Grief can exact a heavy toll on a person’s health. People are more likely to die when they’re in mourning than in ordinary times, a phenomenon that’s so well known it has its own name in scientific literature: the “widowhood effect.” That’s partly due to the negative changes that can affect the heart during mourning. Grief activates the nervous system, including the part that triggers the body’s “flight or fight” response—which, when it’s over-stimulated, has been linked to heart failure.
Here’s a July 6th study. JACC: Heart Failure adds to the evidence that losing a loved one isn’t just painful: it can also be life-threatening. Researchers reviewed the data on health and relatives from nearly 491,000 Swedish patients suffering from heart disease between 1987 to 2018. The average follow-up was four years. People who had recently lost a close family member were much more likely than those who hadn’t. And the worst time to lose someone you love was usually the week immediately after.
Most of these deaths during bereavement were due to heart failure (although bereavement was most closely associated with an increase in so-called “unnatural” deaths like suicide). When someone close to them dies, people are at greater risk of developing heart disease. While the risk increased by 20% for the death or divorce of a spouse, partner, or child, it was only 13% and 10% respectively. The risk did not go up for the death, but the possibility of heart failure in the future. The risk was especially high for people who endured two losses during the period studied—a 35% increased risk, compared to 28% for a single loss.
It was most hazardous to be alive for the first week following a loss. During that time, people who had lost a loved one had a 78% increased risk of dying from heart failure compared to people who weren’t grieving—and a 113% increased risk over the first week if the person had lost a spouse or partner. “When the shock is highest, we see a stronger effect,” says study co-author Krisztina Laszlo, an associate professor from the department of global public health at the Karolinska Institute in Sweden. This is consistent with other studies, according to Dr. Gregg Fonarow of Ahmanson-UCLA Cardiomyopathy Center, who was not involved in the study. “The risk of death after the loss of a loved one is most elevated in the first few weeks and over the first year,” he says.
Laszlo said that although the loss of a spouse seems to have a stronger impact than that of a child or a parent, it was still surprising. “At this age, one doesn’t have such a large network, and if one loses their spouse…that may impact the quality of life much more.”
Since long ago, researchers have known grief could cause changes in the heart. People who live through a very stressful event—such as the loss of a spouse or partner—sometimes develop stress cardiomyopathy, also known as broken heart syndrome, or takotsubo cardiomyopathy. (“Takotsubo” is the Japanese word for an octopus trap, the shape the heart takes under severe emotional distress.) Although broken heart syndrome is usually temporary, it can lead to symptoms similar to a heart attack. These include chest pain, shortness of breath, swelling of one or more of the hearts, abnormal blood flow, and an increase in the size of some of the organs.
Laszlo says that these negative changes—as well as others, such as how grief affects the nervous and neuroendocrine systems—may contribute to the higher rate of death immediately after loss identified in her study. After a loved one’s death, people sometimes make behavioral changes, like drinking more and exercising less, that could also drive up the death rate among grieving people, she adds. However, even though the scientists attempted to control for confounding variables, the researchers couldn’t entirely rule out that something besides grief could be at play. Poor diet and other risk factors are more common in families than they might be.
Laszlo points out several indicators in the data which suggest that grief plays an important role. For example, the risk of dying from the loss of a close friend was higher. Even if relatives died of unnatural causes, there was a relationship between grief and deaths according to the researchers.
The topic deserves further study, but the study serves as a reminder to loved ones and those who provide health care that they need more support following the death of a family member. Laszlo states that losing a loved one can have an enormous impact on your life. “Death is just the tip of the iceberg,” she says. “It denotes there is serious suffering.”
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