Science Friday - What Happens To Your Body When You’re Grieving

Episode Date: February 20, 2025

We have lots of expressions to describe the pain of loss—heartache, a broken heart, a punch in the gut. These aren’t just figures of speech: While grief is an emotional experience, it’s also a physical one. Studies show that grief can change your physiology, most dramatically in the cardiovascular and immune systems.One staggering finding? A heart attack is 21 times more likely to happen in the 24 hours after the death of a loved one. And after the death of a parent, risk of ischemic heart disease rises by 41%, and risk of stroke increases by 30%.Dr. Mary-Frances O’Connor has dedicated her career to understanding the physiology behind grief and grieving. She joins Host Flora Lichtman to discuss what she’s learned over the years, and her new book The Grieving Body.Transcripts for each segment will be available after the show airs on sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

This is Science Friday. I'm Flor Lichten. Today on the podcast, why grief hurts. It is our body's way of absorbing this blow and just telling us, hey, we're taking on a little extra load here as we're trying to understand what's happening in this new world where your loved one isn't with you. We have all these expressions to describe the pain of loss. Heartache, a broken heart, a punch in the gut. I think of them as figures of speech, but my next guest says it's not so simple. Grief is an emotional experience, but it's also a physical one. Studies show that grief can change your physiology.

Here with me is Dr. Mary Frances O'Connor, professor of clinical psychology and psychiatry at the University of Arizona. She's also the author of a new book, The Grieving Body, that looks at the physiological effects of grief. Mary Frances, welcome back to Science Friday. It's so nice to be here, Flora. So a few years back, you were on the show talking about your previous book, The Grieving Brain. When was it clear to you that, yeah, there is enough science to write a whole other book on the grieving body? It's funny. I've been studying the reaction to loss, you know, just that natural grief response in the brain but also the body for, gosh, 25 years now. And as I was writing the grieving brain, I thought I would put all the information all in one book.

And then I realized, wait, I think there's a whole other book in here. I'm not going to have room. So it got transformed into two books. The second book, The Grieving Body, is about the research on cardiovascular and immune responses we have in grieving. Let's get into the science. I mean, when you're grieving, you know, many of us know, you feel it in your heart. It physically hurts. What's actually happening?

We don't often realize that grief is a physiological response as well as an emotional one. And I think the research has really helped us to hone in a little bit on what's going on in the body. So we know that there are changes from excellent research by Tom Buckley and others from Australia that in the first few months after the death of a loved one, our blood pressure actually goes up. a few millimeters mercury and our heart rate actually goes up a few beats per minute across 24 hours. And seeing that in black and white, those mechanisms was very compelling to me. It really sort of validated what a lot of grieving people have been saying, that it feels like grief is in the body. I mean, does that mean that when you have a heartache, your heart is actually being injured?

in some way? Isn't that interesting? So I think there's two parts of that that are really interesting. The first one is we don't actually know we need better research to know exactly what's happening. We have these tantalizing sort of on average across the population kind of statistics, but we need to understand for this individual what does that feeling mean that I think the other thing you said that's so interesting is it makes. not be that it's an injury. That is to say, our body simply reacts and recover. So during a wave of grief, we may have, you know, a knot in our throat, or our gut may hurt, or we may find it more difficult to breathe. That doesn't necessarily mean something is broken. It is our body's

way of absorbing this blow and just telling us, hey, we're taking on a little extra load here. as we're trying to understand what's happening in this new world where your loved one isn't with you. Hmm. You write about people dying of a broken heart, which I thought, again, was sort of a metaphor or just a, you know, a turn of phrase, but it sounds like it's more than that. This has been one of the most compelling findings because we've seen this in very large epidemiological research.

So one and a half million Finnish people, for example, in a study. And what we know from the evidence is that, for example, in the first three months after a man's wife dies, he is almost twice as likely to have a heart attack as a married man during that same period of time. Twice as likely. Twice as likely. Isn't that a crazy statistic? It really is. It's like 1.8% for women, so slightly lower. But an extraordinary. extraordinary risk when we think about medical risks. And this has been replicated again and again in large studies across a population. Do we understand the mechanism? Why are you more likely to, why are you more likely to have a heart attack? This is where my research really sort of tried to dig in. So in a study that I did with Roman Politsky, who's now at Emory University, we looked at could it be that during a

wave of grief is sort of the riskiest moment? And in that study, what we found was, sure enough, people's blood pressure rose during a wave of grief. What's fascinating is the people who were struggling the most with grief when they walked into the lab. So how they'd been doing in the past couple of weeks, they actually showed the greatest increase in blood pressure during that wave of grief. So it starts to give us an inkling that maybe, in fact, we could start to do some predicting of these mechanisms. Maybe we could figure out how to include bereavement in medical care. Like maybe we could treat people or intervene in some way? You know, I think of it a little bit like pregnancy.

This sounds like a funny analogy. But, you know, pregnancy is very physiological. That's sort of an obvious statement. But it's not a disease. It's not a disorder. Although it can sometimes feel like one. Well, this is the thing. You really want medical care, right?

And that's mostly in the sense that we need. need surveillance, so we need prenatal care. And then we need to know what's happening so we can intervene if something goes wrong. Similarly, in bereavement, it's just a riskier time for our physiology. And so it's important to think about how are we supporting that grieving body for this person who's undergoing what we know is the greatest life stress. What's happening with the immune system when you're grieving? When I was at UCLA, I did a post-a. I did a post-a. postdoc in psychonorea immunology. And part of the reason I wanted to do that is because I really wanted to understand what we call all-cause mortality. So while cardiovascular risk goes up in acute

bereavement in those first couple of months specifically, we actually see increased risk for all sorts of different outcomes, cancer recurrence and even things like pneumonia. And so I think that thought, well, what on earth could be a mechanism that's affecting all these different causes of morbidity and mortality? And of course, the immune system acts on every single one of our organ systems. So it makes autoimmune disorders harder like rheumatoid arthritis. And so by looking at blood draws from people who were grieving, who were courageous and agreed to be in my studies, we saw that inflammation levels are higher in bereaved people. And now, you know, larger studies than mine have confirmed that from other labs as well.

After the break, what grief tells us about love? When there's a death, it reveals all the ways that we're being externally regulated by our loved ones. They are our external pacemaker, but we can't really see that often until they're gone. Are the physical effects from grief different than the effects you see of stress on the body, acute stress? That's such a good question. So I like to say, you know, the heart doesn't have a lot of choices. Heart rate goes up or it goes down, right? Blood pressure goes up or it goes down. So at that level of peripheral physiology, we might say. So at the sort of output in the body, there's not a lot of differences necessarily between the stress of grieving and the stress of other things like being in a threatening situation. But in the brain, we think there are differences because you have to

think about the idea, well, really, you can't think about loss without first thinking about love and bonding, right? So when you fall in love with your partner, you fall in love with your baby, the brain is encoding what we like to say. The brain encodes a we, right? It encodes the relationship as a functioning unit. Your body no longer really ends at the end of your skin, but incorporates that other person. Yeah, I think anyone who's had kids can feel this. You feel like your heart's outside of your body. Absolutely. But even beyond metaphorically, think about what we call kangaroo care, where we lay in infant. on the skin, right, of the chest of the parent, and it reduces pain, it improves breathing, all these good factors physiologically, right? Or if I, you know, get a hug from my partner, my heart rate goes down. So it turns out that couples and bonded infant caregiver, they form this we. And what happens is when there's a death, it reveals all the ways that we're being externally regulated by our loved ones. They are our external pacemaker,

but we can't really see that often until they're gone. I want to get a little personal for a minute. I mean, in your book you write about your own grief related to a medical diagnosis. Are you comfortable talking about that? I am now. You know, there's a lot of stigma in society. So this wasn't something I talked about early in, you know, being a postdoc, being an assistant professor because you're nervous about how that will go. But I have multiple sclerosis. And what I didn't realize for many years was that I was actually diagnosed a little more than a year after my mother died in my early 20s. And I want to be very clear that my mom's death did not cause my MS. We have a family history. But the idea that the

predispositions we all carry around can be really revealed again during this stressful time, I think is one way that that happened for me. But what it meant was in my lived experience, I came to deeply know the grief of health, the grief of loss of health, loss of certainty about, you know, my functioning. And it meant that day to day, I had to make room for my body. I had to start incorporating how to care for my body in my day-to-day life because I wanted to do the meaningful work that was so important to me. Is that one of the lessons for us, sort of working with your body, being attuned to what's happening with your body? I often think why would I bother to tell people all this scientific information that I know? And I think it's because when we know these,

facts, and they're on average, they're across people, they might not be perfectly attuned to your situation. But by knowing these things, we can figure out how to work with your body because grief is a natural response to loss. Our body, our mind, it mostly knows what we're doing if we don't get in the way. And so finding, you know, here's a silly sort of example. You can't force yourself to go to sleep. Every grieving person will tell you that sleep is really difficult when we have loss. But you can, for the most part, force yourself to get up at the same time every day. What's important about that is it resets your circadian rhythm if you intervene in your behavior. It means that your hormone system, your endocrine system, knows, oh, this is the set

point that I can come back to again and again and regulate all those stress hormones that's going to help you emotionally to deal with your loss as well. If you're just joining us, I'm speaking with Mary Frances O'Connor, author of The Grieving Body. This is Science Friday from WNYC Studios. I think a lot of people who have grieved may have had this experience. There can be this annoying feeling when you're grieving a loss like, I should be doing it better. I should be getting through this faster or, you know, I should be optimizing this in some way. I know you're interested in helping people grieve better. How do you do that or how do you navigate that? How do you, how do you help people without putting pressure on people? I think it's really important to remember

that this is a natural process, right? In my laboratory, we do something where at the beginning of the summer, we plant seeds, flower seeds. in the lab. And the reason is because think how long it takes. You have to keep watering, right? Like there's no evidence that that seed is sprouting below the surface. You have to keep watering with faith in order to see those first sprouts. There's something about when we look at living systems to recognize that adapting, growing, learning, it takes a long time. If you cut your hair, Think how long it takes for your hair to grow back. And no one says to you, why isn't your hair growing faster? What is wrong with you? Right. The same should apply to our response to the loss of a loved one.

This is the thing. If it is partly a physiological response, to some degree, there's no rushing that. And you're right, our society is consumed with optimizing our experience. I think many cultures, many periods of history, teach us, bereavement is a time to pause. It's a time to give ourselves a little more time and space because our bodies, our minds, our relationships are doing so much to understand the enormity of the loss of this person in our midst. And that pause, that reflection, just giving each other a little bit of extra space and grace maybe. helps us to process what the heck is going on. You know, you've dedicated your career to the subject, the science of grief and bereavement.

You have a whole lab studying it. Why is this such a compelling topic for you? When I was 13 years old, my mother was diagnosed with stage 4 breast cancer. And there was cancer cells in every lymph node they took out. So they knew it had already migrated to other parts of her body. And, you know, I didn't understand this. You know, no one told me when I was 13 that the doctor didn't expect her to live through the year. But I did understand that grief came to our house, you know.

And so in many ways, you know, he described her as his first miracle. She actually lived another 13 years. The doctor did? Yeah, isn't that incredible? She lived till I was 26. Wow. And it meant that during that time, I think I just became more familiar with grief from a very unfamiliar experience to feeling okay about having people cry uncontrollably when they talk to me. And so in some ways, it's it's not so much about figuring it out for myself, but like, how can we help each other? How can we sit with each other? As a we go through this. And maybe, you know, because of my unique background, how do I take what people are telling me and map that on to neuroimaging scans and blood draws that I'm doing, hopefully in a way that helps us to make sense of both the emotional, the relational, and the physical response? Well, I think you have. I've learned so much. Thank you, Mary

Francis. You're so welcome. Thank you, Flora. Dr. Mary Francis O'Connor, professor of clinical psychology and psychiatry at the University of Arizona. Her new book, The Grieving Body, is out now. And that is about all we have time for. Lots of folks helped make the show happen, including... Karee Zeruchi. Sandy Roberts. Robin Kassmer.

Jordan Smudjick. I'm Flora Lichtman. Thanks for listening.