PROTECTING YOUR HEALTH IN THE FACE OF DEATH

A recent study examined how people's immune systems responded to flu shots -- with results that took many people by surprise. The antibody levels of older adults who had lost a loved one during the previous year, whether family member or close friend, were 69% to 83% lower on average than those who had not. And this was after the researchers factored in possible reduction in exercise and proper nutrition that so often accompanies bereavement. The conclusion: Grief itself can and does make people more likely to get sick.

This study was further evidence adding to past research that shows people are more vulnerable to physical illness during the bereavement period, according to Diane E. Meier, MD, director of the Center to Advance Palliative Care at Mount Sinai Medical Center in New York City. For example, studies of surviving spouses of breast cancer victims reveal an increased mortality rate among the men in the year after their wife's death. Given the vulnerability the loss of a loved one causes, I asked Dr. Meier for advice on what people can do to protect themselves and their loved ones during this highly stressful time.

NO QUICK FIX

Dr. Meier immediately emphasizes the importance of recognizing that there is no quick fix to grief. Although people sometimes try to get around grief through denial or attempts to ignore their profound feelings, eventually this comes back at them with heightened sadness, anger, hopelessness and regret and they end up suffering more down the road. Not infrequently, these "stuffed emotions" play out in the body through physical illness and disease. Educating yourself about the normal emotions surrounding grief -- shock and denial, panic, guilt, anger, bargaining and finally acceptance of the loss -- is hugely helpful, says Dr. Meier, because it is comforting to know you are not crazy and that these intense responses are to be expected and are part of healing. She urges people to accept that they are living with grief, to experience the emotions and actually name the feelings as they are having them. This helps keep people fully in the experience as it is happening and then push past it.

HAVE A SUPPORT SYSTEM

This is a time when the support of other people is crucial to protecting the health of bereaved people and helping them successfully come to terms with their loss. For example, studies show that the loved ones of people who die in hospice recover faster and better than the loved ones of those who die elsewhere. While this might reflect the nature of people who seek out hospice care, says Dr. Meier, it no doubt also has to do with the tremendous support network that hospice provides.

For those offering support, the best way to be supportive, she says, is to offer what she calls mindful presence. Don't discuss your experiences with death and do not offer advice, which only further isolates people from their own feelings. Instead, give them the gift of silence that allows their pain and grief to exist. Be there for them, but try and follow their lead with regard to what they need... talking, silence, activity, etc. Practical matters also come into play as part of supportiveness. After the last casserole has been eaten, people might still need some forms of intervention, says Dr. Meier. Older adults in particular may need someone to come in to prepare meals for a time and see to it that the grieving person is taking his/her medications and getting out for walks and other life-affirming activities. Connection is crucial on the road to a healthful recovery. People who have been caregivers for a long period might feel mostly relief at the end, but Dr. Meier cautions that some people derive their identity and purpose from being the caregiver, and after their "patient" is gone, the caregiver is left with no outside connection or life. Reconnecting to others and to life is critical for all people in mourning. For people who do not have much of a previous life to return to, the road can be especially difficult and lonely. This is where family and friends can and should step in to help ease the person into a fresh way of living that involves other people.

HAVE HEALTHY HABITS

After a profound loss, it is difficult for people to give much thought or concern to the healthy lifestyle that would go far to help protect against illness. To ease their pain, this is when people sometimes return to smoking or drinking, even after many years of having quit. However, there are nutritional supplements that can be taken that can help calm and heal. To ease anxiety, Chris Meletis, ND, associate professor of natural pharmacology at National College of Naturopathic Medicine of Portland, Oregon recommends L-theanine (derived from green tea) because it increases the calming alpha waves. Take 100 mg to 200 mg three times a day. To help with sleep, so difficult to achieve in this period but so crucial to buttress wellness, Dr. Meletis advises melatonin, valerian or herbal hops. Dr. Meletis recommends at least 2,000 mg of vitamin C per day during bereavement, because it is nature's buffer against stress.

Some people turn to antidepressants during this period. Although those can be helpful, the majority of people find that they can heal without that kind of support, if their body has the critical emotional support and nutritional elements in place to give it strength.

WHEN THE GOING IS UNUSUALLY TOUGH

Most people emerge from intense grief in a matter of months, but there is a small group of people, about 6% or 7%, for whom grief becomes outsized and seemingly incurable. These are generally people who have lost a loved one to traumatic situations such as a violent death or suicide... people who have lost a child... or people who have had previous psychiatric problems. The result is what Harvard researcher Holly Prigerson, PhD, has termed "complicated grief," and she says that people who are overwhelmed by grief two months after the loss are the ones who are likely to be totally overwhelmed for years. Dr. Meier likens complicated grief to posttraumatic stress syndrome. Symptoms include not eating or bathing regularly, or having intrusive thoughts about the loved one that make it impossible to stay in the present. This kind of grief is considered a psychiatric disorder and requires professional counseling. Dr. Meier says that a type of cognitive therapy, designed specifically for bereavement, is proving to be successful for this group of people and gets them back on their way to a healthy, full life. For most, however, as painful as the grieving process is, they can get through it in a healthy way both emotionally and physically.

Be well,

Carole Jackson
Bottom Line's Daily Health News

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