The late Queen Elizabeth II spent the last 16 months of her life mourning the loss of Prince Philip, her beloved consort of 73 years whom she called her “strength and stay”. The sovereign’s sorrow reminded me of my mother’s grief at losing my father, her husband and chief tea-maker for 52 years. Mum has not drunk a drop of tea in the two years since.
The death of a spouse is not merely a psychological trauma: evidence suggests it can measurably harm the physical health of the surviving partner. While it is never possible to determine the exact role that bereavement plays in the long-term health of a specific individual, large-scale studies point to a phenomenon called the “widowhood effect”, in which the risk of a person dying rises after their spouse passes away.
The findings form part of an emerging field of research called psychoneuroimmunology, focused on how psychological distress can trigger physical changes. That the sorrow of parting can leave its calling card in our bodies suggests that mental and physical health are more closely connected than many of us believe.
“We know that grief affects health in general and that the widowhood effect is real,” asserts Mary-Frances O’Connor, who leads the Grief, Loss and Social Stress (Glass) Laboratory at the University of Arizona, and is author of The Grieving Brain. The phenomenon tends to affect men more than women, she explains, and the risk is highest immediately following bereavement. Widowed men are twice as likely to die as their married peers in the six months following their partner’s death.
The trauma can potentially exert a modest but malign influence on health for longer (estimates, she points out, range from no effect to an increased mortality rate of 5-7 per cent a year after bereavement).
“Many [bereaved partners] lose weight, they become more frail and more susceptible to illness … immune function can decrease and blood pressure can increase,” O’Connor explains. “Even if it’s a small increase, it’s still happening on an older system.” That pushes up the chance of a heart attack and stroke. Widowed older people also show higher rates of sepsis, pneumonia and flu. A 2006 study by Anna Whittaker, now professor of behavioural medicine at Stirling university, found that bereavement in the year prior to flu vaccination was associated more strongly with a low antibody response than a person’s level of social support. Those with the most severe grief symptoms, including depression, tend to suffer the most marked effects. It is the loss of a meaningful attachment that matters: there is no clear evidence, she says, on whether a longer marriage spells deeper grief, “but we do know that losing an ex-spouse is not as impactful as losing a current spouse”.
A malfunctioning immune system, then, is a key link between saddened mind and weakened body. Grieving spouses show higher than normal levels of cytokines, proteins that are marshalled in response to inflammation. Raised levels of the stress hormone cortisol may be the cause, with knock-on effects throughout the body. Bereaved partners have also often lost the person who reminded them to take their pills or attend medical check-ups, adding neglect to the factors that can subtly influence mortality (women tend to take the lead on family healthcare, which could partly explain the higher risk for bereaved men).
Consistent, quantitative findings on the link between bereavement and ill health, accumulating since the 1990s, have transformed the image of psychoneuroimmunology from a fringe discipline to one capable of offering genuine scientific insight into the complex link between mind and body. Importantly, the fledgling science can shape practical guidance for those left behind.
Recognising the heightened risk should prompt vigilance: high blood pressure, for example, is easy to detect and treat. Relaxing activities, such as walking or yoga, offer the body a break from the physical burden of mourning. In addition, having multiple identities, whether as a work colleague, volunteer or parishioner, seems to help cushion the loss of marital identity.
As for “grief-adjacent” children like me, O’Connor advises, we can soften a parent’s loneliness but should recognise that their yearning for a vanished soulmate will linger. Being understanding and supportive matters, for however long it takes for the bereaved to adjust to their new reality.
I think it’s time I stopped asking my mum whether she has had a cup of tea yet. Instead, I’ll be there to drink it with her whenever she’s ready.
Anjana Ahuja is a contributing writer on science for the Financial Times. She has a PhD in space physics from Imperial College London.