Merav Gur, Ph.D.
Clinical Psychologist
Clinical Psychologist
I counsel women, men and couples:
• Considering fertility treatments
• Dealing with failed treatments
• Considering or using donor sperm/eggs, third party carrier
• Considering or going through the process of adoption
• Processing the possibility of living life without children
• Experiencing pregnancy/Prenatal anxiety and depression - learn to manage symptoms
during pregnancy and cope with issues related to expectations and adjustment
• Dealing with post-partum depression and/or anxiety
• Adjusting and transitioning to parenthood
• Experiencing secondary Infertility
• Single-mother pregnancy and parenthood/same sex parents
The Psychological Impact of Infertility
Dealing with feelings of anger, shame, disappointment, and failure are common. These feelings
may in turn disrupt partners’ communications and their capacity to cope effectively. In addition,
couples have to make difficult medical decisions and feel overwhelmed by treatments which
take time, drain financial resources and are experienced as invasive.
Individuals going through fertility treatments may also feel depressed, anxious, and isolated and
may feel they cannot share their experiences. They may experience strained relationship with
their partner as well as levels of stress that may interfere with daily functioning. In addition,
pregnancy loss is often experienced as traumatic and may lead to depression, anger, and
hopelessness. Considering adoption can also be a difficult decision for many, as can
considering the use of a donor egg/sperm or of a third party carrier.
The Role of Psychotherapy for Those Dealing with Fertility Issues
Psychotherapy can be of great help to those confronting fertility issues. Psychotherapy can
help such clients cope with complex and difficult emotions as well as help them manage stress
levels and reduce depressive and anxiety symptoms. Psychotherapy can also provide such
clients and couples with support as they undergo intrusive and overwhelming medical
treatments. Psychotherapy can help couples resolve issues such as anger, low self worth,
blame, and strained relationship, and help them process options. For many, therapy can be
helpful when they are at a crossroads, when fertility treatments are not successful, and when
adoption or third party assistance (egg/sperm donation, surrogacy) may be needed.
Instead of letting infertility become an obstacle in life, I believe that the tremendous challenges
presented by fertility issues can serve as avenues for personal growth, for stronger and
healthier relationships, and for a more meaningful life. For many, learning how to cope with the
stress and the feelings associated with fertility issues can ultimately improve clients’ quality of
life and help alleviate the pressure to get pregnant.
Anxiety and Depression During Pregnancy
Many women who have a history of anxiety and or/depression may experience heightened
levels of these symptoms during pregnancy. They may worry excessively about issues such as
the health of the baby, their own health, their relationships, etc... They may have difficulties
coping with feeling physically unwell or may feel stressed and overwhelmed. They may have
difficulties coping with the impending changes in their lives and their relationships and may feel
ambivalence about the pregnancy. Often times, parents need to consider changes in areas of
work and career; and need to process issues related to other aspects of their identity. Women
who experience depression during pregnancy often feel guilt and shame, as they feel they
should be excited. Worries during pregnancy are normal, however, if they become intrusive
and disrupt daily activities, seeking treatment is important. Excessive stress and anxiety can be
harmful in some cases to both mother and fetus. Many pregnant women choose to discontinue
taking medications they were previously taking for anxiety or depression. Psychotherapy can
help with depressive and anxious feelings during pregnancy, and reduce symptoms during
pregnancy. Therapy can help in emotional preparation and in maintaining overall well-being.
Post - Partum Depression and Anxiety
Women who experienced depression and anxiety before pregnancy are at higher risk of
developing post-partum depression. Going through tremendous adjustment after the birth of a
child is common; however, feeling depressed, overwhelmed, and anxious can have a negative
impact on both mother and baby if not dealt with promptly. At about 50% (or more) of women
experience the "baby blues", which usually begins 1-3 days after delivery and the new mother
may experience sadness, fatigue, irritability, frustration, doubts about mothering skills, etc..
These symptoms usually disappear by two weeks.
Postpartum depression and anxiety on the other hand, may last for a longer period of time and
can appear anytime during the first year after birth. Self doubts about mothering may follow, as
well as feelings of guilt, worthlessness, thoughts about harming the baby or oneself. Panic and
anxiety may be more prominent, as well as difficulties sleeping despite being sleep deprived
due to newborn demands. At about 10% of women experience PPD. Post-Partum psychosis is
very rare and includes hallucinations and delusions. This condition calls for immediate help in
order to assure the safety of mother and baby.
Post-Partum depression may interfere with the ability to bond with the baby and be emotionally
attentive. Mothers may feel so overwhelmed that they have difficulties trying to sooth the infant.
Women who have infants with colic (who are difficult to soothe) may be at higher risk.
Psychotherapy can have tremendous benefits such as working through the process of
bonding, becoming a more competent parent, renegotiating relationships, and adjusting to new
roles and lifestyle. Parenthood can trigger many old and patterns and issues, and
psychotherapy can help in letting maladaptive issues go.
Post-Partum depression can have a long lasting negative impact on both mother and child, and
therefore, early treatment is so valuable.
Post-Partum Support International www.postpartum.net Post-Partum Resource Center of New York www.postpartumny.org Resolve: The National Infertility Association www.resolve.org The American Society for Reproductive Medicine www.asrm.org The American Psychological Association www.apa.org The American Fertility Association www.theafa.org |
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