Like many others, you may be interested in knowing when normal worry, sadness, and stress following a miscarriage might become a mental health concern, such as a mood disorder, depression, or anxiety disorder.
If you have previously experienced mental health difficulties, you may be vulnerable to a return of these symptoms. However, this is not necessarily the case. Conversely, you may have never experienced mental health difficulties before but now feel unable to move on from the miscarriage.
…at the time I really should have been referred to like a psychologist. Because I was really left to my own devices, and devices of family…they were sort of at a loss of what to do with me, when really, I should have sought out some grief counselling or something.
If you have concerns about your mental health, it is advisable to seek the assistance of a trained mental health professional, such as a psychologist, your GP, or other support services. This can be especially important if:
- You don’t have someone to talk to
- Someone who cares about you is concerned about the changes in you
- Your ability to work, care for other children, or study is compromised
- You still feel intense grief over the loss several months after the miscarriage
- You are using alcohol or other drugs to cope
Pregnancy support counselling is available through referral from your GP for anyone who is pregnant or has been pregnant in the last 12 months (for each pregnancy). You are entitled to up to 3 x 30-minute sessions either with an eligible doctor, psychologist, social worker, or mental health nurse through Medicare.
There are a number of websites you can use to find a counselling or psychology service near you, including Healthdirect, e-COPE directory or the Australian Psychological Society’s ‘Find a Psychologist’. It is best to check with the providers as the rebate may cover some costs.
If you require ongoing mental health support, your doctor may assess your eligibility for a mental health care plan. This plan entitles you to up to 10 Medicare subsidised counselling sessions per annum. For more information, please check this Medicare page on Mental Health Care.
Below is a list of the common mental health symptoms which may arise for the first time or be exacerbated by a miscarriage. This list offers guidance to help you care for your mental health or the mental health of a loved one.
If you are experiencing these symptoms, please reach out to your doctor or support service for some help. You don’t need to reach a crisis point before reaching out for help or support services. In truth, it is essential that you contact support before difficult emotions worsen, as it is then often easier to work towards feeling better. Feeling the need to solely talk with someone who understands what you are feeling and going through, reach out. Caring professionals are ready to support you with services designed for you.
High levels of anxiety can feel hard to switch off, and it can cause significant distress and interfere with a person’s quality of life. Anxiety has three key components:
Mental health symptoms
People who experience high anxiety tend to feel plagued by their thoughts. Signs may include difficulty switching off thoughts/worries about bad events happening (catastrophising, “what if…?), rumination over past events, and obsessive thoughts. You may feel disproportionately responsible for things and attempt to manage or control events and outcomes.
These symptoms are associated with high levels of bodily arousal. They can include (but are not limited to) shortness of breath or shallow, rapid breathing, hot and cold flushes, racing heart, tightening in the chest or throat, panic attacks, restlessness, feeling agitated, wound up, or irritable. Difficulties falling asleep, staying asleep, or waking too early may also occur.
To reduce feeling anxious, you might attempt to avoid situations that trigger anxiety (such as social gatherings and contacting friends). Criticising yourself and feeling ashamed about doing this won’t take away your feelings of anxiety. It can help your recovery by avoiding events that might trigger your sadness until you feel ready in the short term.
. . .my wife got diagnosed with depression. . .the counsellor was really good at getting me to understand what the triggers were and what situations to avoid. . .to help look out for her.
Depression is different from sadness. Here is how:
Someone grieving has a fluctuating ability to feel pleasure, finds closeness to others comforting, and can still experience a range of other emotions. They may express guilt over some specific aspect of the loss, but their self-esteem is usually preserved, and any physical symptoms may fluctuate.
In contrast, when someone is depressed, they report feeling worthless, and they tend to struggle with self-loathing. They feel unable to experience pleasure, report feeling “stuck” in a persistently low mood, as well as isolated from themselves and others. They may also have generalised feelings of guilt and may reduce their functioning. They may also have thoughts of suicide.
Symptoms of depression may be similar to symptoms of anxiety, with the addition of some of the following symptoms:
- Mood swings
- Lack of energy
- Slowed thinking
- Feelings of sadness, emptiness, or numbness
Post-traumatic stress disorder
It is normal to feel highly distressed after a frightening event such as a miscarriage. Recovery from traumatic events can take time, but we know that many people do recover with the support of family, friends, and other meaningful social connections (including support groups). These feelings of intense (peak) distress should gradually settle in the following days and weeks after a miscarriage, although it is likely that you will continue to grieve and feel very sad.
Post-traumatic stress disorder (PTSD) can occur following traumatic events where a person or someone close to them was at risk of serious harm or death. Common symptoms of PTSD are:
- Re-experiencing the event (including nightmares or flashbacks)
- Avoidance (avoidance of things or places associated with the event)
- Hyperarousal – or the opposite numbing / dissociation
- Changes in mood and cognition (guilt, shame, irritability)
A list of Australian based services that offer support
We discuss common emotions people experience after a miscarriage