Domains of Grief: Physical
A hand and lower arm on the window. There are raindrops on the window. Outside there is a building with windows.
The body has a role in grief! It may seem like an obvious statement, and yet, it seems like it can easily be missed in some contexts. Grief does naturally result in our body responding to the stress of the loss. The following list is a gentle reminder of some of the ways we feel grief physically:
Fatigue and Exhaustion
Sleep Disturbances
Appetite Changes
Physical Sensations
Impacted Immune System
Anxiety
Muscle tension
Unexplained aches and pains
Though, it is time that we took a deep dive inside the body and explored some of the science of what is happening inside our bodies. It may help explain a lot! Once again, the work of Dr. Mary-Frances O’Connor will come back in addition to the work of others to guide our exploration. The heart, immune system, and endocrine system, are all places that we can investigate in relation to the physical domain of grief. Keep in mind these are not the only places that we could investigate. There are other systems that are impacted as well. Please note that death will be used as an example of loss, but remember there are many types of loss that people experience.
Heart
Have you heard of broken heart syndrome? Also known as stress cardiomyopathy or takotsubo syndrome, broken heart syndrome occurs when a person experiences sudden acute stress that causes a weakening in the heart muscle.There is often mixed information going around about whether this is real; yes, broken heart syndrome is real. There is a researched association between bereavement and a risk of mortality (O’Connor, 2025). So when a loved one dies our heart is physically impacted, not just our metaphorical heart.
Immune System
When it comes to our immune system, we see an increase in inflammation which may contribute to an increased risk of diseases and disorders that can be found in people who are bereaved (O’Connor, 2025). O’Connor (2025) also offers this piece to answer why not everyone gets sick, some people have preexisting vulnerabilities that are exacerbated by the stress from the loss. Something to keep in mind is that, if an issue does arise, it may not be from the stress of the loss. Thus, we still always need to consider a medical exam when we go through a loss to ensure that we are taking care of ourselves consistently.
Endocrine System
Chances are many have heard of the hypothalamic-pituitary-adrenal (HPA) axis, so this description will be brief to provide a gentle reminder and also offer others the opportunity to learn a little more about it. The HPA axis is essential for stress management and interacts with many physiological systems to help us survive, develop, and address homeostatic maintenance (Dunlavey, 2018). A simple way to talk about the HPA axis is that it helps manage the release of cortisol, which is a hormone that sends information to our bodies about the priorities of the brain.
Now that we have an understanding of the HPA axis and cortisol, let’s go back to O'Connor's work. They remind us that when grief is viewed through the lens of attachment theory and the death of a loved one can be considered a physical blow because the part of us that developed through an attachment relationship is gone, which means we can consider stress theory (O’Connor, 2025). What O’Connor further highlights is that grief is considered a high stressor, which means that, in the lens of stress theory, bereavement becomes an added demand for our systems to cope with.
Finally, we need to consider chronic stress versus acute stress to round out the picture. Our systems were made to withstand times of acute stress so that we can survive. What they struggle with is chronic stress, which can be wearing and taxing to our systems. Loss can be considered a chronic stress that goes on for a while. Thus, we may be able to understand why our poor endocrine system is impacted.
As mentioned earlier, there are so many more systems and organs that we could explore. Everyone is encouraged to explore more as you desire. The overall point of this blog post is to introduce why we feel grief physically and respond the way we do. Again, remember compassion, self-compassion, and taking time to grieve or support people in grief.
take action today moment:
We all live in a body. Remember the mind-body connection from previous blog posts or any research that you may have done. Our bodies will also respond to grief and loss. Think about any strategies that you may want to use to support yourself if and when you are experiencing a loss of any kind or ones that you can use to help others.
Learn More About grief and the physical domain:
Introduction to the Hypothalamic-Pituitary-Adrenal Axis: Healthy and Dysregulated Stress Responses, Developmental Stress and Neurodegeneration (Short scientific paper alert!)
Hypothalamic-Pituitary-Adrenal (HPA) Axis
References
Dunlavey, C. J. (2018). Introduction to the hypothalamic-pituitary-adrenal axis: healthy and dysregulated stress responses, developmental stress and neurodegeneration. Journal of Undergraduate Neuroscience Education, 16(2), R59-R60.
O’Connor, M. (2025). The grieving body. Harper One.