Can You Have Postpartum Depression After a Miscarriage?
When I miscarried after my first pregnancy, I was shocked by how long it took me to feel like myself again. At the time, I was a journalist covering reproductive health — intellectually, I knew so much about pregnancy loss. But despite all that information (as well as the massive shift in public awareness of miscarriage, and the de-stigmatization of people sharing their own experiences), I had absolutely no idea how my loss would affect my body and mind.
For months, I felt like I was walking around in someone else’s body. And in speaking to others who have been through pregnancy loss, I realized I’m not the only person who experienced this.
If you’re feeling like you’re in a fog, or like you can’t pull yourself out of the post-miscarriage grief, you may be wondering if what you’re experiencing is depression, or maybe even postpartum depression. Maybe you’re left wondering why you’re feeling the way you feel: Is it the trauma and grief of losing a pregnancy, the hormonal shifts that take place after a miscarriage…or a bit of both?
Emily Guarnotta, PsyD, a licensed psychologist and owner of The Mindful Mommy, a therapy practice that specializes in working with parents coping with the adjustment to parenthood, weighed in on how miscarriage can affect a person’s mental health.
Is it Possible to Have Postpartum Depression After a Miscarriage?
According to Guarnotta, depression after a miscarriage is absolutely possible — but this depression doesn’t meet the clinical definition of postpartum depression.
“Women can experience depression after a miscarriage,” she says. “These symptoms may be similar to PPD and include depressed mood that lasts at least two weeks, changes in sleep and appetite, difficulty concentrating, fatigue, and even suicidal thoughts. However, we don't refer to this as PPD. Instead, mental health professionals may give a diagnosis of major depressive disorder or adjustment disorder with depressed mood to a woman following a miscarriage.”
“By definition, PPD is depression that develops within the first year of giving birth and is related to a combination of factors, like hormonal changes, sleep deprivation, and the stress of adjusting to parenthood,” Guarnotta adds. “Following a miscarriage, a woman's depression is due to the grief associated with the loss. Even though the symptoms may be similar, we use different terms.”
Why might someone experience depression after a miscarriage?
“The exact causes of depression after a miscarriage are unknown,” says Guarnotta. “Like postpartum depression, it's believed to be caused by a combination of factors. The body experiences a shift in hormones after a miscarriage, which may explain why women experience depression post-miscarriage. It is also a very distressing and traumatic event, which has a significant emotional impact on women.”
It’s not just about the actual event, though: Reactions from the outside world may also influence a person’s mood after a miscarriage.
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“Women may feel disappointed by the responses from their support system, which can trigger feelings of loneliness,: says Guarnotta. “Every woman is different, so their experiences will also be different. The straightforward answer is that biological, psychological, and environmental factors all interact together to play a role in developing depression after a miscarriage.”
After a miscarriage, how do you know if what you’re feeling is sadness or depression?
Grief is inevitable after such a major loss. But how do you know if you need help processing what you’re going through mentally? The truth is, regardless of what you’re experiencing on a clinical level, anyone who is struggling after a miscarriage can benefit from community and/or professional help.
“If you are struggling after a miscarriage, you can benefit from speaking with a mental health professional or attending a support group,” says Guarnotta. “Therapy can help you process the loss and develop tools to help you cope. I recommend seeking out a therapist who specializes in perinatal loss, which is the term used to describe loss due to a miscarriage or stillbirth. Postpartum Support International is a non-profit organization that offers free support groups for families who have experienced a perinatal loss. You can learn more by visiting their website.”
There are some signs that what you’re experiencing requires intervention or even medication.
“If you are experiencing severe depression that is significantly affecting your life or if you are having suicidal thoughts, then you may benefit from medication for depression,” says Guarnotta. “You can speak with your healthcare provider or seek out a psychiatrist to determine if medication is right for you. If you are experiencing a crisis or suicidal thoughts, then call the 988 crisis line.”
People may not understand what you’re going through, but your grief is valid.
Societally, we don’t give miscarriage sufferers enough space to grieve their losses. Many people are still uncomfortable with this type of loss, while others may make minimizing comments like “Well you can always try again” or “At least it happened early”. Even when those comments come from a well-intentioned place, they hurt.
So consider this your reminder: You are allowed to grieve your miscarriage. This is a real loss, and your feelings are valid. You did nothing to cause your miscarriage — and if you experience depression in the aftermath of it, you did nothing to cause that either.
“Many people refer to a miscarriage as an invisible or hidden loss,” says Guarnotta. “It can be incredibly isolating because other people in your life may not understand what you're going through or know what to say. They may not say anything out of fear that they'll upset you or they may say things that are very hurtful like ‘everything happens for a reason.’ This can come across as them not caring and feel incredibly painful. That is why having a safe space to talk about it and possibly connect with others who are going through the same thing is so important.”
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, Marie Claire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.