Grief can be so overwhelming that you may only be able to focus on what is most important to you. It might feel important to look after yourself physically or not important at all. This is OK and there is no right or wrong way to feel. But it may help to know that emotional pain can show in physical ways, such as sleep and appetite problems, and physical aches and pains. Improving your physical well being, even in small ways, can help to reduce feelings of exhaustion, isolation or helplessness.

This information covers the links between bereavement and physical well being. It looks at having a routine, social support, managing stress, exercise, sleep, diet and appetite. Ways to help improve physical wellbeing are likely to work best if they feel achievable if they make you feel better and if they give you some sense of control. It is also important to be kind to yourself and to avoid feeling pressure to improve your physical health. Giving yourself space and time to grieve as well is just as valuable.

Having a structure or routine

Grief can affect every part of life, and so your existing routines may disappear for a time. It may be hard to keep a structure to your day, but even small regular habits and routines can help you feel a sense of stability and purpose. Having a regular time to sleep, eat, do tasks or activities, and go out for fresh air or to meet a friend, can all help with wellbeing, and reduce isolation. Some people find that creating an activity schedule or programme can help them keep to a structure. The structure of regular routines can play an important part in processing grief, and slowly adjusting to a new way of life.

I'm not good at dealing with any last-minute changes to routines... additional events on top of what I'm dealing with cause a lot of anxiety.

Social support

Research suggests that when grieving, it helps to have ‘social support’ – positive ways to connect with other people who are supportive. In some cases, friendships or relationships can change. Other people may not understand what you need, some may avoid you, or they might be grieving in a different way to you.

However, when support from others feels helpful, you may feel less alone in your grief. Other people can support you in doing daily activities, or you can do something together that you enjoy. You may be more likely to treat yourself if you are with someone else, and sharing time together may give you a break from stressful thoughts.

If you can talk to other people about the person who has died and share special and everyday memories, this can strengthen the unique connection you still have with the person who has died.

Managing stress

There are several definitions of the word ‘stress’, but it can be described simply as ‘too much pressure’. Sometimes stress can help us to manage a specific situation for a while, but when it continues long-term, it can affect our immune system, and increase risks to our physical and mental health. Finding ways to manage stress may be easier than trying to avoid it.

Worry and anxiety about all kinds of things are very common in bereavement. Sharing worries with someone close to you may help you both. It can be a relief to share similar thoughts and to feel less alone. However, you may want to talk to someone who is neutral, such as a professional support practitioner or by calling a confidential helpline such as at Child Bereavement UK.

You may also find that talking positively to yourself helps, including repeating encouraging or soothing phrases and giving yourself praise as often as you can.

Research suggests that the following may help to reduce the impact of stress on physical health:

• Having information about how we grieve and our reactions to bereavement.
• Continuing with everyday activities, as far as possible.
• Having social connections, especially with people who help to reduce your stress levels.
• Doing at least two health-protective things each week such as taking exercise and eating a nutritionally balanced diet.
• Avoiding or reducing alcohol.
• Cutting down or not smoking.
• Talking to someone who will listen without judging.

Exercise

Bereavement affects everyone differently. Some people find that when they are very focused on specific things, they feel energised. For many, however, grief can be exhausting. You may not feel like doing exercise if you are tired or feeling very low. However, all the muscles of the body hold emotional and physical stresses, so it is very important to try to care for both your mental health and your physical health, as they are so interconnected.

• Exercise may help in various ways when you are grieving.

• Even gentle exercise can boost energy levels and relieve stress.

• Exercise releases natural chemicals that improve mood, called endorphins.

• Exercise can improve your appetite and help you to sleep.

• Physical symptoms such as neck, back or joint pain are common in people who are bereaved, but exercise can help you avoid these by keeping joints and muscles healthy.

• Exercise can help you to focus on your breathing, which may help in managing strong emotions or difficult situations. It may also help to clear your mind.

• Regular exercise can add structure to your day, bringing a sense of purpose and control.

• Focussing on an exercise routine may give you a short break from the pain of grief.

• Doing exercise with other people can reduce isolation and give you a change of scene.

• Exercising outdoors can be therapeutic in bringing you close to nature. Walking, gardening or other activities can be absorbing, helping you to focus on the present moment.

I found walking a great help. You get some exercise and are out in the fresh air. I tend to walk with my wife and while we are walking we can talk through stuff that is troubling us. Big stuff that could be controversial is talked through when we are walking

Any new exercise routine needs to be manageable and safe. This includes stretching and making sure that any medical conditions you have do not put you at risk when exercising. Low impact exercise such as Tai chi, Pilates or yoga can be very beneficial, as well as more strenuous activity. You may be able to match a form of exercise to how you feel. For example, walking or running to relieve fear or stress, martial arts to release anger or frustration, or more meditative forms such as yoga to help manage anxiety or sadness. 

It can also help to do exercise that you enjoy, to reward yourself afterwards, and note how the exercise makes you feel. Any new exercise routine is more likely to work if you start with small, achievable changes that can develop into a habit.

 I have to enjoy the exercise to make me want to do it. It's important for me to plan it rather than just going to the gym when I find the time (it just won't happen!)

Sleep

One of the most common effects of bereavement is not being able to sleep or reduced sleep quality, although this does not affect everyone. Your sleep may be disrupted because other people in your household can’t sleep, for example, children or your partner. Although some people find that their sleep quickly returns to normal, for others, sleep difficulties can continue for months or even years.

A lack of sleep or poor-quality sleep makes daily life feel more difficult. Over the long term, it can also worsen pre-existing problems such as anxiety or difficulties in coping with stress. When we sleep well, our bodies can repair and heal more easily, and we are more able to think clearly, make decisions and cope emotionally.

Managing sleep problems is not always easy but physical activity can help improve sleep. Other ways to help improve sleep include the following:

• Keep to regular times of going to bed and waking.
• Try to reduce or avoid tea, coffee, chocolate, sugar, alcohol and non-prescription drugs in the evening.
• Reduce screen time (TV, computers and smartphones) in the bedroom and just before bedtime.
• Keep a sleep diary (a record of how well you sleep) so you can notice any changes over time and anything that has helped.
• Write down or talk about things that are on your mind, so they are less likely to keep you awake.
• If problems with sleep continue, your GP may be able to help.

Diet and appetite

Bereavement can affect appetite or the kinds of food you feel like eating. You might lose your appetite or eat at irregular times of the day, particularly if your sleep is disrupted. Some people may associate preparing food and eating well with caring for someone they love who has died. If you have recently given birth, there may be bodily changes that can affect your appetite and diet. For all these reasons, it may feel difficult, or not worthwhile, to prepare nutritious meals or to eat as you used to.

However, eating well can help you and those around you to stay healthy and have energy, even if you are feeling low emotionally. If your appetite has reduced, try eating little and often, and drink plenty of fluids. A varied diet which provides energy and strength will usually include carbohydrates, fats, proteins and different kinds of vegetables and fruits. Reducing your intake of caffeine may help reduce any problems you have with anxiety.

As eating can be a social activity, a meal can be an opportunity to see friends or family. Some people find it helpful to share a special meal, to help celebrate and remember the person who has died.

Food is very important emotionally and can be comforting. For some people, eating as a comfort may become a problem if it affects their health or how they feel about themselves. Having a regular routine for sleep, exercise and other activities may help you to identify, and manage, eating habits that you are concerned about.

It worries me that I could easily over eat... in between meals I am trying to eat fruit instead of biscuits.

Alcohol and recreational drugs

Some people may try to manage how they feel through alcohol or recreational drugs. Although this may distract you or block out emotional pain for a while, it can become a problem long-term, and addictive or risk-taking habits can affect your health and wellbeing. Your GP can help if you are worried about your use of alcohol or drugs.

I avoid strong stimulants and alcohol, which tend to make me more depressed.

Conclusion

In summary, looking after yourself physically is very important in helping you to face everyday challenges, stresses and changes, and in having the strength to do what is most important to you. Improving your physical wellbeing may work best when you start with small, achievable changes that become a part of your routine, and when you can feel the benefits of the change quickly.

If your routines can include contact with other people, and time to talk about the person who has died, this can bring further meaning to your relationships, and to the connection that you still have with the person who has died.

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