Vaginismus: Mental Health Support & Coping Strategies

What is Vaginismus?  

Something to do with the vagina?   

Yup! Vaginismus is when the muscles around the vaginal area tense up involuntarily whenever something tries to go in, be it a tampon, a penis, or even during a pelvic exam. Vaginismus tension can cause discomfort or pain, making penetration difficult or even impossible. It’s a condition that can affect intimacy and sometimes reduce sexual desire because let’s face it, pain and pleasure don’t exactly go hand-in-hand.  

Shhhh! Are You Too Shy to Talk About It?  

We get it—talking about vaginas isn’t everyone’s idea of light conversation over kopi. But here’s a surprising fact: vaginismus is one of the top sexual health concerns among Singaporean women.   

According to KK Women’s and Children’s Hospital (KKH), 9 out of 10 patients at their Sexual Health Clinic are diagnosed with vaginismus. That’s a lot! And it’s likely underreported because talking about sex-related issues can still feel paiseh in our culture.  

What Causes Vaginismus?  

There’s no single cause of vaginismus, but vaginismus often stems from a mix of emotional, psychological, or social factors such as:  

Trauma or Negative Experiences: Past sexual abuse or trauma can trigger an involuntary fear response.  

Psychological Factors: Anxiety about pain, whether from fears of tearing the hymen or worries about the penis being “too big”, can create a mental block that the body physically reacts to.  

Cultural and Social Influences: Growing up in environments where sex is considered taboo or shameful can lead to anxiety and aversion to intimacy.    

Other possible causes include prior injuries or medical conditions.  

Vaginismus and Your Mental Health  

Here’s where the mind-body connection comes into play. Anxiety is often at the root, creating a frustrating cycle: the fear of pain causes muscle tightening, which leads to pain, which then reinforces the fear and repeats the cycle.  

Over time, this can affect self-esteem, with thoughts like, “Am I abnormal?” or “Am I failing as a partner?” are all too common. Partners may also feel confused or frustrated, especially if they don’t understand what’s happening. Without support, this stress can lead to depression.  

Can I Ever Experience Comfortable Intercourse Again?  

Here’s the good news: vaginismus is treatable, and we don’t have to face it alone. Options like pelvic floor therapy, counselling, and gradual desensitisation can work wonders. A good first step is speaking with a gynaecologist or psychologist to uncover the underlying causes and find the best way forward.  

If anxiety is a key factor, here are some psychological strategies to try:  

Ψ Self-compassion  

Remind yourself that painful or uncomfortable intercourse is not your fault. Vaginismus is a physical and emotional response, not a reflection of your feelings or capabilities.  

Reframing your thoughts and tell yourself “It’s not that I don’t love my partner; it’s just that this feels painful right now.” Allow yourself to take some time and accept that you might be experiencing vaginismus and remember that treatments are available.   

Ψ Relax your body  

A) 4-7-8 Breathing  

B) Progressive muscle relaxation 

C) Guided imaginary     

1. Sit or lie down in a quiet and cosy spot. 

2. Close your eyes and take deep breaths.  

3. Picture a serene place, like a quiet beach with the sound of waves. Imagine what you can see, hear, smell, touch and taste.  

4. Visualise your body relaxing, rooted to the ground (especially around the pelvic area – hips, back, abdomen), and with each exhale, feel the tension leaving your body.  

5. Hold onto this peaceful image, breathing slowly and deeply, for a few minutes. Let the calm wash over you.  

And of course, communicate openly with your partner! Honestly share your feelings and struggles while explaining what you’re going through. Together, you can discuss ways to approach intimacy that feels safe and comfortable.  

How do I support my partner who has vaginismus?     

Ψ “Take it slow.”  

Patience and understanding would be the greatest gift you can offer. Avoid forcing, blaming, or guilt-tripping your loved one when they are not ready for intimacy. A slow and steady pace is often what they need to feel safe, allow them to set the pace and respect it.  

Ψ “You are not alone, I can help.”  

Learning more about vaginismus to understand what they are going through will help you approach the conversation with sensitivity and care. Show empathy by listening to their feelings and experiences by asking open-ended questions like, “How can I support you?” or “What would make this easier for you?”.   

You can also offer practical help, like accompanying them to medical or therapy appointments if they feel comfortable. Your presence can provide reassurance and show that they are not alone in this journey. 

Endometriosis: Symptoms, Impact, and How to Cope

Painful and/or heavy periods, pain during or after sex, chronic pelvic pain in your lower tummy or back, or pain when urinating during your period? If you’ve experienced some of these symptoms, you might have endometriosis.

Credit: TODAY

What Is Endometriosis?

Endometriosis is a condition where the tissue that lines the inside of the womb (uterus), called the endometrium, grows in other parts of the body, typically within the pelvis.

In a normal cycle, the uterine lining thickens in preparation for pregnancy and sheds during menstruation if pregnancy does not occur. With endometriosis, similar tissue outside the womb responds to the same hormonal signals, building up and breaking down each month, but the blood has no way to leave the body.

Over time, this internal bleeding can cause:

• Cysts in the ovaries

• Lesions or nodules on pelvic organs (uterus, ovaries, fallopian tubes, bladder, intestines)

• Adhesions that cause organs to stick together

Endometriosis affects an estimated 20–30% of women in their reproductive years (from puberty to menopause). While the exact cause remains unknown and there is currently no cure, effective treatments exist to manage symptoms and improve quality of life.

The Hidden Struggle of Endometriosis

Despite its prevalence, awareness of endometriosis is low, even among healthcare professionals. Many women face delayed diagnoses or misdiagnoses with some women waiting years for answers.

The pain and fatigue can disrupt daily life, lower productivity, and lead to withdrawal from social activities. This often creates feelings of isolation when loved ones don’t understand the condition. Nearly half of those affected also report depression and anxiety.

For some, endometriosis also impacts fertility, adding grief to an already challenging experience.

How to Cope with Endometriosis

Living with a chronic condition like endometriosis isn’t easy, but there are strategies to help manage both the physical and emotional toll.

1. Practice Radical Acceptance

Start by acknowledging your feelings, anger, sadness, anxiety, or frustration, without judgment. Notice the thoughts running through your mind and whether they are supportive or self-critical.

Radical acceptance means facing reality as it is, without getting stuck in “Why me?” or “What did I do wrong?” Accepting doesn’t mean approval or giving up. It simply frees up energy for what matters most to you.

2. Challenge Unhelpful Thoughts

A medical diagnosis can trigger negative thinking patterns such as:

• Catastrophising: “I’ll never live a normal life.”

• All-or-nothing thinking: “I’m useless because of this condition.”

• Self-blame: “This is my fault.”
  

To challenge these, ask:

• What’s the evidence for and against this thought?

• What’s the worst and best case scenario?

• What advice would I give a friend in this situation?

3. Ask for Support

Endometriosis is real, and asking for help doesn’t make you a burden. It can feel difficult, but you can ease this by preparing what you want to say. For example:

• “Could you accompany me to my medical appointment?”

• “If you see me curled up on the couch, could you make me a hot drink?”

Educate your loved ones about your condition and express gratitude when they help. A simple “Thank you” goes a long way.

Supporting Someone with Endometriosis

If your loved one has endometriosis, here are two key ways to help:

1. Offer Emotional Support

• Show compassion and flexibility. Plans may change if pain flares up.

• Avoid minimising their pain with phrases like, “It’s just cramps” or “Others have it worse.”

• Validate their feelings: “It makes sense you’re frustrated. I’d feel the same.”

Rather than rushing to solve the problem, listen and acknowledge their experience.

2. Provide Practical Help

• Learn about the condition so you can better understand what they’re going through.

• Offer specific help: grocery shopping, meal prep, or accompanying them to appointments.

• Take care of yourself, too. Supporting someone with a chronic condition can be emotionally draining.

Final Thoughts

Endometriosis is more than a “painful period.” It’s a chronic, life-impacting condition that requires compassion, from both ourselves and others. With awareness, support, and the right coping strategies, it’s possible to live meaningfully despite the challenges.

Fertility Stress in Men: Causes, Impact, and How to Cope

Fertility Stress in Men: Breaking the Stigma and Finding Support

Many men who face fertility challenges remain silent. Not because they’re unaffected, but because they’ve been told, directly or indirectly, that their emotions don’t matter. That they shouldn’t talk about it. That masculinity means strength, and strength means never struggling.

But the truth is this: struggling to conceive can affect men deeply.

It can challenge your sense of self, your confidence, and your relationship. It can bring shame, frustration, and a grief that’s hard to name.

Why Men Often Grieve in Private   

In many cultures, men are raised to fix problems, not talk about them. Fertility difficulties, then, feel like something unfixable. Something that makes you feel helpless. That helplessness often gets internalised as failure or weakness.

You might find yourself thinking:

Ψ “I’m not enough.”
Ψ “I should be stronger than this.”
Ψ “Why can’t I just cope and move on?”

These thoughts are common. But they’re not fair or realistic.

How Fertility Stress Affects Men

Stress related to fertility doesn’t just live in your head. It can affect your body, mood, sex drive, and energy. Research shows that chronic stress may interfere with testosterone levels, sperm quality, and libido, creating a cycle of anxiety and shame.

Fertility-related stress can also:

Ψ Cause irritability, withdrawal, or emotional numbness
Ψ Trigger sleep difficulties and reduced motivation
Ψ Lead to tension in relationships, especially when both partners are grieving differently

This kind of distress is real. And can be managed.

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Managing Fertility Stress: What Helps  

1. Name what you’re feeling

Suppressing emotions may seem like the strong thing to do, but it often makes stress louder. Instead, try giving your experience a name: grief, anger, shame, frustration.

You don’t need to say it all perfectly. Try starting with:

Ψ “I didn’t think this would hit me so hard.”
Ψ “I feel useless, and I don’t know what to do with that.”

Naming an emotion is the first step in loosening its grip.

2. Talk to your partner: More than just the plan, but also the pain

Men often go into “solution mode” during fertility struggles. But emotional connection matters more than quick fixes.

You might say:

Ψ “I don’t know how to fix this, but I want us to get through it together.”
Ψ “I feel like I’m supposed to be the strong one, but I’m struggling too. Let’s try and figure this out together.”

These conversations can feel vulnerable. But they build closeness, not weakness. Your partner might even appreciate the fact that you don’t seem as “okay” as you appear, as that could validate their own struggles.

3. Challenge Old Beliefs

Thoughts like “If I were man enough, this wouldn’t happen” or “Needing help makes me weak” are echoes of old messages, not truths.

Try cognitive reframing to challenge them:

Ψ “Struggling makes me human, not less of a man.”
Ψ “Getting support is taking responsibility for my wellbeing.”

4. Redefine strength

True strength isn’t silence. It’s about your resilience, honesty, and connection. Fertility challenges don’t define your worth, and speaking up doesn’t make you weak.

Ask yourself:

Ψ What kind of man do I want to be in this season
Ψ What kind of compassion or support would I hope to receive from others?
Ψ How can I show up for myself with that same compassion?

You’re Not Alone

Fertility stress can shake your confidence in ways you didn’t expect. It’s not a measure of masculinity but a sign of how deeply you care about your future and your family.

You don’t have to carry this weight alone. If fertility stress is affecting your mental health or relationships, reaching out for professional support can make a difference.

Understanding Trauma Responses and How to Heal

Trauma doesn’t always stem from one life-changing event. It can arise from a single experience, a series of repeated events, or a buildup of stress over time. In response, our brains and bodies develop automatic mechanisms to protect us—these are known as trauma responses.

These reactions often happen reflexively, without conscious choice. While they may have helped us survive in the past, trauma responses can disrupt daily life, relationships, and emotional well-being if left unaddressed.

What Are Trauma Responses?

Trauma responses are instinctive reactions to perceived danger. These reactions are shaped by the brain’s effort to keep us safe based on past threats. Even long after the threat is gone, these responses can remain activated, especially in people who have experienced ongoing or complex trauma.

The 4 Trauma Response Types: Fight, Flight, Freeze, and Fawn

Fight Response

The fight response is characterised by confrontation. This can manifest as irritability, defensiveness, or aggression. While it may appear rooted in anger, it’s often driven by fear and the need to regain control in threatening situations.

Helpful in true danger, but may cause interpersonal conflict when over-activated.

Flight Response

The flight response involves escape. It may look like avoiding conflict, overworking, or feeling the urge to leave situations that feel overwhelming, whether it’s physically or emotionally.

Flight offers protection, but constant avoidance can limit connection and growth.

Freeze Response

Like a deer in headlights, the freeze response involves shutting down. You might feel numb, detached, or stuck, unable to speak or move. This mental “pause” helps the brain cope by disconnecting from the moment.

May delay healing if emotions remain unprocessed or repressed.

Fawn Response

The fawn response is the least talked about. It involves appeasing others to avoid conflict or danger. People who fawn may over-apologise, struggle with boundaries, or place others’ needs before their own to maintain safety and approval.

Over time, this leads to emotional exhaustion and unhealthy relationships.

Common Signs of Trauma in Daily Life

Even when the traumatic event is long past, trauma responses can continue to affect how we think, feel, and relate to others.

Hypervigilance

A state of constant alertness and scanning for danger even when none exists. This may cause overreactions in situations that feel “normal” to others.

Emotional Dysregulation

Difficulty managing emotions. You may shut down, feel numb, lash out, or experience intense mood swings without clear triggers.

Negative Self-Perception

People with unresolved trauma often internalise harmful self-beliefs (“I’m not good enough,” “I’m unlovable”). These aren’t facts, but echoes of how others treated them.

Difficulty Trusting Others

Trauma can create a deep-rooted fear of rejection or betrayal, leading to withdrawal, isolation, or fear of intimacy, even when connection is desired.

How to Heal from Trauma: Steps Toward Recovery

Understanding your trauma is the first step toward healing. Here are small but meaningful ways to start your journey.

Try Grounding & Breathing Exercises

Techniques like box breathing or the 5-4-3-2-1 method bring you back to the present when anxiety or panic sets in.

Journal to Process Emotions

Journalling helps you organise thoughts, release built-up tension, and track your healing journey over time.

Practise Restorative Self-Care

Prioritise rest, nourishment, and comfort. This may include spending time in nature, engaging in hobbies, or simply taking breaks when needed.

When to See a Psychologist for Trauma Support

You don’t have to heal alone. A clinical psychologist can help you:

• Understand your trauma responses

• Rebuild a sense of safety and trust

• Learn healthy coping strategies

• Strengthen relationships and emotional resilience

Therapy provides a safe space to process trauma without judgment and develop practical tools to support your mental health long-term.

Final Thoughts

Healing from trauma isn’t linear. It’s okay if you take two steps forward and one step back. What matters is that you’re moving forward at your own pace with tools, awareness, and support.

If you’re ready to take that first step, reach out to our psychologists to begin your healing journey today.

Sciatica and Mental Health: How Chronic Pain Affects Your Emotions

Our brain acts like a smoke alarm, alerting us when something is wrong through the feeling of pain. However, when the alarm has been ringing for a long period of time, our brain's pain center becomes overstimulated. This leads to changes in our brain structure, causing alterations in the way pain is processed and experienced. It can lead to central sensitization, where our brains are overly sensitive to pain signals.  

Chronic pain also changes the structure of your brain. It can alter brain areas such as the amygdala and anterior cingulate cortex which are responsible for controlling our emotions. This can result in emotional dysregulation where we experience a heightened level of stress, worry and frustration. On top of that, chronic pain also messes with the levels of neurotransmitters in your brain. Neurotransmitters are chemicals that influence our mood and emotions. Research has found that people living with chronic pain have lower levels of glutamate, a neurotransmitter responsible for regulating thoughts and emotions. This connection between our mind and body also explains why two people diagnosed with the same condition can have very different experiences.  

A Vicious Cycle  

Pain’s drastic changes in our brain's chemistry creates a cycle of pain and distress that can prove hard to break. The stress we experience from sciatica pain can cause sciatica flare-ups which in turn intensify the negative feelings – fueling a vicious cycle of pain and distress.  Muscle tension from stress and anxiety puts pressure on your sciatica nerve. High levels of distress cause your body to produce an excess of hormones that trigger inflammation, further compressing your sciatica nerve and worsening pain. The experience of sciatica pain is very real, and it is understandable why it has affected your mental health. But the good news is, there are ways to cope with the mental distress! 

Coping with Sciatica Pain  

If you are someone dealing with sciatica pain, know that you are not alone. There are ways we can manage the emotional burden of sciatica pain. Some strategies include: 

1. Progressive Muscle Relaxation 

Since tensed muscles from feeling high levels of stress and anxiety can exacerbate sciatica pain, we can practice muscle relaxation to promote calm and stress-relief. First, tense up a specific muscle group in your body and notice what the tension feels like. Then, release the tension slowly, paying attention to what this feels like in your body. Move through your body, repeating these two steps.

2. Cognitive Restructuring  

The mind-body connection shows how our thoughts impact our physical body. Practicing self-awareness, we can identify any thoughts that may be causing these negative feelings and reframe them in a more positive and empathetic light.  

A negative thought may look like:  

“My pain makes me unable to do anything” 

Instead, we can restructure it in a more compassionate and positive manner:  

“Sciatica pain is hard, and my life may look different now. However, there are still things I can do, and I can find ways to manage it.” 

Taking control of our negative thoughts can reduce the physical impacts of distressing emotions on our body.  

3. Gentle Exercise  

Moving your body encourages the release of the chemical endorphin – which acts as a natural painkiller and improves mood. However, it is important to engage in activity levels that are suitable for your body. It is essential the exercise is done correctly and at an appropriate leve of intensity to prevent further injury to your sciatica nerve.  

These are all steps we can take to manage the distressing emotions that come with living with sciatica pain. However, if these methods are insufficient to help manage your difficult emotions, it is crucial to seek professional guidance. Our clinical psychologists at Annabelle Psychology are here to provide a safe space for you to find the best ways to cope with the stress that comes with sciatica pain. Should you have any inquiries, please feel free to contact us and find out more! 

Living with Chronic Pain

Pain is important in life. It is our body’s way of signaling to us that something is wrong. It allows us to take active steps to address the cause of the pain, ensuring that we are out of harm’s way. However, pain becomes an issue when it is persistent and disrupts our daily functioning. 

Chronic pain is pain that lasts beyond 3 months and may persist all the time or come and go. It can occur in any part of your body and can be due to various causes. Types of chronic pain includes nerve pain, pain caused by a joint condition or pain caused by illnesses such as osteoporosis. Chronic pain is more common than we may think, affecting 14% of adults in Singapore. Apart from your physical well-being, chronic pain has a profound impact on your emotional and mental health. 

The Connection between Chronic Pain and Mental Health 

Everyone experiences chronic pain differently and symptoms could range from mild to severe. Living with chronic pain is physically and mentally exhausting and could result in serious mental health conditions if not properly addressed. Dealing with chronic pain can disrupt your daily routines and make even the simplest activities hard, leading to feelings of sadness or despair. You may also feel overwhelmed with anxiety or worry, because of the unpredictability of your diagnosis or uncertainty about your future. You may even experience strains in your relationships with your friends and family if they do not fully understand your pain. However, we just want to acknowledge every emotion you may be feeling. Living with chronic pain is hard. It does take a heavy toll on your mental health. In fact, mental health conditions such as anxiety, depression and post-traumatic stress disorder are not uncommon amongst individuals struggling with chronic pain.  

Chronic pain and poor mental health are a vicious cycle. When you are in pain, it brings up unsettling feelings of fear and stress and this emotional distress results in self-isolation and avoidance of situations we think will worsen our pain symptoms. Unintentionally, this intensifies your symptoms of pain as emotional distress can manifest in physical symptoms such as tense muscles. 

Chronic Pain Management 

Breaking the cycle of chronic pain and emotional distress will help improve both physical and mental well-being. And the good news is there are strategies you can adopt to regain control and enhance the quality of life despite your chronic pain. Strategies include:  

• Activity Pacing  

Coping with pain daily can be exhausting. Pacing your activities in a day can help prevent a flare up but also ensure you do not overexert yourself. After you have selected the activity, figure out what your starting point is for this activity. For example, your baseline level for going on a walk may be 200m. This means that you can walk a distance of 200m before your pain starts to worsen. Next, plan for when, where and how you will engage in the activity. Then, plan incremental increases in the distance walked at a rate suitable for your physical ability. Be consistent and do not give up!  

• Build a Support System 

Surround yourself with people you love and trust! Explain how your pain affects your daily life and how they can help. You can also join a support group to help you connect with other individuals battling chronic pain. There is comfort in shared experiences. You are not alone. 

• Caring for Your Mind and Body   

While pain may place a limit on your physical abilities, engaging in low-intensity physical activities can be helpful. Pain-friendly activities like swimming, yoga and tai chi can be incorporated alongside activity pacing. When you exercise endorphins are released and this can help reduce stress levels and improve your mood. Engaging in exercise could also help distract yourself from ruminating on negative thoughts associated with your chronic pain. 

Apart from caring for your body, it is also important to care for your mental well-being. Persistent pain can take a toll on emotional health, thus engaging in mindfulness exercises such as guided imagery can help relieve stress and promote calm.  

Steps in Guided Imagery: 

1. Find a comfortable position (e.g. sit or lie down somewhere you will not be disturbed) 

2. Visualize a scene or setting that makes you feel calm and peace (e.g. your home, the beach, a meadow) 

3. While imagining this scene, notice as many details as you can – What do you hear, see, feel? 

4. Continue staying in the scene for as long as you need 

5. When you are ready, slowly take yourself out of the scene and come back to the present  

6. Check in with yourself – How do you feel right now? 

While no single approach works for everyone, combining these strategies can help you build resilience and regain a sense of control over your life. Living with chronic pain is undoubtedly challenging. However, with the right strategies and a good support system around you, you can live a life full of meaning and joy. Also, if you are struggling with your mental health, do not be afraid to ask a professional for help! Remember, you are not alone, and every small step makes a significant difference on your journey. 

Pregnancy Hormones and Link with Mental Health

Pregnancy is a transformative experience filled with joy and exhilaration. However, it can be physically and emotionally taxing on the mother’s body. During pregnancy, hormonal fluctuations occur and can manifest positively or negatively on a mother’s mental health. These hormonal changes may lead to or exacerbate mental health conditions and can occur before, during or after the pregnancy. Understanding these hormonal changes is crucial to understanding their impact on a mother’s mental health. 

Pregnancy Hormones  

Drastic hormonal changes can have a toll on the mother’s emotional well-being. This includes changes in hormones such as progesterone, estrogen and oxytocin. 

1. Progesterone  

Progesterone is thought to help in regulating our mood and anxiety. During pregnancy, progesterone levels progressively rise but decreases sharply after delivery. This sudden decline results in a drop in mood, increasing the risk of postpartum depression. 

2. Estrogen  

Like progesterone, estrogen levels increase steadily and then sharply decline after birth. It affects body functions including brain function and works together with serotonin to impact an individual’s mood. Its sudden decline could also increase the risk of postpartum depression. 

3. Oxytocin  

However, not all hormonal changes have negative impacts. Oxytocin, also known as the “love hormone” increases in its production during pregnancy. This promotes stress and anxiety relief.  

The intensity of hormonal changes varies by individuals. Factors such as a history of mental health issues, lack of social support, trauma and biological predispositions can increase the risks of experiencing poor mental health during pregnancy.  

 Effects of hormonal changes during pregnancy are more common than you think, with up to 40% of mothers in Singapore reporting feelings anxiety or depression. Therefore, it is important to be aware of the signs and symptoms of these maternal mental health conditions to tackle the symptoms before they escalate. 

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Symptoms of Declining Mental Health 

Maternal mental health refers to the social, emotional and mental well-being of a mother during pregnancy or postpartum. These hormonal changes, if left untreated, can result in maternal mental health disorders such as perinatal anxiety, perinatal depression, post-traumatic stress disorder or bipolar affective disorder. Therefore, it is crucial to understand some of the symptoms and warning signs of pregnancy related mental health disorders.

Symptoms of perinatal anxiety and depression include:  

• General or persistent worrying  

• Feelings of irritability, frustration, or restlessness 

• Changes in appetite  

• Difficulty sleeping, waking early in the morning, or oversleeping 

• Withdrawing from friends or family  

• Diminished interest or enjoyment in activities  

• Feelings of worthlessness, guilt or helplessness 

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Building Mental Resilience During Pregnancy 

Apart from understanding how hormonal changes in pregnancy can affect our mental health, there are also active steps we can take to build our mental resilience. Mental wellness strategies include: 

• Engaging in regular exercise  

Moving your body promotes the release of endorphins also known as “happy” hormones that naturally boost your mood and relieve feelings of stress.  

• Maintain a support network  

Surrounding yourself with people you love and trust, such as your partner, family, friends or pregnancy support groups can provide emotional comfort and practical help. You do not have to struggle alone. 

• Get into a routine  

When your mind feels out of control, maintaining a sense of structure in your life can be reassuring. Setting regular sleep, meal and relaxation times can create a sense of control and reduce feelings of anxiety in your life. 

• Eat a balanced diet 

Did you know that what you eat can also affect your mood? Ensuring you consume a well-balanced diet rich in all the essential vitamins and nutrients is crucial in promoting healthy brain function and mood regulation. 

• Practice mindfulness and relaxation techniques 

Engaging in mindfulness and relaxation techniques (e.g. 4-7-8 breathing) can help manage anxiety and promote feelings of calm, even in moments of stress.  

However, if emotional distress during pregnancy affects daily functioning or persists for an extended period, it is crucial to seek guidance from a mental health professional.  

Hormonal changes play a significant role in shaping a mother’s mental health and the overall pregnancy experience. Thus, understanding the connection between hormones and mental health is essential for fostering self-awareness and reducing stigma. By engaging in self-care strategies and seeking professional care when required, you are equipped to thrive in your pregnancy journey. 

The Hidden Stress of Trying to Conceive: Navigating Fertility Stress

1 in 6 couples in Singapore face difficulties in conceiving naturally. Struggling with fertility stress can cause us to experience feelings of depression and low self-esteem, highlighting the profound impact this stress can have on our mental health. The adverse effects of fertility stress are far-reaching, impacting our mental health as well as putting strains on relationships with our partner, family and friends.  

So what can we do to help with fertility stress?

Understanding Fertility Stress

Struggling to conceive is a deeply personal and emotional journey, and it is completely natural to feel stressed. Pressures of a ticking biological clock and societal expectations may leave you feeling a sense of loss, anxiety and hopelessness.

Stress is our body’s normal response to threatening or overwhelming situations and can result in both physical and mental responses. While we cannot completely get rid of stress, we can first gain a better understanding of it, which will help us learn to better manage it.

When we are stressed, our body releases hormones such as cortisol that can result in an imbalance of key reproductive hormones - estrogen and progesterone. This affects our ovulation and menstrual cycle, which could make it harder to conceive. High stress levels could also result in irregular menstrual cycles, making conception planning unpredictable. In extreme cases, stress can cause anovulation, where our ovaries are unable to release mature eggs.

So stress and fertility difficulties can result in a vicious cycle.

Struggles with fertility may result in distressing emotions like anxiety, frustration and sadness. This emotional toll in turn exacerbates stress levels which causes further disruptions in your body's physiological balance, making fertility challenges even harder to navigate.  

For compelteness, other factors, like ovulation disorders, damaged fallopian tubes, or health conditions like endometriosis can also play a role. 

Managing Your Fertility Stress with Psychological Strategies

Here are strategies we can adopt to regain a sense of control over our bodies. Let’s look at some of them: 

1. Create (Small) Moments of Predictability

Try building in blocks of time where you have “fertility-free” times where you don’t track, research or talk about it. Set aside daily time blocks, morning or evening, for "fertility-free" periods. During these times, avoid tracking symptoms, researching, or discussing fertility. Creating mental space away from the topic can support emotional well-being.

2. Challenge Unfair Self-Criticism

A harsh, often irrational, inner critic tends to rear its ugly head when we think trying to conceive is something that we have control over, or responsibility for (fact: we don’t have control over our genetic or biological makeup). When the self-criticism gets too much, reflect on these critical thoughts and consider:

Ψ Would I say this such unkind words to a friend in my position?
Ψ Is this thought helpful or just punishing?
Ψ What would it mean to be “good enough” right now, instead of perfect?

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3. Relaxation Techniques  

Relaxation techniques such as progressive muscle relaxation and mindful breathing can help ease stress.

When we are stressed, our muscles naturally tense up, causing pain and discomfort. This in turn signals to our bodies that it is stressed and worsens the cycle of stress. In progressive muscle relaxation, you intentionally tense a group of muscles as you inhale, then release the tension as you exhale. You can repeat this process for different muscle groups to promote relaxation in your body. 

Breathing techniques such as 4-7-8 breathing can also help with feelings of anxiety. Here are the steps:

Firstly, ensure you are sitting or lying down comfortably. Next, breathe in through your nose for 4 counts, hold for 7 counts, then exhale through your mouth for 8 counts. These relaxation exercises help reassure your body that it is safe, allowing you to feel calmer.

4. Building (and Relying!) on your Support Systems  

You are not alone. Share about your difficult feelings with your partner or loved ones - fertility stress is not just a women’s issue; men can go through it too. Facing fertility stress together can make a big difference. Communicating how we feel can have a cathartic effect and prevents feelings of isolation.

You may also find comfort in joining fertility support groups like Fertility Support SG where you can connect with others who understand what you are going through and can offer encouragement during this journey. 

5. Final Thoughts on managing fertility stress

Fertility stress can make everything harder.

The fertility process is not just a medical journey - it’s an emotional one, a relational one, and a deeply human one. You don’t have to go through it holding your breath. You can grieve, rage, rest, fall and get up when you’re ready, with supportive people by your side.

And if despite everything, you feel yourself struggling with, consider working with a psychologist to support you to:

Ψ Untangle complicated emotions like guilt, shame or resentment
Ψ Navigate conversations with your partner, family, or doctors
Ψ Reconnect with parts of your life that feel sidelined by fertility stress

Coping After Losing a Loved One to Suicide

You might be asking questions no one can answer. Or feeling emotions that seem to contradict each other: sadness, guilt, anger, even relief, and then guilt again for feeling relief. It’s common. And it doesn’t make you a bad person. Or a bad friend, partner, or sibling.

Grieving after suicide is different. Let’s talk about how to survive it, piece by piece.

Ψ Give space to complicated feelings

You may notice your emotions shifting rapidly. Shock, regret, rage, deep sorrow, numbness. Grief after suicide rarely feels linear.

This is partly because suicide loss carries what we call disenfranchised grief, which is grief that isn’t always openly acknowledged. People don’t know what to say. They avoid the topic altogether. That silence can make you feel even more alone in your pain.

It helps to name what you’re feeling, even just to yourself.

“I’m furious and I miss them.”

“I feel guilty, even though I know it’s not my fault.”

These are complex truths, and they can coexist.

Ψ Let go of the urge to find a neat explanation

After suicide, the mind often goes into detective mode: Was there a clue I missed? Was there something I could have done?

This kind of thinking is natural. It’s a way our brain tries to regain control after something that feels senseless.

But suicide is almost never the result of a single moment, or a single failure. It’s often the culmination of prolonged internal distress that the person may have hidden well. Hindsight can make things look clearer than they ever were at the time.

Guilt and responsibility are heavy burdens to carry but they’re not the same as truth. Acknowledge the desire to believe that you could have done more. But remind yourself it is not realistic.

Ψ Stay connected, especially when you want to withdraw

Grief has a way of isolating us. You may feel like no one could possibly understand, or that it’s easier to stay quiet. But staying connected, even in small ways, is protective.

Talk to someone who can sit with your pain without rushing to fix it. It may be a friend, a therapist, or someone in a support group who’s walked this road too.

If words are hard, you can start with presence. Sit beside someone. Share a cup of tea. Let yourself be around people who make space for you as you are.

 Ψ Engage in rituals that help you make meaning

When someone dies by suicide, there is often no goodbye, no closure. You might be left with unsaid words or unresolved hurt.

Creating your own rituals can help bridge that gap. You might write a letter, light a candle, revisit a shared place, or do something they once loved doing. These are ways of continuing bonds, something grief researchers have found can help the healing process.

Remembering the whole person, their humour, their kindness, their struggles, can help shift your focus from how they died to how they lived.

Ψ Notice how grief is showing up in your body

Grief doesn’t just affect your thoughts. It can show up physically. Fatigue, heaviness in your chest, disrupted sleep or appetite changes.

It’s okay to rest more. To eat simple meals. To let yourself do less.

Some people find movement helpful, like short walks, stretches, even just stepping outside for a few minutes. Others find comfort in breathing exercises or grounding techniques (like naming what you see, hear, and feel in the present).

Caring for your body while grieving isn’t about “fixing” anything. It’s about creating small moments of safety, or “normalcy”.

Ψ If the grief becomes too heavy

Sometimes, especially with traumatic or sudden loss, the pain can tip into despair. You might find yourself overwhelmed with thoughts you didn’t expect, or a numbness that feels frightening.

If this happens, please reach out. Call a helpline. Speak to a psychologist. Let someone know that it’s too much right now.

You don’t have to wait until you're “really struggling”. There’s no threshold of suffering you need to meet before you ask for support.

What healing might look like, eventually…

You may not believe this now, but the pain won’t always feel this raw. Over time, many people find that their relationship with the loss changes.

You may begin to remember with more warmth than pain. You may speak their name again. You may laugh without guilt. These are not signs you’ve “moved on”. They’re signs you’re learning to live alongside the loss.

Grief is not something to “get over”. It’s something you live with. And in that living, you can still find joy, meaning and connection.

If you’ve lost a loved one to suicide and are struggling to cope, you don’t have to figure it out alone.

You are surviving something deeply painful. And you deserve care through it. Let us know if you need a listening ear.

Trauma Anniversaries: Understanding how you feel and how to cope

Trauma anniversaries can be a result of private (e.g. sexual assault, domestic violence or childhood abuse) or public trauma (e.g. natural disasters, terrorist attacks or political violence). Whether private or public, trauma anniversaries can stir up intense emotions and symptoms. These reactions are normal, and they are known as anniversary reactions.   

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Why do trauma anniversaries occur? 

Trauma affects both our minds and bodies. When a traumatic event occurs, our body activates its fight, flight, or freeze response to protect us from the overwhelming danger. When this trauma is not fully processed, this survival response becomes overactive. Resultingly, cues that remind us of the traumatic event can trigger this intense reaction, even when there is no real threat.  

As the trauma anniversary nears, we may feel more on edge as our body reacts to perceived threats. These cues can be internal, such as emotional or physical states (i.e. feeling the same emotions or bodily sensations felt during the trauma). Cues can also be external, such as time-based (i.e. seasonal changes, time of year) or environmental triggers (i.e. sights, sounds, smells). Encountering a cue can activate the body’s survival response and can leave you feeling anxious, nervous or scared. 

However, these trauma reminders are not always negative. In some cases, they can support the healing process. For example, the anniversary of a loss may bring memories of a loved one and offer space to process your grief more deeply. Media coverage of a public tragedy can also rally survivors together and facilitate community support. 

For trauma anniversary signs in children and how to support them, check out our parenting guide.

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Trauma Anniversary Symptoms  

Trauma anniversaries can often make PTSD symptoms worse. You may experience feelings of self-judgement and question “Why am I still bothered by this?”. Or you may face anticipation anxiety, dreading the day for fear you will struggle.  

Other common symptoms include: 

• Reliving the event 

• Most common symptom  

• Re-experiencing the feelings, bodily responses and thoughts that occurred during the trauma  

• Avoidance  

• Avoidance of anything related to the traumatic event (i.e. people, places, objects) 

• Negative changes in beliefs and feelings  

• Old thoughts or feelings of guilt or shame may return  

• Daily mood affected (e.g. sad, anxious, nervous)  

• Affects how they relate to others (i.e. friends and family) 

• Feeling “on edge” (hyperarousal) 

• Constantly feeling jittery, nervous or worried  

• Difficulties sleeping or having nightmares  

• More reactive to small triggers (i.e. irritable, easy to anger) 

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How can we feel better? 

Over time, the distress will become less frequent and less intense. Most people start to feel better within a week or two after the anniversary of the traumatic event. While symptoms can feel overwhelming, there are effective strategies to help you cope.  

1. Caring for Your Physical Health  

Your physical health pays a big role in your mental well-being. A balanced diet, regular exercise and sufficient rest is especially important when dealing with trauma anniversaries, as they help regulate emotions and build emotional resilience. 

Exercise releases endorphins, commonly known as “happy hormones” that reduce anxiety and boost our mood. What you eat can significantly impact your mood. So, eating nutrient-rich foods can ensure your energy levels are stable and improve your feelings of anxiety, fatigue or irritability. Lastly, rest is crucial in facilitating recovery from trauma. Sleep helps restore your brain function, regulates your moods and calms your nervous system. Rest is not a luxury; it’s a necessity when coping with anniversary trauma.  

2. Lean on your loved ones 

When facing something as heavy as trauma, it is important to surround yourself with people who make you feel safe, seen and supported. Surround yourself with people who respect your boundaries, listen without judgement and show genuine concern. Remember, you are not alone! When trauma anniversary symptoms surface, reach out to someone you trust to get support. 

3. Journalling  

Writing down your thoughts and feelings can be a powerful way to reduce your anniversary trauma symptoms. Writing it down can help you acknowledge and process all the complex emotions you may be feeling. It can express emotions or thoughts that are too hard to say out loud, providing an outlet to reduce emotional overwhelm and facilitate healing.  

4. Try Calming Exercises  

Heart pounding, hands shaking and thoughts racing – when our survival response takes over, it can be difficult to steady ourselves admists the overwhelming emotions. Mindfulness exercises can help bring awareness to our emotions, calm our nervous system, and reground us to the present.  

5. Seek Professional Help 

Trauma is not something to dismiss or minimise. When left unaddressed, it can become deeply rooted and lead to serious mental health challenges such as depression, anxiety and emotional dysregulation. Sometimes, self-care alone is not enough – and that is okay! There is no shame in asking for help. Just like how you would visit a doctor when your body’s not feeling well, it can be helpful to visit a mental health professional if you have been struggling with your mental health. Therapists, counsellors and psychologists are trained to create a safe space where you feel supported, understood and heard. Asking for help is the bravest thing you can do for yourself. 

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Anniversary trauma and the distressing feelings, thoughts and physical symptoms it brings can be incredibly difficult to face. Navigating trauma can sometimes feel like an endless dark tunnel. But take heart – healing is possible. Lean on those who love you and be patient with yourself.  

Healing is never linear. Every small step forward makes all the difference to recovery.