PTSD after a miscarriage
22nd May 2020
Miscarriage and PTSD are probably two things you wouldn’t associate together. When you think of post-traumatic stress disorder, you probably imagine fighting in wars, or being involved in a car crash. You may not think about the trauma experienced with early baby loss. However, in January this year, Adia expert Dr Jessica Farren published a major study into the connection between the two. In today’s blog post, we’ll look into what PTSD involves, and learn the surprising statistics that prove PTSD after miscarriage is more common than you may think.
What is PTSD?
Post-traumatic stress disorder is a type of anxiety specifically triggered by a frightening or distressing event. After a trauma, it’s common for people to struggle with heightened anxiety or feelings of stress and sadness. However, with PTSD these issues can go much deeper and can last much longer.
When you go through a distressing situation, your body goes in to fight or flight mode – releasing adrenaline. However, with PTSD it’s like your body has got stuck in that mode. It continues to send out stress signals, even once the trauma is over. Studies show that the part of the brain that handles fear and emotion (the amygdala) is more active in people with PTSD. This can last for months, if not years if not treated properly and result in a myriad of symptoms including nightmares, insomnia, panic attacks and isolation.
Can you suffer from PTSD after a miscarriage?
This recent study, led by Adia expert and gynaecologist, Dr Jesscia Farren, revealed that women who experience early miscarriage and ectopic pregnancy are at risk of developing PTSD.
The study, which was published the American Journal of Obstetrics and Gynaecology surveyed 650 women who had lost their baby at 20 weeks or less, or had experienced an ectopic pregnancy – where the baby develops outside the womb. This was the largest ever study into the psychological impact of early-stage pregnancy loss. The women were sent questionnaires, asking them about their feelings, one month, three months and nine months after their loss. The results were concerning. One month following pregnancy loss, nearly a third of women (29%) suffered post-traumatic stress. In addition, nearly a quarter experienced moderate to severe anxiety and 11% had moderate to severe depression. Nine months later, 18% of the women involved in the study still reported symptoms of PTSD.
Mainly the women involved in this study reported re-experiencing the feelings associated with the pregnancy loss on a regular basis. Many also said they experienced intrusive thoughts about their loss, and had nightmares or flashbacks. Others said that they were avoiding anything that reminded them of the loss – such as friends and family who were pregnant. Nearly a third of the women who were showing signs of PTSD after 9 months, said their symptoms had impacted their work life. Even more said they were affecting their relationship with friends and family.
What does Jessica Farren make of these results?
Adia expert Dr Jessica Farren led the research from Imperial College London. She was astounded at how prominent and long-lasting PTSD like symptoms were amongst the women in the study. “We were surprised at the high number of women who experienced symptoms of PTSD after early pregnancy loss – particularly the number of women who were still experiencing symptoms three months after their miscarriage.” She points out that miscarriage and ectopic pregnancy are incredibly common (1 in 2 women will experience one in their lifetime) – and that this therefore points to an important public health concern.
The fact that this study focused on women who have experienced loss early on in their pregnancy was really important to Jess, as it’s a bereavement that often gets forgotten. “There is an assumption in our society that you don’t tell anyone you are pregnant until after 12 weeks. But this also means that if couples experience a miscarriage in this time, they don’t tell people.” Jess says. “This may result in the profound psychological effects of early pregnancy loss being brushed under the carpet, and not openly discussed.”
Jessica hopes that this research will bolster the case for having more robust mental health checks for women that have experienced loss.
“At the moment, there is no routine follow-up appointment for women who have suffered an early pregnancy loss. We have checks in place for postnatal depression, but we don’t have anything in place for the trauma and depression following pregnancy loss. Yet the symptoms that may be triggered can have a profound effect on all aspects of a woman’s everyday life, from her work to her relationships with friends and family.”
How to recognise the signs PTSD
As the research mentions, one of the most common symptoms of PTSD is flashbacks. These may come in the form of nightmares or could be triggered by something in your day-to-day life reminding you of your horrible experience – for example, walking past the hospital. Flashbacks could be extremely vivid, making you feel like you are reliving the experience. However, it’s possible to have flashbacks at a much lower level. You may find yourself overwhelmed by the same emotions you felt at the time or you could have scary thoughts or nightmares about an unrelated subject.
Insomnia can be another key symptom of PTSD. You may find yourself struggling to sleep if you are having nightmares, but it could also be down to the increased levels of adrenaline in your system if your body is stuck in fight or flight mode. A lack of sleep can also perpetuate your other symptoms and make recovery harder. Other symptoms include, but are not limited to:
- Irritability or outbursts of anger
- Irrational and intense fear
- Difficulty concentrating
- Being easily moved to tears
- Panic attacks
- Anger or aggressive behaviour
- Tense muscles
- Inability to remember an important aspect of the trauma
- Guilt, shame, embarrassment or self-blame
Many people, including those in the study, reported avoiding friends, family or activities they used to enjoy.
Can you have PTSD and depression at the same time?
PTSD and depression share many similar symptoms, but they are separate mental health issues and should be treated as such. That said, it’s very common to suffer from both PTSD and depression simultaneously.
Importantly, if you have depression you are more likely to experience PTSD and vice versa. That means you can be suffering from depression after loss and PTSD. This might sound overwhelming, but pinpointing the unique symptoms will allow your doctor to find the most effective treatment plan for you.
How do you manage PTSD?
Firstly, it’s important to know that It’s possible to make a full recovery from PTSD. Some people even find the symptoms go away on their own over time. However, you can suffer from symptoms for many years, especially if they go unidentified. Early recognition and intervention is one of the most important factors in aiding recovery from PTSD. This is one of the reasons Dr Jesscia hopes screening will be introduced for women who have experienced loss. Once your doctor is aware that you could be at risk of PTSD, they will be able to suggest a tailored plan of action.
Psychological therapy is one of the most effective ways of treating PTSD, and there are many different approaches you can try. Trauma-focused CBT can help readjust your thinking around your negative experience and can help relieve feelings of guilt or shame.
You can also be prescribed medication that can help manage your symptoms – but it is usually a last resort. Some medication usually prescribed for depression can be effective in treating PTSD. If you are struggling after loss you should contact your GP and let him/her know what you are feeling. Your GP will be able to advise exactly what would be the right course for you.
If you are looking for general support on your fertility journey. Join Adia for free today. You will be able to access advice from our panel of experts, including Dr Jessica Farren, as a well as guided meditations and nutrition plans.