Bereavement and physical wellbeing

When a baby or child dies, grief can be so overwhelming that you can only focus on what is most important to you. It might feel important to look after yourself physically or it may not feel 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 wellbeing, even in small ways, can help to decrease feelings of exhaustion, isolation or helplessness.

This leaflet covers the links between bereavement and physical wellbeing. 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. Having 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.

- Bereaved parent

Social support

Research suggests that when you are 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. Others may not understand what you need, some may avoid you or they might be grieving in a different way. 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 about your baby or child with others, and share special and everyday memories, this can strengthen the unique connection you still have with your baby or child.

Managing stress

There are several definitions of ‘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 your 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; and
• talking to someone who will listen without judging.

Exercise

Bereavement affects everyone differently. Some people may 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, even gentle exercise can boost energy levels and relieve stress. Exercise also releases natural chemicals that improve mood, called endorphins. 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.

Physical symptoms such as neck, back or joint pain are common in people who are bereaved, but exercise can help avoid these by keeping your joints and muscles healthy. Exercise can also help you to focus on your breathing, which may help in managing strong emotions or difficult situations.

Doing regular exercise can also be a way to give more structure or routine to your day, and it may help to clear your mind and feel more in control. Focusing on a new skill or routine may also give you a short break from the pain of grief. 

I could never have predicted the physical impact of grief - exhaustion in particular. By walking I’ve gained physical strength, my mood is enhanced and walking has anchored me, provoked discipline and focus. Most significantly, it has facilitated talking - with friends as well as with myself -  which has helped  me to reflect.

- Bereaved parent

If you are trying a new exercise routine, it needs to be manageable and safe. This includes stretching and making sure that any medical conditions 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 Tai chi to help manage anxiety or sadness.

Exercise can help you to feel better about yourself, improve appetite and help with sleep. Exercise with family, friends or a group can reduce isolation and give you a change of scene. 

Exercising outdoors can also be therapeutic in bringing you closer to nature. Walking, gardening or other activities outside 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. 

- Bereaved father

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.

Ihave 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!).

- Bereaved parent

for guidance on stretching and starting exercise, visit: www.nhs.uk/livewell/fitness

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 also 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 improve sleep include the following:

• Keep to regular times of going to bed and waking up.
• Try to reduce or avoid tea, coffee, chocolate, sugar, alcohol or 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.

I avoid strong stimulants and alcohol which tend to make memore anxious and depressed.

- Bereaved parent

In summary

Looking after your physical wellbeing 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 enjoyable, social contact and time to talk about your baby or child, this can bring further meaning to your relationships and to the enduring and precious connection that you still have with your child.