Grief akin to drug withdrawal

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By Natasha Josefowitz, Ph.D.

Natasha Josefowitz

LA JOLLA, California — Although I have written about this topic before, I have some further thoughts that I would like to now share.

After my husband died, I had a very hard time adjusting to singlehood. Although living in a retirement community helped me survive those awful first months, I was still lonely and bereft.

The way I helped myself was by trying to understand what is happening to me. So I started talking to recent widows and widowers and found that they very often experienced the same thing. So I asked myself, what does “loneliness” mean? It is the lack of a companion, the lack of a witness to your life—someone who knows what you think, read, eat, and where you go and who cares. My witness was a caring husband. In a good relationship, one gives and receives constant validation. By this I mean, a knowing look across a room, a hand squeeze, a good conversation, a compliment—whatever makes one feel recognized. We need to feel cared for and care in return.

And where does that good feeling come from? The brain secretes chemicals such as dopamine (which helps regulate movement and emotion and is essential to the normal functioning of the central nervous system), oxytocin (the bonding hormone), and endorphins (which reduce the sensation of pain and affect emotions) flooding the body with happy feelings. So being in a relationship where there is mutual support creates pulses of feel-good neurotransmitters and hormones. We get accustomed to these, need them to maintain our brain chemistry, they become a normal part of our being, and we get addicted to them. Yes, we become habituated to feel-good substances. When a loved one is away from us for a short time we use phone calls or e-mails to stay connected, because they give us small doses to keep us going until we can be with the person again.

Now what happens when that loved one dies? Not only do we mourn, we are also deprived of the endorphins, dopamine, oxytocin, serotonin, and other feel-good substances. We are in drug withdrawal!

If this is correct, it could explain the physiological symptoms experienced by a surviving spouse which are akin to drug deprivation: loss of appetite and thus not eating enough—which impacts the release of serotonin, a neurotransmitter—trouble sleeping; memory problems; feeling disoriented, listless, and unable to engage in an activity; short attention span; depression; crying spells; feeling weak; physical pain; and what seem like psychosomatic symptoms but are actually physiological withdrawal symptoms.

Until we are deprived of them, we are seldom aware of how much we interact with our loved ones and how often our brain chemistry is activated to make us feel good. Parents and children give each other this validation, so do siblings, close friends, co-workers, and even pets. People who don’t have animals can’t understand why the death of one can be so terribly upsetting. Every time your dog makes you smile, every time you pet him, you get a small dose of dopamine to which you become accustomed. When the dog dies, you are deprived of that fix and go into withdrawal.

Every time we have a lifestyle change—be it going off to college, moving to a new neighborhood or leaving a job—we lose some of the reliable ways of feeling good, and we can experience that loss as homesickness.

I am a great believer that, by giving a label to our feelings and making the unconscious conscious, we can then exert some control by understanding our feelings and behaviors. Becoming conscious of one’s needs can help to identify what one must do to better meet them. In other words, knowing that you are in need of some dopamine, what can you do to stimulate its production? Is it by calling up a friend, going to a uplifting movie, listening to music, eating an ice-cream cone, joining a grief group which validates your feelings, going to a fun event, getting involved in an interesting project, doing volunteer work, or whatever else activates the reward centers of the brain. For some people, fond memories can trigger feelings strong enough to release the chemicals.

What helped me were long phone conversations with my children. Also I threw myself into volunteer work and found that helping others provided me with dopamine and therefore helped me in the process.
Because what stimulates those reward centers is different for each one of us, the task for individuals is to figure out what particular thoughts or behaviors seem to trigger an emotional high. Some friends of mine have children who call everyday—and sometimes several times a day—this helps. Others have plunged themselves into non-stop activities, which may or may not affect brain chemistry, but do at least decrease cortisol, which is the stress hormone. Time spent with friends seems to be a universally helpful activity.

Isolating oneself seldom works and can lead to depression. In other words, it may be important to push oneself out of the house, to accept invitations, to initiate contact with people, and not to indulge in the at-times-overwhelming desire to give up all interactions and just stay in bed.

So the task at hand is to find the activity that will provide some dopamine and other feel good hormones that may help you to cope better.

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Josefowitz is a freelance writer based in La Jolla, who may be contacted at [email protected]   This column ran previously in La Jolla Village News. 

 

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