BRUTAL CAUSE-EFFECT CYCLE: INFERTILITY AND DEPRESSION

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Infertility and Depression, infertility, depression

Infertility and Depression

“There is a unique pain that comes from preparing a place in your heart for a child who never comes.”-David platt

Anjali is 32. She is a nurse and works 8 hours a day in a busy private hospital. Anjali helps doctors in delivering new-borns but lamentably her ears are still waiting for the birth cry of her own baby. Her day begins with the taunts from her mother-in-law and ends with the rejection in bed from her husband. Anjali is un-invited in social functions and is labelled as ‘baanj’. Anjali is visiting fertility clinic, but no one asked her to visit a counsellor for dealing with her depression as well.

WHO (World Health Organization) defines infertility as a,  “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”… Therefore, it is nothing but a medical issue.  But, is it so? Infertility, unfortunately, is stigmatized by the society and has mental health consequences as well.  As is pointed out by Forrest and Gilbert, the pain of infertility manifests itself as acute and unique one because,

  1. It is unanticipated.
  2. Most of the time the cause behind Infertility is unexplained (and even if the medical cause behind infertility is known, the question “Why me?” remains unexplained).
  3. It lasts for an indeterminate length of time. (As if the night has no dawn)
  4. Infertility creates great level of stress. (There are various sources of stress, starting from conflictual relationship with partner, disturbed sex life, mind-numbing repetitive questions in the eyes of in-laws to the stigmatized behaviours from the society; i.e. literally ranging from bedroom to the society).
  5. It tests normal coping mechanisms.

In a developing country like India, the consequence of infertility is worsened due to socio-cultural factors. For example, it is common notion in India that a marriage is futile until it gives birth to a child. It is also found that across the world women are stigmatized more than men even if the man is not potent. In India, in most cases women are labelled as ‘infertile’ if the couple is childless without even going for any diagnostic test of the male counterparts.  An infertility study in Andhra Pradesh, India, reported that approximately 70% of women who experienced infertility would be punished for their “failure” through physical violence. Severe violence as a result of childlessness was reported by nearly 20% of the women.  Besides such explicit physical traumatizing manifestations, the extent of infertility affects the mental well-being of the women as well. Serious psychological issues like Depression, anxiety, and deteriorated general mental health are found to be common.

What is Depression?

People often confuse mood swings with depression. It’s necessary to understand what depression is. Persistent sadness or low mood, loss of interests or pleasure, fatigue or low energy is common symptoms of depression. One must keep in mind that persistence of such symptoms for at least duration of two weeks is necessary for diagnosis of depression. The easiest way to understand whether one is suffering from depression is to check whether the person has lost interest in the activities they used to enjoy before or not. Depression is the most frequently found mental issue, hence, is called the ‘common cold of psychiatry’.

Connection between infertility and depression

As Depression is almost the most common response of mind to any unexpected, negative event, it is unnecessary to say that infertility may also have depression as an outcome. In a study by Nelson et al. (2008), it was found that 19% of women had moderate and 13% had severe depression. Therefore, it is easy to understand that infertile women are highly vulnerable to psychiatric issues like depression. More interestingly, the direction of relationship can be exactly opposite too. It is also possible that you are not being able to conceive even after taking consultation from a good gynecologist because of your depression. Researchers like Lapane et. al suggests that a history of depressive symptoms increased risk of subsequent infertility.

  1. Depression may lead to health compromising behaviours like improper nutrition, less conformity to doctor’s advice, less exercise.
  2. Decreased sexual activity.
  3. Depressive state of the body may impair the hormonal system of body.
  4. Depression state induced immunity issues may prove to be a barrier to conception.

And the worst part is, if one takes anti-depressant that can also turn out to be a barrier to her conception. Therefore, pharmacological treatment to deal with depression as a result of infertility is not an option.

First solution is to combat the problem way before one is trapped in depression. A person suffering from infertility might find these tips helpful:

  1. Being a complete woman is not related to being a mother. It’s the society that has attached such value to motherhood. So, you should believe in and tell yourself everyday “I am complete”.
  2. ‘Infertile’ does not mean ‘not productive’. You are of course serving your family as well as your company through your work.
  3. Try to spend more time with your spouse. The condition must be shared by both of the partners. Togetherness matters.
  4. Speaking one’s heart out to at least one friend (may be your spouse). Cry, if you feel like. Don’t suppress.
  5. Ignore the social taunts as much as you can. (It’s difficult though).
  6. Involve yourself in some hobbies.
  7. Give yourself at least one hour a day (to listen to good music, watch movies you like, dressing up).
  8. One can get herself a pet (Enjoy motherhood through it).
  9. Conform to doctors’ advice thoroughly.
  10. Don’t ignore your health.

It’s next to impossible to expect from the society to change their view regarding infertility. What the infertile women can do is changing their perceptions. Having a self-efficacious belief is more helpful than a distressed heart.  There is no reason for stop living one’s life only because she is not being able to give birth. I know it’s easy to say and hard to follow but life is much bigger than all this. Even if one feels depressed, going for a proper psychological counselling is prescribed. In country like India, psychological treatment is highly stigmatized. But, one should value their well-being more than anything else.

P.S: Anjali has adopted a daughter now. She and her husband have named her ‘Hiya’. Needless to say, they are happy now.

Image is for representational purposes only

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Sucharita Maji
Sucharita is a Research Scholar in Department of Psychology at IIT Kanpur. Her research interest lies in the field of Social & Health Psychology; with focus on gender issues, women & mental health. She enjoys Ravindrasangeet, cappuccino and a good read in her leisure time.

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