A shared universe › Blog › Grief is felt in the body too · Español
It is hard to climb the stairs. You sleep in snatches and get up without any strength. You feel a weight on your chest, an upset stomach, and food tastes of nothing. Few people warn you that sorrow is felt in the body too.
Doctors who see bereaved people often come across the same complaints: a tiredness that does not go away, sleeping badly or sleeping too much, an upset stomach, changes in appetite, headaches, palpitations, muscles without strength and a tightness in the chest or throat. Also a restlessness that will not let you sit still.
As early as 1944, the psychiatrist Erich Lindemann, who treated relatives of the victims of a major fire in Boston, described waves of physical distress in them. That distress is real, not a lack of spirit. Sorrow makes the nervous system work overtime, and the body feels it. It is a tiredness different from that of a long day, and sometimes it does not go away even with sleep; it has a lot in common with the one described in the tiredness that sleep doesn’t take away.
A loss puts the body on alert for weeks or months. Stress hormones, such as cortisol, rise, and this shows in sleep, in appetite and also in the immune defences.
At the University of Birmingham, the team of Anna Phillips and Janet Lord measured this in older people. In a study published in 2011 they compared 24 people over 65 who had lost someone in the previous two months with another 24 of the same age who were not bereaved. In the first group, certain blood cells whose job is to destroy bacteria, the neutrophils, worked less well, and the balance between two stress-related hormones was altered. In a later piece of work, in 2014, they saw the same in older people, but not in bereaved young adults, whose defences held up well.
These are small studies, but according to their authors they help explain why bereaved older people are at greater risk of catching infections, and why those months call for a little extra care.
Sleeping badly is among the most common things in grief. In 2020, Marike Lancel, Margaret Stroebe and Maarten Eisma, of the University of Groningen in the Netherlands, reviewed 85 studies with more than twelve thousand bereaved people. They found that sleep problems are very common after a loss, that they are greater the more intense the grief is and that there are early indications that grief and poor sleep influence each other.
It helps to keep similar hours, to get out into daylight and not to turn to alcohol to sleep, which ends up making your mood worse. If what keeps you awake is your thoughts, Night-time worries has a simple technique that may help.
In 1990, Japanese cardiologists at a hospital in the city of Hiroshima described a heart problem that looked like a heart attack but was not. They called it takotsubo, the Japanese name for a pot used to trap octopuses, because on scans the heart took that shape: in the commonest case, the tip of the left ventricle lost its strength and ballooned out. In time it was given a more popular name: broken heart syndrome.
It is uncommon: of every hundred people who arrive at hospital with a suspected serious heart attack, between one and three actually have takotsubo. It causes similar symptoms, such as chest pain or shortness of breath, and mostly affects women after the menopause. In the largest international registry, published in 2015 with 1,750 patients from Europe and the United States, nine in ten were women and the average age was around 67.
Contrary to its reputation, it is not always brought on by grief. In that registry, a little over one in four people had suffered it after a strong emotional upset, such as a death, and a little over one in three after a physical cause, such as an operation or an illness. In about another quarter, no clear cause was found. Sometimes it even comes after great joy: in those cases the same researchers called it happy heart syndrome.
The good news is that the heart usually recovers: in most cases it moves normally again within a few weeks. But while it lasts it is not a minor problem, because it can cause serious complications. That is why chest pain always deserves urgent attention, without waiting to see whether it passes.
A study by Boston researchers, published in 2012 in the journal Circulation, interviewed almost two thousand people who had just had a heart attack. It found that the risk of a heart attack was much higher in the twenty-four hours after the death of someone important, and that it fell day by day afterwards.
Put like that it sounds alarming, but the real risk is still small: according to the authors, in the first week after a close death there would be one extra heart attack for every 1,394 people at low cardiac risk, and one for every 320 among those at high risk. What they do point out is that the risk weighs more on those whose heart is already delicate. For them, and for those who love them, it makes sense not to be left without company in those days and to carry on with the care their doctor has advised.
It is not about doing everything right, but about not leaving your body without the basics. Some simple ideas:
Call the emergency services without waiting if you have chest pain or tightness that does not go away, shortness of breath, a faint or very strong palpitations. You do not need to be sure that it is your heart: it is better to have it checked.
Make an appointment with your doctor if you have been sleeping very badly for weeks, if you have lost weight without meaning to, if the tiredness stops you getting on with your life or if your mood has stayed very low for more than two weeks in a row. And if the sorrow becomes so great that you see no way out, ask for help today. In Spain you can talk to a person at the Teléfono de la Esperanza, 717 003 717, at any time. If you are thinking of ending your life, call 024: it is free and answered 24 hours a day. If you are in another country, call your local emergency number or a helpline there.
On the days when your body can take no more, there is room for you as well: a “For me” star with what weighs on you. Whoever reads it will leave you some comfort, without knowing who you are. And afterwards, if you can, rest.