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How To Manage Emotional Wellness During The Fertility Journey, From A Psychiatrist

Aparna Iyer, M.D.
Holistic and Integrative Psychiatrist By Aparna Iyer, M.D.
Holistic and Integrative Psychiatrist
Aparna Iyer, M.D. is a holistic and integrative board-certified psychiatrist. She is an author and speaker on topics pertaining to emotional health and women's mental health.
A Psychiatrist's 5 Nonnegotiables For Mental Health During The Fertility Journey

Once you've decided to have a baby, you could be surprised to find that your fertility journey might turn out differently than you anticipated. Getting pregnant may take longer than expected, or perhaps you need medical assistance to become pregnant. You may even experience pregnancy loss along the way.

The entire process can take an emotional toll on you and your partner, so it's important to check in with yourself along the way. As an integrative psychiatrist with a focus on maternal mental health, here are my five nonnegotiables for maintaining emotional wellness during the fertility journey:

1. Find your supports and lean in.

It may feel easier to keep your thoughts and emotions around fertility to yourself, but sharing your experiences and emotions with people that you trust is really key to feeling supported. It is important to be clear about your emotional needs and how you'd like to be supported. For example, communicating when you just want to be heard and not given advice.

Some women worry about how to answer questions regarding family planning when asked by people outside of their immediate support group, such as colleagues or neighbors. Just remember, you are in control of how much or little you disclose to them! I often work with my own patients to come up with a standard response—something kind and relevant but direct, such as We're trying to figure things out right now, and I'll let you know when that changes.

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2. If the big picture is too much to handle, focus on the smaller picture.

Sometimes it can feel overwhelming to consider the entirety of the journey—where you've been, where you are, and where you're headed. Thinking into the future may be something you have to do from time to time, especially when you're making plans, but it can be helpful to strategically step back from that on occasion and take in the small pieces instead.

It can be helpful to ground yourself through acknowledging your non-fertility-related wins at times. This could look like celebrating a good day at work, getting a step closer to perfecting that yoga position you've been practicing, or finally getting your house organized!

It can also be helpful to focus on shorter periods of time, such as embracing life on a day-by-day basis or, if that feels like too much at times, even a minute-by-minute basis. Instead of asking where you'll be in five years, consider where you are in the moment and what meaningful moments, thoughts, conversations, and plans you can incorporate in the next few hours. 

3. Maintain some self-compassion.

The highs and lows of the fertility journey can be emotionally taxing. Unfortunately, this can take a real toll on self-esteem, self-confidence, and even self-respect. It is so important to cultivate self-compassion and to remember that you—all of you—are doing the best you can with what you have at the moment.

If you feel a sense of disappointment in your body, focus on exercises and moments that can help recreate a positive and healthy relationship between you and your body. This can look different depending on the person, but quiet time doing yoga, or looking in the mirror and expressing gratitude for yourself and your body, could be good places to start.

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4. Extend the compassion to your partnership, too.

When we hit bumps along the fertility journey, it can sometimes result in divisive feelings and thoughts between ourselves and our partners. Some couples can start to classify the struggles as a partner A problem or partner B problem rather than looking at these hurdles in a more unified way.

If we were to reframe these struggles as an us problem versus a you or me problem, it can help lessen blame and remind both partners they are on the same team. It can also help you to operate from a unified point when considering your next strategy, planning for the future, or simply checking in to see where you both are emotionally.

5. Check in with yourself about your emotional health.

While navigating the pivots and bends of your fertility journey, it can be especially important to check in with yourself regarding your emotional health. At this moment, ask yourself: How are you right now, from an emotional and mental health standpoint? Could you benefit from some additional support?

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I like to emphasize that there should be a low threshold for families on a fertility journey (and frankly, for all people on every journey) to seek additional mental health support. During the fertility journey, this may look like seeking individual counseling from a therapist or psychiatrist. It may also look like seeking couples' counseling to support healthy communication between you and your partner. It could also look like family therapy to ensure the ongoing health and wellness of your family.

Check in with your doctor about group support resources; a lot of other people in your community and nationwide are having their own unique fertility experiences, and there are many in-person and virtual support groups available for additional support!

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Bottom line.

Family planning can be an incredibly enriching but also emotionally challenging time for many. It is so important to check in with yourself to make sure you're staying emotionally well and that your most important relationships are staying healthy and supportive. Remember that there are always resources for additional support if needed! 

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