Dr. Deborah Simmons will be speaking at the annual conference of Resolve, the National Infertility Association on April 21st at Calvary Lutheran Church in Golden Valley, MN.  She will be speaking on gestational surrogacy, depression and infertility, and decision-making about ending treatment.  Join with the Resolve community for information on Western and holistic fertility treatment and adoption.  For more information, go to Exploring Paths of Hope: 28th Annual Infertility and Adoption Family Building Conference

It is not surprising that many women and some men suffer from depression and anxiety when faced with fertility challenges.  The ups and downs of infertility and its treatment drain the spirit right out of people.   I hear daily the intensity of the experience, “This is personal.  I feel invisible in the world.  This is physical.  I hate my body.  I am demoralized and afraid.  This is expensive.  I have no control and I feel out of control.  This has taken over my life.  I’m so worried about my relationship.” 

Some women have mood consequences from using birth  control pills and ovarian stimulation medication, on top of the fear of not having a child.  For many of the people I see, the following “formula” captures their experience: 

Uncertain Outcome of Procedures + Uncertain Length of Time + Internal/External Pressure + Medications + Fear = DEPRESSION and ANXIETY. 

It is important to distinguish between depression and grief when dealing with fertility challenges.  Grief hurts but it does not lead the thinking process toward self-hatred and negative thinking.  Depression is a heaviness all its own. 

Help is Available at Partners in Healing

Our integrated fertility team at Partner in Healing can help.  We provide:

1. Specialized counseling for individuals and couples who are suffering from fertility challenges, that includes hypnosis, cognitive behavioral therapy, and EMDR (Eye Movement Desensitization and Reprocessing); 
2. Acupuncture and Chinese medicine;
3. Naturopathic medicine and nutritional counseling; and
4. Medical massage aimed at reclaiming your body from the rigors of treatment.  We collaborate with national and local leaders specializing in fertility treatment. Let us help you regain your sense of wholeness and rebuild hope as you build your family. 
   

By Deborah Simmons, PhD, LMFT

by Deborah Simmons, PhD, LMFT

As Fall approaches, some households will see the youngest in the family leave for college or for independent living.  For parents who have enjoyed the chaotic pleasure of raising children, the transition to an Empty Nest can bring many emotions and reflection.  Grief, pride, fear, and relief can sit right next to each other. For some marriages, the needs or stresses of parenting have overshadowed the marital relationship.  The transition to the Empty Nest can raise questions and even concerns about what comes next.  Just as young adults have many new experiences in their exploration away from the nest, parents and marriages can find new areas of exploration. 

Here is a list of questions that our team at Partners in Healing have developed to help guide reflection and awaken curiosity about this transition to the next phase of life.  We wish you a smooth transition.  If you find that you have deeper concerns or need more guidance, come see us here at Partners in Healing.  Contact us at 763-546-5797 or info@pih-mpls.com.

• Who am I now at this stage of my life?  
• Where have I/we just been?
• What has parenting been like for you/me/us?
• What did I/you miss for all these years?
• What has been joyful or enjoyable in those years?
• How are I/you different now than before having children?
• What are I/you/me looking forward to now?
• What are I/you/we passionate about now?
• What has not been said in our relationship?  
• How do I/we find passion again?  
• What are our expectations of ourselves and each other now?  
• What are my/your/our dreams now?  
• What are my/our life goals now?  

 (Brought to you by Deborah Simmons, PhD, LMFT)

I have long wondered how nutrition affects our fertility.  This study from The Journal of Reproductive Medicine lends credence to the notion that our high-carbohydrate diet may well explain why some women suffer from unexplained infertility.  My colleagues at Partners in Healing, Dr. Nate Champion and Dr. Nita Champion, specialize in naturopathic medicine and nutrition.  Contact us at 763-546-5797 or info@pih-mpls.com for a holistic team approach to fertility treatment.

Increased Celiac Disease Prevalence in Women With Unexplained Infertility

ScienceDaily (Aug. 18, 2011) — A recent study demonstrated increased rates of celiac disease in women who present with unexplained infertility.

Published in the May-June 2011 issue of The Journal of Reproductive Medicine, the study evaluated 191 female patients presenting with infertility. Each participant underwent serologic screening for celiac disease as well as routine infertility testing. The 4 patients who had positive serum test results were advised to seek evaluation with a gastroenterologist. All 4 patients were confirmed to have celiac disease. They then underwent nutritional counseling to change over to a gluten-free diet.

Among the 188 patients who completed testing, the prevalence of undiagnosed celiac disease was 2.1%. While this rate was not significantly higher than the expected 1.3%, the diagnosis of celiac disease in women with unexplained infertility was found to be significantly higher at 5.9% (3 of 51 women). Interestingly, all 4 patients found to have celiac disease conceived within a year of diagnosis.

Though the study numbers are small, the findings suggest that, at least for some women with infertility, dietary measures may help bolster fertility. "Diagnosing celiac disease in an infertile woman would be particularly beneficial if the low-cost (and low-risk) therapy of pursuing a gluten-free diet could improve chances for conception," says lead author Janet Choi, MD, a reproductive endocrinologist at the Center for Women's Reproductive Care at Columbia University. Co-author Dr. Peter Green, director of the Celiac Disease Center at Columbia University Medical Center, said that these results should be added to the increasing body of knowledge concerning the impact of undiagnosed celiac disease on women's reproductive health.

Brought to you by Deborah Simmons, PhD, LMFT

Today's article in TIME Healthland on miscarriage and depression validates the experience of many of my clients.  Women, and often men, feel so misunderstood about miscarriage and how waves of pain can come, long after a healthy baby is born.   Please don't try to fix it, or ask if someone is over a miscarriage.  They are not over it, just living through a struggle that hangs around for a long time.  Please don't promise that they will have another a baby.  We cannot make such promises.  Compassion and just listening go a long way.  

Images.com/Corbis

By Bonnie Rochman Tuesday, March 15, 2011

When a woman miscarries, it's typically far more hurtful than helpful to say something like, “At least you have other children.” Now, new research backs that up and goes a step further, finding that even women who go on to welcome a child after a miscarriage or stillbirth report prolonged depression and anxiety surrounding their loss.

“We kind of assumed in the academic world that if you have a healthy baby, everything would be fine,” says Emma Robertson Blackmore, the lead researcher and an assistant professor of psychiatry at the University of Rochester Medical Center.

Each year, about 1 million U.S. women endure a miscarriage or stillbirth. Up to 80% of those women get pregnant again, but researchers found that nearly 13% of women who had a miscarriage or stillbirth before delivering a healthy baby still had symptoms of depression 33 months after the birth. Of those with two previous losses, almost 19% of new mothers had symptoms of depression within that same time span, according to the study published online this month in the British Journal of Psychiatry. The researchers tracked 13,133 pregnant women in the United Kingdom who were participating in the Avon Longitudinal Study of Parents and Children. They were screened for depression and anxiety throughout their pregnancy and after giving birth. Most reported no miscarriages, but 21% said they had experienced at least one.

The findings are significant for clinical care. Typically, women are flagged for potential postpartum mental problems based on a previous history of depression or a lack of social support. “But we never thought of flagging women who've lost a pregnancy,” says Robertson Blackmore.  It's expected that women who've suffered a loss might be more anxious in subsequent pregnancies, especially up until the point at which they lost the pregnancy. “Say you had a miscarriage at 15 weeks,” says Robertson Blackmore. “You can imagine until you get to that point, you think, Oh, my God, is everything going to be okay?
“After that point, we really expected symptoms of depression to decrease,” she says, “but they didn't.”

In fact, multiple losses only compounded feelings of despair. Women who lost two or more pregnancies experienced depression more frequently than those who'd lost one; of those who'd lost four pregnancies, 22% reported experiencing depression three years later.  Some of the depression may stem from the inept way in which others can react to miscarriage. People say well-intentioned but insensitive things, or they worry about saying the wrong thing, so they say nothing at all.

“With advancing medical knowledge, everyone assumes pregnancy is going to go well,” says Robertson Blackmore. “When that doesn't happen, it strikes fear in a lot of people. It's so common, but people don't know what to say.”

(Brought to you by Deborah Simmons, PhD, LMFT)

While depression is challenging, there are any number of ways to treat it.  One of my clients recently shared this poem with me when she was in the grip of severe depression.  Her creativity became a touchstone and helped to lift her out of years of depression.  She asked that I share this poem with you.  Please feel free to share it with others.  She is thriving, by the way.  You can, too. 

For a time the world was black and white, right or wrong, true or false…
Then along came humanity, with each diverse individual truth and story.
Coloring false with layers of truth.
Deepening the hues of right and wrong.
Clinging to black and white stories was more and more challenging and  difficult in a polychromatic world.
Beauty—Humanity—Truth
are never monochromatic.

Poetry, photography, scrapbooking, painting, use what you have and find the creative spark that lives within you.  And contact us at 763-546-5797 or info-@pih-mpls.com if you or someone you know is needs help with depression.  We can help. 

Brought to you by Deborah Simmons, PhD, LMFT

This article by Dina Roth Port speaks to the secrecy that surrounds fertility challenges.  Many of my clients suffer silently through fertility treatment, feeling misunderstood and alone.  The yearning to be a parent is painful enough without the silence of shame.  If you are suffering, please know that there is help.  RESOLVE and the American Fertility Association are excellent sources of help and contact.  And come see me and our fertility team at Partners in Healing for compassionate help. 

Infertility: The Disease We Need to Start Talking About

Dina Roth Port

Silence might be golden in some circumstances, but in the case of infertility it has been downright destructive.

Recently RESOLVE, one of the only organizations dedicated to infertility, made a bold announcement on its website: "People with infertility are being ignored." I always knew that insurance coverage for treatments such as in vitro fertilization (IVF) is scant at best, and that many doctors still don't treat infertility as a major health issue. I've learned that blatant misconceptions persist when it comes to our reproductive health. And it's no secret that the media doesn't cover this subject as often as it should.

However, what I didn't realize is that infertility patients' reluctance to discuss their struggles and advocate for change is directly preventing those affected from getting the support and funding they deserve. As Barbara Collura, executive director of RESOLVE, explains, "Infertility is not being discussed in the general public health realm -- it's not taught in health classes, it's barely touched upon in medical schools, and it's not a priority of any government entity. Yet how can we expect health care providers, educators, our government, and insurance companies to pay attention to infertility when the patients themselves aren't even talking about it?"
Why the silence? People battling infertility are certainly not alone -- a staggering one in eight couples face it -- yet many feel like it is an extremely personal matter not to be shared with anyone but anonymous women and men on message boards. Some say they feel shame for not being able to procreate or for having faulty plumbing, so to speak. Also, in our somewhat still Puritanical society, we've been brought up to believe that sex is a private matter. Discussing it in some circles, even when it pertains to a medical condition, is taboo.

Of course, not everyone feels that way. For instance, while plenty of celebrities would never admit having gone through IVF (even when so many give birth to twins in their 40s), Giuliana Rancic has helped break the mold by publicly sharing her fertility battle via her reality show Giuliana & Bill. "We had signed on to do this show and when we started having trouble getting pregnant, we decided we were going to be honest and reveal what was really going on," says Rancic, who suffered a miscarriage last year after undergoing IVF treatments.

The result of her candidness was both surprising and inspiring. "I started getting up to 100 emails a day from people telling me that I helped them because hearing my story made them feel less alone and ashamed," Rancic explains. "I was shocked by the fact that so many people go through infertility because so few talk about it. And while experiencing it myself has been more difficult than I could have ever imagined, I've found there really is a comfort in numbers."

However, Rancic is still in the minority: It seems that for most men and women facing infertility, it's easier to deal with something so emotionally, physically, and financially draining without having to field questions and opinions from every well-meaning friend, co-worker, or family member. Such comments like "Just go on a vacation, relax, and you'll get pregnant," or "You can always adopt," are far too painful to even acknowledge, so people figure that by remaining silent they'll avoid opening themselves up to such commentary in the first place.

It doesn't help matters that there's no general consensus on how to label infertility. In 2009, the World Health Organization officially defined infertility as a disease. Yet many individuals, organizations, and insurance companies still say that having children is a lifestyle choice and that infertility is not a serious medical issue. Some even liken fertility treatments to cosmetic surgery. But ask the millions of couples desperately trying to get pregnant whether or not having children is a necessity. Why would they subject themselves to months or years of such turmoil if, to them, it weren't essential that they try?

Certainly, there are plenty of valid reasons while this secret exists, but it needs to end. Thirty years ago, breast cancer was where infertility is today -- women just didn't talk about it (a topic I touched upon in a recent blog post). There weren't countless support groups, fundraising walks, and an entire month enveloped in pink. Women battling breast cancer did so in silence and, in turn, many felt isolated and ignored. However, now because there is such an international dialogue about the disease, breast cancer receives multi-million-dollar grants each year in research funding and patients are inundated with an outpouring of support and understanding.

Other cancers, AIDS, and many other illnesses follow the same path from shame to global support and advocacy: Once people start talking about it, the awareness, funding, and answers follow. "The silence is one of the key reasons why the infertility movement is not where it should be," says Collura. "By people speaking out and letting the world know that these are real issues affecting real people, that would impact advocacy, public education, and public policy."

What will it take to bring infertility out of the closet, so to speak? Possibly it would help if more celebrities like Giuliana Rancic came forward and if the media started covering the topic more extensively (as SELF magazine did with a groundbreaking piece on the subject). Maybe we need thousands of infertility patients and advocates to come to Washington D.C. for their Advocacy Day on May 5th rather than a few hundred like in years past. Or perhaps we just need the domino effect -- once a few people experiencing infertility open up, more will follow suit.

I don't know what the magic ingredients are that will take infertility from an issue no one talks about to a banner "pink ribbon" type of cause. The bottom line is that far too many people are suffering. But by suffering in silence, the stigma persists and the advances we need to overcome infertility will never become a reality. As Collura points out, it starts with those struggling with infertility saying, "We matter."

And when they do, the rest of the world must start listening.

Dina Roth Port, a freelance writer for publications such as Glamour, Parenting, and Prevention, is author of Previvors: Facing the Breast Cancer Gene and Making Life-Changing Decisions.

Dr. Deborah Simmons will be speaking on "Lessons in Love" with the St. Paul Mothers of Multiples club on February 10, 2011 at 8 pm.  Anyone with lovely lessons to share is welcome to email at Dr. Simmons at info@pih-mpls.com or share them on Facebook at "Partners in Healing of Minneapolis." 

Dr. David Alter and Dr. Deborah Simmons are currently taking a master class in hypnosis with internationally known psychologist and marriage and family therapist, Dr. Jeff Zeig.  Dr. Zeig is the Founder and Director of the Milton H. Erickson Foundation in Phoenix, Arizona.  Dr. Zeig conducts hypnosis and psychotherapy workshops internationally and has edited, co-edited, authored, or coauthored more than 20 books that appear in twelve foreign languages. His current area of interest is extracting implicit codes of influence from various arts, including movies, music, painting, poetry and fiction that can be used to empower professional practice, and everyday communica-tion.  Interested in clinical hypnosis?  Call PIH at 763-546-5797.