Enjoy!

Highly recommended, and the price (free) is right!

Copyright © 2009 The Psychology Lounge/TPL Productions/Andrew Gottlieb

Even pure psychological stress can affect fertility. Here’s the biological mechanism. A few hours before ovulation, the pituitary gland sends out luteinizing hormone (LH), which tells the ovaries to release an egg. But if you are experiencing psychological stress such as a fight with your husband, or a dressing down from your boss, or a kid having a tantrum, then your LH will be suppressed, disrupting ovulation.

Even mild stress may have a big effect. One study of monkeys found that moving monkeys to a new cage, combined with a little less food and 1 hour on treadmill caused 70 percent of the monkeys to have irregular menstruation! So don’t skip that meal and take a long run when stressed, or you’ll greatly lower you odds of getting pregnant.

What’s worse is that IVF treatment itself may lead to large amounts of psychological stress. One fertility expert found that 40 percent of women in infertility treatment had all of the symptoms of an anxiety disorder or depression: sleep disturbances, difficulty concentrating, and irritability. So if stress lowers fertility, and fertility treatment increases stress, then fertility treatment may actually harm fertility!

But cognitive behavioral therapy may improve the situation. Alice Domar and colleagues at Harvard found that a 10 week cognitive behavioral group therapy program improved the success of fertility treatment from 20 percent to 55 percent in the women who participated in the group therapy. So what can we learn from this research?

1. A woman’s body is wise. It will respond to behavioral and psychological stressors by lowering fertility. Anything that resembles stress, even hard exercise, will trigger physical responses that lower fertility.
2. At critical points such as several hours before ovulation, even normal stressors can disrupt the ovulation process. And in stress-prone or perfectionist or angry women, the likelihood of experiencing stress during these critical hours is very high. Thus for women who are experiencing difficulty getting pregnant and who by personality are “stressy” (you know who you are!) cognitive behavioral therapy (CBT) will be helpful in learning to manage and lower stress.
3. Infertility treatment is by its nature stressful, and this leads to a paradox; infertility treatment may lower fertility if it increases stress. It may be helpful to evaluate stress levels in women undergoing IVF and if stress is high, intervene with CBT group or individual therapy.
4. The ultimate in infertility treatment may be what I recommended to my friend Jill, who had tried many cycles of IVF to no avail. I told her, “You’re young, why don’t you and your husband stop trying to get pregnant, and just have sex for fun, and enjoy life for a few years. If nothing happens then you can adopt.” She was pregnant within the year, and now has two lovely children. A good long relaxing vacation with no schedule, no hard exercise, healthy food, and no stress may be the best fertility treatment available, and even if it doesn’t work, at least you’ve gotten a great vacation!
5. Finally, what this research shows us is how linked our minds and bodies are. Changing thoughts and feelings and behaviors changes our bodies, and fertility is just one example of this.

Copyright 2007 The Psychology Lounge/TPL Productions

What is depression, anyway? Is it the same as feeling sad? No. Depression is not just feeling down for a day or two. The diagnosis of depression is based on having certain symptoms.

Two key symptoms are depressed mood, which is feeling sad or blue, and difficulty experiencing pleasure or joy, which is sometimes called anhedonia.

Other symptoms of depression are problems sleeping, changes in appetite (more or less), feelings of worthlessness or guilt, problems concentrating, fatigue or low energy, mental/physical agitation or chronic worry or slowing, and having thoughts about suicide.

To have major depression, you need to have at least five of these symptoms, including one of the first two, depressed mood and anhedonia. And the symptoms have to last at least two weeks, and cause you some discomfort and impairment in your functioning.

The exception is mourning or bereavement, which can cause the same symptoms, but doesn’t count as depression. So if your mother has died and you have these symptoms, don’t worry.

Depression Screening Checklist

Instructions: Check any symptoms that you have been troubled by and that has lasted for the past two weeks.

Category A

___ I have felt sad or blue or depressed

___ I have had a hard time feeling joy or pleasure, even while doing activities that typically bring me joy or pleasure. I feel “flat”.

Category B

___I have had a hard time concentrating.

___I have felt tired or low energy.

___I have had difficulty sleeping (sleeping too little or too much)

___I have had changes in my appetite (eating too little, or too much).

___I have felt mental/physical agitation or slowing down.

___ I have felt worthless or guilty or lowered self-esteem.

___I have had thoughts about death or suicide or hurting myself.

Scoring:

Count the number of checks in Category A. Write that here:____

Count the number of checks in Category B. Write that here: ____.

Add up the number of checks in Category A and Category B, and write that here: _____.

If A is 1 or 2, and the sum of A and B is 5 or more, you have major depression, and should seek help from your doctor or from a psychologist. If A is 1 or 2, and the sum of A and B is 3 or 4, you may have mild depression, and should probably seek help as well.

IMPORTANT: If you are having any thoughts about hurting yourself or killing yourself, you should seek help immediately, calling your local suicide prevention line (listed in the front of your phonebook), or calling 911, or seeing your doctor or a psychologist right away.

Copyright 2006 The Psychology Lounge/TPL Productions