A Double-Edged Sword: Facing the Grief of Miscarriage with Bipolar Disorder

A Double-Edged Sword: Facing the Grief of Miscarriage with Bipolar Disorder


Listen to Executive Director Gabriel Nathan read this post aloud:

Grief is a part of life. We lose loved ones. Sometimes we even grieve parts of ourselves or our lives that are gone; an estranged lover, friend, or family member, our pasts, former homes. And sometimes we grieve things or people that never came to be, such as was the case with my recent miscarriage. It was never a child, but the promise of one, a future I had planned for that never was. Another version of that future may yet exist, and yet I am left with the feeling of loss of something I already felt connected to, of a part of myself.

While miscarriages are common, they can also feel very isolating. No one else was experiencing my exact pain, the loss of this person whom I had named in my head, whom I had pictured, this version of myself that I could imagine, that felt as though it had slipped through my fingers like sand. Plus, there was the loneliness of not being able to talk about it openly, of the way bringing it up would make people uncomfortable or send me into an emotional tailspin. A simple question like “Do you have kids?” could ruin my day. Do I give this grief space, a voice, I asked myself. How much? How do I move on, let go? At times, the pain felt like it would never go away and would, in fact, consume me.

While my loss is less than a year fresh, for some people, grief doesn’t lessen with time. The American Psychiatric Association estimates 7-10% of people struggle with Prolonged Grief Disorder (PGD), which is characterized by intense and persistent grief that causes problems and interferes with their daily life. The APA say symptoms of PGD include “identity disruption (such as feeling as though part of oneself has died); marked sense of disbelief about the death; avoidance of reminders that the person is dead; intense emotional pain (such as anger, bitterness, sorrow) related to the death; difficulty with reintegration (such as problems engaging with friends, pursuing interests, planning for the future); emotional numbness (absence or marked reduction of emotional experience); feeling that life is meaningless; and intense loneliness (APA, 2022). While this isn’t my diagnosis, I don’t want to suggest that all grief goes away or that there is a specific timetable for healing. Every person processes differently.

Another challenge presented by my miscarriage was that, at least in the immediate aftermath of the loss, I was dealing with raging pregnancy hormones that wiped me out emotionally. Add to the mix bipolar disorder, and I was on a wild, and not-at-all-fun, roller coaster ride. The combination of hormones, grief, and brain chemistry made it for me, at times, nearly impossible to function. There were moments when the familiar bipolar rage came out, random and uncontrollable anger at the world and myself that would make me snap at the innocent people around me (mostly my husband) for something innocuous or inconsequential—a snide comment I couldn’t let go, loading the dishwasher the ‘wrong’ way, using a certain tone. These minor setbacks, at times, felt catastrophic, that I wasn’t good enough, that everything would always be this hard. There were days I couldn’t stop crying. And then, of course, there was the bipolar depression, hopelessness, and the overwhelming anxiety that something I wanted more than I’d ever wanted anything would never happen for me. That it would never get better.

People were sympathetic at first (and, in some cases, not so much, with an insensitive remark or lack of empathy), but after a while, I felt like I was supposed to be better by now. To just get over it. Even though my work gave me a week and a half of paid sick leave off (a luxury many, if not most, women/formerly pregnant people don’t get), at some point I had to dust myself off and get back to my life. I was lucky enough to be able to decide to work from home so I could break down on my own schedule. But still. I was expected to move on even when it felt impossible.

People said things like ‘oh, it’s so common,’ or, ‘at least now you know you can get pregnant!’ or ‘it’ll be different next time.’ And while those things may or may not be true, they did little to lessen the sting, and at times, made things much worse. Being told “at least now you know you can get pregnant” (by multiple people) belittled my experience, made it sound like it wasn’t so bad, which made me feel like I wasn’t supposed to feel this way.

“You’re better now, though, right?” a well-meaning family member asked me roughly three months after the miscarriage. After an awkwardly long pause, I said, “I don’t know how to answer that.” Because the truth was…sort of? But also, not really. And it made me feel like, ‘Oh, I’m supposed to be better by now. And I’m not.’ Like my grief was an inconvenience for other people, which perpetuated the cycle of feeling bad then feeling worse for feeling that way.


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“I think you were more attached to it than I was,” my husband said, and of course that’s true, because it was a literal part of me. Also, I’m more emotionally attached to pretty much everything than he is (bipolar is no help there). But the comment did remind me that I was alone in this grief; that maybe he was disappointed when he had to contact the childcare center to take us off the waiting list (I couldn’t bring myself to do it) or when we crumpled the sonograms and threw them in the trash or crossed off the heart on our due date on the calendar in the kitchen. But he moved on. And I didn’t know how to.

Loss and grief can put immense pressure on a marriage. It’s one of those moments that either brings you closer or pushes you apart. Fortunately for us/me, I’ve learned to lean on my husband more when I need to, to share my feelings, even when they’re irrational, even when he doesn’t always understand, and he’s learned to listen (mostly) patiently. It was hard not to resent him at times for seeming to move easily in the world when I felt stuck. Sometimes I snapped at him, but he was good-natured about it. He let me vent, bought me flowers, brought me croissants from my favorite bakery, watched whatever cheesy movie I wanted without complaint. Even though I’m sure it was painful and disappointing for him, too—though he doesn’t talk about his emotions much–he was, as always, my rock.

This kind of loss is unbelievably painful and difficult for anyone, I’m sure. I don’t mean to suggest that my mental illness somehow makes it worse than what other people experience. But it has added a layer of complication towards healing for me. And, in my case, set me back in my mental health journey. I thought I was over this shit! I went to years of intensive psychoanalysis, spent thousands of dollars out-of-pocket, I’m on all the right combination of medications now. I thought I’d been through the worst of it. But this grief feels like a whole new level of depression I’ve never experienced before.

But, I wasn’t starting from scratch. I had learned coping mechanisms, coping mechanisms that have been invaluable to this months-long (and, I can only assume, much longer to go…) process of healing from this specific grief. I had a team in place. I had self-care strategies.


Though I had been out of therapy for more than two years, I immediately reached out to my former therapist, with whom I had developed a strong connection over the course of four years. She got back to me right away, cleared her schedule as soon as possible and made time for a remote appointment. She offered to do so again whenever I needed it. At my regular psychiatrist check-in, I was forthright about what I was dealing with and how it was going (short answer: not great). She asked the right questions: What are you doing to honor the loss? What are you doing to bring yourself joy? Who are you able to talk to during bad days? and I had answers to all of them. Was I getting enough sleep, taking my medications? Yes, and yes. “It sounds like you’re doing what you need to do to take care of yourself,” she said. And I realized she was right. I was doing all the things. I had learned a lot in the past five years since my bipolar diagnosis and the series of manic episodes that led to it. And yet getting through a day without sobbing uncontrollably seemed like an impossible goal.

I canceled plans with friends when I just really needed some quiet alone time, something that always brings a sense of guilt (we’d been planning this party! I wanted to see them! But I knew I couldn’t leave my house.). I worked from home. I took breaks to close my eyes, do breathing exercises, and even take a short nap when things felt too overwhelming. I watched childhood movies that gave me warm-and-fuzzies and comedies that made me laugh through the tears. I bought easy-to-make comfort foods and eventually felt up to cooking again, something that usually calms my anxiety. I took hot baths (something I hadn’t been able to do while pregnant). Wrote in my journal. Got lots of rest.

Still, there were stumbling blocks all over the place: friends talking about their pregnancies or young kids, strangers feeling the need to comment on my body and ask if I’m pregnant, expecting good news that I’d be happy to share, only to be met with tears. Sometimes it was just a comment about the last few months, something about the spring skiing I hadn’t been able to enjoy because my OB/GYN had advised against it, or something else I had missed out on or done differently because of the pregnancy that had ended abruptly and cruelly. The too-big dress I bought for the wedding I thought I’d be attending at eight months pregnant, the beautiful dress that sits in my closet still, tags on.

Grief is always hard, and it never fully goes away. But, in most cases, it does ease with time, just like a mental health crisis does, if properly treated. Slowly—more slowly than I’d like—I am recovering. When friends who I know I can confide in ask how I’m doing in a tone that acknowledges they have an idea what my answer will be, I say, “Today is better than yesterday,” or “Still kind of raw,” or, sometimes, “Eh…not great.” And they nod, give me a hug, say “If you need anything…” Shortly after it happened, my supportive husband asked what I needed and I told him, “I honestly don’t know right now.” And it’s okay not to know, but essential to have supports in place that can help you figure it out, bring you small joys, make each day better than the last.



​EXECUTIVE DIRECTOR / EDITOR: Gabriel Nathan | DESIGN: Leah Alexandra Goldstein | SITE ORIGINATOR: Bud Clayman



Erika Nichols-Frazer (she/her) is the author of the memoir, Feed Me: A Story of Food, Love and Mental Illness (Casper Press, 2022) and the poetry collection, Staring Too Closely (Main Street Rag, 2023). She also edited the mental health recovery anthology, A Tether to This World: Stories & Poems About Recovery (Main Street Rag, 2021). More than 30 of her essays, poems, and short stories have appeared in journals such as HuffPost, River Teeth's "Beautiful Things," Asylum Magazine, oranges literary journal, and elsewhere. She has an MFA from the Bennington Writing Seminars. She is the Writing & Humanities Coordinator at Vermont State University (Johnson) and owns Good Wolf Literary Services. She lives in Vermont with her husband, dogs, cat, and chickens. Find her work at nicholsfrazer.com.