Grief and Lifestyle Medicine

By Jodanna Dawson

9th Aug, 2023

We can’t go over it, we can’t go under it, we’ve got to go through it!

We will all experience grief or loss at some point in our life. Considering not just grief due to a bereavement but also grief associated with a loss, perhaps an unexpected physical disability or a difficult fertility journey.

You are rarely prepared for a significant loss, and it can feel very lonely and isolating. Grief is very personal and individual and the journey through grief is complex. Part of the healing process is experiencing the dark place grief will take you through and those moments of relief and clarity. There is no easy way around it. No two people, even those with the same loss, will experience grief the same. There is no right or wrong way to grieve, and the journey through it comes with time and support.

During this time there are various interventions to help – therapies, medications, clinicians, specialist services, support groups, charities, and each have a very dedicated and effective approach for that stage of your grief. Personally 6 months after my loss due to a bereavement I was no longer receiving any interventions or support, and not because they weren’t available, I just didn’t need them. Because I was simply having a normal response to grief, I was sad. Immensely sad. Only time would help, and I trusted the grieving process, but I wanted to do what I could myself to feel better and process the grief in a healthy way.

It must be understood that there is nothing that can take away a person’s grief, and being completely consumed by grief in a hopeless and painful place is part of the healing journey. But what happens when someone is emotionally exhausted and tired of bearing the weight of their grief? They know the time is coming when they’ll have to learn to hold the grief in a place so they can continue with their life. The acceptance stage of grief can bring with it the time to find a way to continue life without grief defining a person’s life entirely. For want of a better expression, when someone feels ready to start to move on…… and where do they go for support to do this? Being told you’re having a normal response to grief, and you are being so strong, and it’ll just take time, is reassuring. But, moving on is incredibly hard, its daunting, the grieving person may not recognise themselves or their life around them anymore.

Often at this time a person may also begin to question their life choices, changes they have wanted to make, things they have been putting off, it could be considered for some a teachable moment.

Grief and Lifestyle

Grief can affect some or all a person’s lifestyle, including and not limited to:

Nutrition – reduced or increased eating, less motivation to prepare healthy meals so more reliance on processed foods, increase in unhealthy eating habits like comfort eating.
Sleep – disturbed nighttime sleeping, excessive sleepiness, sleeping in the day, nightmares, disturbed or unwanted thoughts, ruminating affecting ability to fall asleep.
Healthy relationships – a person’s relationships will often change after experiencing a loss. It can influence close family relationships, and friendships. The relationships can be positive, in that a close support network is provided, but sometimes relationships are lost, and the grieving person feels isolated or lonely. Or they may seek solitude in processing their grief.
Physical Activity – an increase in a sedentary lifestyle, lack of interest or engagement with previous physical activities, lack of motivation or confidence to begin increasing physical activity.
Harmful substances – an already unhealthy relationship with a harmful substance may be exacerbated, or a grieving person may start to use harmful substances to numb their emotions.
Mental health – grieving can lead to feelings of depression and anxiety, hopelessness, and a lack of confidence. Negative thinking and fears can be difficult to manage whilst grieving.

A person’s experience of grief may also be affected by those social determinants of health that influence their general health and wellbeing. It poses a wider discussion around what is grief within a healthcare system and how do we respond and support individually and as a society? What we have lost will dictate how we respond, and our response to grief is influenced by our habits and lifestyle before the loss, our cultural and social beliefs and health inequalities and inequities.

Lifestyle Medicine and the Grieving Process

Lifestyle medicine is so powerful in supporting people to change and improve their health and wellbeing, is there a place for a lifestyle medicine approach to help people to grieve in a healthy way? Can the interventions and learning of lifestyle medicine assist individuals and health professionals to support a patient experiencing grief?

My personal loss is postnatal bereavement, my daughter was born at 31 weeks and 5 days. She was determined to stay with us for as long as she possibly could, she had an incredible strength and gave us three precious days of memories.

In the first few months after, all the general information I could find about postnatal recovery, exercising after a caesarean, a healthy postpartum diet, even the standard 6-week checks, all referenced a normal postpartum experience, caring for your baby. Losing your baby and finding yourself in a world of postpartum care where you feel like you don’t belong, and you don’t want to be there, is, coupled with the immense grief, brutal.

I was fortunate enough to already have the knowledge of lifestyle medicine and when I was ready, I utilised all the skills and tools I knew to help support me move through my grief. In the first months after I was spending a lot of time sedentary, having had an emergency caesarean and a painful difficult recovery. When I felt ready, I started by getting out into nature and walking. I set myself a small goal for a short walk every day to help with my emotions and post-surgical recovery. At first, it was daunting, and it was very lonely. Sometimes it was uplifting and sometimes it was a place of solitude and peace to let the emotions, sadness, anger, and fear all pour out. But I always felt better for it. As my physical strength improved, I started doing more physical activity, swimming at first as this felt to be the best low intensity postpartum exercise, and then, in a moment of overwhelming gratitude and empathy I gave myself a huge goal and signed up for a charity place for the Great North Run! I had never run a race in my life! But I needed a goal, a purpose, and this was it.

Physical activity really helped to manage my emotions, it was tough and often brought up feelings of anger, but it was also cathartic and incredibly healing. I never felt worse after a walk or a workout. It made me physically feel stronger, it felt like it gave me a literal strength to carry the grief.

For months I did not have the energy or interest in meal planning and preparation. It was easier to choose quick processed foods for meals and sugary snacks. But I knew if I could start to increase my plant-based foods and start to cook wholefood plant-based meals again my postpartum body would recover so much better. I started with a small goal of just trying to eat some fruit and vegetables each day and eating less sugary snacks and then trying to plan at least one or two plant-based whole food meals a week. I also made a goal of drinking more water. As I made these gradual changes, I started to have more physical energy which motivated me to continue to meal plan to make sure I was getting as many vitamins as possible, fibre, antioxidants, and nutrients for my recovery.

Alcohol has always affected my emotions; I didn’t have the capacity to have my already overwhelmed emotions and mental health influenced by alcohol. I enjoy an alcoholic drink and have a healthy relationship with alcohol, but I was very mindful of how alcohol can affect a depressed mood and its effect on sleep, which I was already really struggling with. I didn’t avoid alcohol, but I was mindful of the negative effects it could have.

Nighttime was and continues to be a really difficult time of the day for me. A feeling of being emotionally exhausted from trying to hold it all together, and having less distractions to stop the ruminating and memories from creeping in. For a long time, it took hours for me to fall asleep and I would wake up countless times throughout the night. Thankfully I have made some improvements to my sleep by making new habits and trying to have a consistent sleep routine. In the early weeks after losing my daughter I wrote everything down in a journal. Absolutely everything. This is something I have continued when I have found my grief to be overwhelming and stressful. I try to have a wind-down routine where I avoid the TV and phone use in the hour before I plan to go to bed, instead having a bath and after finding mediation difficult I realised reading a book before I went to bed had the same relaxing effect for me.

As time passed everyone was moving on with their life, yet I felt connected to and lost, trapped in a single moment of time. Relationships and social connections can change when you experience a loss, and this was the experience for me. I surrounded myself with my family and those who embraced me as a grieving friend, those who were there to support me through the most challenging times, holding and carrying me with my grief. Those strong relationships I had, and continue to have, had a powerful positive impact on how I survived the first months of my bereavement, and these supportive relationships gave me the strength and encouragement to begin to heal.
I began with small goals, getting out the house for a walk, trying to eat something healthy, journalling, and then focusing on my half marathon training, driven to continue a legacy of kindness. With each small change, each pillar of health aligned into a healthy lifestyle to support me, a grieving postpartum Mother.

It’s hasn’t been easy, and it never will be. There will always be those days when the darkness comes, remembering things that happened, allowing myself to feel completely devastated, angry and lonely all over again. But I have always tried to remember that my life before losing my daughter had been meaningful and purposeful and despite this immense loss my life will find its purpose and meaning again.

As I trusted the grieving process, I also trusted the power of lifestyle medicine and knew if I could start to make changes to my lifestyle, based on the pillars of health, in time it would help me. At this point in my grief, this is what I wanted, help. I wanted to start to feel better, a new normal, I knew my grief wouldn’t go away but I wanted to feel empowered and resilient enough to start to hold my grief in a comfortable and healthy place.

The grief will always remain, but my life needed to begin to grow around it. Despite my loss I truly believe I am beginning to feel good, healthy and happy because of the way lifestyle medicine has helped me. I believe it could be so powerful in helping others in their grief journey, and what an incredible impact this could have on someone’s life.

I am particularly keen to explore the role of lifestyle medicine and grief associated with baby loss and postnatal bereavement care, as this is my personal experience of grief. But I would welcome the opportunity to discuss with interested others in the BSLM community their own personal experience of grief/loss or their care for grieving patients, both using lifestyle medicine as a support – jodannadawson@hotmail.co.uk

Further support for baby loss can be found from charities such as Sands the still birth and neonatal death charity and Tommy’s the baby charity.