How Grief Affects Health

Barbara Bush recently passed away after a 73-year marriage to President George HW Bush. The couple were devoted to each other and stayed together throughout their long careers in public life. They made it known just how deeply they cared for one another -- both before, during and after Mr. Bush's presidency. Soon after Ms. Bush's funeral, President Bush was reported to be hospitalized with a potentially life-threatening infection. It appears he's still recovering in a Houston hospital, where he's being treated for a serious bacterial infection that spread from his urinary tract into his bloodstream. This type of infection, known as septic shock, is common in chronically ill elderly patients.

While Mr. Bush's recent illness and hospitalization is concerning, research from multiple observational studies has shown that it's not uncommon for a surviving spouse to become ill -- and even die -- in the weeks to months following the loss of a beloved wife or husband.

[See: The Facts on Heart Disease.]

How Exactly Does Grief Affect the Body?

Grief can have a profound effect on our overall health. For those with chronic disease and advanced age, these effects can be even more significant and, at times, life-threatening.

The "widowhood effect" -- the increased likelihood for a recently widowed person to die -- has been well-studied. Previous studies have shown that mortality increases anywhere from 40 to 90 percent in the three months following the death of a spouse and lingers at 15 percent during the months after. In one study that examined over 370,000 elderly couples, researchers found an 18 percent increase in death for men when the wife died first, and a 16 percent increase in death for women whose husband preceded them in death. This effect is real, and the mechanisms by which it occurs aren't well understood. However, there are some known contributing factors:

1. Isolation and loneliness/depression.

When we lose a lifelong partner, we can quickly become isolated, and these feelings of loneliness and loss can lead to depression. Researchers have also found that when a surviving spouse has a chronic disease -- such as COPD or Parkinson's (as in the case of President Bush) -- they may become more prone to accidents or lapses in treatment for their disease. Another study found that the risk of heart attack increases 21-fold in the 24 hours following the death of a spouse, and this risk slowly decreases over the ensuing weeks to months. Many spouses have relied on their partners to assist with the care of their chronic disease, and their absences may result in missed appointments, medications or other activities that can result in negative health consequences.

2. Stress hormones/Takotsubo's cardiomyopathy.

During a traumatic event, our bodies can release large amounts of stress hormones such as adrenaline and cortisol. In extreme cases, this massive release of stress hormones can result in something called Takotsubo's cardiomyopathy. Also known as a stress-induced cardiomyopathy, this condition occurs more frequently in women and can mimic the signs and symptoms of a real heart attack -- including chest pain, shortness of breath and even, in rare cases, sudden death. Most cases of Takotsubo's cardiomyopathy are reversible, and most patients recover completely.

3. Fatigue.

The exhaustion that accompanies the loss of a spouse and all the things that are required when a family member dies -- whether the death is expected or sudden and a surprise. Overwhelming fatigue can cloud thinking and make it difficult to accomplish routine tasks. In addition, excessive fatigue can also weaken the body's ability to fight off infection and can exacerbate chronic disease.

4. Exposure to germs/immunosuppression.

In 2014, British researchers found that bereavement of a spouse can actually suppress our immune systems and make us much more susceptible to infections. In the case of President Bush, he has been in and out of the hospital over the last year with multiple respiratory infections related to his Parkinson's disease. It could be that the death of his wife played a role in his re-admission this month with another serious infection. In addition, the process of planning and attending the funeral of a spouse can involve interaction with large groups of people. For those with chronic disease or weakened immune systems, this can result in exposure to more germs than normal. Many of these germs can cause infections and acute illnesses.

Overcoming Grief When Losing a Spouse: What Can We Do?

Experts suggest several strategies to assist in mitigating the physical and health-related effects of dealing with grief caused by the loss of a spouse. It's important to rely on family and friends to assist during this process. Here are a few specific strategies that can make a big difference:

1. Eat regular meals. Many who experience the loss of a spouse tend to lose weight and do not take in proper calories due to a probable lack of interest in food.

2. Get plenty of rest. It is important stick to normal sleep routines whenever possible. As mentioned previously, fatigue can have many negative health consequences and can contribute to depression.

3. Get regular exercise (if physically able). Exercise can help the body release endorphins which can elevate mood. In addition, physical activity can help improve health status in chronic disease.

4. Make sure your doctor knows what has happened in your family. Your physician can often help you get through this difficult time of bereavement. It's important that your doctor is aware of any changes in your health status.

Grief is a normal part of life. It's understandable that when a couple spends a lifetime together, the separation of death can be a devastating life event. By understanding that risk for health issues (including death) in the surviving spouse, we can better work to prevent negative health consequences during the bereavement process.