When Grief Gets Physical

Trail in Garner State Park 2016

Most people see grief as an emotional response to a loss.  We expect to see grieving people weeping or sitting in stunned silence.  Grief is an internal response to a significant loss, and, as such, it does involve a wide range of emotions.  However, it also includes thoughts and ideas that invade out inner conversation and has a profound effect on our body and physical health. While we are most often attentive to the effects of grief on our soul and our mind, we are less likely to appreciate the toll it takes on our physical well-being.

Grief is a form of stress.  It is the result of an unwelcome change to a significant relationship.   It forces us to deal with a big hole in our lives.  This causes us to either deal with it or avoid it. This the classic fight or flight response.  When this occurs, our body prepares itself to either fight off the threat or do out best to escape it. 

In the next few pages, I will explore how our physical lives respond to grief.  I will then explore ways to deal with the effects that flow out of the “Fight or Flight” response in our day to day living in the world.

What Is Physical Stress?

Stress is commonly understood as the preparations that our lives make when we experience a threat.  These physical preparations include getting the body ready to fight off the threat.  Blood is redistributed to our large muscles and heart to supply them with the oxygen and carry away any waste products like carbon dioxide.  This ensures that the heart and large muscles have what they need.  Our stomach and intestines slow down since they are not a priority at the moment. The brain becomes very sensitive to information from our senses as it probes the world around us for signs of the threat.  The immune system becomes less active.  Our heart rate goes up and our lungs take in more air to build up the oxygen in our blood.  The liver prepares to pump out glucose to power our brain and muscles.  The increased blood pressure puts a strain on our kidneys by forcing them to hold on to or replace fluid in the blood.

These preparations are very “expensive.”  They cause wear and tear on the organs and blood vessels.  They use up our body’s resources.  They are designed for a short-term response to an acute threat to our well-being.  Once the body is out of danger, the body will begin to repair the damage and replenish the resources.  But, if the threat level remains high, the body will have limited opportunities to repair and replenish.

Chronic stress has been linked to cancer due to depressed immunity.  It is also a major factor in cardiovascular disease.  It is suspected as a major cause of Type 2 Diabetes and non-alcoholic cirrhosis (fatty liver disease.)  Stress plays a major role in strokes and aneurysms due to high blood pressure.  It is also a factor in kidney disease and renal failure.  It can cause ulcers and a number of gastrointestinal disorders.  In short, chronic stress plays havoc with our physical well-being.  Complicated, or extended, grief will shorten our lives.  Grief can break not only your heart, but also your liver, kidneys, lungs, brain, and every other organ in your body.

How Do I Physically Experience My Grief?

Grief is most commonly felt as a deep weariness.  We feel physically tired.  This is the cost of simply coping with all the changes.  We are struggling to stay mentally alert and we become tired.  But it may also be a side-effect of poor eating or sleeping habits as well as not getting enough physical exercise.  Grief wears us down.  Unfortunately, rather than taking a break, we keep on going.  We may focus on taking care of others or dealing with the day to day details of mourning, like the funeral or estate.  In short, we become tired and stay that way until our body forces us to get rest through illness or exhaustion.

A second common way we are physically affected by grief is by self-medicating in order to cope with the rollercoaster of emotions.  We may take prescription drugs that we have around the house, or that we have received through a “helpful” medical professional.  More commonly, we will use alcohol or other more readily available drugs to try and numb the pain.  Some folks will turn to comfort food that is high in fat and carbs to cover up the pain.  A third and less common way is through extraordinary exercise, the Forrest Gump response, that releases the natural morphine produced in our body.  This adds the risk of strained and sore muscles to the mix.  Medicating for grief is not bad as long as it is done under the advice of a doctor.  The issue is not the “medicating” part of the phrase, but with the “self-“ part.

Another common physical effect of grief is the change that can occur in our body’s clock.  Our normal rhythms of activity and rest are disrupted.  Jet lag, rotating shift work, and “pulling an all-nighter” will have short-term effects on our physical well-being.  But grief can cause a sleeplessness that changes the way we spend our daylight hours.  Our body chemistry changes which may alter our food cravings.  Routines, like positive habits, help us get through our day so that we can focus on other things.  Once we lose our routines, we become lost in our everyday lives and find that we have to think about the simplest things like eating, paying bills. or taking medications.  We may let these daily chores slide because we are so tired.

Another aspect of physical grief may occur as tension induces aches and pains.  Exercising when under tension can make our leg and shoulder muscles very tired.  Clenching our jaw can cause headaches and possibly jaw pain, TMD.  Tension in our shoulders and chest can cause muscle pain that can mimic a heart attack.  It can exacerbate neuropathy in the hands and feet and Restless Leg Syndrome.  Tension can reduce the functioning of our stomach and intestines causing heartburn, ulcers, and diarrhea or constipation.  It can also reduce the effectiveness of the kidneys.

A more subtle way that grief changes the performance of our body is in our perception of the world.  It can literally change the way we “see” the world.  This is not simply our interpretation of what we see, though it can affect that as well.  It can change the way we perceive color and motion and even shape.  This effect is well known to people who interview witnesses after a traumatic even.  An eye witness is not usually very reliable.  They are known for filling in the details that they feel they should remember.  These gaps in detail are generally caused by the stress.  Stress causes us to focus on what matters most to us.  When we lose someone important to us, we focus on what we have lost and disregard a lot of other stuff.   It is not just our interpretation.  We did not see that “other stuff.”   Further, we may feel pain more profoundly.  We may be distracted by a favorite song on the radio and not even see the stop sign in front of us.  Food may no longer taste the same.  Our sense of smell may become more or less sensitive, especially when it is associated with our loved one.  We do not merely interpret the sensation of the world differently, we are likely perceiving it on a whole new way.

Another effect of grief, especially complicated grief, is a lowered immunity.  This is even more common in seniors.  The older we get the less we are able to keep our immunity up during times of stress.  Every hospice worker has seen the surviving spouse who, following the death of the patient, begins to decline.  The decline is often related to pneumonia or some other infection due to decreased immunity.  I have often worked with bereaved who had to battle their own round of infections after the initial shock of the loss begins to abate.  The changes in blood chemistry and the physical functioning of bone marrow and the liver and pancreas can change our bodies ability to ward off infections.  Long-term grief increases the likelihood that we will face a significant illness.

These are the major threats that grief can bring to our body.  But there are several others that are very common and can have a significant effect on our physical health. 

·      Change in diet – paying less attention to the quality and quantity of what we eat can lead to malnutrition, undernourishment, or obesity.

·      Change in hygiene – Many folks, especially those who have lost their spouse, become less concerned about the hygiene.  They may brush their teeth less often, ignore washing hands, or taking baths/showers.  They may become less attentive to changing their sheets, cleaning the house, or washing dishes.  Each of these carry risks to their physical health.

·      Change in willingness to seek medical or dental care – The bereaved person may no longer find it important to get check-ups, take flu shots, or go to the dentist for routine care.  They may lose any interest in self-care.

·      Change in interaction with family and friends – Some deeply grieving people withdraw from their family and friends.  They increase their isolation and lose the support that can help them move through their grief.

·      Interrupt our financial security – Many grieving people must also face financial insecurity.  They may lose the income from the deceased person.   They may be forced to pay off uninsured medical bills.  They may simply have no idea how to handle the financial details of their household.  This increases the stress and increases all of the risks listed above.

Grief is not simply an emotional response to an unwelcome loss.  It is also a mental and physical response.  The risks and consequences of complicated grief will have a deep and lasting effect on us, body-mind-soul.

What Can We Do?

Identifying the problem is important, we need to be able address it as well.  Each of these physical consequences of grief suggest things that the bereaved can do.  I have neither the space nor the expertise to describe all of these.  However, I will share a few ideas that may be helpful.

For the Grieving Person

Remember T. L. C.

Stay in-Touch with your Body

Listen to your Body

Take Care of your Body

Under normal circumstances, we each carry responsibility for our own well-being.  It is not the professional’s responsibility to keep us healthy.  It is our responsibility to do the things that maintain our health, relying on professionals for assistance and support, when necessary.  Therefore;

·      Stay in-Touch with your physical self.  Get to know and appreciate how your body feels, performs, and responds.  Once you have a baseline of understanding you can begin to see when things happen that may require a response.   Everyone is different.  No one can tell you how your body should feel.  This is something we have to discover on our own, in conjunction with the health professionals around us.  By staying in-Touch with our body, we will know when something needs attention.

·      Listen to your body.  We all have little aches and pains.  We have learned that many of them are just part of who we are.  However, the body has ways of telling us when something is awry.  Pain helps us know that something needs attention.   The loss of visual or aural acuity will also suggest that something is not right.  A new, unexplained bump or lesion on our skin is the body’s way of saying, “Pay attention!”  A change in toilet habits can be a signal that all is not right.  Shortness of breath without exertion or with minimal exertion may be a sign your body is saying, “Get this checked out!”  These signals only work, however, when we listen to them.  If we ignore them, we will pay the price whether we are grieving, or not.

·      Take Care of your body.  Once we have stayed in-Touch, and Listened, we need to take action and actually do something to Care for our body.  Your body is the only one you will get during this lifetime.  There are no body transplants.   See your doctor.  Get the tests done.  Go to the dentist.  Eat right.  Get your rest.  Pay attention to good hygiene.  If something feels wrong, get it checked out.  Take care of your body.  Your life depends on it!

For Those Companioning Someone in Grief

When we are companioning someone who is able to make their own decisions and take responsibility for themselves, our major job is to lovingly hold up a mirror for them and encourage them to be honest with themselves.   

We do them a great disservice when to try and take away their autonomy by telling them what they should do, especially if we have not really spent any time listening to them.  Too often we try and make decisions for them based on our needs rather than their desires.  An adult child has every right to help their parent see the consequence of their parent’s healthcare choices.  They need to have the courage to hold up that mirror so that the parent can see what is happening.  The adult child then needs to have the love that lets go of their desires when the parent has made an informed decision based on their needs and desires.  The same applies to a friend. 

The caregiver may believe that the grieving person may not be seeing clearly.  They may believe the grieving person’s judgment is warped by their pain.  But this does not necessarily mean that they are incapable of making an informed decision.  We each have our own reasons for making our self-care decisions.  The one in grief has the right to place comfort and quality of life over length of life.  As a companion who cares about them, we must give them emotional room and support to make their decision and then walk with them as they live out that decision in everyday life.

However, if we, as a loving companion, believe that our family or friend is not capable to making a decision in their best interest, then we have an obligation to explore this situation.  We may want to talk with other family of friends and check our perceptions.  We may want to raise the issue with the person in a gentle and tentative way.  If our suspicions grow, we may want to talk with the next of kin or people who hold a medical or durable power of attorney and share your suspicions.  As a friend or family member, your role ends when you report this concern.  You should continue supporting your friend, but you are not the one who is responsible for making any further decisions for them. 

If you are the next of kin or medical power of attorney, you may want to have a sit down with your family member and their doctor.  Mental capacity is a very difficult judgment call and must be left in the hands of the medical professionals.  They will be able to assess and declare whether the one in grief has legal capacity or not.  If they do not, then those with the power of attorney become the responsible parties.  It is their responsibility to make decisions for the grieving person in the best interest of the grieving person.

Grief will always have physical consequences.  As a companion to the one in grief, our task is to continue to love and respect them. We are there to walk with them through the shadowed valley.  We are at their side so that we can allay their fears of being abandoned and left alone in their suffering.  And, above all else, we are there to remind them that they continue to be a person worthy of your love and respect.  As you walk with them may you find the strength, the hope, and the love you need to make that journey at their side.

Blessings,

Bob