Core Concepts for Grief-Sensitive Care
How Grief Affects the Body
Adapting to loss or significant change places substantial demands on the body and mind.
Bereavement, in particular, is widely recognized as one of the most stressful life experiences. Any experience that involves grief can affect the body physiologically.
In addition to grief affecting cognitive functioning, it can also affect the body physiologically.
Stress associated with grief can influence immune, cardiovascular, and neuroendocrine processes and may be associated with symptoms such as fatigue, changes in appetite or sleep, inflammation, and cardiovascular strain.
"Grief is not a disease, but it has physiological effects, just as pregnancy is not a disease, but it increases risk of hypertension and gestational diabetes."
Common Physical Effects of Grief
- Appetite changes (loss or increase)
- Cardiac symptoms (e.g., tachycardia, chest pain, stress-induced cardiomyopathy)
- Changes in energy level
- Elevated cortisol and inflammation
- Gastrointestinal issues
- Headaches and joint pain
- Muscle tension or body aches
- Reduced immune function
- Sleep disturbances and fatigue
- Weight gain or loss
Grief and Cardiovascular Risk
Grief can be associated with increased cardiovascular risk. Research indicates that the risk of acute cardiac events may be elevated in the first 24 hours after the death of a significant person.
While some health risks are highest in the immediate period following a death, elevated vulnerability can persist beyond the initial months. Conjugal bereavement has been associated with reduced life expectancy, with some evidence suggesting greater effects in men.
These risks are not limited to spousal loss. The death of a parent may also be associated with increased risk of ischemic heart disease and stroke, highlighting the broader cardiovascular effects of severe psychological stress related to loss.
Broken-heart syndrome (Takotsubo cardiomyopathy) refers to a temporary weakening of the heart that is often triggered by acute emotional or physical stress and typically occurs during periods of intense distress.
In contrast, bereavement has been associated with increased risk of cardiovascular events such as heart attack and stroke, which may emerge over days, months, or longer following a loss. The phrase “dying of a broken heart” is sometimes used to describe these risks and reflects a broader range of outcomes than Takotsubo cardiomyopathy alone.
Grief And Physical Pain
Emotional pain associated with grief can engage neural pathways involved in physical pain. Neuroimaging studies have found that reminders of loss activate brain regions linked to both emotional distress and bodily pain, which may help explain why grief is sometimes experienced as physical discomfort alongside emotional distress.
“You wouldn’t think that feeling emotions would give you physical pain but it would hurt.”
When Asia Khan was 14, her mother died in a car accident. In this video, courtesy of WPSU, Asia reflects on the physical effects she experienced in the aftermath of her loss.
Emotional pain related to loss can engage neural pathways involved in physical pain, and research on social and emotional loss suggests that reminders of loss can activate brain regions linked to both emotional distress and physical pain.
Bereavement-related immune and inflammatory changes may also contribute to physical symptoms, as inflammation is known to influence pain sensitivity.
Coping Strategies and Negative Health Implications
Grief can affect physical functioning, and the ways individuals cope with grief may also influence health over time. While there is no single “right” way to grieve, some coping strategies may be associated with greater health risk and downstream effects.
"Problems are not the problem; coping is the problem."
Maladaptive Coping
Some coping strategies may provide short-term relief but have been associated with longer-term health risks. These responses are often avoidance-based and may hinder adaptation over time.
Examples of Maladaptive Coping
Examples include:
- Behavioral addictions (e.g., gambling, excessive spending)
- Compulsive overworking
- Compulsive use of social media or digital platforms
- Disordered eating patterns
- Increased risk-taking behaviors
- Rumination and social withdrawal
- Self-harm behaviors (e.g. cutting, self-injury, self-mutilation)
- Substance use or misuse (e.g. alcohol or other drugs)
When these patterns persist, they may be associated with worsening mental health, increased distress, and reduced overall well-being.
Raising Concerns Using Grief-Sensitive Language
When concerns arise about how someone is coping, approaching the conversation with curiosity rather than correction can help maintain trust and support engagement. Framing questions around wellbeing and function, rather than labeling behaviors as problematic, may make it easier for patients to reflect and share.
Grief-sensitive language may include:
- “Many people find themselves coping in different ways after a loss. How have you been getting through things lately?”
- “Are there any habits or strategies you’ve been relying on that feel helpful in the moment but harder over time?”
- “Sometimes coping strategies that offer short-term relief can start to affect sleep, mood, or health. Have you noticed anything like that for yourself?”
- “Would it be okay if we talked about what’s been helping and what might be making things harder right now?”
These conversations can open space to explore coping patterns, reinforce patient autonomy, and identify opportunities for additional support when needed.
Grief Screening as Routine Care
Grief can affect multiple body systems and may exacerbate existing health conditions or contribute to new concerns, sometimes months or years after a loss.
For healthcare professionals, recognizing these potential physical health effects, including in some cases serious medical risk, can support more comprehensive care for patients and the people who support them.
Because patients may not recognize, validate, or name grief on their own, meaningful losses can remain unspoken unless they are gently invited into the conversation. Open-ended questions can help surface experiences that may be influencing health, decision-making, and engagement in care without requiring patients to label their experience as grief.
Grief-sensitive prompts may include:
- “Have you experienced any significant losses or changes recently? In the past?"
- “Has anything important changed in your life that has been hard to adjust to?”
- “Is there anyone or anything you have lost that may be affecting how you are feeling or functioning?”
- “Are there life changes or stressors outside of your medical concerns that feel important for me to know about?”
Supporting the Physical Effects of Grief
While grief is not a disease, it can be associated with significant and sometimes lasting effects on health. Healthcare professionals can support these physical impacts by normalizing grief-related symptoms, offering brief education on how grief may show up in the body, and incorporating brief screening for recent losses or major life changes to support more informed, whole-person care.