It is not always clear when to seek help after pregnancy/infant loss. We wonder whether consecutive days of incessant crying is part of the healing process; Or perhaps feelings of numbness is perfectly normal. For many, seeking help may come with stigma. For others, it may appear unnecessary and unhelpful in dealing with the acute pain of loss. Still, it is important to recognise that seeking professional support can enable us to cope better following a miscarriage/infant loss, especially when dealing with anxiety and depression.
Nothing Really Matters
Following our loss, Florian and I learned that so many things we once thought important, no longer were. Office politics, that pay raise, the cute bag at the store… They no longer looked shiny and desirable. Next to the lives we had connected with in those six short months, they paled. They were nothing.
Instead, we realised even more, the importance of valuing time – Time with each other, time with family, time with friends. We decided to invest more quality time with the people who matter, and the people who we matter to.
Some arguments, we realised, weren’t worth having. Our lives, as the world recognises, are far too short to be spent on mindless misunderstandings. Instead, we have been using our time to create new memories, to laugh more, and to love harder.
For Florian and I, our loss taught us to see more clearly, the things in life that truly matter. The thing is, for some parents who have suffered pregnancy/infant loss, what happens when nothing matters anymore?
Grief or Depression?
How can we tell when grief weeps into clinical depression? This may be a difficult one to look out for because the line between grieving and depression can be somewhat blurred. You see, while many may look towards how long the feelings of listlessness, sadness, hopelessness… have lingered, the truth is, there is no time limit for grief. Some parents grieve for months, others, years.
Are you finding it too difficult to face the world each morning? Are you unable to eat regular, balanced meals? Is it still too painful to forget even for a moment, and laugh with friends, or engage in something you used to enjoy doing as a form of therapy? If sadness is too overwhelming and affects your daily life, then you may be struggling to cope with the aftermath of your loss.
For women who have had depression before, pregnancy/infant loss can trigger a spiral back into another episode. For those who struggle with fertility and have no children yet – like me, there is a higher chance of developing depression. In cases such as these, I suggest seeking a therapist or psychologist even before depression sets in.
Seeking Help for Depression
I have shared previously that I sought out my therapist immediately after our pregnancy loss. My first session with her was less than a week after – only a day or two after I was discharged from hospital. I felt that I needed that extra support to set me on the right track towards emotional healing. Even though I had all the love surrounding me already from Florian and our loved ones, I knew that I needed A to help me untangle all the knots that had built up in the two weeks I was in hospital.
There were days where I wondered whether there was anything more in life for me. Many times, I visited the ‘whys’ and ‘what ifs’. Every day, I still think of our precious babies, but no longer in a way that makes my heart ache. With A’s help, I learned to accept what happened from a healthier perspective.
Some parents may need medication to help treat depression. Others may be able to find healing and ways to cope through a support group. I tend to believe in prevention rather than cure. As such, I think there is no harm in seeking professional support before grief is diagnosed as depression.
A shared with me that aside from looking out for signs of depression, she also had to watch for symptoms of anxiety disorders after our pregnancy loss. The more common ones seen after pregnancy/infant loss are generalised anxiety disorder (GAD), acute stress disorder (ASD) and post-traumatic stress disorder (PTSD).
Generalised Anxiety Disorder (GAD)
I struggled with GAD to some extent a couple of months after our miscarriage. I began worrying excessively and persistently day after day about anything relating to fertility and pregnancy.
When my doctor suggested a Saline Infusion Sonohysterography (SIS) to check for possible scarring or lesions in my uterus, I anticipated the worst. I loathed the idea of finding something wrong and having to wait longer than expected to try conceiving again. And yet, I feared not falling pregnant again. On the flip side, if I did, I also worried miscarrying again. I wondered if my cervix was too weak, or whether my frame is too small to carry even a single baby. I questioned my womanhood as if it were tied to birthing healthy babies.
While fears and worries are normal, they can be especially heightened due to the sense of grief experienced post-loss. This makes GAD difficult to control. Some symptoms of GAD are fatigue, restlessness, memory lapses or poor concentration, and irritability (which may be related to poor quality sleep).
Acute Stress Disorder (ASD)
ASD is more commonly found in women who have miscarried before 20 weeks of gestation. It occurs shortly after loss and can last up to a month.
Symptoms include a sense of feeling numb towards the event, as though it was all a blur. Some women may find themselves having flashbacks or repetitive dreams about their miscarriage. As such, they may try to avoid interaction or visiting places that remind them of their pregnancy.
Post-Traumatic Stress Disorder (PTSD)
PTSD follows a similar set of symptoms from ASD except that it carries on and stretches out longer than a month. How severe PTSD symptoms are have no relation to when the miscarriage occurred. Symptoms usually alleviate after the second month.
That being said, I still struggle with going to certain places especially where happy memories were made with my burgeoning belly. I continue to have flashbacks of the labour and delivery. Sometimes, I twist reality and imagine that we managed to save them. However, I cannot deny that the sharp ache I once used to feel at the thought of our little angels has dulled substantially. I have returned to places where we once were together, and each time, the pain lessens.
Seeking Help for Anxiety Disorder
There was a study performed suggesting that as many as 15% of women who have had a miscarriage showed signs of clinical anxiety and/or depression persisting for as long as three years. As such, dealing with emotional and psychological issues after such a big loss is far more common than we may think.
It doesn’t matter whether you have been struggling with symptoms for a week, or five years. No symptom should ever be ignored.
In this day and age, professional help is easily accessible. You can find lists of qualified mental health professionals online, read reviews on them, and find one you may be comfortable with. You can also get access to help through your GP or the hospital you were with. Seeking professional help can help us cope with our fears, worries, and sadness. It can help us regain some semblance of normalcy, and return the control we may have lost.
Remember this: Healing does not mean we forget.
Surround yourself with loved ones. Search for support groups. Give yourself time to grieve. When it all gets too overwhelming, know that it is okay to look for external help to get you through the storm of emotions. And you will get through it, stronger and braver than before!