Grief is the price we pay for losing someone we love. We expect grief to be a time of profound emotional stress, but it also can cause serious physical effects. In some individuals, intense grief over the loss of a spouse, beloved family member or even a dear friend can manifest as an array of symptoms or, in some people, trigger a heart attack or stroke.
That’s why it is important to understand the potential physical symptoms of grief and know when to seek medical care.
What Is Grief?
Grief is a natural response to loss that differs widely and varies in intensity among individuals.
“Some people have very strong responses, while others’ responses are muted,” says Cleveland Clinic psychiatrist Rebecca Brown, MD. “People can feel extreme sadness, extreme anger or denial. No physical or emotional response is unexpected when it comes to grief and how we process it.”
Why Does Grief Affect the Body?
Exactly how a form of psychological stress like grief can affect the body can be explained by the interrelationship between your mind and body.
“The mind-body connection is an inextricable link between mental and physical wellness,” Dr. Brown says. “If we use anxiety as an example, some people get an upset stomach when they feel anxious. They feel anxiety in their mind, but it produces a physical reaction in their body.”
Common Physical Symptoms of Grief
Universally, people who are grieving suffer from fatigue, low energy levels and trouble sleeping. It is also normal to have difficulty concentrating.
Other common physical symptoms of grief include:
- Headaches and body aches
- Changes in appetite
- Digestive issues (nausea, stomach upset, changes in bowel habits)
- Muscle weakness
- Restlessness or agitation
- Chest pain or tightness
- Heart palpitations
Multiple studies have found that the death of a loved one can trigger a major cardiovascular event. The risk is highest immediately after the grief event and remains elevated for a period of time before gradually tapering off.
A study of 1,938 individuals (Circulation, Jan. 24, 2012) found that within 24 hours after the loss of a significant loved one, the rate of sudden heart attack was 21 times higher than the rate during the six-month period before the loss. In the week after the loss, the risk of acute heart attack was nearly 4.5 times higher in individuals at high 10-year cardiovascular risk than in those at low cardiovascular risk.
A larger study used the UK Primary Care database to compare the rate of cardiovascular events in 30,447 older individuals whose partner died with 83,588 matched individuals whose partner was alive on the same day (JAMA Internal Medicine, April 2014). In this study, the rate of heart attack or stroke within 30 days was twice as high among individuals whose partner had died. The risks of stroke, acute coronary syndrome, and pulmonary embolism were even higher than the risk of heart attack during the first 90 days. The risk of death peaked at three months after losing a partner, then gradually declined. However, for a year it remained 25% higher than the risk of death among older individuals who had not lost a partner.
Research has uncovered multiple factors that probably contribute to increased cardiovascular risk:
- Disruptions in sleep increase inflammation and accelerate the growth of plaque in the arteries.
- Increased platelet activation and aggregation make blood sticky and prone to clotting.
- Rising levels of the stress hormones cortisol and adrenaline raise blood pressure, blood sugar and cholesterol.
- In some individuals, the surge of stress hormones suddenly weakens the left ventricle, causing symptoms consistent with a heart attack, but without blocked coronary arteries. The condition, called takotsubo cardiomyopathy, is often referred to as “broken-heart syndrome.”
- The normal flow of oxytocin, a bonding hormone associated with feelings of safety and security, abruptly ceases, causing a surge in blood pressure, shortness of breath, and an accelerated heart rate.
How Long Do Physical Symptoms Last?
The risks of a heart attack appear to remain elevated for a year after the death of a loved one.
Most of the other physical symptoms caused by grief abate over time.
“Give yourself time, and recognize that your feelings may persist for life. It’s the way you feel and respond to triggers that improves or changes over time,” Dr. Brown says. “As a psychiatrist, my goal is not to make the feelings go away, but to change how you respond to them. For example, when you see a photo of your loved one, you may initially be overcome with tears. At some point down the road, you will be able to look at that picture without crying, but you will still feel sad.”
Coping with the Physical Symptoms of Grief
The process of grieving takes time. Just how much time is subjective: There is no proper timetable. “Some people grieve for a long period of time, and they are OK with that,” Dr. Brown says.
Similarly, there are no shortcuts or medications that will make grief magically disappear. Nevertheless, medications may be useful for some individuals. “If you have coexisting anxiety, depression or panic attacks, there is no doubt meds can be beneficial,” Dr. Brown says.
The physical symptoms of grief can be reduced or avoided by relieving stress. Practicing a healthy lifestyle is a solid foundation for progress. “Eat healthy foods, participate in physical activity, and practice good sleep hygiene,” Dr. Brown advises. (Sleep hygiene refers to behaviors that help to promote good-quality sleep. Common recommendations include, among other things, going to bed and getting up around the same time each day, refraining from caffeine consumption in the late afternoon/evening, avoiding the use of electronic devices around bedtime, and keeping your bedroom dark, cool, and quiet.)
Furthermore, Dr. Brown emphasizes the importance of staying connected with people you care about. “It is important to spend time with people who make you feel good, even if you don’t necessarily feel like it,” she says. “Avoid isolating yourself by making excuses like, ‘I’m not very good company right now.’”
Many individuals find a grief support group helpful. “It can be comforting to know you are not alone in your grief. There are others who are struggling with the same emotions as you,” she says.
Look in the self-help section of your local library or bookstore to find books about coping with the loss of a loved one. The only drawback is that you may find it difficult to determine which of the many techniques they suggest might be helpful to you.
When to Seek Professional Help
The inability to function day after day for a long period of time or losing interest in things that previously brought you joy can be very concerning. “It suggests your grief is proceeding into depression,” Dr. Brown says. “Similarly, thoughts of wanting to die or joining your loved one are red flags best served by a visit to the emergency department.”
The same is true if you experience any symptoms of a heart attack. “Don’t wait to see if they go away. Call 911 immediately, and let the paramedics determine whether or not you are having a medical crisis,” she advises.
If your grief is simply lasting longer than you expected, a professional can help set you on a path to healing. “Start by telling a physician you trust. For most people, this is their GP [general practitioner],” Dr. Brown says.
This physician will assess your situation and decide whether you would be best served by a psychiatrist or a psychologist, and whether you need medical care.
“Grief therapy can provide an outlet for the grief you are experiencing while you discuss different coping skills and techniques that can help you navigate the strong feelings and emotions associated with loss,” Dr. Brown says. “Your GP also will be able to treat most of the physical symptoms of grief and ensure they resolve.”
