Recalling memories of a deceased loved one can cause a measurable physical increase in blood pressure, and for people suffering from long-term grief, this physical stress response may not subside normally. A recent study found that thinking about the deceased triggers cardiovascular changes similar to acute stress for up to two years after the loss. The study was published in the journal Biopsychosocial Sciences and Medicine.
Losing a close friend or family member is one of the most powerful stressors a human can experience. Psychologists and medical professionals recognize that grief is much more than emotional distress. In fact, bereavement triggers a series of physical reactions in the body.
In various cultures around the world, periods of mourning are associated with an increased risk of physical illness and even death. These negative health effects result in part from how the body deals with the overwhelming pain of separation. Moments of intense grief, often referred to as grief pain, can cause temporary but rapid changes in bodily function.
Vincent Goldberg, a physician and researcher at the Department of Mind-Body Medicine and Psychotherapy at the University of Ulm in Germany, led a team of scientists to investigate these physical reactions. Researchers set out to measure how cardiovascular biomarkers change during sudden waves of sadness. They focused specifically on changes in blood pressure over time.
Blood pressure serves as a reliable measure of the body’s physiological stress response. Systolic blood pressure measures the force of blood against the artery walls at the moment the heart beats. Diastolic blood pressure represents the pressure in your blood vessels while your heart is resting between beats.
When a person experiences sudden emotional distress, the nervous system often causes an increase in both systolic and diastolic blood pressure. Over time, repeated or sustained increases in blood pressure can damage blood vessels and increase your risk of heart disease. Researchers wanted to see if prolonged severe grief could alter this normal cardiovascular stress response.
Typically, the intensity of grief diminishes over time as the person adjusts to life without the deceased. For a small percentage of the population, the overwhelming symptoms of separation distress last for months or even years. When these emotional and behavioral symptoms last longer than six months and interfere with daily life, medical professionals classify the condition as a long-term grief disorder.
To understand the physical burden of this condition, Goldberg and his colleagues recruited 67 adults between the ages of 50 and 70. Each participant had experienced the death of a parent, spouse, sibling, or child. Deaths occurred 6 to 24 months before clinical examination.
Most of the participants were women, and the research team excluded people with serious medical conditions. We also excluded people taking medications that significantly affect the autonomic nervous system. This screening process ensured that participants’ cardiovascular stress response mechanisms could be safely measured without being influenced by other diseases.
To track the psychological severity of bereavement, the researchers used a standardized questionnaire. Participants reported daily feelings of longing, loss-related cognitive symptoms, and changes in personal behavior. This study allowed researchers to calculate an overall numerical score representing the severity of participants’ sadness.
After arriving at the lab, participants completed a neutral rest period known as vanilla baseline. Participants looked at pictures of nature on a computer screen for 10 minutes and selected their favorite image. The gentle drawing task helped ensure truly calm baseline blood pressure readings, as sitting in an empty room can cause the human mind to return to painful thoughts.
Following baseline measurements, participants underwent a specialized clinical interview designed to elicit temporary grief pain. The researchers asked each person to recall a specific situation since the loss in which they felt completely alone. Participants focused on the moment when they sincerely wished that the deceased would support them.
Subjects selected overtly stressful memories to ensure that the intensity of their emotions matched their actual lived experience outside of the laboratory. The interviewer asked specific follow-up questions to allow the participant to remain emotionally reminiscing for 5 to 10 minutes. The researchers avoided measuring blood pressure during the interviews to prevent physical distraction from memory recall.
Instead, an automated blood pressure cuff took measurements immediately after the interview phase ended. The device recorded blood pressure again after 5 minutes and a final blood pressure 10 minutes after the emotional task was completed. The researchers then compared these post-interview numbers to the original vanilla baseline measurements, mathematically adjusting for variables such as the patient’s age, biological sex, time since death, and baseline use of blood pressure medication.
The results showed that recalling painful memories reliably increased both systolic and diastolic blood pressure across groups. Immediately after the interview, participants experienced an increase in cardiovascular status. This physiological arousal remained high throughout the 10-min recovery period.
Researchers initially hypothesized that people who reported higher overall grief severity would experience a sharper rise in blood pressure. The data ultimately did not support this expectation. Statistical tests showed that the relationship between general grief severity score and raw increase in blood pressure was not statistically significant.
The researchers then categorized the participants into strict subgroups based on their survey responses in order to explore the data descriptively. They identified a small subgroup of six individuals whose symptoms formally met clinical criteria for long-term grief disorder. Scientists evaluated this particular subgroup in parallel with the rest of the participants, who reported more typical symptom severity.
People with long-term grief disorder approached the task with significantly higher baseline blood pressure than other people. When they recalled a painful memory, their blood pressure spiked by about the same amount as everyone else’s. The most dramatic differences between subgroups appeared during the recovery period.
In participants with typical sadness patterns, blood pressure began to fall toward normal resting levels as 10 minutes passed. In contrast, the group with long-term grief disorder showed a clear delay in cardiovascular recovery. Both their systolic and diastolic measurements remained stubbornly elevated long after the emotional interview ended.
A delay in returning to baseline after a stressful event is widely considered to be a biological warning sign. As the body struggles to stop the stress response, it places continued strain on the cardiovascular system and can promote the development of chronic hypertension. The findings suggest that the struggle to adjust psychologically to loss may reflect the biological struggle to adapt physically.
The research team acknowledged several specific limitations that should be addressed in future research. Data collection was unexpectedly halted due to the onset of the global pandemic, resulting in fewer participants than originally planned. Additionally, the participant population lacked ethnic diversity and had a high proportion of women, limiting broad generalizability.
In the broader population, men are at higher risk of dying after bereavement than women. A larger demographic sample might reveal gender-specific differences in how the heart responds to sad reminders. Including individuals with a variety of pre-existing health conditions also paints a more realistic picture of the typical aging population.
Despite sample limitations, this study demonstrated that the grief recall interview can safely measure cardiovascular reactivity in a modern laboratory. This mechanism could help medical professionals objectively track the physical burden of bereavement. Recognizing the physical effects of extended periods of mourning could change the way clinicians schedule physical exams.
Standard medical surveillance for widows and widowers may benefit from a slightly more aggressive cardiovascular evaluation during the 2 years following loss. If a person is showing signs of long-term grief disorder, their body may be at risk for invisible hypertension. Treatment of the physical symptoms of this pain usually follows standard hypertension protocols without the need for specialized medications.
Psychotherapy serves as a proven and effective intervention for those directly suffering from long-term grief disorders. The researchers noted that basic relaxation techniques can also be layered with standard talk therapy. By learning how to calm their nervous systems voluntarily, grieving people may be able to protect their cardiovascular health while processing emotional loss.
The study, “The Grieving Mind: Associations between Hemodynamic Responses to Grief Reminiscences and Long-Term Grief Disorder Symptoms,” was authored by Vincent Goldberg, Mary Frances O’Connor, Siyar Türkmen, Johannes Cox, Roman Palicki, Harald Gündel, and Mark N. Jarzog.
