The Pain Of Loss: Understanding The Physical Symptoms Of Grief

Grief over the loss of a loved one can be a deeply distressing, fatiguing, and challenging experience. In addition to the potential psychological impacts, severe grief responses can negatively affect your physical health. What are the physical symptoms of grief, and where do they originate? Understanding how painful emotions can affect your body may help you maintain your well-being as you come to terms with your loss.

Grief can involve a prolonged period of heightened emotions and mental stress. This may lead to abnormally high activity in your body’s sympathetic nervous system, potentially causing downstream effects on aspects of function like sleep, digestion, and cardiovascular health. Taking care of your physical health and seeking help from loved ones and grief counselors may relieve these grief-related symptoms. 

How does grief affect your health?

Recent advances in medical science have illuminated the many links between emotional stress and health complications. The loss of a treasured relationship can be a source of profound mental strain and strong negative emotions, such as sadness, guilt, anger, bitterness, and despair. This type of severe stress can disrupt several crucial biological systems that are regulated in part by brain activity, including those discussed below.

Immune function

The body’s response to disease and injury can be strongly affected by psychological distress. Strong negative emotions, including those commonly experienced during the grieving process, can lead to excessive activation of the hypothalamic-pituitary-adrenal (HPA) axis. This interconnected set of brain structures and endocrine glands typically plays a significant role in the regulation of immune activities like inflammation. 

Researchers have found that stronger grief reactions tend to be associated with higher concentrations of stress hormones and higher levels of inflammation throughout the body. This elevated, prolonged immune response can disrupt the healthy functioning of various physiological systems, leading to many physical symptoms.

Gene expression

The emotional disruption caused by bereavement may also change patterns of genetic and epigenetic activity. Some studies have found evidence that grief-related stress could cause the increased expression of genes involved in immune system activation. This could increase the inflammatory response to loss described above in the short term while heightening an individual’s long-term sensitivity to stress.

Gut microbiome

Recent research has found that the activity of symbiotic bacteria and fungi within the human body may play a significant role in regulating health, and that these microorganisms may respond to changes in mental and emotional states. Stress-induced shifts in these microbial communities within the digestive system could play a role in the development of metabolic and appetite-related symptoms often seen in people living with grief.

Types of physical symptoms related to grief

The body may respond to the experience of grief in many ways. Below are some of the most common reactions.

Sleep disturbances

This association seems to be linear. More severe grief may lead to higher rates of sleep disorders. When you’re strongly affected by bereavement, you may have trouble falling asleep and staying asleep, and you may sense you are less well-rested in the morning.

Fatigue

Intense grief can result in tiredness due to the toll that distressing emotions can take on the body. Fatigue can be a commonly reported response to bereavement. This may be due partly to reduced sleep quality, but research suggests that it may also occur as a psychosomatic response to elevated inflammation resulting from grief-related mental health difficulties.

Changes in eating and metabolism

Loss of appetite can be another common effect of grief. Psychological stress can lead to increased activation of the sympathetic nervous system — the initiator of the so-called “fight-or-flight” response that normally activates in the presence of a threat. Because your body may be expecting danger at any moment, your appetite may decrease in preparation for making a rapid getaway. 

However, responses to loss tend to be highly variable, and some grieving individuals may experience overeating, binge eating, or consuming “comfort foods” that lack nutritional value. Foods high in salt, sugar, and fat may soothe acute stress in the short term but can contribute to poor health consequences in the long run. This risk may be exacerbated by grief-related changes in metabolism that can increase fat storage and appetite.

Heart disease

Investigations into grief and mortality have found that people who lose close family members are usually at an elevated risk for a fatal heart attack. This danger seems to be highest in the first week after the loss, though it doesn’t necessarily go away completely afterward. 

The loss of a spouse, child, grandchild, or sibling may carry a particularly high risk. One form of heart failure — takotsubo cardiomyopathy — tends to be so strongly associated with grief and stress that it’s earned the nickname “broken heart syndrome.” 

Grief can increase the risk of heart problems in a variety of ways, including the following:

• Acute emotional stress
• Weight gain due to appetite changes
• Grief-related metabolic shifts
• Elevated blood pressure
• Increased inflammation

Health risks of normal grief vs. complicated grief

While any form of grief may carry a risk of physical symptoms, some kinds of maladaptive grief responses may substantially elevate this danger. These conditions are considered mental health disorders and may be referred to by a variety of terms:

• Prolonged grief disorder (PGD): Previously known as prolonged complex bereavement disorder, PGD generally refers to an intense grief reaction that persists for a year or more and causes significant impairment. 
• Complicated grief: While complicated grief isn’t an official diagnostic category, many researchers and clinicians use this term to describe grief that’s intertwined with severe symptoms of mental illnesses, such as major depressive disorder or generalized anxiety disorder.
• Traumatic grief: This indicates a specific type of complicated grief resulting from an unexpected or violent death, which may increase the likelihood of PTSD-related physical symptoms like panic attacks. 

Prolonged grief disorder is usually associated with a variety of health concerns, including a greater overall mortality risk. 

Treating and coping with physical symptoms of grief

If you’re experiencing negative health effects as part of a difficult grieving process, here are a few ways you may be able to find relief.

Engage in self-care

Taking care of yourself may not be at the top of your mind when you’re grieving, but neglecting your personal care routine can worsen physical health challenges. Sticking to some of these stress-relieving habits could help you feel better:

• Maintaining a regular sleep schedule
• Exercising for at least 30 minutes a day
• Eating plenty of vegetables, fruits, whole grains, and lean protein
• Limiting or avoiding alcohol and tobacco
• Engaging in relaxing mind-body activities like deep breathing, yoga, and meditation

Seek out company

Research indicates that social support can protect against many of the physiological symptoms of emotional stress. Having other people with whom you can talk and who can empathize with your grief may relieve difficult emotions and boost your ability to regulate your feelings, helping the pain of bereavement seem less overwhelming. 

Spending time with trusted friends and family members as you grieve could help alleviate your physical symptoms. This doesn’t necessarily mean you have to talk with them about your loss — simply being in their company may be enough. Grief support groups can also be a valuable resource, providing you with an expanded interpersonal network of people who can understand how you’re feeling.

Work with a therapist

A licensed therapist can help you develop healthy coping skills, address unhelpful thoughts and beliefs, and give you a compassionate and non-judgmental space to work through your complicated feelings, potentially relieving mental and physical symptoms of grief. 

Early research suggests that therapies based on cognitive behavioral therapy (CBT) may be the most effective modalities for treating prolonged grief disorder. 

Complicated grief treatment (CGT) is one specific modality that’s demonstrated strong results in some clinical trials, but there are many other options as well. 

The idea of looking for a new therapist amid the other pressures that accompany bereavement can sound exhausting to many grieving people. Receiving mental health treatment online might be more convenient. Online therapy platforms can connect you with a licensed mental health care provider from your own home, making scheduling much easier. 

Web-based treatments for complicated grief have been found effective in multiple clinical trials. One study from 2023 found that online CBT usually substantially reduced the symptoms of depression, PTSD, and prolonged grief in people who had experienced a traumatic loss. If you’re experiencing physical health complications from bereavement, online therapy may provide relief.