Grief over lost loved ones is physical and can hit hardest during the holidays. Having been through it multiple times, I’ve got science-backed advice to help you through.
Dr. Jan Patterson. Published in Wise & Well
I have a personal interest in grief, its causes, and its effects after losing a son to suicide 12 years ago, as well as losing both parents and my brother in close succession. I was diagnosed with cancer a few weeks after my son died. We recently experienced a house fire, and I found that the loss of the safety and comfort of our home was even more devastating than the loss of some of our possessions.
Fortunately, I have regained my health, and our house is being restored. As I reflected on my experiences over the past decade, I became interested in how our bodies respond to grief, how I worked through my grief, and how to help others when they suffer losses.
Yet the toughest time of the year is upon us.
The holiday season can gift us with the most painful reminders of loss and grief. The sight of the empty chair at the table. The smell of their favorite holiday food. The sound of the carol they loved to sing.
How grief affects us
Grief is the pain and suffering we experience after a loss that affects our body and mind as well as our spirit. We can grieve after losing a friendship, possessions, or a cause we worked hard for. In 2024, we learned that election grief is real.
While all losses are painful, the Social Readjustment Scale studied types of losses and ranked the death of a spouse or life partner as the most stressful event in life. Divorce, death of a close family member, and major personal injury or illness also ranked highly. Notably, the death of a child was not specifically included in this rating scale. I can attest that this is the most painful loss I have ever experienced.
Grief eventually affects everyone. About 2.5 million people in the US die each year, leaving an average of at least five people grieving over each loss. This means that 13 million Americans are potentially grieving annually over the loss of a loved one. A 2019 survey found 70% of US respondents grieved over a life event in the past three years.
The bereaved are at increased risk of death and illness in the first six months to a year after the loss. Grieving acts as a stress reaction that causes physiological changes, including increased heart rate, breath rate, and blood pressure, as well as decreased sleep and immune function.
In 2024, we learned that loss can accelerate biological aging. In a long-term study looking at teens and following them to adulthood, those with a history of loss had higher biological ages than those without. This effect was seen even before midlife. In addition, more losses were associated with higher biological ages.
The body grieves
A continually activated stress response, lack of sleep, sadness, rumination, anxiety, poor nutrition, and dehydration can all lead to physical, as well as mental and emotional fatigue. Grief is exhausting.
The heart hurts
Grief emotions including sadness, anxiety, and anger can increase blood pressure, as well as decrease sleep. The body increases the production of its stress hormone, cortisol. All of these activate the body’s “fight or flight” response, and increase inflammation.
Stress causes blood vessel constriction, which can disrupt blood flow to the heart or disrupt cholesterol plaque in blood vessels, resulting in obstruction of blood flow. In addition, those in mourning may neglect to take their regular medications, leading to less control of their blood pressure or heart rate. All of this leads to increased risk of heart attack in those suffering intense grief.
Sometimes, the stress on the heart is so severe that it causes “broken heart syndrome.” The medical term for this is stress-induced cardiomyopathy. The stress response of grief causes a weakening of the heart’s main pumping chamber. Another medical name for this syndrome is Takotsubo’s Syndrome, named not after a person but for the shape of an octopus trap (takotsubo, a round-bottomed, narrow-necked jar ), which the heart assumes during this stress response.
Initially, it can look just like a heart attack and can be fatal, although most people recover. While I did not have this extreme response, I do remember acute pains in my chest — literal heartache — that would come and go in the early days after my son’s death.
Sleep is elusive
There are several reasons why grievers have difficulty sleeping. As above, the stress reaction is activated, which does not allow relaxation. Thoughts of their loved one at night or bedtime are common. This can lead to rumination, or repetitive negative thoughts that are disturbing and produce anxiety.
For example, guilt is common after a loved one’s death, and worrying over questions like “What if I had done this…?” lead to rumination. Fear of the future leads to questions like “What will I do without them…?” which further increases anxiety.
Nutrition is neglected
Loss of appetite occurs in the acute stress response and is exacerbated by sadness. Chronic stress can eventually lead to cravings for comfort foods high in refined sugar and fat. This is typically the food that friends and family bring to grieving people. While it can be comforting in the short term, this type of food can result in irritability, indigestion, and fatigue in the long term.
Those in mourning may also be dehydrated. Someone preoccupied with loss may not think of drinking water, even though the stress response increases the need for hydration. Crying and increased activity required after the loss to plan arrangements can also contribute to dehydration. Grievers may also drink more alcohol than usual, leading to dehydration and sleep disturbance.
How to care for yourself
Grief is a normal part of loss. It happens because you loved the person or entity that you lost. Be patient and reserve time for reflection, which may help you feel more under control.
Breathe to ease the stress
Deep, slow, regular abdominal breathing is a powerful way to decrease the stress response. A long inhale and a longer exhale activate your body’s “rest and relax” response. Take a deep breath, expanding your abdomen as well as your chest. Dr. Andrew Weil’s 4–7–8 breath is used for decreasing anxiety. Inhale for 4 counts, hold for 7 counts, and exhale for 8 counts. Repeat this 4 times. Use the series at least twice daily. Using it at night before bedtime may help with sleep.
Along with the breathwork, guided meditations on an app, such as Insight Timer, helps to decrease your stress response. Another reason that meditation benefits those who are grieving is that it can decrease the risk of cardiovascular disease.
Make yourself move
Movement helps. Exercise is known to release the body’s “feel good” hormones, and recent studies suggest it can relieve depression. Physical activity during the day can also help with sleep at night. Exertion may help decrease repetitive negative thoughts.
I know that vigorous exercise, specifically running outdoors, was able to decrease my rumination after the loss of my son. Outdoor movement may be especially beneficial. Studies on “forest bathing,” or meditative walks outdoors using all your senses to see, hear, smell, and feel nature has been shown to improve mental health.
Meditative movements like yoga and tai chi can not only help you relax but may also reverse anxiety and stress at the molecular level. Chair yoga counts, which can be done by those not used to strenuous activity.
There is increasing evidence that traumatic events not only affect the mind but also the body. Movement helps us become more aware of our physical sensations, release emotions, and learn tools to calm ourselves.
Make plans for sleep
Strategies helpful for beneficial sleep include setting a routine bedtime, exercising for at least 20 minutes daily, and being outdoors. Avoid alcohol because it interferes with restorative sleep stages. Take time to settle your mind and body before bedtime. Make the bedroom as dark as possible and as cool as is comfortable for you. Insight Timer and other apps have meditations and music specifically for sleep.
Despite all the above, sleep can still be a challenge, especially with acute grief. Consult with your health care provider about whether short-term sleep support is needed in the form of supplements such as melatonin, magnesium, or L-theanine, botanicals such as valerian or passionflower, or pharmaceuticals.
Eat healthy
After a major loss, it is common to lose interest in cooking or eating. Order something healthy to be delivered. Enlist the help of friends who may be able to bring food. Mealtimes at home can be lonely and it may help to eat lunch with friends. This human connection can also help decrease a sense of isolation.
Avoid high amounts of refined sugar and fat and choose anti-inflammatory foods including fruits, vegetables, and lean protein. Think of “eating the rainbow” and choose fruits and vegetables from all the rainbow colors. Drink plenty of water. Your healthcare provider will know the right amount for you if you have a heart, kidney condition, or other chronic disease.
Connect with others
Grief is isolating. You may not feel like being in a large crowd, and you may find that some friends and family want to avoid your grief. Find a trusted friend, family member, or worship leader who will listen. Grief needs a witness. Take a walk with someone if you can.
Walk your pet or offer to walk a neighbor’s pet. Being with animals can be very therapeutic. Some studies have suggested that oxytocin, a hormone that is associated with positive emotions, increases with human and animal interaction, and cortisol, the stress hormone, may decrease.
Online support groups such as GriefShare or The Compassionate Friends are good resources. Check local resources for hospice care services that offer grief counseling or seek a therapist or counselor who does. If you are part of a faith community, reach out to this network for support. Grief expert David Kessler offers an online training course, Tender Hearts, for the grieving.
Seek meaning
Doing something for others is restorative — volunteer at a food bank, a pet shelter, or in your faith community. A study of older adults volunteering to help young people showed positive effects on the brain compared with a control group. Community organizations will know of people in need. I found that meaningful work to help and serve others was vital to my healing.
Holidays are challenging
Those grieving a loss will feel it even more acutely during the holiday season. We think about our loved one missing at the family table and reminisce about previous holidays with them. Sometimes, we are bewildered and hurt that some family members do not even seem to notice that our loved one is missing.
You can acknowledge and remember your loved one in ways that are helpful to you. Light a candle for them at the table. As their holiday gift, donate to a charity that was meaningful to them. Hang decorations that were meaningful to them when you can do so. Give a flower arrangement to a place of worship or a facility that serves others in their memory.
Waves of grief are more common for me during the holidays, and I keep my favorite essential oil handy to inhale when these hit me. Our olfactory (smell) nerve goes directly to the most primitive part of the brain, the limbic system, which influences emotion. Aromas can distract and they have a powerful effect on our mood.
Because of all the physical effects of bereavement, keep regular visits to maintain your health. About 10% of grievers will have a prolonged (more than a year), or complicated intense grief that makes reintegration with work, family, and friends very difficult. Your primary care provider can advise you whether you are developing a clinical depression that needs a specialist who can intervene with therapy, such as cognitive behavioral therapy, or pharmaceuticals.
All of us will be affected by grief at one time or another; it’s been said that it is the price we pay for love. I have found that grief is a journey; there is not an endpoint to the grief of losing my son. However, I have learned to live with the loss as I continue with meaningful work and connection with others. I experience joy and even a new normal of happiness. As grief survivors, we can help others who are suffering and offer them the support they need.
If you’re interested in learning more about self-care to deal with the stress in life, check out our book, Breath for the Soul: Self-Care Steps to Wellness and my website http://www.drjanpatterson.com
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