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Helping Older Adults with Grief

Story at-a-glance -

  • Older people are particularly at risk from weakened immune systems during the grieving process and are more likely to develop infections while grieving than younger people.
  • The disparity between young and old grievers seems to be due to a balance of two stress hormones, cortisol and dehydroepiandrosterone sulphate (DHEAS), which respond differently to grief with age
  • The function of illness-fighting white blood cells called neutrophils was reduced among the older bereaved study participants, which was the result of an imbalanced cortisol:DHEAS ratio
  • Sedentary behavior is linked to a 25 percent greater likelihood of being depressed compared to those who are active
  • Exercise is one of the best treatments for grief and may boost your mood, brain function, and immune system health
 

Grief Can Weigh on Immune System in Older Folks, Study Says

October 09, 2014 | 48,604 views

By Dr. Mercola

Experiencing the loss of a loved one takes a heavy toll on your emotional health, but it doesn’t stop there. The extreme stress that results during bereavement affects you physically, too, and can manifest as both chronic disease and acute illness.

Stress plays a major role in your immune system, and can impact your blood pressure, cholesterol levels, brain chemistry, blood sugar levels, and hormonal balance.

It is through this latter factor, hormonal balance that grief may leave you vulnerable to infections and other illness by weakening your immune system, and it appears the elderly may be most affected.

Older People More Likely to Have Weakened Immune Systems While Grieving

New research shows that older people are particularly at risk from weakened immune systems during the grieving process and are more likely to develop infections while grieving than younger people.

The disparity seems to be due to a balance of two stress hormones, cortisol and dehydroepiandrosterone sulphate (DHEAS), which respond differently to grief with age. In short, while the stress hormone cortisol is known to suppress the immune system, DHEAS is immune enhancing, so maintaining a relatively balanced ratio helps to keep your immune system functioning properly.

The research showed, however, that while younger people had balanced stress hormones, the ratio was unbalanced in the older group, leaving them vulnerable to infection. 

Specifically, the researchers found the function of illness-fighting white blood cells called neutrophils was reduced among the older bereaved study participants.

This, they believed, was the result of the inability to maintain stress hormone balanced, specifically the cortisol:DHEAS ratio. They explained:1

“Stress activates the hypothalamo-pituitary-adrenal axis and subsequently induces the secretion of cortisol, a hormone with immune suppressive effects. DHEAS, also secreted by the adrenal gland in response to stress, is considered to be immune-enhancing.

Whilst cortisol has been shown to decrease the adhesion and increase mobility of the neutrophils, DHEAS increased neutrophil ROS production in vitro. An imbalance between these two hormones, i.e., a high cortisol:DHEAS ratio can arise in response to stress and have negative implications for immunity including increased risk of bacterial infection.”

How Grief-Driven Excess Cortisol Might Make You Sick

Grief isn’t only linked to infectious diseases like colds and sore throats; it’s also associated with chronic diseases like ulcerative colitis, rheumatoid arthritis, asthma, heart disease, and cancer.2 The common culprit may be, at least in part, chronically elevated cortisol.

When researchers from Carnegie Mellon University infected study participants with a common cold virus, those who had reported being under stress were twice as likely to get sick.3 When you're stressed, your body releases stress hormones like cortisol, which prepare your body to fight or flee the stressful event.

Your heart rate increases, your lungs take in more oxygen, your blood flow increases and parts of your immune system become temporarily suppressed, which reduces your inflammatory response to pathogens. When stress becomes chronic, however, such as in the case of complicated grief, your immune system becomes less sensitive to cortisol, which actually heightens the inflammatory response.

This is what actually leads to coughing, sneezing, and other cold symptoms, as well as makes you more vulnerable to getting sick in the first place. And, in the event you do get sick, emotional stressors like grief can actually make your cold and flu symptoms worse. As Dr. Sheldon Cohen, a professor of psychology at Carnegie Mellon University, noted:4

"Inflammation is partly regulated by the hormone cortisol and when cortisol is not allowed to serve this function, inflammation can get out of control. … The immune system's ability to regulate inflammation predicts who will develop a cold, but more importantly it provides an explanation of how stress can promote disease.

When under stress, cells of the immune system are unable to respond to hormonal control, and consequently, produce levels of inflammation that promote disease. 

Because inflammation plays a role in many diseases such as cardiovascular, asthma and autoimmune disorders, this model suggests why stress impacts them as well."

If You Lose a Loved One, Your Risk of Heart Attack Increases 21-Fold

Acute grief can be literally devastating. I have only experienced it once about 20 years ago when I lost someone very close to me. I had chest pain, lost my appetite and about 40 pounds and looked like I was going to die. So I fully appreciate the devastating capacity of grief, as it can even lead to suicide.

If you’re struggling with grief, it’s important to understand that your body is reeling both emotionally and physically, and you’re more vulnerable to illnesses of all kinds during this time, including heart attack.

In comparing how grief affects your heart disease risk within a period of time, researchers found that losing a significant person in your life raises your risk of having a heart attack the next day by 21 times, and in the following week by 6 times.5

The risk of heart attacks began to decline after about a month had passed, perhaps as levels of stress hormones begin to level out.

The study did not get into the causes of the abrupt increase in risk of cardiovascular events like a heart attack, but it, too, is likely related to the flood of stress hormones your body is exposed to following extreme stress such as grief.

For instance, adrenaline increases your blood pressure and your heart rate, and it's been suggested it may lead to narrowing of the arteries that supply blood to your heart, or even bind directly to heart cells allowing large amounts of calcium to enter and render the cells temporarily unable to function properly.

Interestingly, while your risk of heart attack increases following severe stress, so does your risk of what's known as stress cardiomyopathy -- or "broken heart syndrome" -- which is basically a "temporary" heart attack that occurs due to stress.

The symptoms of stress cardiomyopathy or broken heart syndrome are very similar to those of a typical heart attack -- chest pain, shortness of breath, low blood pressure, and even congestive heart failure can occur. It can be life-threatening and requires immediate medical attention. However, it is often a temporary condition that leaves no permanent damage.6 When the stress begins to die down, the heart is typically able to recover.

Being Sedentary May Make the Grieving Process Worse

Sedentary behavior is linked to a 25 percent greater likelihood of being depressed compared to those who are active,7 and this is true whether or not you’re grieving. It was unclear from the study whether sedentary behavior leads to depression… or depression leads to sedentary behavior, but a strong link was noted regardless and whatever the cause sedentary behavior will not promote health.

The last thing you may feel like doing while in the throes of grief is exercising… but it can be remarkably beneficial. Part of the reason why exercise makes you feel better is because of its impact on your brain. It will increase blood flow to your brain, for starters, allowing it to almost immediately function better. If you’ve been in a grief-induced fog, this can help you to feel more focused, virtually immediately.

A number of neurotransmitters are also triggered, such as endorphins, serotonin, dopamine, glutamate, and GABA. Some of these are well-known for their role in mood control. Exercise, in fact, is one of the most effective prevention and treatment strategies for depression.

Further, when you exercise, particularly at high intensity, it requires intense focus while giving you a sense of control. If you’re lost in a seemingly bottomless-pit of shock and disillusionment, exercise brings a sense of purpose that requires nothing more than putting one foot in front of the other.

Don’t Get Antidepressants… Get Moving

Many people succumb to the suggestion of taking antidepressants to overcome grief, not realizing that this temporary Band-Aid may leave you with even more problems to deal with. As explained by Robert Berezin, M.D. in “The Theater of the Brain:”

Mourning is the biological process of the brain-body for healing and recovery from loss… Keep in mind that antidepressants should never be prescribed for grief. They inhibit mourning. They numb out feeling and harden the personality. I’ve treated many patients who had been on antidepressants for years and years after a death. It wasn’t until they got off of them that they were able to mourn and feel and come back to the world of the living. This is what it is to be human. Grief is not a brain problem, but part of the human condition.”

Exercise, meanwhile, has been shown to effectively relieve depressive symptoms. For instance, one study found that 30-minute aerobic workouts done three to five times a week cut depressive symptoms by 50 percent in young adults.8 A meta-analysis published in the Cochrane Database of Systematic Reviews also found that exercise is moderately more effective than a control intervention for reducing symptoms of depression.9 Meanwhile, exercise can help to buffer some of the effects of grief on your immune system, because when you exercise, you increase your circulation and your blood flow throughout your body.

The components of your immune system are also better circulated, which means your immune system has a better chance of finding an illness before it spreads. This includes (but is certainly not limited to) seasonal colds and influenza. If you’re currently grieving, you needn’t get bogged down with the details… simply get moving. Any activity that appeals to you is worth it – hiking, swimming, yoga, group classes, dancing, bicycling… whatever will get you moving is great. Once you have begun to heal, you can read about what a comprehensive exercise program should entail here.

Be Gentle on Yourself During the Grieving Process, and Embrace EFT

During the grieving process, be gentle with yourself and take steps to support positive mental health. Aside from exercise, other common stress-reduction tools with a high success rate include prayer and meditation. The Emotional Freedom Technique, or EFT, is another option; it's a psychological acupressure technique, one I highly recommend to manage stress and optimize your emotional health. Sadly, when I went through my acute grieving 20 years ago, I was not aware of EFT. But embrace the pain as I did and understand it is for something really good. In my case, it changed my medical path and actually helped me find EFT.

Also, please remember that both your mind and mood are significantly affected by your diet, so don't dismiss that part. While it may not be a miracle cure in and of itself, it can be extremely difficult to achieve sound mental health without the proper foundation of a sound diet to support your emotional healing. Sound sleep is another critical issue, as without it your mental health can suffer and it is difficult to make healing progress. If you've been dealing with debilitating feelings of grief that last for a year or more, professional help, including counseling or working with an EFT professional, may be warranted.

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