When Grief Affects Our Health
Author: Kenneth Doka
Our responses to a loss — the ways we grieve, can be very different. Some of us may experience grief in all sorts of ways. We may find we are hurting — physically. Here we may experience actual physical pain. We may ache or feel unwell. We may cope with a variety of emotions — sadness, anger, guilt, yearning, or loneliness to name but a few. Grief may affect how we think and how we behave. It may even create spiritual concerns. Others may be more resilient — perhaps even troubled their grief reactions are not more intense. We may feel we are on a roller coaster — sometimes experiencing bad days while other days seem less troubling. All these are part of what might be called typical or normal grief.
Yet sometimes our reactions can be more problematic — more complicated.
Sometimes grief can seriously affect our health. While physical manifestations of grief may very well be related to our grief, any persistent physical complaints ought to be evaluated by a physician. We are more vulnerable to illness when we are grieving. Grieving, after all, is a form of stress and stress both can lower our ability to fight off infections and be a factor in certain illnesses. In addition, we may have changed some of our own behaviors. We may not be eating as well, exercising, or sleeping as soundly after a loss. We may neglect our own health – perhaps skipping needed medications. It is important that our physician be aware that we experienced a significant loss.
Grief can also affect our mental health. This can be especially true if we have a prior history of anxiety or depression. If we have suffered from these conditions in the past, it would be wise to assess with a professional the risk of a relapse. For Charles, the death of his wife caused him to relapse into a depression—a depression he had not experienced for nearly two decades.
When a loss is traumatic, we may even experience Post-Traumatic Stress Disorder. PTSD used to be called “shell shock” or “battle fatigue.” While it is not uncommon among veterans or others who have witnessed violent and sudden deaths, it can occur in the families of victims who died suddenly and violently as they have vivid images of how the death may have occurred. While many survivors may experience a sense of nervousness, helplessness, fear, and anxiety, in PTSD these feelings are both intense and long-lasting. In PTSD, it is not unusual to see symptoms where individuals avoid places that remind them of the trauma or relive or imagine the experience of the death in nightmares or flashbacks. In some cases, we have intense arousal — reacting to loud noises, finding it difficult to sleep, or extreme anger and irritability. Like other grief reactions, it can include physical symptoms such as increased blood pressure or other stress-related reactions. Shawna, for example, constantly had intrusive images of her husband’s death from a land mine. Even though she was thousands of miles from the incident, it did not stop these fantasies. Here it is wise to consult a specialist with specific training and expertise in PTSD. TAPS’ Community Based Care may be helpful in locating such specialists.
We should also seek help if grief is interfering with key roles in work, in school, or at home – especially if we cannot seem to minimally function in those roles and see little improvement in our abilities to function over time. For George, it was difficult to focus on work — months after his daughter’s death in a military accident.
We should also be sensitive to any destructive behaviors. While anger is a natural part of grief, intense anger or thoughts of hurting others should be a sign to seek help. So should self-destructive behaviors such as thoughts of suicide, excessive drinking, disproportionate use of, or dependence upon, prescription medications or illegal drugs. Again these are signs to seek immediate help.
Basically, we should follow our own instincts as well. If we feel we need or should speak to a counselor, it is probably wise to do so. Similarly if friends and family are consistently urging such actions, it may be prudent to act on such advice. We will likely feel better even if we are simply validated — told that our grief is a natural response to the loss we have experienced.
If you need to find a counselor, there are a number of options. Often hospices and funeral homes may have information about support groups or counseling. In addition, the Association for Death Education and Counseling, a national organization for grief counselors, can refer you to a trained counselor. The important thing is to choose a counselor that has specific expertise in grief. TAPS can assist you in finding appropriate help within your own community.
When to Seek Additional Support
- Frequent or serious symptoms of illness — consult a physician
- Constantly depressed or anxious, or prior history of such reactions
- Constantly obsessing about the death, continually focusing or having persistent images of how the death occurred
- Unable to function in key roles weeks or even months after the loss
- Self-destructive behaviors, increased drinking, over-use of prescription or non-prescription medications
- Thoughts of suicide or other destructive acts
TAPS is always here to help. Call the TAPS Helpline at 202-588-TAPS (8277) for further information or local referrals.
From the pen of...
Kenneth J. Doka, Ph.D., is a Senior Bereavement Consultant to Hospice Foundation of America (HFA) and recipient of the 2019 Lifetime Achievement Award from the Association for Death Education and Counseling (ADEC). He serves as editor of HFA's Living with Grief® book series and its Journeys bereavement newsletter. He is a prolific author, editor, and lecturer; a retired graduate school professor at The College of New Rochelle; past president of ADEC; and a member and past chair of the International Work Group on Death, Dying, and Bereavement (IWG). In 2018, the IWG presented Doka with the Herman Feifel Award for outstanding achievement in thanatology. He received an award for Outstanding Contributions in the Field of Death Education from ADEC in 1998. Doka is an ordained Lutheran minister and a licensed mental health counselor in the state of New York.