Nieman: Grief is more than an emotion, it has a biological effect
One word which seems to summarize the past two years the most accurately is the word “loss.” Many of us had to deal with loss of income, loss of freedoms, loss of meaningful face-to-face connections, loss of employment, loss of health and, in some unfortunate situations, loss of hope, even to the point of being connected directly or indirectly with someone whose life ended in suicide. In my clinic, I have observed how some parents had to deal with a loss of a parent or parents. Away from my clinic, I belong to a private group of parents who all are learning together what it means to deal with the loss of a child (To be clear, this particular group is not navigating the specific loss of a loved one due to COVID.) Medical science knows quite a bit about the psychology of grief. It knows surprisingly little about the biology of grief. In the U.S., the National Institute of Health serves as the main funding agency for research. Grief is not a disease nor is it classified as a mental disorder. Only a handful of researchers are studying the biology of grief currently due to underfunding. One such researcher is Dr. Mary Francis O’Connor, a psychologist at the University of Arizona. She studies both the psychology and physiology of grief and its biological changes. Her work and the work of a small number of her peers indicate that, following the sudden loss of a loved one, a whole cascade of physiological changes unfold, not just over the short term, but also for years after the tragedy. When intense stress strikes a human being suddenly, the brain responds by orchestrating the release of certain hormones that disseminate throughout the body. These hormones have a widespread impact on the heart and the immune system in general. Researchers know that after the loss of a child or a spouse, the heart rates of bereaved people are initially faster and that this may last as long as six months in some cases. Not surprisingly, for some, elevated blood pressure ensues. There is a higher risk of blood clots due to an increase in clotting factors. Due to chronic inflammation induced by stress, cardiovascular disease is far more common in people who experience the loss of a loved one. In one particular study, conducted at Rice University, researchers collected blood samples of bereaved people and found that for as long as three months after their loss, inflammatory markers were abnormally elevated. These researchers also found that 16 per cent per cent of the bereaved group experienced myocardial infarctions or strokes within 30 days, compared with 0.08 per cent in a non-bereaved control group. Inflammation also drives conditions such as Type 2 Diabetes, some auto-immune conditions and certain types of cancers. Hormones such as insulin, cortisol, and epinephrine were measured over time and found in some cases to be chronically elevated. In 2001, Dr. O’Conner first began imaging the grieving brain using a functional magnetic resonance imaging scanner (fMRI). It was interesting to note that hearing words such as “funeral” or “loss” and seeing pictures of the person who died lit up the same areas of the brain as when humans experience physical pain. One surprising discovery was found in a part of the brain called the nucleus accumbens. This is part of the brain’s network for reward — the part that responds to the pleasant experiences of consuming chocolates as an example. Patients with complicated grief, when showed pictures of deceased loved ones, had fMRIs where the nucleus accumbens lit up similar to when pictures of living loved ones were shown. In a recent New York Times column (April 22, 2021), Ann Finkbeiner reflects on the implications of the 565,000 deaths in the U.S. due to COVID. Each left an average of nine people grieving. That means that close to five million people are going through the biology of grief. Finkbeiner lost her 18-year-old son in a 1987 train accident. She ended her column by noting “The feeling of connection to the person who died gradually moves from preoccupying the mind to residing comfortably in the heart.” Now, 34 years later, she says she feels more in charge of her emotions and that “if the pain never quite goes away, then neither does the love.” Dr. Nieman is a pediatrician in private practice. He began running daily in 2009 and has completed 112 marathons. His second book, 101 Finish Lines, went on sale in May 2021.
![Prof. Henry T. Greely, director of the Stanford centre for law and bio-sciences. For Conversations That Matter with Stu McNish. Handout, provided by the subject. MUST CREDIT: Steve Gladfelter [PNG Merlin Archive]](https://smartcdn.prod.postmedia.digital/vancouversun/wp-content/uploads/2021/05/henry-t-greely_261562263-w.jpg?quality=90&strip=all&w=232)
