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Part 1: Anatomy and physiology of grief

Charlie Brown<br />
by leonardocharra, Creative Commons
Illustration: Charlie Brown by leonardocharra (Creative Commons)

Grief is a complex emotional response to loss, and its anatomy and physiology involve a combination of psychological, neurological and physiological processes. Whilst ‘good grief’ may sound like a contradiction in terms, an oxymoron to be specific, many factors are at play here. In developing an understanding of the components of grief and how our bodies and minds can react to this powerful mix of emotions and the chemical cascade that inevitably follows, we may begin to learn ways to manage them.

I have wanted to write about grief for some time, within the context of chronic illness, specifically mast cell diseases, to bring to the fore how the loss of our previous ‘life before illness’ can have an impact on how we feel from day to day. The components of grief can look just like the symptoms of our illness, so you can imagine how grief could amplify your illness on any given day.

Grief is not necessarily linear but can cycle back into our consciousness at any time. Potentially, we can have layers of unresolved grief, many of which may have occurred before we became ill. We could have internalised, denied or minimised difficult emotions related to previous losses, which can then unleash when we least expect it, causing even more significant emotional and physical distress.

Through necessity, we often spend a lot of time focusing on our medical needs and less time becoming aware of our emotional needs. Grief is not just a mix of feelings but a state of physiology. Becoming aware can assist with taking control of our journey and provide valuable insight into how we can best manage our own psychology.

The following is an overview of how grief (in general) can affect the body and mind:

1. Psychological aspects

Emotional responses: Grief triggers a wide range of emotions, including sadness, anger, guilt, anxiety, shame, fear and sometimes even relief. These emotions can be intense and may fluctuate over time.

Cognitive responses: Grieving individuals often experience intrusive thoughts, memories and a preoccupation with the loss. They may also have difficulty concentrating and making decisions (brain fog).

2. Neurological aspects

Brain activity: Neuroimaging studies have shown that grief can affect brain function. The areas associated with emotional processing, memory and the stress response, such as the amygdala and prefrontal cortex, may be involved. Changes in neurotransmitters like serotonin and dopamine can occur, contributing to symptoms such as sadness, sleep disturbances and changes in appetite.

3. Physiological aspects

Stress response – neuroendocrine activation: Grief activates the body’s stress response, leading to the release of stress hormones like cortisol. This can result in physical symptoms like increased heart rate, muscle tension and shallow breathing.

Immune system: Grief can impact inflammatory cell mobilisation (neutrophils), immune imbalance – reduced T-lymphocyte proliferation, prothrombotic response (platelet activation and increased vWF-ag) and haemodynamic changes (heart rate and blood pressure). Prolonged grief may weaken the immune system, making individuals more susceptible to illnesses.

Sleep disturbances – electroencephalography changes: Grief can disrupt sleep patterns, leading to insomnia or frequent awakenings during the night.

4. Behavioural aspects

Appetite changes: Some people experience a loss of appetite, while others may engage in emotional eating during grief.

Social isolation: Grief can lead to withdrawal from social activities and relationships as individuals may struggle to express their feelings or fear burdening others.

5. Long-term effects:

Chronic grief: In some cases, grief can become complicated or prolonged, leading to persistent symptoms that interfere with daily life, which may require therapeutic intervention.

Physical health: Chronic grief can contribute to health problems over time, such as cardiovascular issues, weakened immune function and an increased risk of certain diseases.

However, it is essential to note that the experience of grief is highly individual, and people may go through different stages and processes. Grief can also be influenced by cultural, social and personal factors, making it a unique and complex human experience. Seeking support from friends, family, or mental health professionals can be beneficial in coping with grief and its physical and emotional impacts.

During research for this article, I was reminded of the cartoon character Charlie Brown and the beloved Peanuts comic strip gang created by Charles M. Schulz in 1950. Charlie Brown and his friends have long been cherished characters who touch on various aspects of life, including themes of grief and chronic illness. Charlie Brown, with his enduring optimism despite constant setbacks and disappointments, represents the resilience that individuals with chronic illness often display.

Charles Schultz once said:

‘Life is like an ice cream cone, you have to lick it one day at a time.’

Sound familiar?

‘Sometimes, just being there for someone can bring hope when all seems hopeless.’

We look forward to meeting with you at the TAMS Zoom Support meeting from 4 – 5 pm, Saturday, 25 November 2023. As always, we can learn so much from each other at these meetings and your contributions will undoubtedly embellish this topic. Register to attend our 25 November support meeting.

Part 2 of ‘Good Grief’ will be revealed at this meeting, and will be discussed at the final support meeting for the year on Saturday, 9 December 2023, following our AGM. Register to attend our 9 December support meeting.

Sue Dickinson
TAMS Support Chair

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