For couples who have been struggling for years to conceive, facing the fear of infertility is extremely stressful. So stressful in fact, many wonder if they are depressed, and if depression contributes to their struggle to achieve pregnancy. If this sounds like you or someone you know, you are going to want to keep reading this natural guide to infertility related depression.

While stress and depression may contribute to problems related to reproductive function, such as hormone imbalance, they do not directly cause infertility. What is truly most important here is to recognize that the feelings a person has surrounding this type of struggle is deeply painful and often isolating. This is the perfect setup for potential mental health problems. Infertility is rarely spoken about and often shrouded in shame. The topic of infertility is generally taboo, which creates a situation for family and friends to have a lack of awareness on what causes it, or what to say to someone who is going through it.

Couples experiencing infertility often shut-down, keeping what they are feeling inside. As days turn into weeks and then months and then years of trying to conceive, the sadness deepens, which may lead to depression. Infertility affects every aspect of life; relationships, work, schooling, and even the ability to go the grocery store. How can anyone expect a person experiencing infertility to not shut-down emotionally? The loss is profound. Anyone who experiences a situation of loss knows how heart wrenchingly sad they feel. This is how infertility can feel.

Common Emotions of Infertility

• Feeling out-of-control
• Grief over the loss of, or fear of the loss of the pregnancy and birth experience
• Grief over the loss of, or fear of the loss of the ability to pass on the genetic legacy
• Grief over the loss of, or fear of the loss of nursing a baby
• Grief over the loss of, or fear of the loss of a grandparent relationship
• Feelings of low self-worth
• Lack of libido
• Lack of interest or anxiety about social outings and work
• Feelings of hopelessness for the future
• Nervous tension, anxiety
• Feeling alone
• Resentment toward the body
• Resentment toward husband, wife or life partner
• Resentment and anger toward pregnant women or families with children
• Doubt toward and abandonment by God, or a connection to a spiritual practice

These experiences seem expected and a normal response, especially when you consider infertility is a state of crisis for 1 in 8 couples. So how can a person determine if they are just really sad because of infertility of if there is a deeper problem like major depression at hand? Well, no one but a professional counselor can determine that and that is why seeking mental health care is so important! Only 10 states have insurance coverage for IVF, but almost all health insurance covers mental health, so that couples can receive counseling for free or through copay.

Mental Health Effects Physical Health
Infertile couples should seek counseling and consider natural at-home options for feelings of sadness, and depression. Not doing anything about it and keeping it to yourself is NOT going to help. Profound feelings of loss, depression and trauma are so stressful emotionally and mentally that they can lead to physical manifestations in the body; actually affecting how the physical body is functioning. Once mental health affects the physical body, the situation becomes worse as physical symptoms feed the depression.

Infertility is a very real part of millions of peoples lives, and all of those going through this deserve to be heard and guided to mental health support on this journey. In fact, the mental health aspect of infertility needs to be part of every couples health plan. Whether a couple decides to continue to pursue parenthood or not, a mental health plan must be part of the overall picture.

Ways stress, negative emotions and thoughts affect the body…
The running of thoughts over and over in the head, thinking about infertility treatments, the thoughts of the loss, the feelings of loss, all the swirling of emotions surrounding fertility struggles trigger what is known as the “fight or flight” response. This initial response is the release of adrenaline, catecholamines and cortisol, which cause these physical symptoms:

• Muscle contraction
• Pupil dilation
• Increased heart rate and blood pressure
• Blood flow moves away from digestive system to the vital organs, affecting proper digestion of food
• Increased blood sugar
• Disturbed sleep cycles

A person who is under extreme stress, common in infertility, can begin to experience the above symptoms frequently, over time, which may lead to physical symptoms of chronic stress, which can play a key role in the development of depression. The long-term impact of the fight or flight response is the lingering after effect of the hormone cortisol. Over time, cortisol begins to “hang out” in the body, causing more severe physical symptoms that can affect fertility and the body’s ability to reproduce.

Physical symptoms due to long-term stress and depression:

• Immune system suppression
• Water retention
• Hyperglycemia
• Insulin resistance
• Catabolism – breakdown of muscle tissue
• Fat redistribution and obesity
• Increased gastric juices
• Removal of calcium from bones
• Suppressed inflammation response – In the end this signals a heightened immune system response which can lower serotonin levels feeding depression and potentially causing autoimmune disease or more severe health issues like cancer.

Important Steps to Intervention and Recovery

Professional Counseling

Finding a professional counselor is invaluable. A person, not involved in what you are experiencing, that you can talk openly and honestly with is so important to working through depression. There are counselors that specialize in infertility. Another option is art therapy counseling services, where you can be creative during your session. Mental health is covered by most insurance plans, so take advantage of this type of service. Your mental and emotional health is just as important as your physical health!

Nutrition as Your Foundation

What you put into your body is something you have total control over. Research has shown that when you eat and what you eat have a profound effect on stabilizing moods, feelings of sadness and depression by promoting proper brain chemistry.

These steps can help you recover from depression by promoting balanced blood sugar levels and providing key nutrients to help your body produce the right amounts of serotonin, so you can be happier from the inside out. If you don’t support your body through healthy diet choices, you may continue to struggle with depression despite working on other areas to combat it.

6 Steps to reverse depression through nutritional support:

1. Eat protein with a complex carbohydrate for breakfast everyday

• This step is truly your anchor, your foundation for the rest of the day. It is important you eat enough protein for your weight. To do this divide your weight in pounds in half to give you the total number of protein in grams that you should eat each day. Eat 1/3 of that amount at each meal. So if you weigh 135 lbs., you will want to eat a total of 67.5 grams of protein per day, and 22.5 grams per meal.
• Eat dense protein foods like meats, fish, eggs, cottage cheese, whey protein in a smoothie, nuts or nut butters, or beans.
• Eat a complex carbohydrate along side of your protein. If you are a petite person, 1/2 cup will do, if you are larger 1-2 cups will be a good serving size. Eat whole grains like oatmeal, brown or wild rice, quinoa, potatoes with the skin on them, whole grain tortilla, or beans. Avoid eating any white refined carbohydrates like cakes, pastries, white bread, etc.
• Eat within one hour of waking up.

2. Eat all meals with a serving of protein

• In step one you learned how much protein you should eat for your weight. Eat that amount of protein per meal.
• Include a complex carbohydrate in your meal, again, remember the appropriate serving for your weight.
• Eat meals with no more than 6 hours in between meal times.
• Be sure to include a wide variety of fresh vegetables and some fresh fruit to each meal.

3. Include key nutritional supplements to your diet daily
Magnesium
Magnesium is a must for those wanting to heal from depression. It promotes deep, restful sleep, ideal for combating sleep disturbance. Sleep is very important to maintaining proper serotonin levels. The preferred magnesium supplement will be in powdered form that is added to liquid.

Calcium
Because depression and stress affect calcium stores, it is important to supplement with calcium. Most quality calcium supplements are combined with magnesium for proper assimilation.

Vitamin D3
Adequate levels of vitamin D3 have been shown to prevent depression and treat it. You can get it for free by making sure you expose your skin to the sun for 15-20 minutes a day, by supplementing with Cod Liver Oil and taking a whole food source.

Cod Liver Oil
Cod liver oil is rich in two important acids, DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). Low levels of DHA and EPA have been linked to depression and other mental health issues. DHA is essential for proper brain development and function, while EPA supports healthy behavior and mood. Cod liver oil is also anti-inflammatory, a central nervous system tonic and supports nerve regeneration via neuron wall regeneration.

Vitamin B12 in Vitamin B complex
Vitamin B12 is important for supporting proper function of the central nervous system, behavior and mood. It is helpful for those with groggy, brain-fog type depression, those with excessive daytime sleepiness known as hypersomnia. Be sure to take B12 in the form of a vitamin B complex supplement to prevent B vitamin imbalances.

4. Keep a food journal about what you eat and how you feel after eating
A food journal can be a resource to show you the link between what you are eating and how you are feeling. It will give you a clear picture of your progress and areas that need to be improved upon. Make sure to note the date and time of your entry, what you eat and drink, supplements and herbs you are taking, and how you are feeling emotionally and physically.

5. Reduce or eliminate sugars, alcohol, and caffeine
These three indulgences greatly impact insulin levels, the nervous system, may cause vitamin and mineral deficiency, thus contributing to depression and hormonal imbalance. As long as these are consumed regularly, any one of them, or all of them in the same day, there is going to be a roller coaster of insulin levels. It is nearly impossible to heal depression as long as these are part of your diet. It is common to feel a bit crazy or not like yourself as you eliminate these from your diet, don’t worry, this is a normal reaction as your body detoxes from them. Learn more about how these affect your mental, emotional and physical health below:

Sugar May Contribute to Infertility
Alcohol & Fertility
Caffeine and Fertility

6. Eat a potato before you go to bed
Now you may be thinking, this is crazy, but the research is not. According to Kathleen DesMaisons, Ph.D., author of Potatoes Not Prozac, the potato changes your brain chemistry. She says, “The potato creates an insulin response that affects the movement of the amino acid tryptophan from your blood into your brain. Your body uses tryptophan to make serotonin, the brain chemical that makes you feel mellow and happy. Serotonin also helps you to “just say no” to sweets and other things by putting the brakes on your impulsivity.”

Dr. DesMaisons’ guidelines are pretty simple, eat a potato with the skin on (mashed, baked, roasted, hash browns) 3 hours before you go to bed. Avoid topping the potato with a protein. Good topping choices are olive oil, salsa, mustard, spices, garlic. The potato doesn’t have to be big, it can be a fingerling, red, small russet or Yukon gold.

For those with low serotonin levels, introducing a potato before bed may cause wild dreams, headache or the feeling of a hangover. This is a signal to reduce the serving size of the potato you are eating. The larger the serving, the bigger release of serotonin. More is not better, ease into it and start of with a smaller serving until you feel just right and are sleeping well and daytime moods are stabilized. The goal here is to get your body to produce and regulate serotonin levels, so you can feel your best.

Herbs for Depression, Anxiety and Stress

Plant medicine is gentle, nourishing and very effective if the correct herb and dosage is used. The following herbs may be considered as part of a holistic approach to resolving depression and the blues related to fertility challenges. If you are unsure how to use herbs, find an herbalist in your area to work with. If taking a tincture, be sure to follow the directions on the product label.

California Poppy, whole plant (Eschscholzia californica)
Works similarly to the above description for Skullcap. This variety of poppy help to normalize psychological function. Gentle support for depression, nervous anxiety, and tension. It is also a mild sedative, aiding sleep. California poppy helps a person to move forward with resolve. A standard dose of the tincture is 15-25 drops, 3 times a day. Combines well with Milky Oats and Skullcap.

Hawthorn flowers and berry (Crataegus oxyacanthoides)
A tincture of the flowers combined with the berry of this plant makes for a great cardiac (heart) tonic and mild nervous system support. Useful for those who feel anxiety is trapped in the body. 60-90 drops of the tincture, 3 times a day. Combines well with Linden flower and Milky oats.

Lavender flower (Lavandula officinalis)
This “herb of all herbs” is a wonderful aid for those who find they have difficulty concentrating, foggy thinking, and sleepy depression. It is a gentle nervous system tonic, soothing for nervous exhaustion. May be used to promote sleep. It is also supportive of healthy digestion. I find it best taken in an infusion, 1 tsp. dried herb to 1 cup boiling water, steeped covered for 10 minutes, 3 times a day. Combines well with all other herbs.

Lemon Balm flowering tops, leaves (Melissa officinalis)
This herb is excellent for immediate action to control bouts of depression, stress and anxiety. As soon as one begins to feel “off”, a dose of Lemon balm can help support the body to work through it. It is also supportive of the immune system in states of stress. Not for use in those with hypothyroidism, not for long-term use. 1 tsp. dried herb to 1 cup boiling water, steep covered for 10 minutes, 3 times a day. As a tincture, 30-60 drops, 3 times a day.

Linden, flower and bract (Tilia platyphyllos, T.cordata)
Linden mildly lowers blood pressure, reduces depression, through nervous system support. It is great for anxiety, depression and insomnia. It is very gentle and safe for daily, long-term use. As an infusion, 1 tsp. dried blossoms to 1 cup water, steeped covered, 3 times a day. 30-60 drops of tincture, 3 times a day. Combines well with Hawthorne and Milky oats.

Milky oats, oat flowers, flower tops (Avena sativa)
The best long-term central nervous system tonic. Milky oats helps to build and strengthen the central nervous system. It is especially helpful in supporting a person find their voice, helping them to turn their experiences into a narrative. A tincture of the fresh flowering tops is best, 60-120 drops, 3 times per day. Combines well with all other herbs.

Motherwort aerial parts(Leonurus cardiaca)
This traditional heart remedy, it’s name actually means Lion heart, is one of the best herbs to dispel sadness, depression and anxiety, all while supporting proper function of the heart. This herb is so supportive for women and all aspects of female fertility. As an infusion, 1-2 tsp. of dried herb to 1 cup of water. Cover with boiling water, steep for 10-15 minutes. Drink 3 cups a day. Tincture dose is 5-25 drops a day, 3 times a day. Combines well with Passionflower, Skullcap, Lemon balm and chamomile. It tastes pretty nasty, so sweet herbs help to balance it’s bitterness. Learn more here…

Passionflower aerial parts (Passiflora incarnata)
The tincture of this plant is excellent for immediate feelings of anxiety, depression and stress that have stimulated symptoms of the “fight or flight” response. Extremely soothing for those with core pain, trouble sleeping and anxiety. This herb can be sedating at higher doses, around 40 drops, so be sure to only use 10-15 drops as a maintenance dose. It is also good in an infusion blend with other herbs such as Lemon balm, lavender, chamomile and skullcap.

Pedicularis also known as Elephant’s Head, aerial parts (Pedicularis spp.)
This plant alters the cyclical “fight or flight” response, great for those who have trouble turning off thoughts from running over and over in the mind. Best as a tincture, 15-30 drops, 3 times a day. Has been reported to make some people feel “spacey”, if this is the case, lower the dose. Combines well with Skullcap.

Skullcap aerial parts (Scutellaria laterifolia)
Has an effect on GABA (gamma-aminobutyric acid) in the central nervous system which raises the threshold for the “fight or flight” response. GABA inhibits the firing of the neurons, similar to the medication Xanax. For depression and states of heightened stress, Skullcap is best taken everyday as a tincture with one day off a week as a rest. 1-2 tsp. of dried herb to one cup boiling water, steeped covered for 10-15 minutes, 3 times a day as an infusion. 60 drops of tincture, 3 times a day. Combines well with Milky oats, Lavender and Passionflower.

Simple Actions Shown to Lower Cortisol Levels, While Boosting Serotonin Levels

Reduce the time spent on the computer – The lights in the screen and the EMF’s emitted are linked to elevated cortisol levels.

Hugs – Hugs have been shown to lower cortisol levels, while boosting both serotonin and oxytocin levels. Get or give a good hug today!

Aerobic Exercise – Do some physical activity that increases your heart rate for at least 30 minutes a day.

Sex – Yes, sex is good for you and it releases the hormones dopamine, serotonin and oxytocin. All of these help you to feel better. The oxytocin plays a key role in feelings of attachment and connection to your partner, this is extremely important for those dealing with depression.

Laughter – Laughter really is the best medicine. Try to get in a good belly laugh each day.

Body Stance – Standing with your feet planted at shoulder width, with your hands on your hips (like Superman) lowers cortisol, improves serotonin release and can help you regain your confidence. Keeping your shoulders more open and slightly back, hips aligned and open, and feet planted firmly with arms out, not crossing the body. Try it and see how you feel.

Meditation – Meditation has been shown to help align your breathing with your heart and brain waves, so you can induce a state of complete relaxation and clarity. Just 5 -20 minutes of daily meditation can be extremely helpful in helping the body to resolve depression and establish wellbeing.

Yoga – We love yoga for increasing fertility, but did you know it also increases serotonin levels, promoting a sense of wellbeing and confidence.

Closing Thoughts

If you feel sad, hopeless, frustrated and lost because of your fertility challenges, it is okay, you are not alone. How you feel is very real. You deserve support and you deserve to be heard. My hope is that you will find the courage to get the help you need.

• Step Four: Take Vitamins. Have a Potato Before Bed. (n.d.). Retrieved from http://www.radiantrecovery.com/4r.htm
• Radiant Recovery. (n.d.). Retrieved from https://radiantrecovery.com/
• Seven Steps to Feeling Great. (n.d.). Retrieved from http://radiantrecovery.com/7-steps/
• Pedicularis (Lousewort) Monograph-Pedicularis as a Skeletal Muscle Relaxant. (n.d.). Retrieved from http://7song.com/pedicularis-lousewort-monograph-pedicularis-as-a-skeletal-muscle-relaxant/
• Aztec Gold: The Medicine of the Mexican Poppy. (n.d.). Retrieved from http://bearmedicineherbals.com/aztec-gold-the-medicine-of-the-mexican-poppy.html
• Bartholow, Lydia Ann PMHNP. Stress, Trauma & Depression talk. Portland Plant Medicine Gathering, 2012.
• www.resolve.org/infertility-overview/what-is-infertility/hidden-no-more-the-hidden-emotions-of-infertility.html
• Hoffman, David. The New Holistic Herbal, Element Books, 1990.

Dalene Barton-Schuster - Certified Herbalist, Birth Doula

Practicing natural health and herbalism for over 18 years, Dalene received her training and herbal certification under the guidance of Lynn Albers at Yarmony Mt. Herbal College in Colorado in 2000. She went on to become a Certified Birth Doula at Birthingway College of Midwifery in Portland, Oregon in 2007. As a Birth Doula, Dalene has helped to bring many new lives in to this world. Dalene has written 280+ fertility articles and with her vast array of herbal and holistic healing knowledge has helped 1000’s of women on their journey to Motherhood.

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