Fertility, Pregnancy & Post-Partum issues

I counsel women, men and couples
• Considering fertility treatments
• Dealing with failed treatments
• Considering or using donor sperm/eggs, third party carrier
• Considering or going through the process of adoption
• Processing the possibility of living life without children
• Experiencing pregnancy/prenatal anxiety and depression – learn to manage symptoms during pregnancy and cope with issues related to expectations and adjustment
• Dealing with post-partum depression and/or anxiety
• Adjusting and transitioning to parenthood
• Coping with pregnancy loss
• Single-mother pregnancy and parenthood/same sex parents

The Psychological Impact of Infertility

Dealing with feelings of anger, shame, disappointment, and failure are common. These feelings may in turn disrupt partners’ communications and their capacity to cope effectively. In addition, individuals and couples have to make difficult medical decisions and feel overwhelmed by treatments which take time, drain financial resources and are experienced as invasive.

Individuals going through fertility treatments may also feel depressed, anxious, and isolated and may feel they cannot share their experiences. They may experience strained relationship with their partner as well as levels of stress that may interfere with daily functioning. In addition, pregnancy loss is often experienced as traumatic and may lead to depression, anger, and hopelessness. Considering adoption can also be a difficult decision for many, as can considering the use of a donor egg/sperm or of a third party carrier.

The Role of Psychotherapy for Those Dealing with Fertility Issues

Psychotherapy can be of great help to those confronting fertility issues. Psychotherapy can help such clients cope with complex and difficult emotions as well as help them manage stress levels and reduce depressive and anxiety symptoms. Psychotherapy can also provide such clients and couples with support as they undergo intrusive and overwhelming medical treatments. For many, therapy can be helpful when they are at a crossroads, when fertility treatments are not successful, and when adoption or third party assistance (egg/sperm donation, surrogacy) may be needed.

Instead of letting infertility become an obstacle in life, I believe that the tremendous challenges presented by fertility issues can serve as avenues for personal growth, and for stronger and healthier relationships. For many, learning how to cope with the stress and the feelings associated with fertility issues can ultimately improve clients’ quality of life and help alleviate the pressure to get pregnant.

Anxiety and Depression During Pregnancy

Many women who have a history of anxiety and or/depression may experience heightened levels of these symptoms during pregnancy. They may worry excessively about issues such as the health of the baby, their own health, their relationships, etc… They may have difficulties coping with feeling physically unwell or may feel stressed and overwhelmed. They may have difficulties coping with the impending changes in their lives and their relationships and may feel ambivalence about the pregnancy. Often times, parents need to consider changes in areas of work and career; and need to process issues related to other aspects of their identity. Women who experience depression during pregnancy often feel guilt and shame, as they feel they should be excited. Worries during pregnancy are normal, however, if they become intrusive and disrupt daily activities, seeking treatment is important. Excessive stress and anxiety can be harmful in some cases to both mother and fetus. Many pregnant women choose to discontinue taking medications they were previously taking for anxiety or depression. Psychotherapy can help with depressive and anxious feelings during pregnancy, and reduce symptoms during pregnancy. Therapy can help in emotional preparation and in maintaining overall well-being.

Post – Partum Depression and Anxiety

Post-Partum depression and anxiety may potentially have a long lasting negative impact on both mother and child, and therefore, early treatment is so valuable. Individuals who experienced depression and anxiety before pregnancy are at higher risk of developing post-partum depression. Going through tremendous adjustment after the birth of a child is common; however, feeling depressed, overwhelmed, and anxious can have a negative impact on both mother and baby if not dealt with promptly. At about 50% (or more) of women experience the “baby blues”, which usually begins 1-3 days after delivery and the new mother may experience sadness, fatigue, irritability, frustration, doubts about mothering skills, etc..These symptoms usually disappear by two weeks.

Postpartum depression and anxiety on the other hand, may last for a longer period of time and can appear anytime during the first year after birth. Self doubts about mothering may follow, as well as feelings of guilt, worthlessness, thoughts about harming the baby or oneself. Panic and anxiety may be more prominent, as well as difficulties sleeping despite being sleep deprived due to newborn demands. At about 10% of women experience PPD. Post-Partum psychosis is very rare and includes hallucinations and delusions. This condition calls for immediate help in order to assure the safety of mother and baby.

Post-Partum depression may interfere with the ability to and bond with the baby and become emotionally attentive. Mothers may feel so overwhelmed that they have difficulties trying to sooth the infant. Parents who have infants with colic (who are difficult to soothe) may be at higher risk.

Psychotherapy can have tremendous benefits such as working through the process of
bonding, building greater competency as a parent, renegotiating relationships, and adjusting to new roles and lifestyle. Parenthood and the parent-child relationship can trigger many old and patterns, trauma and other issues, and psychotherapy can help in resolving these issues and in becoming a more mindful and aware parent.

Services Offered

• Consultation and Evaluations
• Individual Psychotherapy for older adolescents and adults – Long and Short-Term
• Conjoint patient/family/partner sessions as indicated
• Consultation and counseling for family members
• Coaching
• Career Guidance and transition/life transition
• Supervision and consultation to other mental health professionals

Demographics: I work with adolescents and adults and with individuals from diverse ethnic background and
and sexual orientations. I provide services in both English and Hebrew and provide psychotherapy to Jewish
and Orthodox patients

Treatment Modality:
• Psychodynamic Psychotherapy
• Cognitive Behavioral Treatment (CBT)
• Interpersonal Psychotherapy (IPT)

Issues

• Anxiety (panic, social anxiety, general worry and fears)
• Depression (including Pre and Post Partum Depression)
• Relationship issues, difficulties with forming relationships or having healthy relationships.
• Unhealthy and impulsive coping and behaviors
• New mothers/New parent support
• Fertility counseling
• Adjustment to life changes
• Trauma
• General life dissatisfaction
• Acceptance of treatment
• Coaching and career/life change
• Develop higher self worth and build confidence and mastery

Fees and Insurance

I accept insurance as an out-of-network provider and can bill most insurance
companies directly on your behalf.  Generally you will get reimbursed within 2-3 weeks of claim submission.
Your out-of-network coverage may range from 50-100% after the deductible was met. You may want to call
your insurance and ask what is your coverage for mental health outpatient services. Fee is due at the time
of your appointment and is payable by cash, checks, and most credit and debit cards. Sliding scale of full fee is
available for a selected number of individuals with poor insurance coverage and financial need.