Grief can make you ill

Grief can make you so very ill
Grief can make you ill
Can sadness leave you obese, diabetic or hypertensive? Yes, say doctors, whose research proves that heartbreak, career slumps and bereavement can kill

She started out dreaming of a bright career and love. At 25, she hanged herself. In her last letter, actor Jiah Khan wrote of the pain a failed relationship had caused, how it had "destroyed every bit of me, destroyed my soul" and why she was "running away from everything". Khan encountered a frightening enemy — the grief following a romantic break-up and stunted career — and found that she was unable to battle it. In a first of its kind study on the motivations for suicide, published in the official journal of the American Association of Suicidology, two were found to be universal: hopelessness and overwhelming emotional pain. Heartbreak, divorce, the loss of a job, terror attacks, communal riots and accidents — the modern world is fraught with incidents that leave you grieving. The reaction to it tends to be commonly marked by anguish, numbness, guilt and deep sorrow. Health professionals are concerned about the absence of adequate support the urban resident faces to cope with grief, thus jeopardising not just his mental but physical health, too.

Hidden risks
While anxiety and depression have been associated with grief, doctors warn that life-threatening diseases like obesity, cardiovascular disease and diabetes are possible fallouts, too. An Italian study published in 2011 in the International Journal of Psychiatry in Medicine suggests a link between the death of a parent in childhood and obesity in adulthood.

Holly G Prigerson has spent more than 20 years studying grief. The director at the Centre for Psychological Epidemiology and Outcomes Research, Harvard Medical School says that empirical evidence demonstrates that intense grief (yearning for a dead loved one, dwelling in the past and failing to reengage with life) that persists for more than six months is an invitation for an adverse health outcome. "It can include a significant increase in alcohol and tobacco consumption, changes in eating and sleeping patterns, skipping work, high blood pressure, and even the incidence of cancer," she says in an email interview. In extreme cases, she has seen it leading to hospitalisation after a heart attack. "There is some evidence that grief affects blood clotting and predicts high blood pressure, which explains the heightened risk of heart attack," she says.

The mortality project
Dr Toni Miles, director at the Gerontology Institute at University of Georgia, is heading an initiative called the Mortality Project, which trains the spotlight on life after death — more specifically, health after death. "Our project asks, 'If you experience the loss of someone else, what does that do to your health?"

Grief is now a public health issue, Dr Miles warns, in much the same way that infectious diseases are. "It is a mistake to separate negative emotion from physical illness. Depression causes changes in our body, and these are measureable. I suspect that being depressed for an extended time causes the injury. In our survey, we found that newly bereaved persons are more likely to be hospitalised during the year after a death." Which is why her claim that "(grief) kills people" has been recognised. Prolonged grief will now be listed as a new disorder in the International Classification of Diseases 11 (ICD 11). "Prolonged Grief Disorder is essentially a social attachment disturbance where those separated from a highly significant other feel intense emotional pain, abandonment and a yearning, craving to be reunited (explaining the suicide risk)," she says.

Call in support staff
Social support is one of the most important factors in recovery from grief. This can come from partners, family, friends, relatives, a spiritual leader or a support group. "Indians shy away from seeking professional help. Seeing a behavioural expert is not the first move they'd consider. That's a mistake. If you sense you are unable to deal with your grief, and even close ones can't help, it's time to look outside," says Nagpur-based psychiatrist Dr Tushar Shinde.

Confirming perception that men and women handle grief differently, research suggests that men, who are used to emotional restraint, are more reluctant to address feelings of pain than women. In a paper published in The Review of General Psychology in 2001, psychologists at the University of Utrecht in the Netherlands revealed that widowers display a higher incidence of mental and physical illness, disabilities, death and suicide than widows. Women who lost their husbands spoke of "feeling abandoned or deserted", while men spoke of their loss as "dismemberment".

The way ahead
What will help cut down the sense of loss? The answer to that one lies in identifying the 'accurate' process of dealing with grief. Dr Shinde says processing grief needs time, patience and care. "Accept the loss, work through the pain, and learn to be without (the person, circumstance)."

Dr Miles raises a red flag when she says, "Often, people say there is nothing new about loss and depression. That grief is natural. There is nothing to be 'done'. Our research proves there are several strategies to diminish the ill health effects of loss. Our goal is to identify effective ones."

Do it like Kia
Kia Scherr was in Florida for Thanksgiving when she heard that the Oberoi Hotel in Mumbai had been attacked by terrorists. Her husband, Alan, 58, and daughter, Naomi, 13, were staying there. Hours later, she heard that both had been killed. A few days on, she stunned the world by saying in a press interview that she had forgiven the terrorists and felt compassion for those "so separated from humanity that they would kill". Scherr shares her 4 steps to tackling grief guideline.

I was open
Find support. I had multiple levels of it — I family, friends, and so many people whom I had not met, but empathised. Everyone's wishes were sincere and heartfelt, and I felt connected to the world as a family. Even the funeral was taken care of for me. Things hit me only after everybody went home. I was left to deal with the pain.

I didn't let it linger
Lingering grief is a private matter; unless you have gone through it, no one completely understands it. Emotion has a life of its own. Grief can fester. You can numb it through alcohol or drugs, or you can try distraction (work, television etc). I understand why people go down that path. But repressing painful feelings does damage — it may seem good in the short term, but over the long run, it's deadly.

I sought professional help
Grief doesn't go away on its own. You have to seek help. I went in for counselling sessions and meditation. My healing process started with setting up One Life Alliance, a peace organisation, but pain continues to engulf me at times. That I decided to return to Mumbai was part of the healing process. My mother died of lung cancer two years ago, and I was with her through it. This may be an experience that almost all of us go through — a parent's death — but that doesn't mitigate the pain or loss.

I connected with others like me
Support groups are helpful because they bring together people who have suffered loss. Life goes on for others, but someone who has experienced terrible grief needs support and encouragement. Often, the loss is so immense that you have no words to express it. It's someone's presence that makes the difference. Be there for the person, show your love. Love makes all the difference; it has the power to make you sail through the roughest times.

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