Is It Normal to Feel Depressed After a Miscarriage? Telling Grief From Depression
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Expert health information, double-checked for accuracy and written to be helpful.
Last updated
Written by
Expert health information, double-checked for accuracy and written to be helpful.
Last updated
It has been three weeks since the miscarriage. You are halfway down the cereal aisle when your phone lights up: the pregnancy app you never deleted, cheerfully announcing this week's size comparison. You stand there holding the cart, and you cannot remember what you came in for.
Yes, it is normal to feel depressed after a miscarriage, and it is common. Anxiety is often part of it too, and neither means you are grieving wrong. If low mood or anxiety fills most of your day for two weeks or more, book a visit with your OB or midwife now. You do not need to wait.
Is it normal to feel depressed after a miscarriage?
Yes. Depression after a miscarriage is common, and it is more common than during an ongoing pregnancy.
The clearest recent numbers come from Farren and colleagues, published in 2020 in the American Journal of Obstetrics and Gynecology. They followed 737 women seen at three London hospitals after an early pregnancy loss between 2013 and 2016. About 3 in 4 of the losses were miscarriages, and most of the rest were ectopic pregnancies. The women filled in screening questionnaires. These flag symptoms, but they do not give a diagnosis.
One month after the loss, about 1 in 9 women reported moderate or severe depression. At nine months, about 6 in 100 did. In a comparison group of women whose pregnancies were still ongoing, about 2 in 100 reported the same.
Depression was not the most common result. At one month, nearly 1 in 4 women reported moderate or severe anxiety. Nearly 3 in 10 met the screening criteria for posttraumatic stress, the shaken, on-alert response that can follow a frightening experience. Distress was highest early and eased over time. Even so, the researchers found it was still "at clinically important levels" nine months on.
Grief, depression or anxiety: how to tell
All three can follow a miscarriage, and they can overlap. The shape of your days tells you more than how strong the feelings are.
The American Psychiatric Association (APA) describes grief as painful feelings that come in waves, often mixed with positive memories. Depression looks different. It means low mood or lost interest most of the day, nearly every day, for two weeks or more. It also brings a clear change in how your days go, such as work, relationships or the things you used to enjoy.
The APA writes this about grief after a death, so using it after a miscarriage is a reasonable extension. It also says grief and depression can happen together. When they do, the grief is more severe and lasts longer.
Guilt is not a reliable sign either way. In a 2015 US survey, almost half of people who had a miscarriage said they felt guilty. Guilt tied to the loss, such as "I should have rested more," is common in grief. A sense that you are worthless as a person points more toward depression.
| What your days look like | What it may point to | Next step |
|---|---|---|
| Painful feelings come in waves, with moments of relief or connection in between | Grief | Tell someone close to you. Book a visit if it does not ease. |
| Low mood or lost interest most of the day, nearly every day, for two weeks or more, with changes in sleep, appetite, work or relationships | Depression | Book a visit now. |
| Constant worry, racing thoughts, panic attacks, or avoiding reminders of the loss | Anxiety or a trauma response | Book a visit now. No diagnosis is needed first. |
| Waves of grief, plus low mood that does not lift between them | Grief and depression together | Book a visit now. |
If most of your days look like the second, third or fourth row, book a visit with your OB or midwife now rather than waiting to see whether it lifts.
Anxiety after a miscarriage
Anxiety after a miscarriage is as real an outcome as depression, and in the London study it was more common. It can show up even when your mood feels mostly okay.
Postpartum Support International (PSI), the main US organization for perinatal mental health, lists signs of anxiety that apply after a loss:
- Constant worry
- A feeling that something bad might happen
- Racing thoughts
- Trouble sleeping or eating
- Feeling on edge and unable to relax
Some people have panic attacks. A panic attack is a sudden wave of fear, often with a racing heart, trembling or tingling. The National Institute of Mental Health (NIMH) says one can last "from a few minutes to an hour or sometimes longer." NIMH also notes that a single panic attack on its own is not a mental disorder. Panic attacks are still worth telling a clinician about.
Others notice signs of a trauma response. These include flashbacks to the loss, nightmares, or going out of your way to avoid reminders of it. NIMH counts symptoms like these as PTSD (posttraumatic stress disorder) when they last longer than a month and get in the way of daily life, such as relationships or work.
A diagnosis of generalized anxiety disorder needs at least six months of hard-to-control worry, according to NIMH. That does not mean you have to wait six months for help. PSI puts it plainly: "You do not need a diagnosis to reach out for help."
When it eases, then comes back
For many people, the hardest weeks are the first ones. In the London study, distress was highest at one month and eased from there.
Some people describe a different pattern. They start to feel better, then get hit again weeks or months later. It might come around the due date, or when life slips back into its usual routine. Research has not measured how often this happens. That does not make it any less real for the people it happens to.
A second wave gets the same answer as the first. If low mood or anxiety fills most of your day for two weeks or more, book a visit, even if you felt fine a month ago.
It is easy to talk yourself out of it. It may not look like the depression you expected. You may feel you should be past it by now, or that an early loss does not count. Those thoughts are a reason to speak up sooner.
For more on how grief itself changes with time, read about whether grief gets better after a miscarriage.
What to do this week
You do not have to sort out exactly what you are feeling before you act. These steps make sense whether this turns out to be grief, depression, anxiety or a mix.
Today: tell one person
Pick one person you trust and tell them how you are really doing. Here is a suggestion you can change to fit you: "I'm not okay since the miscarriage. I don't need you to fix it. I just need you to know." Feeling alone after a miscarriage is common. In the same 2015 survey, about 4 in 10 people who had a miscarriage said they felt alone.
Keep the basics going where you can. The APA says regular, good sleep, healthy meals and avoiding alcohol can help ease symptoms of depression. NIMH says choices like getting enough sleep can reduce anxiety when paired with treatment. This is general guidance for depression and anxiety, not something tested after a miscarriage.
Some people also choose to mark the loss in their own way, such as writing a letter or planting something. That is a personal choice, and there is no right way to do it.
In the next few days: book a visit
Call your OB or midwife's office, or your primary care clinician, and ask for a visit about your mood. ACOG, the national organization for OB-GYNs, tells people who are having trouble with their feelings after a pregnancy loss to "talk with your ob-gyn or a counselor." The APA suggests asking for "a thorough evaluation."
At the visit, ask for a depression and anxiety screen, such as the PHQ-9 and the GAD-7. These are short questionnaires that most clinics already know. Both ask about the past two weeks. The EPDS, a screen written for after birth, asks about the past week instead. None of these has been checked specifically for people after a miscarriage. They still give you and your clinician a shared way to put your experience into words.
If things get worse before your appointment, call your OB or midwife's office, and call 911 or go to the emergency room if you cannot reach them.
If you hear "it's normal"
Some clinicians answer grief with reassurance and stop there. You can ask again. Here is one suggested way to say it, in our words rather than a guideline's: "I know grief is normal. What I'm describing has filled most of my days for weeks, and I'd like a screen for depression and anxiety, or a referral to a perinatal therapist."
For more ideas on wording, see what to say to your doctor about miscarriage grief.
You can also go straight to a perinatal therapist. PSI's online directory lists mental health professionals in the US and Canada who have completed specialized perinatal training. The PSI HelpLine, 1-800-944-4773, can help you find one. You leave a confidential message, and a trained volunteer calls or texts you back. The HelpLine runs from 8am to 11pm Eastern and does not handle emergencies.
If you are in crisis
If you have thoughts of not wanting to be here, or of ending your life, call or text 988 now. The 988 Suicide & Crisis Lifeline is free and open 24/7, and you can also chat with it online. If you are in immediate danger, call 911 or go to the nearest emergency room. Two other lines offer support, but they are not crisis lines. The National Maternal Mental Health Hotline, 1-833-852-6262 (1-833-TLC-MAMA), answers calls and texts 24/7 for support before, during and after pregnancy. The PSI HelpLine, 1-800-944-4773, is a call-back line for non-urgent support.
What treatment looks like
Structured help after a pregnancy loss has evidence behind it. A 2021 review of trials looked at psychosocial support for parents after a pregnancy loss, including miscarriage. Psychosocial support means structured help that is talk-based or support-based. The review found it reduced depression, anxiety and grief.
PSI lists evidence-based talk therapies for depression and anxiety in the perinatal period, which PSI defines to include life after a loss. These include cognitive behavioral therapy (CBT), which looks at the links between thoughts, feelings and actions, and interpersonal therapy (IPT), which focuses on relationships and changing roles. For PTSD after a miscarriage, NICE, the UK's national guideline body, recommends trauma-focused CBT or EMDR (eye movement desensitization and reprocessing).
Therapy is for people who are struggling. It is there if your days look like the harder rows of the table above.
Therapy is not the only option, and a clinician can help you weigh the others. Whether medication belongs in your plan is a decision to make with a prescriber, such as your OB, a primary care clinician or a psychiatrist.
Depression and anxiety after a miscarriage are treatable. A perinatal therapist is trained in mental health around pregnancy, including after a loss, so you do not have to explain why an early loss can hurt this much. Phoenix Health offers online grief therapy after miscarriage with perinatal therapists. All sessions are via secure video. Most Phoenix Health therapists hold PMH-C certification, which is PSI's certification in perinatal mental health, awarded after specialized training, work experience with perinatal clients and an exam. You can check your insurance coverage before you book.
The cereal aisle, the app you could not bring yourself to delete, the days that feel heavier than you expected: none of it means you are grieving wrong. It means you lost something, and you are allowed to get help carrying it.
Frequently Asked Questions
- Clinicians usually would not use that label, because the term postpartum depression is defined around childbirth. Postpartum Support International, though, counts depression and anxiety after a pregnancy loss as part of perinatal mental health, alongside pregnancy and the months after birth. In practice, the name matters less than the help. Depression after a miscarriage is treated in much the same way, and perinatal therapists work with it.
- Not in the way many people assume. In a 2022 analysis of the same London women, how far along the pregnancy was did not predict who was struggling a month after the loss. An early miscarriage is still a loss, and the feelings that follow it deserve the same care.
- No. You can contact a perinatal therapist with what you have noticed so far. NIMH describes a first appointment as a conversation: the clinician may ask when your symptoms began, how long they have lasted, how often they happen and how they affect your life. If a diagnosis fits, it comes out of that conversation. You do not have to arrive with a name for what you feel.
- Maybe not, and a difference is not a sign that either of you is doing it wrong. In the London research, male partners were less likely than the women to reach the screening cutoffs for anxiety, depression and trauma-type stress, though some still did. ACOG notes that your feelings of grief may differ from your partner's. A gap like that can feel lonely, and it is worth saying out loud.
- Yes, for now. Stepping back from showers, announcements and pregnant friends is common in the weeks after a loss, and it can protect you while things are raw. It becomes worth raising with a clinician when the avoidance has lasted more than a month and is shrinking your life, such as missing work or cutting off most of the people close to you.
- It can. In the 2022 London analysis, about 3 in 4 women with a current mental health diagnosis met the screening cutoff for anxiety, depression or posttraumatic stress a month after the loss. So did more than half of those with a past diagnosis, and fewer with none. About half of women with a previous loss met it too. The researchers still concluded that "all women should be considered at risk."
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