Physical Reactions to Loss and Grief

“Sometimes I feel like I’m floating, like this just can’t be real. Am I losing my mind?”

“My hands feel freezing cold, like they’re in a bucket of ice water. I’ve never had this kind of feeling before.”

“My skin has been a mess for the past month. I haven’t had acne like this since I was in high school. What’s happening to me?”

After the sudden and unexpected loss of a loved one, we are not really sure what to expect. We are not surprised to feel sad, tearful, or even occasionally guilty for getting on with our daily lives. What we may not expect, however, is the physical reaction our body has to such a traumatic loss. It can be surprising and disheartening to have our body “betray” us when we feel we are most vulnerable.  

In fact, our body is only doing what years of evolution and survival have proved to be the best for us: preparing for the natural response of fight or flight in the face of a threat. While it is true our physical safety may not be at risk after the death of a loved one, certainly our emotional well-being can feel threatened. Our body reacts to the threat by thrusting the autonomic nervous system into overdrive. Far from betraying us, our body is trying to protect us.

The Fight or Flight Response

The human body is truly amazing. The systems within the body function together which allows for an immediate and continuous response to changes in the environment and within the body itself. When sensing danger, the body responds by secreting hormones that will assist in reacting to the danger. The goal is to get blood and oxygen to the parts of the body where it is needed most. The heart and large muscles of the legs need oxygen in case you need to run. The brain and sensory organs need it so you can get as much information as possible and then react to the danger.

One response of the body during times of physical or emotional stress is to secrete catecholamines (hormones released into the bloodstream by the adrenal glands, which sit on top of the kidneys). The major catecholamines are dopamine, norepinephrine, and epinephrine (also known as adrenalin). The result is an increase in heart rate and blood pressure, the diversion of blood to muscle tissue, an increase in breathing rate, and a slowdown in digestion. This gets the energy you need where it is most needed. Even the pupils dilate so you can take in more information about the possible threat.

Another response to perceived danger is the secretion of corticosteroids, or stress hormones. These hormones increase your access to the energy stored in your body, inhibit antibody formation, and regulate sodium retention. The body is making energy available for use and focusing on the danger at hand, rather than fighting disease for the long term. In other words, the body’s response to an imminent threat leaves us vulnerable, compromising the immune system and disrupting normal functions.  

These responses make sense from a survival perspective, but may not serve us well in the long term, especially if we have just lost a loved one. Rather than being adaptive, this response can have effects on the body that are not beneficial.

Effects on the Body’s Functioning

The disruptions to normal bodily functions may present various physical symptoms: numbness and emptiness or a “hollow feeling, a constant ache where my heart was supposed to be” as one mourner described, fatigue, “an elephant sitting on my chest” as mentioned by another, sleep and appetite disturbances, aches and pains, and trouble concentrating.

Digestive disturbances can be explained as the result of blood being shunted away from the stomach and intestines, as it is directed to the major survival organs: the brain, heart, sensory organs, and large muscles of the legs.  

Circulation can also be affected by the flight or fight response. There may be decreased circulation to the extremities (the fingers and toes) while blood is shunted to the larger muscles. The result is feeling like your hands and feet are freezing cold. Another result of the circulatory system reacting to stress is migraine headaches. These headaches – which can be recognized by vision disturbances, sensitivity to light and sound, and even nausea – can be experienced when you finally get an opportunity to relax! The thinking is that if our circulatory system reacts to stress for long periods of time, the body rebounds when we finally relax, and our blood vessels dilate too much. This causes pressure on surrounding tissue and results in the throbbing pain.

It isn’t always the circulatory system that reacts most strongly to the stress of losing a loved one. Some people react by breathing in a shallow manner. In other words, they hyperventilate. It might not even be perceptible to others, but taking in too little oxygen with each breath can result in a sensation of floating, a tingling feeling in our lips, fingers, and toes, and even light-headedness. Many people, when they notice signs of hyperventilation, will get anxious and breathe even more rapidly and shallowly, thus making the sensations worse! One way to tell we are doing this is to notice if we often catch ourselves sighing. This is our body’s way of trying to ward off the effects of hyperventilating.

Another reaction may be increased muscle tension. This can be thought of as the body’s way of bracing against the threat and emotional pain. Muscle tension can result in headaches and increased sensitivity to pain. To understand how muscle tension can result in more pain, imagine holding a telephone book at arm’s length for more than a minute. Even something like statically holding your arm out can become painful. Now imagine tension over an extended period of time and the effect it can have on your body.

Not to be overlooked is the decreased immune function that can result from the ongoing stress of having lost a loved one. Remember, the increased secretion of corticosteroids inhibits the immune system. This means we might experience more head colds and skin break-outs, or simply feel run down.

These are just a few examples of how the body reacts physically to the stress of losing a loved one. People react differently, but the effects of loss can be felt throughout our muscular, circulatory, respiratory, and even immune systems. It is really NOT all in your head. 

How to Help Your Body Help YOU

There are any numbers of ways to counteract the flight or fight response and help us get through this scary and unsettling time. Some useful techniques are: 

• Diaphragmatic breathing: Imagine a string pulling you straight up from your abdomen as you slowly inhale through the nose, and slowly exhale through the mouth. 
• Biofeedback training: Learn to control involuntary body responses such as heart rate and blood pressure. 
• Dedicated Worry Time: Set a timer for a specific period of time to worry; when the buzzer sounds, get up and do something positive for yourself. 
• Regular exercise: Make exercise a priority, especially aerobic exercise or brisk walking, just to get your body moving. 
• Appreciation of nature: Lie in the sun and feel the warmth, walk among the leaves, make a snowman. 
• Relaxation: Use tapes or CDs to enhance relaxation. 

When to Get Additional Help 

Everyone grieves in their own way, and there is no right or wrong way to grieve. We simply need to listen to our bodies and try different techniques to help us get through this period. In order for any of the techniques to be effective, we need to ensure we are getting adequate rest and nutrition. When prolonged sleeping difficulties and physical problems continue to disrupt daily functioning, it may signify that it is time to talk to a professional.

There is comfort in knowing that the way you are feeling isn’t all in your head. The physical symptoms are normal reactions during times of stress or grief. Left untreated, high levels of stress can lead to more serious health concerns. Although seeking professional guidance will not guarantee immediate resolution of the body’s response, it will allow us to start on the road to recovery by using additional therapeutic activities.   

Susan R. Blankenship MS, BSN, RN, CCM is a registered nurse and certified case manager and works in Clinical Operations at the Joint Task Force National Capital Region Medical Headquarters, Bethesda, Maryland.

Rebecca I. Porter, PhD, ABPP, LTC US Army is a board certified Clinical Health Psychologist and serves as the Behavioral Health Officer at the Joint Task Force National Capital Region Medical Headquarters.