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Infertility and Depression 101

Understanding the Causes, Signs, and Treatment of Depression-Related Infertility

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Updated July 11, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

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Wondering if you're depressed? Take this depression symptoms quiz and find out.

Infertility and depression frequently go together. While you may not be surprised to learn that infertility can lead to depression, you might not know that people who experience depression are more likely to have fertility problems. You may also be surprised to learn that depression during pregnancy and after pregnancy (postpartum depression) is more common in women who have struggled with trying to conceive.

But just because depression is common among the fertility challenged, this doesn't mean you should ignore it or fail to treat it.

What Is the Difference Between Depression and Regular Sadness?

It's completely normal to feel sadness when dealing with infertility. You may get hit with the blues when your period comes, when a fertility test comes back with bad news, when treatments fail, or upon diagnosis of infertility. You may also feel sadness when reminded of your fertility struggles, like when a friend throws a baby shower or your sister has her fourth child.

One difference between sadness and depression is sadness lifts after some time, while depression lingers, involves other symptoms, and interferes with your life. How serious the depression is depends on how much it affects your daily life.

Signs of depression include:

  • Sadness that lasts for weeks or months.
  • Feelings of hopelessness and helplessness.
  • Frequent crying or tearing up.
  • Frequently irritated or intolerant of others around you, specifically people who you used to enjoy being around.
  • Lack of motivation, struggling to get work done at the office or around the home.
  • Difficulty sleeping, either sleeping too much or unable to sleep well (insomnia).
  • Difficulty with eating, either overeating or experiencing low appetite.
  • Struggling with experiencing pleasure in life, including a low interest in sex.
  • Frequent feelings of anxiety or worry.
  • Thoughts of dying, self-harm, or suicide. (If you're considering taking your own life, please get help immediately.)

If what you're dealing with seems like "just the blues," and not full blown depression, don't let that stop you from seeking help. Many things that help those with depression, like counseling, support groups, and mind-body therapies, can also help with the infertility blues.

What Causes Infertility-Related Depression?

Infertility is a stressful condition, having a strong impact on your sex life, relationship, sense of self-worth, and daily life. In the midst of testing and treatments, infertility may literally feel like it has become your entire life, as you go to and from doctor appointments. All of this stress can potentially contribute to the development of depression.

Depression is more common among the fertility challenged who have a family history of depression, who experienced depression before their fertility struggles, or those who lack a support network. Infertility frequently causes feelings of shame, which may make it more difficult to talk to friends and family about your struggles. This isolation makes depression more likely.

Some hormonal imbalances that cause infertility may also contribute to mood symptoms and vulnerability to depression. Be sure to mention to your doctors if you're experiencing any feelings of a low mood, as it may help them diagnose your infertility and manage your overall care.

Can Depression Cause Infertility?

No one definitively knows whether depression itself can cause infertility, though some studies have found a correlation between depression and increased rates of infertility. Some theorize that this may be due to an overlap in some of the hormonal issues involved in both conditions.

Also, depression may lead to lifestyle habits that can negatively impact your fertility. For example, depression often causes overeating or lack of appetite, and being overweight or underweight can cause infertility. People who are depressed are more likely to smoke or drink, which can also hurt your fertility.

Will Pregnancy Cure the Depression?

If not getting pregnant is contributing to depression, it seems logical to assume that finally achieving pregnancy will cure depression. However, this isn't always the case. In fact, those who have experienced infertility are more likely to feel depression during pregnancy and are at an increased risk for postpartum depression.

If I Never Get Pregnant, Will I Always Feel Depressed?

Not achieving pregnancy, or failing to have children through adoption or other means, does not mean you'll feel depressed the rest of your life. It is possible to find happiness in life again. However, if depression has taken hold, it's unlikely to resolve on its own.

Researchers have found that after failed IVF, certain couples were still grieving up to three years later. Counseling can help you get through the grieving process and take back your life after infertility.

How Can I Feel Better?

Some couples hesitate getting treatment for depression, thinking that antidepressants can't be taken when trying to conceive. While some antidepressants may negatively impact your fertility, not all drugs do. In fact, some studies have found that treating depression with counseling and antidepressants together increased pregnancy success.

That said, for milder depression, antidepressant medications are just one of many treatment options. Depression can also be treated with talk therapy, support groups, and mind-body therapies.

Be sure to speak to your doctor if you're experiencing depression while going through infertility. Many fertility clinics offer counseling or support groups. Your fertility doctor may also be able to adjust your fertility medications, giving ones less likely to affect mood, since fertility drugs can aggravate depression and cause mood swings.

If medication for depression is needed, your fertility doctor and psychiatrist should ideally work together to help you decide the safest and most effective treatments for your condition while you try to conceive.

More on coping while trying to conceive:

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Sources:

Chachamovich JR, Chachamovich E, Ezer H, Fleck MP, Knauth D, Passos EP. "Investigating quality of life and health-related quality of life in infertility: a systematic review." J Psychosom Obstet Gynaecol. 2010 Jun;31(2):101-10.

Depression - Symptoms. NHS. http://www.nhs.uk/Conditions/Depression/Pages/Symptoms.aspx Retrieved online April 11, 2012.

Karjane NW, Stovall DW, Berger NG, Svikis DS. "Alcohol abuse risk factors and psychiatric disorders in pregnant women with a history of infertility." J Womens Health (Larchmt). 2008 Dec;17(10):1623-7.

Lapane KL, Zierler S, Lasater TM, Stein M, Barbour MM, Hume AL. "Is a history of depressive symptoms associated with an increased risk of infertility in women?" Psychosom Med. 1995 Nov-Dec;57(6):509-13; discussion 514-6.

Pinto-Gouveia J, Galhardo A, Cunha M, Matos M. "Protective emotional regulation processes towards adjustment in infertile patients." Hum Fertil (Camb). 2012 Feb 6. [Epub ahead of print]

Ramezanzadeh F, Noorbala AA, Abedinia N, Rahimi Forooshani A, Naghizadeh MM. "Psychiatric intervention improved pregnancy rates in infertile couples." Malays J Med Sci. 2011 Jan;18(1):16-24.

Volgsten H, Svanberg AS, Olsson P. "Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment." Acta Obstet Gynecol Scand. 2010 Oct;89(10):1290-7.

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