daughter be my only child by birth? Since we are not likely to qualify for adoption due to our financial situation, the threat that we may never have another child is very real.

Already I am sick of hearing, “You should be grateful you have one.” I am grateful – every single day I wake up next to my daughter and thank God I have this amazing little girl. That simply does not erase the pain of wondering if the fleeting months of her first year are the “baby” I get.

If you are facing secondary infertility, understand that your feelings are just as real and natural as they are for anyone facing infertility. You have a right to want a baby. You have the right to mourn being able to have a baby as easily as others do. You have a right to feel the ache of empty arms – and to do all you can to reach your goal of having another baby.

Domar found that women experiencing infertility were as depressed as women who had been diagnosed with a chronic illness. She developed a program that helped them work through the depression, restoring hope to their lives and repairing tattered marriages. As these women restored their faith in themselves, nearly one third of them became pregnant.

Domar’s advice is far different than the simplistic “relax and you’ll get pregnant” platitudes offered by those who do not understand infertility. While she does focus on how stress and depression change our fertility, she also looks at the real aspects of how emotion changes our bodies. We all know people who are total stress-magnets who get pregnant easily – so stress alone is not the culprit in infertility.

Domar’s book offers a look at how strong emotions can impair fertility. Her writing shows her deep caring and understanding of the rigors of infertility treatments, depression and the longing for the elusive goal of motherhood.

Reading this book may not get you pregnant, but whatever the results of your fertility journey, you will have new tools and newfound strength to cope. Domar has written several books on women’s health and how emotion impacts our bodies. I highy recommend any of her books. I have read several and have found them to be very useful in my infertility journey.

“Tiny Toes” is Damron’s personal story of how infertility, treatment and the eventual birth of very premature twins impacted her personally as well as how it impacted her marriage. Damron does a good job of explaining the medical terms and events of her journey without interrupting the flow of her story.

Whether you are just beginning your infertility journey or whether you are experienced in navigating the emotional and medical mine field that is infertility, Damron’s story will feel familiar. Her personal account is bound to make you feel less alone.

One of the most important messages Damron shares is that recognizing and treating depression is vital for healing from the scars of infertility and in preserving relationships. Women (and men) who are experiencing infertility often deny their feelings of depression or anger because they feel that they “should” be handling things better or that what they are experiencing is trivial. Often there is a feeling that “with so many bad things in the world, I should just be able to deal with this.” Others deny their feelings because they are so strong that looking directly at the feelings is simply toomuch to deal with in the midst of handling infertility. Treating depression can make it easier to handle the ups and downs of infertility as well as improving the outcome of treatment. Alice Domar’s work has shown that women who get help dealing with the grief and depression of infertility have a better chance of becoming pregnant.

Damron’s story of the tension in her relationship with her husband and her withdrawal from friends and extended family are also a common experience with those who are experiencing the extreme grief that can accompany infertility.

4 DPO (days past ovulation): I think I feel sick to my stomach. I can’t know already can I? My mom said she could tell from day 1 with her first baby. Maybe I really am pregnant. Thank goodness, no more infertility treatments, no more stupid questions about when we are planning to have kids.

7 DPO: I can start testing Thursday. No, wait, the tests say they might work as early as Monday. Maybe I should, just so I know for sure. I mean, they say to start being careful about your diet from the beginning. How will I know I need to be careful unless I test early. Well, a doughnut now won’t hurt the baby.

12 DPO: If I test too soon it is a waste of a test. Besides, those things add up. And a negative test will just depress me. I need to know. I hate suspense, I just need to know! White, just pure white where that line should be. This is only day 12! Of course, it just doesn’t work yet. I might BE pregnant.

13 DPO: Is that a line? There is a little bit of a different color where the positive line is supposed to be. Kind of. Wait, no, that is a trick of the light. Evaporation lines? A really light positive. No, it has been ten minutes. I will NOT cry.

14 DPO 7 AM: I am not even going to test. My temp chart is still up. Testing again will jinx it. I’ll wait until next week and the positive will be so dark I can’t mistake it. My period will start today if I am not pregnant anyway.

14 DPO 10 AM: I will NOT test yet. Dangit, was that a cramp. That felt like a cramp. I ca’t get my period. Please, dear Lord, don’t let me get my period. I want a baby, this baby, this month, I need to be pregnant this time. I can’t take another “negative panty test.” No, that wasn’t a cramp. It could have been implantation pains. Right?

14 DPO 10:30 AM: I can’t take it. I need to test NOW. Where is that test?

14 DPO 10:40 AM: I have to STOP crying long enough to go to this meeting. I can do this. We’ll just try again next month. I can do this. Maybe I don’t even want kids. Noisy, messy things. I need to just travel, or get a hobby, or …. Why on earth did I wear mascara today? You’d think I’d learn. What is wrong with me? Why can a 15 year old kid in the back seat of a car do something that I can’t get right even with a team of trained professionals, expensive drugs, temperature charts and a baby-dance card that was punched in time, every time?

15 DPO: Still no period. I must be pregnant. I’m late, the test is just not registering right. I am one of those women who just takes forever to test positive. I think I feel a little sick to my stomach. And tired. I definitely feel tired. See, late period, sick to my stomach, tired. This is our month. I can just feel it.

17 DPO: Three days late. I knew it, we are going to have a spring baby. That is so cool. Maybe I could just surf on over to that cool online store and see the cute stuff. I mean, if I am pregnant, I need to start planning, right? What was that store called… Yes! Little for Now. I’ve waited long enough for this baby. I am doing everything right. No chemicals will pass my child’s lips until they are 18. I’ll breast feed til they potty train. I’ll get it right, cause I have worked too hard for this baby to take even the smallest risk that anything could ever go wrong. I’ll be the perfect mother.

Day 17 3:00 PM: Here I am, slumped against the wall in the bathroom, sobbing so hard I can’t catch my breath. Why was I so stupid? I should have known I wasn’t pregnant. I need to just accept that I will never have a baby. I’ll learn to sew, or paint, or …. Oh, Gid! Why? I know a thousand people who don’t even treat their kids right. Why?

CD 1: I’m going to do it this month, I’ll make sure we baby dance every other day, the whole month, no matter how tired I am. I’ll eat only organic food. I won’t have a sip of caffeine. No white sugar. No white flour. I’ll gag down 20 vitamins and herbs and even use injectables if I must.

You might even believe this for a while. Then it happens. A chance remark from a friend. The site of a belly swelling with life. The “When are you two going to have kids? Don’t you like kids?” questions may trigger it. Maybe it is that darned toy store ad. At some point your stoic demeanor snaps and you are struggling to hold back waves of emotion. Tears fall through wracking sobs and you wonder if perhaps you just aren’t somehow fated to be a parent.

Depression, grief and sadness are often unwelcome visitors for any couple experiencing infertility. The holidays are a particularly tough time for most of us. Not only do the holidays bring an emphasis on family, they are also a reminder that another year has passed without a baby. Insensitive questions and remarks can make an already difficult situation harder.

Some people will take insensitivity to a whole new level. Avoiding these toxic people is ideal, but in some cases this is not possible. Someone in my life has made a point of making snide remarks and rude comments about my inability to have children. Every holiday, even my birthday, she finds a way to point out that she is a parent and I am not. Sometimes she is direct if no one else is around, “Maybe that is why you aren’t supposed to have kids.” Other times she is more subtle beause others can hear. I know she is likely to say or do hurtful things, but I can’t avoid her any more than I do because of the situation. When it is not possible to avoid that person, you can plan how you will react.

This woman was approaching her due date of her third child when the topic of my 34th birthday came up in a group discussion. I mentioned that this one would be really hard since I was so close to 35 and still no baby. She wrote me an email the next day telling me not to come see the baby when she was born because I might make the new baby sick. Then she invited all my entire family to the hospital without me (I am the only one with germs?). Finally, showed up at my home with the baby just days later — on my birthday.

I knew the visit was a possibility, so I was able to make my excuses and leave. In other cases I have simply had to grin and bear it, but I prepare myself as much as possible in advance, knowing that chances are SOMETHING will be said.

One very effective way of handling grief and depression is to journal. Writing about how you feel can change the feelings of helplessness and make you feel empowered. Writing out your feelings can also help to calm you and make it easier to stay level in a difficult situation.

Volunteer work can also help. Plan to spend part of your holiday in a soup kitchen or distributing stockings or gifts at a homeless shelter. Not only will you be doing good, you’ll feel better. Studies show that helping others actually improves your health and boosts feel good brain chemicals.

If you are up for it emotionally, consider offering respite care during the holidays for foster children. Many foster parents ask for or must use relief foster care during the holidays if they are unable or unwilling to travel with their foster child. You will need to be approved as a foster parent in your area, but this can be a rewarding way to help a less fortunate child at a time when they will also be experiencing grief and sadness due to separation from their birth families.

However you decide to ease the pain, be sure to give yourself some time to grieve. Grieving is not the same as wallowing in misery. But a hot bath and a good cry the night before the family party can help to release the pressure so you can enjoy the holidays without a public crying jag. Give yourself permission to be sad. You are experiencing something very painful – it is normal to be hurting. Put a time limit on how long you will spend on this, then move on to something else so you don’t get lost in it.

It is possible to get through the holidays with a minimum if heartache over infertility. When possible, be sure you don’t miss out on too many holiday activities as that can also increase your sadness. If all else fails, wear a sarcastic sweatshirt and go to the big gathering anyway!

Infertility Hurts Sweatshirt