While things seem to be slowly returning to normal in SA, the constant reminders to practice “social distancing” along with business closures and treatment cycle postponements can start create uncertainty about the future. The lack of control that comes with these periods of instability can result in feelings of fear, anxiety and despair.
Feeling anxious is a very normal response to the highly unusual circumstances we find ourselves in at the moment. Many of us have had these periods of uncertainty in our lives, or times where we feel like we are up against challenges or loss. It may feel like all of your vulnerabilities are coming to the surface. It can be common to play out the worst-case scenario in our minds, especially thoughts related to future health and fertility.
Below is a toolkit of coping strategies that you may find useful to manage feelings of anxiety or stress and help you feel more in control. These strategies can be used now or at any point in your life where you might need to re-center and take more care of yourself.
Stay informed, but set limits on media coverage
The current COVID-19 crisis has had many of us watching the news a lot more than normal. While it is important to stay up to date, it can also lead to a lot of stress and anxiety, especially when there is a lot of negativity. In order to stay informed without feeling like things are out of control, some of the following ideas might help:
- Select a few credible outlets as trusted sources of information. Most of our stress and anxiousness is due to a lack of information, wrong information, or both.
- Remember that many media sources focus on the scary headlines to draw you in. There are still good stories out there, so try to focus on them.
- Limit yourself to a few updated from these sources each day (preferably not right before bedtime). Hearing about the news topic repeatedly can cause distress.
- While you will want to stay updated, make time away from the news to focus on things in your life that are going well and that you can control. This can include things like meditation, breathing exercises, physical exercises or practicing self-care (however that might look for you) so you aren’t tempted to turn back to the news.
Establish routines and make a plan
You might be feeling a little lost without your normal schedule if you are working from home. It can feel disjointed and unnatural to not have any structure, such as getting up for work, going to the gym or attending meetings or social events. As restrictions continue to ease, this will become less of an issue, but it highlights the fact that it is important to provide yourself with as much structure as you can. Wake up at the same time each day, have a shower, get dressed and keep the same, or similar, work hours daily. This includes eating your meals and finding a way to exercise at a similar time. If you have regular social connections, you might need to find a creative way to keep them going online or change the way that you meet up.
Stay connected with people
Staying connected to friends and family is one of the best ways to reduce anxiety, depression and loneliness through the infertility struggle, as well as social distancing and isolation. Remember that social distancing and the restrictions at cafes, pubs and restaurants are the new temporary normal, so staying connected may take some planning and creativity.
Use the telephone, email, text message and social media to connect with the people you love and care for. Try to not only have conversations about your feelings, whether it be about the outbreak or your fertility journey, but also completely unrelated topics (albeit not easy). Connecting visually using Skype or Zoom still allows you to share hobbies, or to get together for food and drinks.
While connecting with others is one of the best buffers of distress, also know that it’s OK to give yourself permission to have time alone in a tranquil space just for you, especially if you are living with a partner, parents or roommates etc.
Practice a breathing or relaxation technique
One of the best ways to decrease anxiety is to learn and practice breathing and relaxation strategies, since they work right away, in the moment. The easiest way to do this is to download free apps. Some trusted and reliable examples include the MindfulIVF App, Mindfulness App, Calm or Headspace. If you practice daily, you will notice immediate relief, and after a week or two you should start to notice that your overall stress levels begin to decrease.
Set boundaries - it's OK to say no
In times of crisis, we often feel the need to help those around us. Whether it is requests to donate money, volunteer, work extra shifts or care for others, think carefully before you commit yourself. It can be a good feeling to help others as it tends to make us feel less anxious and overwhelmed when we focus on a task. However, choose carefully what will make you feel good and what you can fit into your life. It is also very important that you maintain a solid self-protection zone.
Take care of your body
When we are stressed, we tend to seek things out that help us feel better, and while there is no harm in indulging momentarily, long term this can contribute to us feeling worse. Try to maintain a regular exercise regime and focus on an 80/20 eating plan where 80% if what you eat and drink will nourish you (water, fruits and vegetables, fish, nuts and whole grains) and the other 20% can provide some of those comfort moments, but without the guilt.
If you are actively in treatment or trying to fall pregnant on your own, follow your doctor’s recommendations to maintain healthy lifestyle habits. This frequently includes limiting alcohol consumption, coffee intake, stopping smoking, working to keep your BMI in a healthy range and moderate exercise regularly. No matter what stage you are at in life, staying healthy can help you feel stronger emotionally and physically, and have you ready to handle any situation that arises in the future.
Practice good sleep hygiene
One of the biggest culprits to interrupt our sleep is stress. Many of us don’t realise that when we are sleep deprived we feel irritable, stressed and sad throughout the day. Learning good sleep habits can significantly improve your sleep quality and thus your mood.
Here are some tips that can help:
- Limit caffeine in the late afternoon and evening, as well as alcohol intake at night. Caffeine can affect your ability to fall asleep, while alcohol tends to interrupt our sleep later in the night/early morning.
- Regular exercise can help improve sleep quality, however, try to avoid this right before bed.
- A regular night-time routine (i.e. reading, meditating, taking a bath) and get up at the same time each day, even if you are working from home. Try to avoid using devices 30 minutes before going to bed. Try not to do work or watch the news/a tense TV show in bed so that your body associates your bed with relaxing and sleep.
- You can’t reverse sleep deprivation with daytime naps, so if you feel tired during the day, limit napping to no more than 30 minutes. A brief walk, stretch or change of scenery can help you feel re-energise.
Maintaining hope and balanced thinking
It’s hard enough to stay hopeful, control negative thoughts and stay positive along the fertility journey. Adding a world pandemic and social distancing didn’t make this any easier! Although difficult, it’s important to try and learn to catch yourself when you start to have negative thoughts. You can challenge negative thought patterns by asking yourself, “Is this thought contributing to my stress?” If the answer is yes, then try to find a way to distract yourself from that thought (see sections on relaxation, breathing, staying active and connected) or restructure the it to come up with a more realistic and balanced thoughts rather than all-or-nothing thinking. Focus on the things you can control and know that if you reach out for support, you will find people who understand.
Practice self-care and activities that bring joy
During stressful times, it can feel natural to be angry with the world, yourself and/or your body. Many people experiencing stress related to seemingly uncontrollable situations stop doing nice things for themselves. The opposite is actually true, as this is a really important time to nurture yourself. In times like these, although there are still a lot of things largely out of our control, often we can still choose how we spend our time. By nurturing yourself, you reclaim your power to make yourself happier and to be more in control of your body and mind.
Some suggestions include:
- Making a list of 20 things that make you happy (from reading a book to taking a walk) and start to incorporate items on that list into your daily life as a reminder that you matter and deserve to feel good.
- Pace yourself between stressful activities and reward yourself after the hard task.
- Write your feelings and emotions down on paper to see if things start to feel a little lighter.
- Keep a gratitude journal to shift negative thoughts and help you maintain a sense of hope.
It’s OK to ask for help
Situations like the current pandemic can trigger other times in your life that you felt out of control, like a struggle with infertility or a previous trauma. Try to be aware of these triggers and get the support you need. When times get tough, practice patients and compassion, not just with others but most importantly, with yourself.
How do you know when it is time to reach out for professional help? Ask yourself some of the following questions:
- Have you lost interest in activities that used to make you happy?
- Do you find yourself unable to think of anything other than the stressful situation?
- Are you isolating yourself more than you used to (not connecting with others in your home, virtually, or by phone)?
- Do you have more difficulty with others in your life, such as your partner, family, friends or co-workers?
- Are you feeling bitter, guilty, worthless, hopeless, or that you are being punished?
- Are you having trouble getting a good night’s sleep, sleeping too much, or are there changes in your appetite?
- Are you feeling the desire to use alcohol or drugs to cope?
- Are you experiencing intrusive distressing memories, flashbacks (reliving an event), nightmares, or are you easily startled?
If you experience any of these reactions more often than not, and for an extended period of time, contact your GP to get support and a referral to the right health professional. If you are undergoing fertility treatment with us, a professionally qualified counsellor is available to offer confidential support during times that can be emotionally demanding.
Want to find out more?
If you have any further questions about the information provided above, you can arrange a nurse chat with one of our fertility nurses.
For up to date health and wellness information on how to increase your chances of conception, check out our fertility news page, or download our e-book below.
*This information was adapted from an article provided by Ferring Pharmaceuticals, written by Dr Alice Domar and Dr Elizabeth Grill. The information provided is based on recommendations made by these authors. Image credit @kinga_cich.