How to manage your expectations during fertility treatment

This is the first in our “Dear Linda” series, where we respond to questions anonymously submitted to us from people going through infertility or fertility treatment. Have a question about mental health and fertility? Submit yours here.

Dear Linda,

I find I'm on a constant seesaw between hope before a round of fertility treatment and sadness when it doesn't go to plan. How do you deal with managing your expectations around fertility treatment and how can you stop yourself from oscillating between hope and despair,

Sincerely,

Emotional Seesaw

Dear Emotional Seesaw,

What is most difficult about being in the emotional seesaw is simply the movement itself.

Usually, when we're feeling extreme isolation, we think, “Okay. We're feeling isolated. What can we do about it?” Or if we're feeling really in despair. “Okay. We're feeling despair. What can we do about it?” 

The tricky part about managing the emotional seesaw is where to focus your attention. 

How do you focus on getting through this emotional experience when you are on the emotional seesaw?

My best advice is to try to slow that seesaw down. Find interventions that help you move slower, not just physically, but emotionally. One example is breathing, calming your heart rate down, and doing things that slowly remove yourself from the intense emotions that are distracting. 

For example, if you're going for a walk, you can move through your difficult emotions or thoughts better because you hear birds, smell different smells, and are distracted by other stimuli. 

So what are some of the things that can help you move slower? Because nothing will take it away completely. 

When you're in the emotional seesaw, we typically go inward and try to figure everything out.

I want you to push against that as much as possible and really connect to someone in your community that's also going through this. 

There's no one who's going through fertility treatment who's not feeling some of this bouncing around as well, so try to connect with other people who may be in the same space as you. They might not be exactly experiencing exactly what you're experiencing, but just know you are not alone.

Managing expectations during fertility treatment

When we're thinking about expectations, what I really want you to work on and think about first is your expectation of self.

Yes, yourself first.

Are there expectations about your healthcare team, your family, and your friends? Absolutely. 

But right now, I really want to focus on expectations of self. 

Why? Because in all of the years that I've done this work, expectations of others is a way for you to distract yourself from reflecting on your expectations of yourself, and if they are leaving you feeling let down.

Many of my patients feel inadequate. 

And what does that lead to? A lot of anger turned inward, or depression. Also anxiety, and fear for the future. 

And it's really difficult to manage stress. 

So what exactly are you expecting of yourself through your fertility treatment journey? 

I want you to get really specific. Write down three expectations that you have of yourself.

And tell me if you think they’re reasonable.

Would you ask a friend or expect a friend to do the same? How do you expect yourself to feel? 

How do you expect yourself to think, how do you expect yourself to behave in this situation? 

I guarantee you probably have expectations of yourself that you don't even realize that you're carrying around, and I'm not too sure if that's really fair, because have you been through this situation before and the outcomes were exactly what you expected? 

And even if you've been on a fertility journey for years, it changes over time. 

What expectations do you have around your decision-making? So many people that I work with, feel like they can make a decision at the snap of a finger.

It's not that easy when you're asked to quickly make decisions through fertility treatment, because you've got new information. That's not easy. 

Are you giving yourself time? Are you giving yourself time to grieve? Are you giving yourself time to process? 

Are you giving yourself space to behave and even have thoughts that you've never had before? 

How are you expecting yourself to deal with the stress? How are you expecting yourself to deal with the financial stress that often comes along with fertility treatment? 

I gave you so many questions to journal about! 

At the core of it all, ask yourself “what am I expecting of myself, and is that reasonable or fair?”

I guarantee, that during this process you're going to start uncovering that you might not be giving yourself nearly enough room that you certainly deserve during your family-building journey. 

Set smaller milestones

I think milestones are always best if you set them smaller and with flexibility, as opposed to looking really far into the future which leads to pressure.

Remember, fertility treatment has a lot of great chances, but they are chances.

Do not pressure yourself to be hopeful. Honor your current feelings

When it comes to oscillating between hope and fear, it's so important to not pressure yourself, to feel hopeful, to feel positive.

Oftentimes it's just hard to sustain when you're going through fertility treatment. 

Honor your feelings and give them space, no matter whether they’re positive or negative.

Try neutrality

Allow yourself to move through your emotions, but maybe try to pull yourself out more of the fear and into a little bit more of a neutral place.

If you're in hope and you're in positivity, great. We know that positive emotions are a great defense mechanism against depressive symptoms.

But if you're feeling fear, how do you pull yourself out of fear to at least be in a neutral place? That can be really crucial for coping.

Asking yourself questions (like the journal prompts above) is a technique you can utilize to pull yourself into neutrality.

Pull away from future predictions

“Can I predict the future?”

No. Therefore, it's really not in your best interest to keep thinking about all the scary things that might happen. If you catch yourself doing this, try to ask yourself what you know is true for today.

Realistic planning

The only thing that you can do is try to plan for the next step, not the next five, not the next 10, not the next 20. 

Oftentimes when I'm working with someone individually or with a couple, there's always a partner spouse that is really having a lot of trouble because they're thinking about all the “what ifs” and all the scenarios.

It's a very normal, emotional response when we're scared.

How to fight that is to bring yourself back to the present, bring yourself back to the fertility step you're in, and what may be one step ahead of that.

I know that's not easy to do, but focusing on where you are instead of the “what ifs,” and planning on how you are going to get through your current step and possibly prepping for the next one is what I recommend.

Sincerely, 

Linda

Have a mental health fertility question you can’t ask anyone? Submit your question anonymously here.