“Relax and Reframe”: Using Cognitive Behavior Therapy (CBT) To Help Infertility Patients Cope with Anxiety and Depression
Women struggling with infertility often experience isolation, fear, changes in sleep/appetite, decreased self-esteem, irritability and feelings of being overwhelmed. In a recent article Dr. Kimberly Pearson summarized that depression and anxiety rates increase among couples undergoing infertility treatment. She cites several studies which demonstrate that symptoms of anxiety and depression may negatively impact pregnancy success rates. The findings from several relevant studies conclude that both psychotropic medication and cognitive behavioral therapy (CBT) can be helpful in alleviating these symptoms. However, many women express ambivalence or reluctance regarding the use of medications due to the potential effects on their pregnancy if treatment is successful. A study conducted by M. Faramarzi et al concluded that CBT was not only a reliable alternative to pharmacotherapy, but was also more effective than fluoxitine (Paxil) in reducing anxiety and depression in women experiencing infertility.
Although some situations necessitate the need for medication, CBT works well with women dealing with unexplained infertility, failed treatment cycles and recurrent pregnancy loss. CBT combines the use of relaxation therapy and restructuring negative thoughts to help individuals identify negative thought patterns and learn effective coping techniques. CBT often helps women feel more proactive in their care, while helping then learn strategies, such as:
mindfulness (i.e. focusing on week by week and celebrating small successes)
relaxation exercises (progressive muscle relaxation, deep breathing, visualization)
positive thought replacement (reframing intrusive negative thoughts or fears (such as "I'll never be a mother" or this treatment will never work")
Therapy is usually short-term and may coincide with a treatment cycle, during early pregnancy or even during a needed break from trying to conceive. Women experiencing symptoms of depression or anxiety are encouraged to seek counseling through their fertility clinic or to locate a mental health professional through ASRM or The Fertility Authority.
Leslee serves as the Mental Health Consultant for Houston IVF and is an active member of Resolve and the ASRM Mental Health Group.