The Physical Impact of Grief

Why grief affects us physically

The reason grief affects our physical well-being is because “we co-regulate with our loved ones,” said Mary-Frances O’Connor, Ph.D., professor at the University of Arizona, clinical psychologist specializing in grief research and author of The Grieving Body.

“To think about grief, we really have to think about love and bonding. When we bond with our spouse or our child, we form a dynamic system with them, and it means that each person is an external pacemaker for the other person’s heart,” O’Connor explained. “When a loved one is amputated from our life, our body has to figure out how to regulate without that external pacemaker.”

This sudden disruption forces our physiological systems to adapt, creating a cascade of physical symptoms.

Common physical symptoms of grief

The way grief shows up physically can range widely depending on the person and what existing conditions they may have. Common symptoms can include chest pain, insomnia, appetite changes, digestive issues, a “lump in the throat” feeling, as well as cognitive effects.

But it can also have a significant impact on immune function. “Bereavement is associated with all-cause morbidity and mortality,” O’Connor noted, “which is a fancy way of saying that all the different diseases and causes of death increase when you’re grieving.”

This includes increased rates of chronic obstructive pulmonary disorder (COPD), stroke, pneumonia, sepsis and flu, O’Connor said. “As I was doing research, I wondered, How can it be that every system could be impacted? But if we think about the fact that our immune system affects every organ in the body, then it might start to make a little more sense.”

Research from O’Connor’s lab and others has shown that inflammation increases following the death of a loved one. A study published in Psychoneuroendocrinology found that people experiencing intense grief showed significantly higher levels of inflammation compared to those with lower grief severity.

This systemic inflammation can affect the immune system and manifests differently depending on a person’s existing health conditions or predispositions. For example, in someone with rheumatoid arthritis, it might present as worsening joint pain, while someone with asthma might experience more breathing difficulties.

O’Connor experienced this herself: About a year after her mother’s death, she developed symptoms that were later diagnosed as multiple sclerosis. While her mother’s death didn’t cause her MS — it runs in her family and she had other risk factors — the intense stress of grief may have contributed to its emergence at that particular time.

What is broken heart syndrome?

Some experience “broken heart syndrome,” or what is officially called “takotsubo cardiomyopathy” — a weakening of the left ventricle of the heart, which can create the symptoms of a heart attack even when there are no arterial blockages. Nine out of 10 cases are reported in women, and most of those are in women over 50. Takotsubo is not typically fatal, O’Connor said, but it does require medical attention.

Still, others experience more serious heart problems as a result of grief, distinct from takotsubo cardiomyopathy. A study published in the Journal of the American Medical Association found that in the first three months after losing a spouse, people over 65 have nearly twice the risk of experiencing a heart attack or stroke. An older study in the American Heart Association journal Circulation found the danger of a heart attack was highest in the first 24 hours after the death of a loved one, particularly for those who have existing heart conditions.

O’Connor’s research shows that blood pressure rises during waves of grief, with the most significant increases occurring in those having the most difficulty processing their grief.

In the first weeks and months following her son’s death, Faber’s symptoms included extremely high blood pressure, heart palpitations, muscle spasms and headache attacks. She additionally suffered from memory loss, chronic fatigue, a weakened immune system, inability to sleep, PTSD, panic attacks and stress-induced early-onset osteopenia, or low bone-density.

“I had been healthy, yet from one day to the next, I aged 1,000 years,” said Faber. Ten years later, she continues to have issues with her blood pressure and bone loss.

Studies show that cardiovascular disease markers like blood pressure and heart rate tend to return to baseline within about six months for most people. However, O’Connor emphasized that this timeline varies greatly between individuals. For those experiencing chronic grief stress — where the intensity and frequency of grief waves haven't diminished — physical symptoms may persist, causing additional wear and tear on the body.

Managing grief's physical impact

O’Connor stressed that experiencing physical symptoms during grief is entirely normal. “You are not broken because you feel grief in your body,” she said. Still, because bereavement is a time of increased medical risk, these symptoms shouldn't be ignored.

For those experiencing the physical toll of grief, O’Connor and Faber offered some advice.

1. Get regular medical care: Many people who were caring for a terminally ill loved one have neglected their own health. Schedule routine checkups to identify issues like hypertension early.
2. Consider both conventional and alternative treatments: Faber found a combination approach helpful. She visited her healthcare provider and got medication to lower her blood pressure, but also sought alternative, holistic treatments. She found that water therapy (exercising in a hospital pool), gardening, hiking in the forest and Pilates helped her process.
3. Connect with nature and gentle movement: “I spent as much time as I could in nature, planting trees and working in the vegetable garden in the gentle company of my cats and dogs,” Faber shared. Research supports this approach, finding that nature-based activities can help reduce stress hormones.
4. Find community support: “Find a support network where you can fully express your grief, be it by regularly attending grief sessions with others, or online grief groups,” Faber advised. “Repressed grief will only surface later and inevitably makes us ill.”
5. Be aware of harmful coping mechanisms: “Avoid alcohol; try not to self-medicate,” Faber cautioned, echoing O’Connor's warning that using substances to numb grief feelings can add physical strain to an already stressed body.
6. Practice self-compassion: Give yourself extra time, attention and understanding during this physically demanding time.

A journey, not a recovery

“Learning to live again following traumatic loss is not about recovery or survival,” Faber said. “It is about slowly doing painful and exhausting grief work so as to arrive at a point of acceptance, a place where we can both grieve and find joy in life again.”

O’Connor similarly suggests that paying attention to our physical responses helps us honor our connections. “We really honor our loved one by noticing how our bodies changed in their absence,” she said.

For those currently experiencing grief’s physical toll, Faber emphasized that there’s no timeline for healing. “In these 10 years, my grief has not subsided, but has become softer; it lies just below the surface,” Faber said. “It doesn’t take much for me to touch the deep sorrow I feel in knowing that my son is no longer alive, yet in some ways I live more intensely now and appreciate every moment of every day.”