Why Clomid Causes Anxiety and Feelings of Depression

Clomid is famous for causing mood swings. Sometimes referred to as the “Clomid Crazies,” you can find lots of Internet memes making jokes about clomiphene citrate-induced mood swings.

The big question women tend to ask themselves is... is this just me? No, it’s not just you. And it’s not “all in your head.”

Overview

Not everyone will experience Clomid the same way. In the largest studies on the subject, 41% of women experienced depressed mood and 45% experienced mood swings while taking Clomid.

Almost half of all women experienced some sort of mood disturbance.

Notably, this is significantly more than the rate reported in early clinical studies. According to the clinical studies conducted prior to the release of the drug, mood swings or anxiety on Clomid occurred less than 2% of the time.

Emotional Impact

Those early studies either defined mood swings very differently or the occurrence of emotional reactions was seriously under-reported.

How might Clomid affect your emotions?

The Clomid Crazies may include:

• Anxiety: some women will even experience panic attacks.
• Difficulty with sleep: including insomnia or frequent night waking.
• Irritability: your partner and best friend should be warned!
• Mood swings: now you’re fine, now you’re in tears, now you’re angry.
• PMS-like emotional symptoms: including cravings for snacks and sweets.

Whether you will experience mood troubles or not depends on so many things, including:

• Your own hormonal system
• How your body reacts to the medication
• Whether you have a history of PMS mood swings
• Whether you have a tendency towards depression or anxiety

How Stress Contributes

The stress levels in your general life can also affect your Clomid experience.

Infertility can be stressful alone. But if you have additional tensions in your life, the Clomid Crazies may be more pronounced for you.

If you’re taking progesterone during your two-week wait in addition to Clomid, this may compound your depressed mood. Fatigue and depression are known side effects of progesterone therapy.

The Role of Estrogen

Why does Clomid make you feel so crazy? It’s similar to the reasons that some women get PMS mood swings and women going through perimenopause frequently experience mood issues—it’s all about variations in your estrogen levels.

Clomid is a selective estrogen receptor modulator. Or, in laymen's terms, it tricks your body into thinking estrogen levels are low. It does this by blocking some of your estrogen receptors.

Generally speaking, low estrogen levels can cause feelings of depression. When estrogen levels are too high, they can cause anxiety.

These “high” and “low” levels are different in everyone. It’s more about what your body considers to be the baseline. If you’re higher or lower than your own baseline, you may experience estrogen-related mood effects. Because Clomid affects how estrogen is perceived in the body, it can also impact your mood.

How to Cope

So now you understand more about what causes the Clomid Crazies, and you know it’s not just you. How can you cope? Here are some tips.

• Remind yourself that it is the medication and not you. Having this awareness can help you cope significantly better. It also will help remind you that this, too, will pass. You’re not going crazy; you’re not falling apart. It’s just the medication. The Clomid Crazies will only last the month you take them.
• Be realistic about how long your symptoms may last. Your mood swings may last longer than the days you’re taking the pills. In fact, you may not start to feel the mood effects until after you finish taking them. While Clomid is actively only taken for five days in your cycle, the effect is cycle long. Your next cycle, though, should be normal.
• Remember that these feelings are temporary. It can be easy to fall into Oh-My-God-Will-I-Feel-Like-This-Forever mode. Try not to go there. Things should be back to normal next month.
• Schedule stressful life events for after your treatment cycle. If you have a meeting with your boss—and your boss tends to push your buttons—try to reschedule for next month, after your Clomid cycle. Also, maybe this isn’t the best time to visit your in-laws. Or your own parents, if they tend to trigger you.
• Schedule lots of self-care time. If you had the flu, you’d have no hesitations of taking time off and resting. You’d make yourself chicken soup (or have a friend make it); you’d do whatever it took to get yourself well again. Unfortunately, people frequently don’t take care of their emotional “colds” the way they care for physical illnesses. Give yourself permission to take extra good care of yourself. Take naps. Watch your favorite funny movies. Spend some time with friends. Whatever you need, do your best to give it yourself.
• Let your doctor know if you have a history of depression or anxiety. If you have a history of depression or anxiety troubles, you’re more likely than the general population to have mood side effects while taking Clomid. You should let your doctor know if the side effects are really intense for you. There may be other treatments to try that won’t have such a strong mood effect.
• Make sure you have support. If you have kept your fertility struggle a complete secret from everyone to this point, this would be a good time to reveal your secret to at least one or two close friends. You need the support, and your friends want to be there for you.
• Consider seeing a therapist. Do you need a therapist just for Clomid? Highly unlikely. But counseling can be a big help as you go through infertility and fertility treatment, and it’s frequently covered by health insurance plans. Not only can a counselor help you get through the Clomid Crazies, but she can also teach you coping skills to help lessen the stress of trying to conceive and pregnancy (if you conceive). (Yes, you will likely still need support after you get pregnant. Pregnancy after infertility is not emotionally easy.) Another great reason to see a therapist: some research has found that your odds for pregnancy success are higher with the help of cognitive-behavioral therapy.

A Word From Verywell

Infertility and fertility treatment are stressful by themselves. Add into the mix hormonal fluctuations, and it's a recipe for having an emotionally difficult time.

The good news is that these struggles are not forever. The mood swings triggered by fertility treatment only last the cycle they are being used, and you will not be trying to conceive indefinitely. In the meantime, take good care of yourself. Know that those mood swings aren't "only in your head," and reach out for support from friends and family.