You may have expected the sadness. The exhaustion, the 3 a.m. waking and the meals you cannot finish can come as more of a surprise. Grief happens in the body as well as the mind, and the physical side is a recognized part of it.
This article covers what is typical, what studies of sleep, immunity and the heart found, and when a symptom calls for a doctor instead of patience. For the emotional side, see what grief feels like.
What does grief do to the body?
The National Cancer Institute's summary for health professionals lists insomnia, loss of appetite and fatigue among the common reactions to a loss, next to sadness, guilt and a daily routine that falls apart. It also mentions crying and sighing. These are described as part of grief itself, not as a complication of it.
The same summary describes grief arriving in highly intense, time-limited bursts, for example 20 to 30 minutes, often called waves or pangs. A wave like that can leave you drained in a way that feels physical.
On timing, NCI is careful. It says there is no clear agreement on how long recovery takes, and that most bereaved people notice their symptoms lessening after about six months. Lessening is not the same as ending, and your own pace may be different.
Why is sleep so hard after a loss?
Sleep problems after a loss are well documented. A 2020 systematic review in Sleep Medicine Reviews brought together 85 articles covering 12,294 participants. It found a high prevalence of sleep disturbances in bereavement, and that more intense grief went along with more sleep difficulty.
The review also reported that grief therapy partly improves sleep difficulties, and that no intervention studies had specifically targeted sleep problems in bereaved people. So poor sleep after a loss is common, while the research on how best to treat it in grieving people is still thin.
If you have been sleeping badly for weeks, that is a reasonable thing to bring to your primary care doctor. You do not have to wait until it becomes unbearable.
Does grief weaken the immune system?
There is some evidence that bereavement is linked to changes in immune function. A 2019 systematic review in Psychosomatic Medicine looked at 33 publications. In the authors' words, a handful of recent, good-quality studies show that bereaved people have higher levels of systemic inflammation, maladaptive immune cell gene expression and a lower antibody response to vaccination than people who are not bereaved.
The authors also say the research is heterogeneous in its methods and quality. These are differences between groups on laboratory measures. They do not tell any one person whether they will get sick, and they are not a reason for alarm.
What does research say about grief and the heart?
This is the area where headlines tend to run ahead of the data, so the numbers matter.
A 2014 study in JAMA Internal Medicine followed 30,447 people in the United Kingdom, aged 60 to 89, whose partner had died, and compared them with 83,588 matched people who were not bereaved. Within 30 days of the death, 50 of the bereaved group (0.16%) had a heart attack or a stroke, compared with 67 of the comparison group (0.08%). That is roughly double the rate in relative terms. In absolute terms it is 16 in 10,000 against 8 in 10,000. The increase was seen in men and women and faded after 30 days.
Studies of death rates after losing a spouse point the same way. A 2011 meta-analysis of 15 prospective cohort studies, covering more than 2.2 million people, found the relative risk of death for widowed people was 1.41 in the first six months and 1.14 after that. It was larger in men (1.23) and not statistically significant in women (1.04). The authors noted substantial variation between studies.
These are relative increases in what is already a small short-term risk, seen in observational studies of mostly older spouses. They show an association. Most widowed people do not die soon after their partner.
Is broken heart syndrome real?
Yes, and it is rare. The American Heart Association describes broken heart syndrome, also called stress-induced or takotsubo cardiomyopathy, as a condition in which part of the heart temporarily enlarges and does not pump well. It can follow an emotionally or physically stressful event, such as a death, a divorce or even a good shock. Women are more likely than men to experience it.
Grief is only one of several possible triggers. In the largest registry of patients, 1,750 people at 26 centers, physical triggers were more common than emotional ones (36.0% compared with 27.7%), and 28.5% of patients had no evident trigger. The published summary of the registry does not report how many cases followed a bereavement.
The Heart Association says most people make a full recovery within weeks and are at low risk of it happening again. It is not always mild, though. It can lead to severe, short-term heart muscle failure, and in rare cases it can be fatal. The symptoms and test results resemble a heart attack, which is why you cannot sort it out at home.
When should you see a doctor?
Because grief explains so much, it is easy to put every symptom down to it. A few situations should not wait.
- Call 911 for chest pain or shortness of breath. After a loss these cannot be told apart from a heart attack without tests, so treat them as an emergency.
- Make an appointment if poor sleep or poor appetite has gone on for weeks, or if exhaustion is keeping you from the basics of your day.
- Make an appointment for any symptom that is new, is getting worse, or simply worries you, and if a health condition you already have has become harder to manage.
- Call or text 988 if you are having thoughts of wanting to die, or call 911 in an emergency.
Tell the doctor about the loss. It is relevant medical information, and it helps them decide what to check.
Where does therapy fit?
Most people who are grieving do not need therapy, and physical symptoms on their own are a matter for a physician, not a psychologist. Therapy is one option when the grief itself feels unmanageable, or when sleeplessness and exhaustion seem to be feeding low mood and you are no longer sure what is grief and what is something else. The article on grief and depression explains how clinicians tell them apart.
Dr. Rabin is a licensed clinical psychologist in Brookline who works with people through grief and loss, in person and by telehealth across Massachusetts. If you would like to talk it through, she offers a free phone consultation of about 15 minutes through her contact page.
Keep reading
Sources
- National Cancer Institute, Grief, Bereavement, and Coping With Loss (PDQ), Health Professional Version (2024)
- Lancel, Stroebe and Eisma, Sleep disturbances in bereavement: A systematic review, Sleep Medicine Reviews (2020)
- Knowles, Ruiz and O'Connor, A Systematic Review of the Association Between Bereavement and Biomarkers of Immune Function, Psychosomatic Medicine (2019)
- Carey, Shah, DeWilde, Harris, Victor and Cook, Increased risk of acute cardiovascular events after partner bereavement: a matched cohort study, JAMA Internal Medicine (2014)
- Moon, Kondo, Glymour and Subramanian, Widowhood and mortality: a meta-analysis, PLoS One (2011)
- American Heart Association, Is Broken Heart Syndrome Real? (2024)
- Templin, Ghadri, Diekmann and colleagues, Clinical Features and Outcomes of Takotsubo (Stress) Cardiomyopathy, New England Journal of Medicine (2015)
- National Heart, Lung, and Blood Institute, Cardiomyopathy: Types (2024)
Last reviewed October 2026. This guide is general information, not medical advice or a diagnosis. If you are in crisis, call or text 988, or call 911 in an emergency.
