Posts Tagged anxiety

The latest news Chez Nishkanu (preg ment)

As always, please skip this post if you are feeling sensitive about pregnancy.  There is plenty of other stuff to read around here.

Today: the news in numbers.

5w5d

That’s where I’m at today, if I calculated everything correctly.

I started thyroid meds a few days ago to make up for the fact that either pregnancy or the combination of estrogen patches + progesterone suppositories have put not only my self but also my thyroid to sleep.  Before the meds I was pretty much prone-on-sofa-only, now I can get a couple of things done before the prone-on-sofa stretch of the day happens.  But of course, being a proper infertile, the slightly increased energy makes me think, “Maybe the embryo died!”  This despite my own dang recommendation to take to heart A Beautiful Day’s advice that symptoms vary all the time in pregnancy and it just means your body is adjusting, not that anyone is dead.

But 5w5d then also became the first day of actual barf, rather than just waves of nausea.   Getting in the shower this morning, I yawned and it immediately turned into gagging. I shouted the news to a delighted Mr. Nishkanu.  Getting onto lunchtime I have to suddenly run to the toilet, because, OMG, well… you get the idea.  And simultaneously feeling sorry for myself that I feel really, really sick and delighted because it means – maybe someone isn’t dead.   These are weird headspaces I am living in right now.

5w1d

Last Thursday.  That’s the day I finally gave in and bought new bras.  I didn’t want to buy anything pregnancy-related until after we see the heartbeat, but the straitjacket-like fit of all my current bras was driving me nuts and I decided it was worth it to be comfortable for the couple weeks until my 7w ultrasound.  Yep, and for real, I am already one full cup size larger.  Who the heck is already one size larger when they are only 5w along?  It’s gotta be the progesterone, Dr. Google says this shouldn’t be happening until the end of the 1st trimester.   If any of you ladies out there have experience with this I would love to hear about it, right now I feel like some kind of boobular circus freak.

  • Updated to add: my clinic confirmed that the extra progesterone and estrogen from my meds is what caused me to swell up extra-ultra-early.  No circus freaks around here.

4w6d

That’s the first day I went back to the gym (note: with RE permission) since laying off on exercise since a few days before transfer.  I just wanted to see how things would go, and did the world’s lamest workout ever – 20 minutes on the elliptical at the pace of a slightly enthusiastic snail.   I got overheated almost immediately (something that is Not Allowed in pregnancy) and switched to a colder exercise room, then I watched my heart rate wander all over the place even at the geriatric pace I was keeping.  Finally: dizziness and I got off.  It was sad.

Next trip to the gym was after the thyroid meds had started kicking in, 5w3d.  And: hitting the weights again (note: in case you haven’t picked up on this from previous posts my main exercise is serious full-body weight-lifting, which I love love love, and you will too if you use this program).  I modified my exercise program by dividing all the weights that I had used before transfer in half – I figured that would be a good, conservative start.  And, sad but true, often that was just plenty, thankyouverymuch.   But still: I actually really got to do a workout, and I didn’t overheat, and I actually got sore in places, and it felt so good to be back doing something I just love to do and makes me feel great.

Then I went home and napped on the sofa the rest of the day.

5w3d

That’s the day I decided to actively choose to give up some of my post-BFP anxiety, come what may.   It occurred to me that if this does work out and we get a real live actual baby out of it, we will be kind of bumming if we had spent the pregnancy freaking out constantly that it might be dead instead of being happy that it was alive.  And if it does not work out, am I going to say to myself, “Gee, I am so glad that I spent the last weeks totally stressed out and worried – that makes this miscarriage so much better!”?  I don’t think so.

So: not exactly going nuts and decking out the nursery, but at least trying consciously to move away from a focus on doom and gloom.  The grip is loosening up a bit.    Still retain the right to express future Dead Baby Thoughts.  Even in this very post.

7w6d

April 21.  That’s when I finally get to have my 7w ultrasound, and find out if the baby has a heartbeat or not (that sound you hear in the background is fingernails being chewed, Newfound Acceptance (TM) notwithstanding).  Why do I have to wait so fricking long?  Because I have the only RE in the world who is going on vacation and closing their entire clinic from 6w2d until 7w5d.  He said we could come in earlier if we wanted reassurance, but I know I won’t really feel reassured until we see the hearbeat.  It is possible to see the heartbeat at 6w, but it is also possible not to.  And I definitely don’t want to get into the situation where we go in and he says “gee, it doesn’t look so good, but now you will have to wait 10 days while I am on vacation before I tell you if your pregnancy is doomed or not.”  Better to just get the bad news in one big fell swoop, I think.  What thinks you?

And for reassurance?  Thank god for the barfing.  Yes, I realize that is a little twisted.  But let’s run with what we’ve got for now.

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So, you did IVF and it worked. What now? (preg ment)

This post is an expanded version of a previous blog post on The Stirrup Queen Ballroom.

I can’t say I am really an expert on this topic, since until now I have never managed to make it past the 7th week.  But I do have a few small suggestions.

1. Some of the scarey things that could happen to you don’t actually mean a thing with regards to the health of your pregnancy.

The first and most important suggestion, which you really must follow, especially if you are spotting or your symptoms are going away and you are afraid you are miscarrying, is to race right over to  A Beautiful Day and read her classic and extremely informative post: When IVF Works: What the RE Doesn’t Tell You.  Go ahead, go do it, this post can wait.

Now wasn’t that exceptionally informative and reassuring?

2. You might not feel 100% happy, and that’s OK.

So, now that you’re back, let’s sit down and have a heart-to-heart about how you are feeling.  Giddy?  Excited?  Elated?  If so, good for you!!

But if you have a lengthy infertility battle behind you, and especially if that battle involves prior losses, here are some words that might also describe you: terrified, numb, freaked out, anxious, sad, angry… unfortunately, these emotions, too, are par for the course for the post-infertility pregnancy.

In my recent 2ww, I had accepted my infertility and was OK with whatever would happen.  As I said to my friends after the transfer, “60% chance I start building my family with DE, 40% chance I start building my family through adoption.”  When I POAS’d the day before the beta, while I was waiting for the test I sat with my eyes shut, imagining a blank result and chanting mentally “We are going to adopt!” But within 30 seconds my husband said “There’s a second line!”

My first reaction: incredulity.  My second: shock.  My third: numbness.  I sat with that numbness for a day or so, poked at it a bit to try to find out what was going on, and unearthed a deep, smoking pit of terror.

I was OK with a BFN.  I was OK with moving on to adoption.  I am not OK with losing a baby once it has shown signs of preferring to stick around.  The stakes are now much, much higher.

And so I wake up at 3 AM and stare at the ceiling and wonder whether there will be a heartbeat at the 7w ultrasound.  Whether we are enjoying the first short weeks of a very long acquaintance.  Or whether we are already getting ready to say good-bye to the little life that we created.  Dr. Google says insomnia is a common early pregnancy symptom, according to What You’re Not Expecting When You’re Trying to Expect.  Maybe Mr. Nishkanu is pregnant too because most nights when I am awake, he is lying awake right next to me.  He is normally a pretty resilient, unworrying kind of guy but now he is looking drawn and tired.

And after 2 or more years of finally being OK being around pregnant women and young families, I find myself again reverting to that earlier heated jealousy of pregnant women.  Yes, I am ashamed to admit it, but I am jealous of pregnant women who are farther along than me, who can be more sure than I am that their baby will live.  Today I saw a woman in her 4th or 5th month, wearing a tight shirt that showed off her mini-bump, looking happy and energetic, and I thought to myself, “She has probably never had a miscarriage. She probably thinks everything will be fine.  And everything probably will be fine… for her.”  Yeah, ok, I know it is time to get a grip.

But my point is,  if you are feeling negative emotions instead of the sense of elation you expected to feel, this is totally normal for post-loss (including post-infertility) pregnancy.  If there’s one thing a person learns from infertility, it is that the dice don’t always roll in your favor, and there are no guarantees now, either.   To be honest, I think to some degree the post-infertility pregnancy attitude is simply more realistic than the naive innocent person’s.  Yes, it could go wrong.  And it could break your heart.  Life is like that.

3. There are things you can do that can help to make you feel a bit less anxious, if that is a problem for you.

Nevertheless, after some initial hyperventilating panic, I started to find some things that made differences for me – small differences, but important ones.

I found this article on dealing with fear in post-loss pregnancy incredibly helpful, especially this piece:

“When a fear is a remnant of past experience, it isn’t necessarily a predictor of future events. Your worries are not foolproof evidence that something terrible is actually going to happen. How can you tell? Try to separate out which fears are arising from your imagination and memories of what happened before, and which fears are arising from cues you are actually observing or tuned into. If a fear is coming out of imagination or memory, discount it. It’s not real.”

When I read this, it really helped me to make a mental separation between the fear and trauma from past pregnancies and the current one.  This pregnancy isn’t necessarily doomed, just because the last ones were.

I also remembered that one characteristic of anxiety is that it is often based on desperate attempts to run away from the frightening emotions that are driving the anxiety. Sometimes it helps to stop running, face your fears and clarify them, and find out what you’re really afraid of, rather than leaving them as a big, foreboding, unclear mass.

When I actually sat still and let myself really feel the bad feelings that were welling up instead of covering them up with numbness and racing thoughts, I realized that part of the issue was that I am still really traumatized by the awful D&C that I had after my last miscarriage. It was a collision course of incompetent and uncompassionate care – even Mr. Nishkanu is still traumatized from watching me cry while a bumbling nurse tried over and over again to place an IV in my hand, until I started passing out from the pain (at which point she started complaining about me being a bad patient). I promised myself that if I have a miscarriage this time, I will find compassionate, competent caregivers, and if any of my health care providers start causing me unnecessary pain or treating me rudely I will insist on getting treatment from someone else. Once I had done that, I felt a lot better.

As Katie suggested to me, some women find it helpful to repeat positive  affirmations to themselves, such as “No matter what happens, I am pregnant today,”  “My baby has a good chance to live,” or “My body is taking care of my baby’s needs.”  They work best if they are things that you can really believe – if you are scared of a miscarriage “I won’t have a miscarriage” probably won’t do much for you, but “I will find peace, whatever happens” might.  You should note when constructing an affirmation for yourself that your subconscious doesn’t understand “not”, so something like “I will not let fear destroy my pregnancy” might get turned subconsciously into “I will let fear destroy my pregnancy.”  It’s therefore best to formulate your affirmations as positive statements, eg. “It’s safe to enjoy my pregnancy.”

A lot of women who have worries about their pregnancy get comfort from living one day at a time, reminding themselves that no matter what happens, they are pregnant today.   It can also help to break the pregnancy up into smaller goals – make it to the second beta, make it to the 7w ultrasound, make it to the end of the first trimester… and celebrate every small victory you make it through.  From my experience with miscarriage I can say that I never regretted the time I was happy and I thought the pregnancy would work.  If anything, I wished that time had lasted longer.  So I don’t think you need to feel that if you are enjoying your pregnancy now that you will regret it later if something goes wrong.

I find The Anxiety + Phobia Workbook a good source of longer-term coping strategies. I am working on the strategies suggested there for consciously blocking obsessive worrying but I’m not particularly good at that yet…

Being kind of a research geek, I also found it comforting to read about Denise Cote-Arsenault’s research on how women who feel when they are pregnant after loss in an attempt to educate health-care providers about how they should treat these women. Her article “One Foot In, One Foot Out” explains the coping mechanisms that women use to deal with post-loss pregnancy. My favorite part of the article was this:

“Although the metaphor, One Foot In – One Foot Out [i.e., that women do not fully commit to the pregnancy], seemed ubiquitously applicable, each woman’s response and situation were quite unique. These differences were easily shared and accepted by the other participants, sending the message that getting through the pregnancy was so difficult that no one would pass judgement on how it was managed. How to ‘do’ pregnancy was certainly individual and each woman, not others, knew what was best for herself.”

And that really matters here.  In the end, each of us has to find her own way through – there is no one “right” way for anyone to approach pregnancy.

You might find some comfort out of some of the other measures I mention in my post on Anxiety and Infertility.

If anyone has additional suggestions I would love to hear them – please add in the comments (lord knows I can use some more suggestions myself).

4. You don’t have to read the dreaded pregnancy books to find out what you should be doing, just this next section.

I don’t know about you, but I can’t stand to read regular pregnancy books because they are all so dang happy and positive.  In fact, they seem to presume that you actually will have a baby at the end.  What a crock!   I therefore asked a less infertile friend of mine to report back what you are / aren’t supposed to be doing while you are pregnant.  Let this tide you over until you can stand to look in those books.

  1. Don’t eat: raw or undercooked: fish, meat, eggs (including homemade mayo or soft-boiled eggs), cold meat (including luncheon meat) unless you heat to steaming before popping it in your mouth, raw milk products, moldy cheese (e.g. brie, blue cheese), artificial sweeteners, alcohol.
  2. Take your prenatal vitamins with 800 mcg folic acid.  Also take a calcium supplement, or your teeth and bones will start to suffer while your baby is making his/her teeth and bones.  Most prenatals do not provide enough calcium by themselves.
  3. Do not get overheated (whirlpools, saunas, exercising in hot weather, etc.).
  4. Avoid all your favorite illegal drugs.  Check with your doctor before taking over-the-counter medications. If you are smoking, try to stop.
  5. It’s probably a good idea to take fish oil capsules, but check that they have been tested for mercury first.  In general, fish would be good for your baby’s developing brains if it were not full of toxins; you need to be careful what you eat and it is a bit complicated.  The guidelines for which fish are OK to eat are here.
  6. Reduce caffeine consumption to the equivalent of 1 cup of coffee per day.  And I don’t mean one of those Starbucks Grande cups either.  Be very careful with herbal teas, because many ordinary herbal teas such as chamomile or lemongrass are bad news to drink while you are pregnant.
  7. A healthy diet with lots of fruits and vegetables, low-fat protein sources, and unrefined carbs is always a good idea.
  8. If you are feeling nauseous, frequent small meals are a good idea.  If you are feeling really really nauseous then just focus on getting in enough calories and don’t worry about general nutrition.  “Enough” calories is generally about 300 more calories than you would usually eat.  But it’s not unusual, if you have severe morning sickness, not to gain weight or even to lose some in the first trimester.  Your baby won’t starve, it gets first dibs on the nutrients.  But definitely talk to your doctor if you have any concerns or if you’re having trouble keeping food down.
  9. It is generally OK to exercise when you are pregnant, in fact it is a good idea.  Check with your doctor about the limitations they would have for you.  Chicklet has a great post on what generally is/isn’t a good idea when it comes to exercising during pregnancy.

5. It is OK to complain.

If you have been infertile for any period of time you have probably gone through a period of severe annoyance at women who complain about their pregnancies, and thought to yourself “I would gladly trade my infertile state for your nausea, lady” or even “God, if you let me get pregnant, I will not complain about anything.”  Now a miracle has happened, you have your nausea, and you know what?  It kind of s*cks.   Granted, it doesn’t s*ck anywhere near as much as not getting pregnant does, but that doesn’ t make it a walk in the park either.  It is extremely common for infertile women to feel that they should not complain about their pregnancy, that they have to be happy about all the weird things that happen to their bodies and all the discomforts and anxieties that come with it.  This is not my attitude.  Yes, you should probably not expect much sympathy from people who are suffering from infertility, and it would probably be kind to take your complaints elsewhere.  But I don’t see any reason why, just because you got the short stick and had to walk a trail through hell to get to pregnancy, you now also have to draw the short stick and don’t even get to complain.  Complain away, just be sensitive about who you complain to.

p.s. If you don’t believe me, then please ask A Beautiful Day.

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Anxiety and Infertility

It is extremely common for people struggling with infertility to be dealing with high levels of anxiety.   In this post, I look at the relationship between anxiety and infertility from my own personal experience and suggest some coping strategies that I found helpful.  Some of this is about clinical levels of anxiety, but the suggestions included below are intended to be helpful for anyone dealing with anxiety arising from infertility.  You can skip the background and leap straight to the strategies for coping if you want. Please note I am not a doctor, I am just relating my own experiences.

1. What is anxiety?

We all know that women have the tendency to go a bit crazy during IVF cycles.  No surprise – you’ve got insane doses of hormones racing through your system, and you’re generally stressed and worried about whether the cycle will work.   Usually for me, the cycle would be a rollercoaster of hope and fear and terror and hormonal craziness, to be replaced by crushing depression afterwards.  But on my 5th cycle – the last with my own eggs – the overwhelming feelings of fear and terror and craziness never left, even after the drugs were all out of my system.  Uh-oh.

It wasn’t because I was sad it was my last cycle (with my own eggs) – I never wanted to do stims again, I think if my RE had said to me “Great news!  We have a new treatment for you that will have a 100% success rate!” I would still have turned it down, I was that worn out from the whole process.   I had accepted that things were the way they were, and was ready to move on to something new, but I was so continually agitated I wasn’t in any state to move on to anything or even to go to work (fortunately this happened conveniently close to the Christmas holidays).   I started to develop all kinds of nervous tics, which freaked me out even more.  I went to see the doctor, who told me that I was suffering from anxiety and sent me on to a therapist.

Of course, before my appointment with the therapist  I went to Dr. Google to find out what this anxiety business was all about.   Anxiety is often defined as “excessive worry.”  That didn’t sound right to me at all.  I wasn’t “worried” that I was infertile, that my IVF wouldn’t work, or that I would not be able to bear a biological child: these things were simply facts (and anyway, being ‘worried’ about not being able to achieve one of my life’s major goals didn’t seem ‘excessive’).   In any case, I didn’t feel like I was sitting around worrying about anything, I just felt agitated, keyed up, scattered, restless, jumpy, and completely unable to deal with everyday life.  But I didn’t feel anxious about anything.

Nevertheless, the therapist confirmed that, indeed, these things I were feeling were anxiety.   I think a better way to understand anxiety, at least in my case, is as an extreme version of the fight-or-flight response.  If you are continually in situations that frighten you, with no possibility for escape, then eventually you are going to get into adrenalin overload, and that is what anxiety is – worry is more of a symptom than a cause.   The cause is adrenaline overload and a nervous system that has become a hairtrigger for stress, which in turn causes agitation, racing thoughts, and worrying.

2. What is the relationship between anxiety and infertility?

My extensive, yet totally undocumented internet research has revealed a strong link between anxiety and infertility.  Here I’m not talking about the “just relax, you’ll get pregnant” crowd but rather about the fact that after seeking infertility treatment, and especially after a length of time of unsuccessful trying, there is a high rate of clinical anxiety among infertile couples.   If you think about what causes anxiety – being caught in situations that frighten you, with no escape – the reasons are pretty straightforward.  For people who want to conceive, infertility is a huge life crisis, a stressor that can easily trigger anxiety in those disposed to it.   And when you have been cycling for a while, the prospect of life without children becomes a huge, looming danger, and each failed cycle is a desperate, but eventually unfruitful, attempt to avoid that danger.  I began to feel after a while like Sisyphus, pushing a giant rock up a hill with each cycle, then watch it tumble back down again and my task start over.  I told my friends I was on the “Hamster Wheel of Doom”, running, running, running, but never getting anywhere.  It’s easy to see how your system can get overloaded and oversensitive when facing such a seemingly never-ending life crisis.

I suspect, though, that there is another link between anxiety and infertility.  People who are prone to anxiety tend to have certain personality traits in common.  On the negative side, people prone to anxiety tend to be more perfectionist; we tend to seek approval, need to be in control, and drive ourselves regardless of personal cost, ignoring signs of stress.  On the positive side, we tend also to be more creative, intuitive, sensitive, and empathic.  These personality attributes may contribute to more suffering with infertility.  Please note I’m not saying that somehow a predisposition to anxiety causes you to become infertile.  Rather, these personality traits may lead people to (a) feel the losses involved in infertility more acutely (b) to feel a strong compulsion to have children in the way we wanted and imagined or think “ought to be”, rather than in whatever way is possible (c) have difficulty handling the reality that something so important to us is not in our control, despite a strong need to be in control and a long track record of doing so and (d) continue with cycle after cycle despite it causing way too much wear and tear on our psyches and bodies (yes, I know, I am the poster child for this one).  I have friends who TTC’d for 2 months and then said “screw this, we’re adopting,” and others who adopted without any interest in trying on their own.   Although they may be infertile (quite likely, because of their age), these two couples never suffered from infertility.  And you can believe I was jealous of them; although on the surface it looked like joining them would be easy, what I was really jealous of was that they never had to grieve (at least, not about that).

3. What can help with dealing with anxiety during or after infertility?

Here’s some things I found helpful.

Something that really helped me a lot  was The Anxiety and Phobia Workbook, by Edmund Bourne.  This is a giant bible of techniques and ideas which help to mitigate anxiety.  It is really practically oriented, it’s full of concrete activities to try that help both moment-by-moment and in the long run.  I can’t recommend this enough.

One of the most helpful techniques for dealing with anxiety is cognitive-behavioral therapy – i.e. where you identify what you are telling yourself when you are upset, and practice telling yourself things that make you feel better.  You can work on this with a counselor, using the Anxiety and Phobia Workbook mentioned previously, or using the book Feeling Good: The New Mood Therapy.   The basic idea is that when you are feeling bad, stop and write down immediately the thoughts that are coming to mind (e.g. “I will never have kids” – “God must think I would not be a good mother” – “Everyone else can conceive easily.”)  Trust me, if you do this religiously for a few days you will be astonished to see the volume of negativity you are spewing at yourself.   When you have calmed down, write down more supportive and helpful statements that counter what you were saying to yourself previously (e.g. “I will have kids someday, somehow, someway” or “I will make myself a good life, no matter what happens” – “God will help me through this trial” – “Plenty of people have trouble conceiving, and they find a way to survive it”).  Note: the positive things have to be things you can really believe, “I will magically 100% for sure get pregnant on my next cycle” would be nice but you’ll probably find it hard to really believe it.   Practice saying those positive things instead when you notice yourself getting upset and notice how much better you feel.  Pretty soon the more supportive thoughts will become second nature, a way that you can take care of yourself.

It is really important when dealing with a serious emotional crisis not to feel bad about feeling bad.   Many of us carry along a lot of baggage about how we “ought” to be feeling – I “should” be able to handle this, I “should not” be so upset, I “should” behave rationally, etc.  All these shoulds just make us feel worse.  Dealing with infertility is a genuine crisis.  You don’t have to feel bad about not being able to handle it without any emotional upset.  At one point when I was dealing with infertility anxiety, I told my mom about how bad I felt, I was getting hardly any work done, etc., and my mom started saying “that is so terrible, you have to be working now, it is really important for you to be productive,” etc.  I gritted my teeth and said “Mom, that doesn’t help.”  And yet how many times have I said the same kinds of things to myself?  Recognize that you are in a major life crisis and your body is telling you that you need to take the time to deal with it.  And don’t apologize about having that need.

Since anxiety is based on a fight-or-flight reaction, what’s really going on is often that your racing thoughts, behaviors, and actions are attempts to run away from something which is too frightening to confront directly.  Sometimes it helps to sit down and take some time to consciously face the thing you fear.   Be brave and spend some time really experiencing the feelings of sadness, anger, or grief that are welling up in you.  It won’t be fun but… if you give yourself a chance to really feel them it will make it a lot easier for you to move on.   When I’ve done this successfully, I felt an intense sense of catharsis and an immediate improvement in my anxiety symptoms.

Something my counselor always emphasized – and he was right – is the importance of regular exercise.  If you’re feeling anxious you’re running around with a lot of extra adrenalin in your system, and exercise helps to burn some of that off.  If the exercise requires a lot of concentration (e.g. following an instructor in an exercise class, paying attention in sports, or intense exercise like weight training that you can’t do unless you are fully concentrated), it really helps you to get your mind off the stuff you are anxious about for a while.   And, let’s face it, infertility treatments are not kind to your body nor to your waistline, and it can feel really empowering to work on getting fit again – just ask Chicklet.  Note: if you would like to exercise and are near, in, or just after an IVF cycle please read my post on the safety of exercise during IVF first.

In any case, a lot of anxiety is “being in your head” – being preoccupied with the bad stuff that is happening to you, racing thoughts, an inability to mentally slow down.   It can really help to engage in activities that get you out of your head and back into your body again.  That includes exercise, but it can also include other kinds of physical activities, from going to the sauna to dancing to some music you love.  This might sound kind of weird, but during one of my anxiety episodes I got a lot of comfort out of going down to the local stable and scooping poop after the horses.  Whenever I got in a bad way, Mr. Nishkanu would say, “Why don’t you go down to the stable again?”  I’d always come back feeling a lot better.

When you are anxious you are carrying around a lot of muscle tension in your body, and that tension can keep you feeling anxious.  You can short-circuit some of that using progressive muscle relaxation (PMR), a technique whereby you alternately tense and relax different body parts.  There are lots of free mp3’s on line that guide you through PMR (see for example Dr. Todd Finnerty’s site), you can download some and see what works best for you.  PMR works best to lesten your overall anxiety if you do it regularly, 1 or 2 times a day.

If you are having trouble calming down because of racing thoughts, this site has an excellent description of the “Stop Sign” method of consciously blocking your racing thoughts.    Another excellent practice to get into which will help with racing thoughts is meditation.  I am terrible at this but that is why I need it so badly.  In principle meditation is pretty simple, you can just close your eyes and notice your breath going in and out.  And when I do that?  In 10 seconds I am off on the monkey-mind thought train, wallowing in my worries again.  15 minutes later I remember “oh wait, I wanted to meditate.”  What I found really helpful was the guided meditation recordings available (free) on The Meditation Podcast. Just plop one into your mp3 player, plug in your headphones, and off you go.  The ‘guided’ aspect helped to keep my mind from wandering.  The podcasts are part of a whole series that teach you to meditate.

If you are in or just coming off of treatment and/or a miscarriage, remember that your body is grappling not only with a lot of stress but also with a very strong flood of hormones. These hormones amplify any emotional reactions that you are already having to your bad situation.  It helped me when grieving a miscarriage, for example, to remember that once the HCG washed out of my system and the progesterone wore off, I would automatically start feeling a bit better.

If things are getting out of hand…

I found counseling incredibly helpful.  In my early days of counseling I went a couple of times to a counselor who specialized in infertility.  She was not very helpful, I got a lot of stories about other people who had trouble conceiving but got knocked up quickly and the classic  “you have to relax or you won’t get pregnant”.  Later I found a counselor who knew little about infertility or infertility treatments but was smart, sensitive, and experienced in dealing with anxiety.  He was happy to be educated about the treatments and their implications and ‘got’ the emotional issues instantly (unlike the fertility-experienced counselor, who seemed to get the lingo but not the emotions) and gave really practical, useful suggestions for how to feel better.

In my worst days I was very happy that my doctor had given me some medication for anxiety.   The stuff pretty much knocked me out and it was not the kind of stuff you want to be on all the time but when it got out of control and I couldn’t take it any more it was nice that I could get a brief break from it for a while.  Just knowing I had it and if I got into an emergency I could use it was already a huge comfort.

I am very sad to say this, but if you are hoping to adopt from China in the near future, before you seek a doctor or therapist you should be aware that under the current rules, you will be ineligible for adoption with a ” Current diagnosis of depression or anxiety or currently on medication for depression or anxiety. If you were previously diagnosed with depression or anxiety, you must be off medication and recovered for at least 2 years.”   In my humble opinion, you should not allow this to hold you back from treatment though if you need it.

Did I get something wrong?  Do you find other coping strategies useful?  Please add in the comments below.

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