Grieving? Don’t overlook potential side effects

Nothing quite prepares you for the heartache of profound loss. It settles in like a gloomy thrum — sometimes louder, sometimes softer — with a volume switch you can’t entirely shut off.

For me, that heartbreak arrived this past October, when my mother died after a long battle with Parkinson’s disease, dementia, and disability. Now, for the first time in my life, I’m experiencing real grief. As a health reporter, I know this emotional experience comes with the risk for physical side effects. “Most of these side effects are the result of emotional distress responses,” explains Dr. Maureen Malin, a geriatric psychiatrist with Harvard-affiliated McLean Hospital.

Whether you’re grieving the loss of a loved one, like I am, or the loss of a job, a home, or a beloved pet, it’s important to understand how the process puts your health in jeopardy.

Stress and grief

Grieving takes a toll on the body in the form of stress. “That affects the whole body and all organ systems, and especially the immune system,” Dr. Malin says. Evidence suggests that immune cell function falls and inflammatory responses rise in people who are grieving. That may be why people often get sick more often and use more health care resources during this period.

But why is stress so hard on us? It’s because the body unleashes a flood of stress hormones that can make many existing conditions worse, such as heart failure or diabetes, or lead to new conditions, such as high blood pressure or heartburn. Stress can also cause insomnia and changes in appetite.

Extreme stress, the kind experienced after the loss of a loved one, is associated with changes in heart muscle cells or coronary blood vessels (or both) that prevent the left ventricle from contracting effectively. It’s a condition called stress-induced cardiomyopathy, or broken-heart syndrome. The symptoms are similar to those of a heart attack: chest pain and shortness of breath.

Depression and grief

Intense feelings of sadness are normal when we’re grieving. But some people become depressed. Up to 50% of widows and widowers have depression symptoms during the first few months after a spouse’s death. (By the one-year mark, it’s down to 10%). Depression symptoms include:

• extreme hopelessness
• insomnia
• loss of appetite
• suicidal thoughts
• persistent feelings of worthlessness
• marked mental and physical sluggishness.

Dr. Malin says people who are depressed often isolate themselves and withdraw from social connections, and they often stop taking care of themselves properly. “You’re not as interested in life. You fall down on the job, miss doctor appointments, stop exercising, stop eating properly. All of these things put your health at risk,” she explains.

Picking up the pieces

It may seem impossible to think about maintaining good health when it’s difficult to simply get through each day. But Dr. Malin says it’s okay to just go through the motions at first (fake it until you make it).

• That may mean walking for five minutes every day, and then gradually increasing the amount of time you walk.
• And even if you don’t feel like eating, go ahead and eat three healthy meals per day anyway. Your body needs calories to function, even if you’re not hungry. Eating too little may add to fatigue.
• And don’t forget about social connections, which are crucial to good health. Stay in touch with friends and loved ones. Try to get out of your house and spend time with others, even if it’s to talk about your grief.

One step at a time (and your doctor can help)

A good way to stay on top of your health when you’re grieving: “See your doctor, especially if symptoms worsen, and get back to a healthy routine as soon as possible,” Dr. Malin suggests. For a while, at least, you can simply follow your doctor’s instructions to maintain health, putting one foot in front of the other until you develop your own routine.

In time — and there is no standard period of grief for anyone — the sun will come out again, and you’ll feel a little stronger emotionally and physically each day. I’m counting on this. But we all need a foundation of good health in order to get there. Let’s give ourselves that advantage. Our loved ones would want that for us.

For more information, check out the Harvard Special Health Report Grief and Loss: A guide to preparing for and mourning the death of a loved one.