all our griefs and comfort
Back in January 2020, I wrote about grief and comfort. Little did we know that Covid was only three months away.
At the time, I wrote about grieving my father’s death.
But now we are all grieving, one way or another. And it’s been a year.
Whether Covid brought you tragic bereavement, or just terrible boredom; unemployment, or job craziness; homeschooling, or isolation - it's brought all of us some kind of loss.
Even for those who’ve had positive experiences in lockdown, there are still losses: plans, travel, social life, celebrations. Normality!
This blog is about how grief and stress connect with physical symptoms, and offers practical ideas, both to relieve those symptoms, and to alleviate emotional strain.
If you want to jump straight to the practical ideas, scroll down to “simple ways to alleviate inflammation” below.
And if you want to imagine more clearly how stress connects with physical symptoms, then do read on.
Inflammation, grief and stress
As I’ve mentioned in previous posts, inflammation is the body’s way of fighting unwelcome invaders. We see it when we cut ourselves, and the cut turns red and swells a little. Versions of this process happen throughout the body. Too much of it usually creates symptoms.
Numerous studies find that bereaved and depressed people exhibit higher inflammatory markers (eg Interleukin 6 and 1) than those who are not bereaved or depressed – and in one case, the level of these markers correlated with the perceived severity of the grief or depression.
And stoicism doesn’t seem to help. One study found that those who avoided expressing their grief had more potent inflammation than those who did express it.
Since the same or overlapping brain regions are involved in perceived emotional and physical pain, perhaps it should be no surprise that physical and emotional stress can produce similar effects.
But what would increased inflammation in the body actually look like?
Well - it all depends on the individual’s pre-existing areas of vulnerability.
Increased inflammation could manifest as:
- an eczema flare-up
- more pronounced allergies
- arthritic pain
- mysterious stomach aches
- interrupted sleep
- constipation or diarrhoea
- brain fog
- new food intolerances
- low mood
….among many things. It is remarkable what a diversity of symptoms can be triggered by excess inflammation.
But how would grief or stress trigger inflammation?
It’s complicated. I will just mention one way for now.
Strap in, and I hope it’ll become clear.
How grief / stress can trigger inflammation in the body:
1. stress triggers activation of the ‘sympathetic’ nervous system, which in turn prompts the release of stress hormones like adrenaline and cortisol from the adrenal glands.
2. the sympathetic nervous system prepares us for action: it amps up our access to blood glucose, for example, and increases heart rate. BUT it also inhibits anything that’s not needed in immediate action, such as the reproductive system and, crucially, the digestive system.
3. being in a ‘sympathetic’ nervous state for a long time reduces blood flow to the digestive system. This can prod the gut microbiome into dysbiosis: ie, the less-beneficial bacteria flourish.
4. gut dysbiosis causes changes in butyrate production, which may reduce the integrity of the gut wall.
5. a permeable or ‘leaky’ gut may allow insufficiently digested proteins to enter the bloodstream.
6. misplaced proteins in the blood can trigger the immune system to attack them, ie produce inflammation.
7. inflammation produces symptoms across the body of the kind noted above.
8. systemic inflammation may in turn worsen an existing low mood, because when it crosses the blood brain barrier, it is generally felt as anxiety, brain fog or depression.
On top of all this, if we have some extra physical stresses layered in there, eg poor diet, environmental stress (like household mould), antibiotics, poor sleep, or lack of exercise - these may also provoke damage to the gut lining and gut microbiota and thus increase inflammation levels.
emotional stress + diet and lifestyle factors = key to one’s level of inflammation.
systemic inflammation + diet and lifestyle factors = key to one’s emotional state.
Now, that may have felt slightly complicated.
But whenever I work with my clients, I always try to begin with the simplest things, which are often the most powerful too.
Here we come to the practical part:
Simple ways to alleviate inflammation and potentially reduce stress
If we remove the ‘extra’ triggers of inflammation, we may see an improvement both in our mood and in the other inflammatory symptoms. Here are some simple things we can do.
1. Sleep support
Sleep is the most obvious bedrock of health. It is an inflammatory state, interestingly, but in a healthy way (see my previous blog on sleep for more info).
With good sleep, we produce fewer of the stress hormones that trigger sugar cravings and low mood next morning.
I’m amazed by how many clients report improved sleep after removing their late evening drinks. Less liquid just before bed = fewer loo trips at night = better sleep = fewer symptoms. Small trick, huge effect.
2. Food wisdom
The other surprisingly simple thing I often ask my clients to do, is to increase protein at meal times. This could mean meat, eggs, fish, cheese, beans/legumes + rice, nuts, seeds (all sustainably produced, ideally).
Protein keeps one fuller for longer, reducing the sudden hunger that can prompt sugar cravings. This is important because sugar consumption is intrinsically inflammatory (try reducing sugar/high carbs, anyone who’s menopausal, and you may well see a reduction of hot flashes).
3. Toxin awareness
Nutritionists are renowned for our low view of alcohol, caffeine and sugar.
Now, not everyone needs to cut these things out altogether. But here’s why reducing them might help you:
Alcohol. The liver has to detoxify the ethanol in alcoholic drinks, because it’s a poison. If your liver’s sluggish, you’ll get inflamed. So if you remove alcohol for a week and find you’re less depressed and more energetic of a morning – this may be why.
Caffeine. This is an ‘anti-nutrient’ because it speeds up digestion and reduces the gut’s absorption of nutrients from the food passing through. A perfect diet + too much caffeine = waste of the diet!
Sugar. This stuff increases inflammation both via the insulin spike it triggers and by encouraging the less beneficial bacteria in your gut to flourish.
There are many many other things that can be done to reduce inflammation, not least supporting the gut microbiome and gut integrity (ask me if you want to know more).
But this is just a start. Simple comforts are another useful approach.
In these strange times we are all being forced to discover whether our habits truly help us. The things that used to bring us comfort, may now be making life worse.
More than ever, we need to find healthy ways to soothe ourselves in times of stress.
By helping to switch us from a ‘sympathetic’ into a gut-supporting ‘parasympathetic’ nervous state, they can reduce inflammation.
Here are a few simple ideas to try.
1. A day-duvet. I decided to keep a small duvet downstairs to wrap around myself whenever I am taking time off and reading on the sofa. For me, it somehow feels more comforting than a blanket or rug, signals true rest, and helps me forget my to-do list.
2. Breathing. This is our one sure-fire way to hack into our nervous system and switch it from sympathetic (stress, running around) to parasympathetic (peaceful, internal housekeeping). I recently connected with Mel from breathgal.com who assessed my breathing over zoom, showed me how to correct it, and gave me all sorts of ideas and techniques to help me increase energy or calm myself down. Couldn’t recommend this highly enough.
3. Small amount of protein at night. If you’re waking up anxious in the small hours, you may have a blood-sugar balance issue. This can be common in hypothyroidism. I make a very small cup of unsweetened coconut milk at night, mixed with a little protein powder, to carry me through. (The opposite of intermittent fasting, for sure, but then not everyone suits intermittent fasting.)
Well, I do hope that some of this will be helpful. We can’t remove Covid and its effects from our lives, but I hope that one or two of these ideas may inspire you, reduce inflammation, or improve your emotional set-point.
It’s been a year. It’s been tough. Amidst it all, here’s to healthy grieving, and to true comfort.
To your very best of health,
Clare Backhouse, dipION, Registered Nutritionist MBANT,
Registered Nutritional Therapist CNHC
References and resources
Calarge, C.A., Devaraj, S., Shulman, R.J., 2019. Gut permeability and depressive symptom severity in unmedicated adolescents. Journal of Affective Disorders 246, 586–594.
Choy, E.H., Jones, S.A., Aletaha, D., Takeuchi, T., McInnes, I., Smolen, J., 2018. IL-6: To immunity and beyond. Considerations in Medicine 2, 19–23.
Cohen, S., Janicki-Deverts, D., Doyle, W.J., Miller, G.E., Frank, E., Rabin, B.S., Turner, R.B., 2012. Chronic stress, glucocorticoid receptor resistance, inflammation, and disease risk. PNAS 109, 5995–5999.
Cui, B., Su, D., Li, W., She, X., Zhang, M., Wang, R., Zhai, Q., 2018. Effects of chronic noise exposure on the microbiome-gut-brain axis in senescence-accelerated prone mice: implications for Alzheimer’s disease. J Neuroinflammation 15, 190.
Fagundes, C.P., Brown, R.L., Chen, M.A., Murdock, K.W., Saucedo, L., LeRoy, A., Wu, E.L., Garcini, L.M., Shahane, A.D., Baameur, F., Heijnen, C., 2019. Grief, depressive symptoms, and inflammation in the spousally bereaved. Psychoneuroendocrinology 100, 190–197.
Knowles, L., Ruiz, J., O’Connor, M.-F., 2019. A Systematic Review of the Association Between Bereavement and Biomarkers of Immune Function. Psychosomatic Medicine 81, 415–433.
Lépine, A.F.P., de Wit, N., Oosterink, E., Wichers, H., Mes, J., de Vos, P., 2018. Lactobacillus acidophilus Attenuates Salmonella-Induced Stress of Epithelial Cells by Modulating Tight-Junction Genes and Cytokine Responses. Front. Microbiol. 9.
Lobionda, S., Sittipo, P., Kwon, H.Y., Lee, Y.K., 2019. The Role of Gut Microbiota in Intestinal Inflammation with Respect to Diet and Extrinsic Stressors. Microorganisms 7, 271.
Lopez, R.B., Brown, R.L., Wu, E.-L.L., Murdock, K.W., Denny, B.T., Heijnen, C., Fagundes, C., 2020. Emotion Regulation and Immune Functioning During Grief: Testing the Role of Expressive Suppression and Cognitive Reappraisal in Inflammation Among Recently Bereaved Spouses. Psychosomatic Medicine 82, 2–9.
Lopresti, A.L., Maes, M., Maker, G.L., Hood, S.D., Drummond, P.D., 2014. Curcumin for the treatment of major depression: a randomised, double-blind, placebo controlled study. J Affect Disord 167, 368–375.
O’Connor, M.-F., 2019. Grief: A Brief History of Research on How Body, Mind, and Brain Adapt. Psychosom Med 81, 731–738.
O’Connor, M.-F., Irwin, M.R., Wellisch, D.K., 2009. When grief heats up: Proinflammatory cytokines predict regional brain activation. Neuroimage 47, 891–896.
Schultze-Florey, C.R., Martínez-Maza, O., Magpantay, L., Breen, E.C., Irwin, M.R., Gündel, H., O’Connor, M.-F., 2012. When grief makes you sick: Bereavement induced systemic inflammation is a question of genotype. Brain, Behavior, and Immunity 26, 1066–1071.
Shulman, L.M., 2020. Emotional Traumatic Brain Injury. Cognitive and Behavioral Neurology 33, 301–303.
Stevens, F.L., Hurley, R.A., Taber, K.H., Hurley, R.A., Hayman, L.A., Taber, K.H., 2011. Anterior Cingulate Cortex: Unique Role in Cognition and Emotion. JNP 23, 121–125.
Velikova, T.V., Miteva, L., Stanilov, N., Spassova, Z., Stanilova, S.A., 2020. Interleukin-6 compared to the other Th17/Treg related cytokines in inflammatory bowel disease and colorectal cancer. World J Gastroenterol 26, 1912–1925.
Walter, C.A., McCoyd, J.L.M., 2015. Grief and Loss Across the Lifespan, Second Edition: A Biopsychosocial Perspective. Springer Publishing Company.