When You Suffer Clinical Depression After a Miscarriage

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Research increasingly shows that depression and anxiety are common in both partners after a miscarriage or later pregnancy loss. This is likely no surprise to anyone who has been through a pregnancy loss. But where is the line between normal grief and clinical depression? That can be a tougher question.

Symptoms of Depression

According to the National Institute of Mental Health, the symptoms of depression are as follows:

  • Persistent feelings of sadness, emptiness, hopelessness, guilt, or helplessness
  • Irritability or restlessness
  • Loss of interest in formerly enjoyable activities
  • Fatigue and low energy
  • Problems in concentrating and making decisions
  • Sleep disturbances
  • Appetite changes
  • Thoughts of suicide
  • Persistent pains or digestive problems that do not respond to treatment

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

Of course, looking at that list, nearly every woman who has been devastated by a miscarriage has probably had at least a few of those symptoms. But that doesn't mean that the majority of women should be diagnosed with clinical depression—the normal grief response can be nearly identical to depression, especially to an outside observer.

Grief or Depression?

It is impossible for any outside observer to draw a general line in the sand over what is grief and what is depression for any particular person. Researchers who have studied post-miscarriage grief do not have set guidelines for how to differentiate grief from depression. One factor could be the length of time that the symptoms last, but there isn't a time limit for what is and isn't normal for grief.

There is no set point when you are "supposed" to have coped with your miscarriage grief, and for many people, it tends to be a lifelong process. Grieving for a long time doesn't necessarily mean you need an evaluation for depression.

Perhaps the best indicator would be your feelings about how your grief and sadness are affecting your daily life. Although you may not even feel like getting out of bed in the morning in the immediate aftermath of your loss, over time you should begin to feel like you can function, laugh at jokes, eat and sleep normally, and enjoy your favorite activities—even if you're still deeply upset about the miscarriage. If you don't feel like you're starting to be able to cope, you may have depression.

If you do have a feeling you might be depressed or if you have any hunch that it could benefit you to seek help, talk to someone. You can see a grief counselor, a family therapist, a psychologist or a trusted health practitioner for advice. Any of these people should be able to point you in the right direction for how to get help. And if you are feeling at all suicidal, please seek help right away.

Remember that even if you are clinically depressed, treatment doesn't have to equal medication. Medication is a perfectly valid option, but others might include attending a support group, attending counseling by yourself or with your partner or using other non-drug therapies for anxiety and depression.

Who Has Increased Risk?

Some women do have increased risk for developing clinical depression after a miscarriage. If you have had a history of depression prior to your loss, you'll have increased risk for another episode. In addition, women without living children or who have concerns about future fertility can be at increased risk for long-term problems coping with the miscarriage.

And if any of these apply to you, please don't feel you have to face these experiences alone. You are not alone, and there are others out there who will understand what you are going through, even if no one in your life seems to get it. If you don't have sympathetic family and friends who can support you through this, find a counselor or support group to lean on.

3 Sources
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  1. Bardos J, Hercz D, Friedenthal J, Missmer SA, Williams Z. A national survey on public perceptions of miscarriage. Obstet Gynecol. 2015;125(6):1313-20. doi:10.1097/AOG.0000000000000859

  2. National Institute of Mental Health. Depression.

  3. Demontigny F, Verdon C, Meunier S, Dubeau D. Women's persistent depressive and perinatal grief symptoms following a miscarriage: the role of childlessness and satisfaction with healthcare services. Arch Womens Ment Health. 2017;20(5):655-662. doi:10.1007/s00737-017-0742-9

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.