Pregnancy can be one of the most joyful times in a woman’s life, but also the most stressful. The mother forms an essential bond, a connection with her child as it develops and grows in her womb.
Because of this maternal feeling, if a woman miscarries, loses her baby—whether she has carried it for a few weeks or a few months—the mother can experience more than just physical pain: severe grief which many other people cannot really grasp or fully understand. The resulting mental and emotional pain can manifest as an emotional breakdown or depression as she readjusts following the sudden vacancy in her womb and heart.
Grief and Depression
Even when a woman gives birth, she may experience postpartum depression. With a miscarriage, it can be many times worse. Coping with such severe grief can lead to drug or alcohol addiction. Hospitals are getting better at providing grief counseling following miscarriage, but that's an improvement from a deep deficit.
The nonprofit Seleni Institute says it is not how long the pregnancy lasted that determines the level of grief but how long the woman had been trying to get pregnant. It is the depth of the bond the mother felt, not the duration of the pregnancy. It can affect the father, too.
Even subsequently getting pregnant, carrying the child to term and giving birth may not end the problem. Depression isn't just a bad mood or feeling blue; it is a mental illness.
Family, friends and peer support groups can help, but professional counseling and therapy sessions also may be necessary to help mothers who experience a miscarriage to cope with the pain in a healthy way.
Stages of Grief
There are at least six stages of grief, as enumerated by The Mayo Clinic. While depression falls near the middle, you may not experience every stage or experience them in this order:
The Mayo Clinic Depression doesn't expressly name a seventh stage, but it is generally considered to be "Acceptance": Coming to terms with the loss of your child and more-or-less getting on with your life, maybe trying to get pregnant again or—if that is not possible or safe—to accept that you cannot.
Getting to acceptance may be too difficult on your own if you fall into depression. Medical and psychological support can serve as a guide to a fast and full recovery.
Depression and Other Mental Illnesses
Not that grief is bad necessarily. It is part of the healing process. Allowing someone to grieve, especially after a major loss such as a miscarriage, can help the person to heal. Repressing grief can lead to worse problems later on, including a greater likelihood of substance abuse.
The problem, according to the American Pregnancy Association, is that “the hormonal change that occurs after a miscarriage can intensify the symptoms”, which may lead to severe depression or anxiety.
Just as the grief of the loss of a child can lead to mental disorders such as depression or addiction, that grief can be exacerbated by an existing mental ailment.
Signs of Mental Illness
Signs of mental illness may include:
- Isolating yourself from your support network
- Experiencing difficulty in determining reality from delusion
- Constant negative thoughts about yourself, including suicidal
- Feeling passive about almost all things in and around your environment
- Having a hard time calming down from extreme emotions or reactions
- Difficulty concentrating
- Difficulty sleeping
- Dramatic changes in mood, energy, and behavior
- Little or no appetite
- Engaging in obsessive-compulsive rituals and patterns
- Inability to maintain employment, relationships or home
Depression borne of miscarriage-driven grief can last for weeks, months, or even years depending on a number of factors, including if there have been multiple miscarriages. Such a repeated loss can cause so much turmoil to both parents that the couple can no longer provide emotional or moral support to each other.
Friends and family can help by treating the grieving parents' loss with respect. Most people cannot fully appreciate the agony caused by the loss of a child before birth. Just acknowledging their tragedy can show support and lighten their burden.
Even acknowledging the loss can help. Miscarriage isn't that rare; as many as 16 percent of pregnancies end in miscarriage or stillbirth, but we seldom talk about it. As many as 40 percent of women who miscarried suffered from symptoms of post-traumatic stress disorder—re-experiencing the miscarriage, feeling numb and detached all of the time, having sudden mood changes—like a soldier returning from war. About 20 percent had symptoms of anxiety or general depression, and 13 percent still had them three years later.
Depression, addiction, or other mental health issues may require additional measures.
Mental Health Disorders and Their Treatments
If professional help is needed, the first step is to diagnose the exact problem. Before any treatment can begin, you need a thorough assessment. Your complete medical history, including your psychiatric record, need to be evaluated to determine your present condition. If you have turned to drugs or alcohol to self-medicate, be sure the doctor or therapist knows or else the diagnosis may be skewed.
The most common types of mental health disorder associated with or caused by addiction include:
- Bipolar disorder
- Eating disorders such as anorexia and binge eating
- Obsessive-compulsive disorder
- Attention deficit hyperactivity disorder
Unfortunately, most emergency room nurses “lack appropriate training to support women experiencing a miscarriage” or “quickly identify women who might be at risk for complicated grieving”. A pilot program in Canada is working on such a “brief grief screening tool”. In the meantime, you may have to ask for or seek out proper medical and psychological care yourself.
Drugs and Addiction
The sooner you seek help the better. Most advanced hospitals can offer appropriate, tailored treatment onsite: peer support groups, therapists, maybe anti-anxiety or anti-depressant drugs if needed. Drugs like grief are not bad in themselves. Taken as prescribed they can provide a helping hand to your recovery.
Not all drugs are equal, however, and not all drugs affect all people the same way. Don't try to self-medicate with alcohol, prescription pills you've begged or borrowed or stole, or illegal drugs. You might just be adding another problem—addiction—that you will have to treat as well.
A miscarriage—or even miscarriages—doesn't mean you cannot give birth and raise a healthy child or children. Just take care of yourself—mentally as well as physically—and be honest and forthcoming with your physician.