Grief on the mind: Understanding what loss does to our brains

The death of a loved one can leave us reeling. But understanding its impact on the neural pathways can help us come to terms with the loss

Pic: iStock

GRIEF is a mind-body experience, and understanding it can help us manage it.

“There is no script with grief. It is a unique experience for everyone,” says Eric Clarke, a lecturer at the RCSI University of Medicine and Health Sciences, who has a special interest in death, dying, and bereavement.

The five stages of grief as outlined by Elisabeth Kübler-Ross are: denial, anger, bargaining, depression, and acceptance.

“We may think that these stages happen in a linear way, that we go through these steps to reach a destination, but it’s not the case,” says Clarke. “It’s more like we take a squiggly line through the stages. And that’s OK, that’s your experience. It doesn’t mean that you’re not grieving the right way.

“With loss, we’ll experience a huge range of emotions: sadness, anger, irritability, depression, fear, helplessness, relief and guilt, and, of course, we’ll go through the ‘if onlys’ and ‘what ifs’,” says Clarke. “It’s about how we adapt to our loss, that’s the grief work.”

With grief, we can feel fine one minute and like we can’t do anything the next — the grief overwhelms us.

Margaret Stroeb and Henk Schut, from Utrecht University in the Netherlands, termed this the ‘dual-process model of grief’, by which we “oscillate between loss-oriented and restoration-oriented phases”.

Following a loss, most people will be able to function on some level, says Clarke. They will return to work, parent their children, and go through life, but, sometimes, the grief can come crashing in to their train of thought out of nowhere.

People describe this as a fog or a preoccupation that comes unexpectedly.

But why does this happen? Our brain sees loss as a threat to survival and can kickstart our fight-or-flight response, says Galway-based clinical and behavioural psychologist Dr Diana Bast.

“When we’re in fight-or-flight mode, we are trying to survive, which can cause changes in our behaviour, our memory, and our sleep. This can lead to a type of brain fog, where we struggle to make sense of what’s happening. This is a natural reaction to loss.”

Stuck in grief

According to the American Brain Foundation, when we are in fight-or-flight mode, our brain creates new connections between nerves and strengthens or weakens existing connections, “depending on the duration and degree of the emotional response”.

The ability to tweak neural connections helps our brains deal with traumatic events like loss “by forming new neural connections based on these experiences. This helps individuals adapt to new situations or environments”.

Again, this process is our brain’s normal reaction to grief. But where people experience prolonged stress or grief, the brain’s nerve growth and memory will reduce and fear increase as it operates in survival mode.

If this continues long-term, it can affect memory, decision-making, attention span, and how we interact with the world.

“While grief doesn’t necessarily shrink, your life gets bigger as you have new experiences and meet new people. There is no set timeline, of course, but most people will eventually adjust to their loss,” says Clarke. “However, 8-9% of people can get stuck in their grief, what’s called prolonged grief disorder. This is tricky to diagnose, but if someone is struggling to process their grief and appears stuck in the sadness of it, they may need professional intervention.”

As well as the mental effects, extreme grief can also impact us physically, says Clarke.

“It can make us feel sleepier, more lethargic, more forgetful, and affect our ability to absorb new information.”

Broken heart syndrome

A 2023 University of Arizona study on the impact of grief on heart function showed that long-term, severe grief can cause a significant jump in blood pressure. This increased blood pressure can be a risk factor in cardiac events.

The study’s lead, Mary-Frances O’Connor, said the research was inspired by the idea that someone could die of “a broken heart”.

Indeed, broken-heart syndrome is also known as stress cardiomyopathy and can be caused by physical or emotional stress, like the kind of stress people experience after the loss of a loved-one. In the time immediately following loss, your body will release higher-than-normal amounts of cortisol, the stress hormone. Over a long period, elevated stress can lead to increased blood pressure and impact your heart rate.

Practices like journaling, light exercise, meditation, crafting, and counselling can all help us manage our grief and convince our brain that we’re feeling calmer and more secure.

It can be difficult at first, but Bast says it’s important to rediscover yourself in the face of loss and to have new experiences.

“Take these steps gradually. It can make sense to avoid doing certain things as they may trigger feelings of sadness, but don’t bury those feelings.

“Grief is complicated, and so many things can trigger memories and feelings. By limiting your life, you will only prolong the grief you’re feeling.

“Mindfulness can be a gentle way to heal your brain, to switch off that fight-or-flight mode,” she says. “Acknowledging our feelings and checking in on ourselves is also helpful.”

You adjust to your loss and “become used to it”, says Clarke. “In many cases, your deceased loved-one’s memory will persist very strongly; they are physically gone, but never truly forgotten. And that’s OK. We shouldn’t hide away from that.”

• To contact the Irish Hospice Foundation’s bereavement support line, call 1800 80 70 77, Monday to Friday, 10am to 1pm.