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Infertility according to the WHO is the inability to conceive after 12 months or more of regular unprotected sexual intercourse. It is also the biological inability of a person, animal or plant to contribute to conception or reproduction.

Mental Health pertains to flourishing cognitive, behavioural, and emotional aspects of human functioning. Cognitive refers to the intellect and reasoning capacity. Behavioural has to do with actions and habit patterns, while emotional concerns the feelings, internal predispositions, and attitude. Health is a state of complete physical, mental, and social well-being. It is not merely the absence of disease or infirmity.  Mental health is one part of being healthy. Mental illness occurs when the three afore-mentioned aspects of human functioning languish. Factors that cause mental illness or contribute to mental health include;

  • Biological factors; such as genetics, hereditary, or brain chemistry.
  • Psychological factors such as personality, cognitive impairment, family dynamics, and communication.
  • Life experiences: such as trauma or abuse.
  • Psychosocial causes such as life events or difficulties, stress, migration, substance use, place of residence, homelessness, etc.
  • Family history of mental health problems.
  • Problems with primary support group
  • Tension with partner.
  • Death
  • Social isolation
  • Financial difficulties.

How is Infertility Linked to Mental Health?

Parenthood is one of the major transitions in adult life for both men and women (that have always wanted to have children of their own). A large percent of those trying to navigate the terrain of infertility will agree that, if not managed properly, it is one of the most traumatic experiences anyone could have. The inability to meet one of their most important life goals is rather devastating and more often than not, has a negative impact on mental health.

Infertility could be a harbinger of one or more of the factors that cause mental instability. Because of the Nigerian culture, infertility could be a source of problems with primary support group, social isolation, tension with partner, financial difficulties, and trauma.

Couples faced with the challenge of infertility are more likely to have various mental health concerns, such as anxiety, depression, and mood disorder in the face of the stress encountered throughout this process. It is rather obvious that infertility brings about overwhelming struggle, stress, fear, frustration, and a host of other emotions that can be psychologically draining. The stress of the non-fulfilment of a wish for a child is associated with anger, marital problems, sexual dysfunction and social isolation. Couples experience stigma, sense of loss, and diminished self-esteem in the setting of their infertility.

Although the advent of medical interventions that offer hope and the much-needed help, studies shows that they also add to the stress that the patients are already experiencing from the infertility itself.

 

How Does Medical Intervention Affect Mental Health of Infertility Patients?

Apparently, everything that has an advantage also has a disadvantage no matter how small. I mean drugs are supposed to make you feel better right? Then how come you’re still hinted on the side effects of these drugs? Also, a coin isn’t one-sided for a reason, if it were it would be worthless as it wouldn’t be exchanged for anything of value.

Medical interventions although helpful still brings its own stress and could affect mental state, how?

  • Medication: Most drugs, if not all have a wide range of side effects, and the drugs used for infertility treatment may cause a variety of psychological side effects like mood swings, irritability, insomnia, depression, etc.
  • Financial Capability: The infertility treatments are of significant high cost and patients who do not have the insurance coverage or the financial capability to obtain these treatments may end up feeling even more helpless and hopeless than before as the thought of having a child may appear so close yet so far away.
  • Choices and Outcomes: Infertility interventions like IVF and the likes help about half of patients become parents. Patients who learn they are to become parents may be overwhelmed and overjoyed but must learn to adjust to the new pressures. For women who have had multiple miscarriages, they are likely to fall into anxiety about their strength and capability to carry the pregnancy to term. For older couples, they may debate whether to go for prenatal testing.

Also, in a case of treatment failure, this may trigger a renewed cycle of grieving and distress as shattered hope is even more devastating for patients who have been through the entire procedures and envisioned their children in their nearest future.

 

Also, there are patients who don’t know when to stop seeking treatment as they still keep their hopes up for a miracle or the patients who just can’t handle the refusal of the physicians to continue treatment even if it’s best for their health. For these patients, acceptance that they can’t be biological parents is rather traumatic and affects their mental health as they could fall into depression.

 

Signs to watch out for

  • Sleeplessness (insomnia)
  • Unnecessary worrying
  • Excessive worrying

(These two don’t mean the same thing. Unnecessary worrying is about irrelevancies while excessive worrying is about doing it too much)

  • Loss of interest in previously enjoyable activity.
  • Sudden change of interest.
  • Lethargy (Feeling that you are struggling with everything)
  • Crawling sensation
  • Internal heat or peppery sensation
  • Unexplainable sadness
  • Unexplainable agitation
  • Mood swings
  • Unnecessary suspiciousness
  • Marked change in behaviour of spouse.
  • Marked change in quarrel pattern with spouse.
  • Reduced interaction with spouse.

 

How do I deal with infertility and my mental health?

Most people challenged with infertility seek coping mechanisms to help them go by daily as the emotional impact of infertility takes its toll on them. These are possible ways to deal with infertility that could in turn keep your mental health stable to a large extent.

  1. Identify your feelings: There are too many emotions and feelings attached to infertility and they are not caused by one single factor. To overcome this, acknowledge the emotion and name (identification) it to enable you deal with it appropriately. The feeling could be that of failure or inadequacy, loss, guilt, being judged, shame, jealousy or anger, fear of rejection, loss of self-esteem or even financial stress. Thorough understanding of such feeling or emotion is needed; know what the feeling is about, where it comes from, who it is channeled to, why you feel that way, etc. This is to help you share the problem rightly with someone who can be of help.
  2. Get help: Help can be gotten from family, friends, support groups, or even a professional. This helps increase coping strategies. It is recommended to begin this even before commencing any fertility treatment process because psychological treatment may increase the chances of birthing a child.
  3. Psychotherapy: This is also Talk-Therapy. It is known to help people deal with emotional difficulties. This is done in three phases of treatment; assessment, therapy, and closure. Likely areas for assessment include the individual spouse, the marital relationship, and the familial and social network. The primary goal of this is to help individuals and couples learn how to cope with the physical and emotional changes and challenges associated with infertility, as well as with the medical treatments that can be painful and intrusive. A good therapist can help sort out feelings, strengthen already present coping skills and develop new ones, and help couples maintain a positive and communicative relationship.
  4. Relaxation Techniques: Since infertility and its treatment often cause considerable stress, experts recommend various relaxation techniques to help deal with it. Relaxation techniques such as progressive muscle relaxation, deep breathing, meditation and imagery can help you transition to a relaxation response state. These techniques can help you deal with any type of stress including that related to infertility.
  5. Deal with Sexual Stress: Sexual stress is very common among couples with infertility, mostly because sex becomes more of a duty rather than a fun activity. The reason for sex shifts from intimacy to solely making a baby. To deal with this, take a break from baby-making, distinguish between work and fun sex, and learn sensual contact that doesn’t lead to pregnancy. Keeping a good sex-life is good to keep your body and soul together amidst the stress of infertility.
  6. Medications: For moderate or severe cases of depression and anxiety, medications such as anti-anxiety or antidepressants are used. Although, medications are not a cure, they help treat symptoms, so if one stops taking them, the symptoms can return. It can take time to feel better with medications but it sure helps a great deal. Medications such as antidepressants help reduce such feelings as sadness or depressed mood and anxiety as well as suicidal thoughts. They do not, however, make people “happy” or change their personalities.
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