How Grief Can Affect Our Health
As Benjamin Franklin famously noted: nothing in this world is certain except death and taxes.
But when death comes sooner than expected to a loved one, or even when we’re prepared for the possibility, the ensuing grief can be debilitating, impacting many aspects of our life and our ability to focus and function when it comes to basic living skills.
Grief affects people differently. Some muster through, while others suffer under the crushing emotional weight. Loss sends some into a deep depression. Others battle insomnia, the trauma of death playing on a constant repeat loop as they struggle to find a psychological pause button to help them survive and thrive.
If you’re grieving, there is help. Start by leaning on your family, your friends and your healthcare providers. They can help you develop strategies to cope and practice self-care to minimize grief’s potential to harm your health.
The physiological impact of grief has been well studied. When a close loved one dies, studies show correlations with an increased risk of health issues. When we lose our partner, especially in our later years, our own mortality risk goes up within the first six to 12 months.
One study of more than 4,000 widowers in the 1960s found that 40% died within the first 6 months compared to non-bereaved participants in the control group. The findings confirmed the direct link between spousal bereavement and adverse health, even when accounting for socioeconomic factors and other health risks.
A more recent study found that compared to non-grieving participants, those who were grieving were at increased risk of dying from any cause, including stroke, cancer, coronary heart disease, cardiovascular disease and even accidents.
Studies have focused on different health impacts, but there is no known physiological mechanism identified that raises our risk during the early bereavement period. Stress, cardiovascular disease, immune function, even digestion may play a role in raising our mortality risk or it may be a combination of variables.
Even so, research has identified specific negative health impacts that grieving people face: Increased stress, increased cardiac risk, weakened immune function, disrupted sleep or insomnia, abdominal issues and an overall diminished quality of life.
Studies of bereaved spouses and parents show that levels of the stress hormone cortisol rise and remain increased for the first six months of bereavement for spouses. Those levels can stay elevated for longer. When the death was unexpected, cortisol levels were even higher. Interestingly, cortisol levels were higher for bereaved men than women.
Immediate and prolonged grief affects both heart rate and blood pressure, increasing cardiac risk. Grief can also trigger an irregular heart rhythm or atrial fibrillation.
While there have only been a few studies to date looking at heart rate impact, the Cardiovascular Health in Bereavement (CARBER) study found bereavement can significantly raise the heart rhythm by five beats or more due to increased levels of cortisol and anxiety, and it can take six months or more to return to normal.
Hemodynamics—how blood flows through the body’s systems—is also impacted by traumatic grief, causing potential increases in blood pressure (BP). The combined conclusions of several studies and prospective surveys of widows and widowers show that increased BP can take considerable time to resolve — an average of four years after bereavement. Increased BP associated with the stress of mourning has also been linked with an increased prevalence of hypertension after controlling for other cardiac risk factors.
A more recent study that measured BP at two weeks and six months of bereavement found that BP can increase significantly, especially in older people.
Grief also impacts our immune system. Research shows that especially during the early grieving period, neutrophils—non-specific inflammatory cells—can significantly increase, and leukocytes decrease. Those are the white blood cells that fight foreign invaders such as bacteria and viruses. This can lead to systematic inflammation, which can negatively affect the health of a number of systems in our bodies, including our heart health.
Grieving can potentially cause a variety of gut health and abdominal-related symptoms, including loss of appetite, nausea, overeating and general stomach pain. Separately or together, these can lead to reduced energy levels due to nutrient and vitamin deficiencies and negatively affect your immune system, sleep and mood.
While not definitive, research is starting to point to a brain-gut pathway that may be affected by depression and anxiety experienced with grief.
Questionnaires, community-based studies and EEGs (electroencephalography) show evidence of sleep disturbance caused by grief during bereavement, lasting for months and sometimes years. This includes lower sleep quality and efficiency, increased risk of interrupted sleep and, as one study found, a higher incidence of hypnotic medication use. Worse sleep measures are also linked to higher levels of depression during bereavement.
Researchers believe that bereavement-related thoughts can disturb our sleep and is the primary mechanism causing sleep interruption, especially the duration and quality of deep REM sleep. People who are grieving may be unable to shut off their thoughts, especially when they’re alone at night and there are no other distractions.
Not surprisingly, this prominent disruption of sleep patterns is associated with bereavement-related depression.
Grief from the loss of a loved one triggers a powerful range of swirling emotions that can overflow when least expected. Anger, sadness and hopelessness during bereavement can lead to negative physical outcomes, including chronic pain, weight changes, poor sleep hygiene, withdrawal from activities normally enjoyed and general and sometimes total social withdrawal.
Studies show grief is also linked to increased episodes of suicide.
Help for Grief
While studies show that grief can hurt our health, there are strategies for coping with it. And the extent of our bereavement, how we handle loss and the direct impact on our health varies greatly from person to person.
No matter how healthy you are, when a devasting loss happens, in addition to accepting the support of family and friends, it’s imperative to have a check-in with your primary care doctor who can monitor your health closely, refer you to additional services as needs and help you navigate through your grieving process.