Grief in the body: the physical side of loss

Can grief cause physical symptoms?

Yes. Grief is felt in the body as well as the mind, and physical symptoms are a normal part of it. Cleveland Clinic describes loss as an extreme stressor that can take a major physical toll, and lists tiredness, headaches, queasiness, restlessness, stomach upset, a racing or pounding heartbeat, muscle weakness or joint aches, tightness in the chest or throat, changes in appetite, and sleeping too little or too much.

Many people do not connect these symptoms to grief at first. They notice they are tired all the time, catching every cold, or waking at three in the morning with their heart racing, and wonder if something else is wrong. Sometimes it is, which is why it helps to keep a doctor in the loop. Often it is grief doing what grief does.

Why does grief show up in the body?

Losing someone close sets off the body's stress response, the same system that handles danger. Stress hormones such as adrenaline prepare the body for action: the heart beats faster, muscles tense, digestion slows, sleep gets lighter. That is useful for a short emergency. After a death, the stress can go on for weeks or months, and the body pays for it.

Grief also changes behavior in ways that affect health. People stop cooking, skip meals or eat whatever is easy, drink more, stop exercising, miss medications and put off their own appointments, especially after months of caring for someone else. The National Institute on Aging notes that grief can be hard on your health and that drinking too much or smoking can put it further at risk.

Sleep, appetite and exhaustion

Trouble sleeping is one of the most common effects of grief. Some people cannot fall asleep because the mind will not stop replaying; others wake early and lie there; some sleep far more than usual and still wake tired. The exhaustion of grief is real, and it adds to the fog that makes concentrating and deciding so hard. What grief feels like covers the mental side of that.

Appetite often disappears, or swings the other way. The NIA suggests making mealtime plans, such as eating with friends or turning on the radio, because eating alone in a quiet house can be one of the hardest parts of the day. A few practical habits help many people:

• Keep a roughly regular wake-up time, even after a bad night.
• Eat something simple at regular times, even if you are not hungry.
• Get outside and move a little each day; a short walk counts.
• Notice how much you are drinking, since alcohol can deepen low mood and break up sleep.
• Use slow breathing or other calming skills when your body is on high alert; calming your body when stress hits has some to try.

Can grief affect your heart?

It can, and this is one of the most studied physical effects of grief. Researchers in the Determinants of Myocardial Infarction Onset Study interviewed 1,985 people hospitalized for a heart attack. They found that the rate of heart attack was 21 times higher than expected in the 24 hours after the death of a significant person, and that the risk fell steadily each day after that. The authors stressed that the absolute risk was still low for most people, and highest in those already at high cardiovascular risk.

Grief can also trigger broken heart syndrome, known medically as Takotsubo or stress cardiomyopathy. Cleveland Clinic describes it as a sudden, usually temporary weakening of the heart muscle after an intense physical or emotional stressor, and names grief from the death of a loved one as one example. It feels like a heart attack, with chest pain and shortness of breath. Most people recover fully with treatment, but some have serious complications.

Because the two are hard to tell apart without tests, chest pain, trouble breathing, fainting or a racing heart that will not settle should never be written off as just grief. Call 911.

The widowhood effect

Researchers have long observed that people are more likely to die in the period after their spouse dies, sometimes called the widowhood effect. A large study by Felix Elwert and Nicholas Christakis followed 373,189 older married couples in the US and found that the death of a spouse from almost any cause raised the surviving partner's risk of death, from a wide range of causes.

That finding is about populations, not a prediction for any one person, and it is not meant to frighten. It is a reason to take your own health seriously after losing a partner: keep up with checkups, take your medications, and let your doctor know what has happened. Losing a spouse or partner looks at that loss more closely.

When should I see a doctor, and when should I talk to someone?

See your doctor if physical symptoms are new, getting worse or not easing, if you have lost a lot of weight, or if you cannot sleep for long stretches. The NIA recommends scheduling a checkup after a loss and telling your provider if everyday tasks like dressing or making meals have become hard. Let them know you are grieving; it changes how they read your symptoms.

Talking to someone can help too. Laura Bass, a psychotherapist in Charlotte, North Carolina, works with adults on grief in individual counseling, as part of her psychotherapy practice. She works with the whole person, mind, body and spirit, and counseling can include noticing where grief is sitting in your body. She does not provide medical care; physical symptoms belong with your doctor. You can ask Laura about grief counseling or return to the grief and loss guide.

If grief brings thoughts of ending your life, please reach out now: in an emergency call 911, and for crisis support in the US call or text 988.

Common questions