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Photo of author and infertility patient, Jenny Cooke Malstrom.

Jenny Cooke Malstrom is a licensed marriage and family therapist, infertility patient, and reproductive mental health advocate. Her online therapy practice, Sea Change Therapy, serves people in Washington and Florida. She has spent the past decade navigating infertility both personally and professionally, including: primary infertility, in vitro fertilization (IVF), miscarriage, endometriosis, secondary infertility, and recurrent pregnancy loss. She loves spending time by the water with her husband, their IVF son, and mini-Aussie puppy. This article is written from Jenny’s point of view based on her own fertility journey and her extensive experience working with individuals and couples who are impacted by infertility. 

From personal experience, I know that infertility is stressful, to say the least, and it often feels like friends and family may minimize the mental toll it takes. If you were talking with a friend, and she said, “I have this chronic health condition. I have to decide if I want to undergo treatment for it, and if I do, treatment may be expensive, and time-consuming, and success may not be guaranteed. On top of it all, my mind feels like it has been consumed by stress, anxiety, and even hopelessness at times.” Would you think that friend was wrong for feeling stressed? My guess is probably not! You’d maybe even understand why such a thing would be impacting her in those ways. My own experience with infertility, as well as my job as a therapist, has continued to illuminate that we need to better acknowledge the mental toll infertility takes and treat it similarly to other chronic health stressors that may impact mental health. 

jenny cooke malstrom with her family at a baseball game

Photo of author and infertility patient, Jenny Cooke Malstrom and her family.

So, let’s explore a few ways to consider addressing your mental health while on your fertility journey:

1. Start where you are

Take a brief self-assessment of your current emotional state. Some questions you may want to ask yourself include:

  • "Have you been more tearful lately?"
  • "Has anxiety kept you up at night?" 
  • "Do you feel stressed with administrative tasks like medication orders and appointment making?" 
  • "Are you able to be present for work and other personal commitments?"

Or, you may ask your partner or a trusted friend: "How do I seem to be coping lately?"

Reflecting briefly, kindly, and honestly on how you’re managing the emotional aspect of your fertility journey may offer you important insights. You may be surprised with how well you’re coping, or you may realize you need additional support. The psychological toll of infertility is often underestimated, even by those going through it themselves. I often tell my patients that acknowledging their present emotions is one of the first steps they can consider taking to help improve their well-being. 

2. Start small

Once you know where you are emotionally — and what you may want to work on or change, start small. Select one feeling, one stressor, or one sticking point — only one! Infertility may be all-consuming and involve a wide mix of complicated emotions. By focusing on just one thing at a time, you may begin to regain emotional control and make some progress. For example, you may say: "I want to focus on getting better at identifying when I’m having negative thoughts" or "I’m going to work on trying to minimize the time I spend worrying this week." In identifying one very specific goal, you’re avoiding what I call ‘problem pile-up,’ which can feel overwhelming.

You can then make a plan for how you want to focus on that issue, which may help you feel less anxious and more in control of the situation.  

Need help making that plan? Consider finding a mental health professional that specializes in infertility, or join a support community like Rescripted. To find out more about infertility, visit fertilityjourney.com for infertility information.  

3. Take care of your body

We often treat our minds and our bodies as separate entities. The truth is, there is a connection. By caring for your body, you’re also helping to care for your mind. So, take a minute to ask yourself: "What would feel good to my body this week?" Taking a long shower with relaxing instrumental music in the background? Going for a walk alone and in silence? Doing a fertility-friendly yoga series? Identify something that may help make your body feel good — and make the time to do it this week.

An exercise I recommend my patients do in real-time (and regularly) is practicing relaxation breathing. You can do this by breathing in slowly and deeply for a count of four. Hold your breath for a count of seven. Now, smoothly and evenly, release your breath over a count of eight. Do this sequence again, 4-7-8. One more time, 4-7-8. Ask yourself, "How do I feel?" Notice how your mind feels at this very moment. 

jenny cooke malstrom

Photo of author and infertility patient, Jenny Cooke Malstrom. 

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4. Manage your thought patterns 

We may tend to have a thought and then an accompanying emotion or feeling. You may think to yourself “Oh, that co-worker is pregnant again? I can’t believe it!” Then comes the accompanying frustration or guilt that can set your brain off to the races, creating a series of thoughts and emotions, often without consciousness.

Consider labeling your thoughts as just thoughts. “I’m frustrated that I got my period, is a thought I am having.” Or “I just had the thought - when will I get pregnant?” 

Once we’ve labeled our thoughts, we can create space and recognize we are more than our thoughts. Labeling a thought as a thought gives us the opportunity to decide whether we want to give it more energy — or maybe ignore it. 

We can also evaluate our thoughts, asking ourselves: "Is it true? Is it necessary to think about this at this time? Is it a kind thought?" It may be helpful to challenge your thoughts to break the cycle of negative thinking (like fear of a failed cycle or anxiety that a loss will happen again), try to change your perception of the situation, and help better regulate your emotions.

5. Connect with the people that matter to you

We often feel better when we’re with people we can confide in and trust. The desire to tell a friend after you’ve gotten your period, or update your spouse that your follicle count looks strong, is part of the drive to be seen and known by another person. 

So, consider making a point to connect with another person this week. Schedule an overdue phone date with a faraway friend, make plans to meet a friend for lunch or a walk – and try not to cancel. In spending time with others, you may get a reprieve from your own thoughts. Need to connect with a few people who specifically understand the infertility side of things? I often recommend my patients go to a support community. 

Your mind and mental health may be a powerful part of your fertility journey. Remember, you’re not alone in this. 

Visit fertilityjourney.com for infertility resources and information.