What Grief Does To Your Body (And How To Manage It)
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What Grief Does To The Body (And How To Manage It)
In life, we will almost all lose loved ones and suffer bereavement. For most people, this starts with grandparents, eventually moves to parents, and then people our own generation; partners, siblings, close friends. And of course, sometimes and perhaps most devastatingly, we can lose people younger than ourselves.
For something that almost everyone suffers, there is often very little in the way of preparation given beforehand, and afterwards, a condolences card is nice but can’t do a lot for our mental health.
And with mental health, our physical health can go too, if we very understandably neglect it at such a time.
So, how to survive devastating loss, and come out the other side, hopefully thriving? It seems like a tall order indeed.
First, the foundations:
You’re probably familiar with the stages of grief. In their most commonly-presented form, they are:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
You’ve probably also heard/read that we won’t always go through them in order, and also that grief is deeply personal and proceeds on its own timescale.
It is generally considered healthy to go through them.
What do they look like?
Naturally this can vary a lot from person to person, but examples in the case of bereavement could be:
- Denial: “This surely has not really happened; I’ll carry on as though it hasn’t”
- Anger: “Why didn’t I do xyz differently while I had the chance?!”
- Bargaining: “I will do such-and-such in their honor, and this will be a way of expressing the love I wish I could give them in a way they could receive”
- Depression: “What is the point of me without them? The sooner I join them, the better.”
- Acceptance: “I was so lucky that we had the time together that we did, and enriched each other’s lives while we could”
We can speedrun these or we can get stuck on one for years. We can bounce back and forth. We can think we’re at acceptance, and then a previous stage will hit us like a tonne of bricks.
What if we don’t?
Assuming that our lost loved one was indeed a loved one (as opposed to someone we are merely societally expected to mourn), then failing to process that grief will tend to have a big impact on our life—and health. These health problems can include:
As you can see, three out of five of those can result in death. The other two aren’t great either. So why isn’t this taken more seriously as a matter of health?
Death is, ironically, considered something we “just have to live with”.
But how?
Coping strategies
You’ll note that most of the stages of grief are not enjoyable per se. For this reason, it’s common to try to avoid them—hence denial usually being first.
But, that is like not getting a lump checked out because you don’t want a cancer diagnosis. The emotional reasoning is understandable, but it’s ultimately self-destructive.
First, have a plan. If a death is foreseen, you can even work out this plan together.
But even if that time has now passed, it’s “better late than never” to make a plan for looking after yourself, e.g:
- How you will try to get enough sleep (tricky, but sincerely try)
- How you will remember to eat (and ideally, healthily)
- How you will still get exercise (a walk in the park is fine; see some greenery and get some sunlight)
- How you will avoid self-destructive urges (from indirect, e.g. drinking, to direct, e.g. suicidality)
- How you will keep up with the other things important in your life (work, friends, family)
- How you will actively work to process your grief (e.g. journaling, or perhaps grief counselling)
Some previous articles of ours that may help:
- How To Keep On Keeping On ← this is about looking after general health when motivation is low
- The Mental Health First-Aid You’ll Hopefully Never Need ← this is about managing depression
- How To Stay Alive (When You Really Don’t Want To) ← this is about managing suicidality
If it works, it works
If we are all unique, then any relationship between any two people is uniqueness squared. Little wonder, then, that our grief may be unique too. And it can be complicated further:
- Sometimes we had a complicated relationship with someone
- Sometimes the circumstances of their death were complicated
There is, for that matter, such a thing as “complicated grief”:
Read more: Complicated grief and prolonged grief disorder (Medical News Today)
We also previously reviewed a book on “ambiguous loss”, exploring grieving when we cannot grieve in the normal way because someone is gone and/but/maybe not gone.
For example, if someone is in a long-term coma from which they may never recover, or if they are missing-presumed-dead. Those kinds of situations are complicated too.
Unusual circumstances may call for unusual coping strategies, so how can we discern what is healthy and what isn’t?
The litmus test is: is it enabling you to continue going about your life in a way that allows you to fulfil your internal personal aspirations and external social responsibilities? If so, it’s probably healthy.
Look after yourself. And if you can, tell your loved ones you love them today.
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Fatigue? Unexplained weight gain and dry skin? Could it be Hashimoto’s disease?
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Maybe you feel worn out. Perhaps you’re also having trouble losing weight. Generally, you just don’t feel 100%.
Could it be Hashimoto’s disease? This common autoimmune thyroid disorder is when your immune system (which fights off viruses and bacteria), mistakenly attacks a part of your body. In this case, it’s your thyroid – a gland located at the base of your neck – and can cause low thyroid hormones levels (hypothyroidism).
Hypothyroidism affects one in 33 Australians and Hashimoto’s is one of the most common thyroid conditions in first-world countries.
While symptoms can be subtle, untreated Hashimoto’s can cause long-term problems with your heart, memory and fertility. Here is what you need to know.
What happens when you have Hashimoto’s?
Your thyroid gland is a butterfly-shaped gland in the neck. It is essential in regulating things like muscle function, digestion, metabolism, the heart and lungs. In children, thyroid hormones are also needed for normal growth and development.
Hashimoto’s thyroid disease, named after the Japanese doctor who discovered it in 1912, is also known as Hashimoto’s thyroiditis or chronic lymphocytic thyroiditis. The disease can cause the immune system to mistakenly produce proteins called antibodies (thyroid peroxidase and thyroglobulin). These can cause inflammation and long-term damage to the thyroid gland. Over time, as thyroid tissue is inflamed and/or destroyed, there can be a decrease in the production of thyroid hormones (hypothyroidism).
Hashimoto’s can present subtly at first. If you only have antibodies with no change in thyroid levels, it is likely you won’t have any symptoms.
However, as the disease progresses, you may experience fatigue, weight gain (or difficulty losing weight), increased sensitivity to the cold, constipation, dry skin, muscle aches, irregular or heavy menstrual cycles, enlarged thyroid (goitre) and occasionally hair loss, including at the ends of your eyebrows.
What causes Hashimoto’s thyroid disease?
Several risk factors can contribute to the development of Hashimoto’s including:
genetic risk – your risk is higher if you have family members with Hashimoto’s
gender – women are up to ten times more likely than men to develop the disease
age – you are more likely to develop the disease from 30 to 50 years of age
autoimmune condition – having another autoimmune condition like systemic lupus, Type 1 diabetes and celiac disease increases your risk
excessive iodine intake and radiation exposure may also increase risk in people who are already genetically at greater risk.
What are the long-term risks?
Long-term, untreated Hashimoto’s thyroiditis can cause heart issues, higher cholesterol levels, nerve damage (peripheral neuropathy), reduced cognition and infertility.
In pregnancy, Hashimoto’s has a higher risk of pre-eclampsia (high blood pressure affecting several organs), premature birth, placental abruption (when the placenta separates from the inner wall of the uterus before birth) and, in severe cases, pregnancy loss.
The disease has also been linked with an increased risk (but low incidence) of the lymphocytes of the thyroid turning into cancer cells to cause thyroid lymphoma.
How is Hashimoto’s diagnosed?
Diagnosis can be confirmed with a blood test to check thyroid levels and antibodies.
Thyroid peroxidase antibodies are commonly present but about 5% of patients test antibody-negative. In those people, diagnosis depends on the thyroid levels, clinical presentation and ultrasound appearance of general inflammation. An ultrasound may not be required though, especially if the diagnosis is obvious.
Three hormone levels are tested to determine if you have Hashimoto’s.
Thyroid stimulating hormone (TSH) is produced by the brain to speak to the thyroid, telling it to produce two types of thyroid hormones – T3 and T4.
If you have either relative or absolute thyroid hormone deficiency, a test will show the stimulating hormones as high because the brain is trying to get the thyroid to work harder.
Hashimoto’s thyroiditis under the microscope. Antibodies against thyroid peroxidase and thyroglobulin were elevated.
Patho/Wikimedia Commons, CC BY-SACan it be treated?
The management of Hashimoto’s depends on the severity of the thyroid levels. Up to 20% of the population can have antibodies but normal thyroid levels. This is still Hashimoto’s thyroid disease, but it is very mild and does not require treatment. There is no current treatment to reduce antibody levels alone.
Because thyroid peroxidase antibodies increase the risk of abnormal thyroid levels in the future, regular thyroid testing is recommended.
When the thyroid stimulating hormone is high with normal thyroid hormone levels it is termed “subclinical hypothyroidism”. When it is paired with low hormone levels it is called “overt hypothyroidism”. The first is a mild form of the disease and treatment depends on the degree of stimulating hormone elevation.
Overt hypothyroidism warrants treatment. The main form of this is thyroid hormone replacement therapy (levothyroxine) with the dose of the drug adjusted until thyroid levels are within the normal range. This is usually a lifelong treatment but, once the dose is optimised, hormone levels usually remain relatively stable.
In some people with very enlarged thyroid glands causing compressive symptoms (such as difficulty swallowing or breathing), thyroidectomy (surgical removal of the thyroid) is considered.
Hashimoto’s thyroiditis is a common condition caused by your body’s immune system incorrectly damaging to your thyroid and can go undetected. Long-term, untreated, it can cause issues with your heart, cognition, and fertility. It can be diagnosed with a simple blood test. Speak to your doctor if you have any concerns as early diagnosis and treatment can help prevent complications.
Aakansha Zala, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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100 Hikes of a Lifetime – by Kate Siber
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This is published by National Geographic, so you can imagine the quality of the photos throughout.
Inside, and after a general introduction and guide to gear and packing appropriately, it’s divided into continents, with a diverse array of “trips of a lifetime” for anyone who enjoys hiking.
It’s not a narrative book, rather, it is a guide, a little in the style of “Lonely Planet”, with many “know before you go” tips, information about the best time to go, difficult level, alternative routes if you want to get most of the enjoyment while having an easier time of it (or, conversely, if you want to see some extra sights along the way), and what to expect at all points.
Where the book really excels is in balancing inspiration with information. There are some books that make you imagine being in a place, but you’ll never actually go there. There are other books that are technical manuals but not very encouraging. This one does both; it provides the motivation and the “yes, you really can, here’s how” information that, between them, can actually get you packing and on your way.
Bottom line: if you yearn for breathtaking views and time in the great outdoors, but aren’t sure where to start, this will give you an incredible menu to choose from, and give you the tools to go about doing it.
Click here to check out 100 Hikes Of A Lifetime, and live it!
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Lost for words? Research shows art therapy brings benefits for mental health
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Creating art for healing purposes dates back tens of thousands of years, to the practices of First Nations people around the world. Art therapy uses creative processes, primarily visual art such as painting, drawing or sculpture, with a view to improving physical health and emotional wellbeing.
When people face significant physical or mental ill-health, it can be challenging to put their experiences into words. Art therapists support people to explore and process overwhelming thoughts, feelings and experiences through a reflective art-making process. This is distinct from art classes, which often focus on technical aspects of the artwork, or the aesthetics of the final product.
Art therapy can be used to support treatment for a wide range of physical and mental health conditions. It has been linked to benefits including improved self-awareness, social connection and emotional regulation, while lowering levels of distress, anxiety and even pain scores.
In a study published this week in the Journal of Mental Health, we found art therapy was associated with positive outcomes for children and adolescents in a hospital-based mental health unit.
An option for those who can’t find the words
While a person’s engagement in talk therapies may sometimes be affected by the nature of their illness, verbal reflection is optional in art therapy.
Where possible, after finishing an artwork, a person can explore the meaning of their work with the art therapist, translating unspoken symbolic material into verbal reflection.
However, as the talking component is less central to the therapeutic process, art therapy is an accessible option for people who may not be able to find the words to describe their experiences.
Art therapy has supported improved mental health outcomes for people who have experienced trauma, people with eating disorders, schizophrenia and dementia, as well as children with autism.
Art therapy has also been linked to improved outcomes for people with a range of physical health conditions. These include lower levels of anxiety, depression and fatigue among people with cancer, enhanced psychological stability for patients with heart disease, and improved social connection among people who have experienced a traumatic brain injury.
Art therapy has been associated with improved mood and anxiety levels for patients in hospital, and lower pain, tiredness and depression among palliative care patients.
Studies suggest art therapy could support people with a range of health conditions. mojo cp/Shutterstock Our research
Mental ill-health, including among children and young people, presents a major challenge for our society. While most care takes place in the community, a small proportion of young people require care in hospital to ensure their safety.
In this environment, practices that place even greater restriction, such as seclusion or physical restraint, may be used briefly as a last resort to ensure immediate physical safety. However, these “restrictive practices” are associated with negative effects such as post-traumatic stress for patients and health professionals.
Worryingly, staff report a lack of alternatives to keep patients safe. However, the elimination of restrictive practices is a major aim of mental health services in Australia and internationally.
Our research looked at more than six years of data from a child and adolescent mental health hospital ward in Australia. We sought to determine whether there was a reduction in restrictive practices during the periods when art therapy was offered on the unit, compared to times when it was absent.
We found a clear association between the provision of art therapy and reduced frequency of seclusion, physical restraint and injection of sedatives on the unit.
We don’t know the precise reason for this. However, art therapy may have lessened levels of severe distress among patients, thereby reducing the risk they would harm themselves or others, and the likelihood of staff using restrictive practices to prevent this.
This artwork was described by the young person who made it as a dead tree with new growth, representing a sense of hope emerging as they started to move towards their recovery. Author provided That said, hospital admission involves multiple therapeutic interventions including talk-based therapies and medications. Confirming the effect of a therapeutic intervention requires controlled clinical trials where people are randomly assigned one treatment or another.
Although ours was an observational study, randomised controlled trials support the benefits of art therapy in youth mental health services. For instance, a 2011 hospital-based study showed reduced symptoms of post-traumatic stress disorder among adolescents randomised to trauma-focussed art therapy compared to a “control” arts and crafts group.
Artwork made by a young person during an art therapy session in an in-patient mental health unit. Author provided What do young people think?
In previous research we found art therapy was considered by adolescents in hospital-based mental health care to be the most helpful group therapy intervention compared to other talk-based therapy groups and creative activities.
In research not yet published, we’re speaking with young people to better understand their experiences of art therapy, and why it might reduce distress. One young person accessing art therapy in an acute mental health service shared:
[Art therapy] is a way of sort of letting out your emotions in a way that doesn’t involve being judged […] It let me release a lot of stuff that was bottling up and stuff that I couldn’t explain through words.
A promising area
The burgeoning research showing the benefits of art therapy for both physical and especially mental health highlights the value of creative and innovative approaches to treatment in health care.
There are opportunities to expand art therapy services in a range of health-care settings. Doing so would enable greater access to art therapy for people with a variety of physical and mental health conditions.
Sarah Versitano, Academic, Master of Art Therapy Program, Western Sydney University and Iain Perkes, Senior Lecturer, Child and Adolescent Psychiatry, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Do You Have A Personalized Health Plan? (Here’s How)
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“Good health” is quite a broad umbrella, and while we all have a general idea of what “healthy” looks like, it’s easy to focus on some areas and overlook others.
Of course, how much one does this will still depend on one’s level of interest in health, which can change over the course of life, and (barring serious midlife health-related curveballs such as a cancer diagnosis or something) often looks like an inverse bell curve:
- As small kids, we probably barely thought about health
- As teenagers, we probably had a narrow view of health (often related to whatever is considered sexually attractive at the time)
- In our 20s, may have a bit of a health kick in which we learn and apply a lot… Which often then gets to later take a bit of a back seat to work responsibilities and so forth
- This is commonly followed by a few decades of just trying to make it to Friday by any means necessary (definite risk factor for substance abuse of various kinds), double if we have kids, triple if we have work, kids, and are also solely responsible for managing the household.
- Then just as suddenly as it is predictably, we are ambushed when approaching retirement age by a cluster of age-related increased health risks that we now get to do our best to mitigate—the focus here is “not dying early”. A lot of health education occurs at this time.
- Finally, upon retirement, we actually get the time to truly focus on our health again, and now it’s easier to learn about all aspects of health, even if now there’s a need to juggle many health issues all at once, most of which affect the others.
See also: How Likely Are You To Live To 100? ← in which we can also see a graph of 10almonds subscribers’ ages, consistent with the above
So, let’s recap, and personalize our health plan
There are often things we wish we could have focused on sooner, so now’s the time to figure out what future-you in your next decade (or later!) is going to thank you for having done now.
So, while 20-year-old us might have been focusing on fat levels or athletic performance, how much does that really help us now? (With apologies to any readers in their 20s, but also, with the bonus for you: now’s the perfect time to plan ahead!)
At 10almonds, while we cover very many health topics, we often especially focus on:
- Brain health
- Heart health
- Gut health
…because they affect everything else so much. We’ve listed them there in the order they appear in the body, but in fact it can be useful to view them upside down, because:
- Gut health is critical for good metabolic health (a happy efficient gut allows us to process nutrients, including energy, efficiently)
- Metabolic health is critical for good heart health (a nicely ticking metabolism will not strain our heart)
- Heart health is critical for good brain health (a strong heart will nourish the brain with well-oxygenated blood and the nutrients it also carries)
So, this isn’t a catch-22 at all! There is a clear starting point:
“How do I do the other bits, though?”
We have you covered here: Your Health Audit, From Head To Toe
“Wait, where’s the personalization?”
This comes once you’ve got those above things in order.
Hopefully you know what particular health risks you have—as in, particular to you.
First, you will have any current diagnoses, and a plan for treating those. Many chronic illnesses can be reversed or at least lessened with lifestyle changes, in particular, if we reduce chronic inflammation, which is implicated in countless chronic illnesses, and exacerbates most of the rest.
So: How to Prevent (or Reduce) Inflammation
The same goes for any heightened risks you have as a result of those current diagnoses.
Next, you will have any genetic health risks—so here’s where genetic testing is a good one-shot tool, to get a lot of information all in one go.
Learn more: The Real Benefit Of Genetic Testing
…and then, of course, take appropriate steps to avoid suffering the things of which you are at increased genetic risk.
Finally, you will have any personal concerns or goals—in other words, what do you want to still be able to do, later in life? It’s easy to say “everything”, but what’s most important?
This writer’s example: I want to remain mobile, free from pain, and sharp of mind.
That doesn’t mean I’ll neglect the rest of my health, but it does mean that I will regularly weigh my choices against whether they are consistent with those three things.
As for how to plan for that?
Check out: Train For The Event Of Your Life! ← this one is mostly about the mobility aspect; staying free from pain is in large part a matter of avoiding inflammation which we already discussed, and staying sharp of mind relies on the gut-heart-brain pipeline we also covered.
You can also, of course, personalize your diet per which areas of health are the most important for you:
Four Ways To Upgrade The Mediterranean (most anti-inflammatory, gut-healthiest, heart-healthiest, brain-healthiest)
Take care!
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The Good Life – by Robert Waldinger, MD, and Marc Schulz, PhD
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For any who have thought “there must be some middle-ground between entirely subjective self-help books advising how to feel better, and sifting through clinical data on what actually affects people’s moods“, this book is exactly that middle-ground!
Drs. Waldinger and Schultz went through the 80-year-long Harvard Study of Adult Development with a fine-toothed comb, and this book details—more readably—what they found.
There are frequent references to data from the study. Not just numbers, though, people’s answers to questions, too. And how different factors about people’s lives affected their answers to the same questions.
We hear from all ages, from young adults to octagenarians, and learn how attitudes (including: of the same people) change over time. Not because people are fickle, but because people grow… or become disillusioned. Or sometimes, both.
We learn about the importance of money… And where that importance ends.
We learn importance of relationships of various kinds, and this is certainly a recurring theme throughout the study—and thus, throughout the book.
The book doesn’t just present data, though, it also presents actionable insights along the way.
Bottom line: the combined wisdom and life-experiences of a lot of people provide a very “big picture” view of life, and what makes us happy, really. We highly recommend it!
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How I Cured My Silent Reflux – by Don Daniels
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Acid reflux, in its various forms (not all of which include heartburn as a symptom!), affects around 1 in 8 people. Often it takes the form of coughing or excess mucus after eating, and it can trigger ostensibly random sweats, for example.
Don Daniels does an excellent job of demystifying the various kinds of acid reflux, explaining clearly and simply the mechanics of what is going on for each of them and why.
Further, he talks about the medications that can make things worse (and how and why), and supplements that can make it better (and supplements that can make it worse, too!), and a multiphase plan (diet on, meds weaned off, supplements on, supplements weaned off when asymptomatic, diet adjust to a new normal) to get free from acid reflux.
The writing style is simple, clear, and jargon-free, while referencing plenty of scientific literature, often quoting from it and providing sources, much like we often do at 10almonds. There are 50+ such references in all, for a 105-page book.
So, do also note that yes, it’s quite a short book for the price, but the content is of value and wouldn’t have benefitted from padding of the kind that many authors do just to make the book longer.
Bottom line: if you have, or suspect you may have, an acid reflux condition of any kind, then this book can guide you through fixing that.
Click here to check out How I Cured My Silent Reflux, and put up with it no longer!
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