Grieving and Exercise

Dear Dr. Neimeyer,

I’ve heard that exercise can make a big difference for people who are suffering grief after a loved one dies.  Is that really true?  I know exercise is good for you in general, but how does it help when you are broken hearted after the death of someone who meant the world to you?  If it really does work, what kind of exercise would you recommend?

Brittany

Dear Brittany,

Exercise is not a panacea for the many ways in which loss erodes the quality of our lives, nor does it answer all the hard questions that can be opened up by a death of a loved one, from the question of how we will embrace a changed future, to concerns about our loved one’s intentions in ending his or her life in the case of suicide.  But it can indeed help us in adapting to bereavement, in several respects, both for the direct benefits it confers in terms of our mood and health, and in terms of its indirect benefits of a social kind.  Here I’ll comment on several payoffs to giving your body the attention it needs, even–or especially–when contending with grief.

1.  Exercise is one of the best antidepressants.  Many studies have demonstrated the effectiveness of exercise regimens, especially of an aerobic type, in improving mood for people who are moderately depressed, effects that are observed within a few weeks of beginning a fitness program.  Although walking and/or running are the best documented forms of exercise, even anaerobic exercise such as weight training show a good deal of promise, suggesting that the benefits of exercise are not limited to activities that yield cardiovascular benefits primarily.  Instead, factors having to do with mastery (setting progressive, achievable goals and accomplishing them) may be at work here, countering the sense of helplessness and hopelessness that is at the heart of depression.

2.  Getting up and getting going counteracts rumination.  In the wake of loss we can easily be pulled into the quicksand of rumination–going over and over the events leading to the death, or forlornly cycling endlessly through the memories of what we will never have again.  In addition to contributing to depressive lassitude, this vicious cycle of corrosive self-questioning or focusing on a frightening future alone can feed into our self-blame and anxiety.  By launching ourselves out of self-imposed isolation and into the world we work against this tendency.

3.  Action precedes motivation.  Psychologists use the concept of “behavioral activation” to refer to our follow-through on our action plans–including engagement in an exercise program.  As we do so, we may naturally connect with others who share our interests, as with joining a cycling meet-up or seniors swimming group, or arranging to take a regular afternoon walk with a neighbor, in a way that also invites natural conversation.  In other words, one positive behavior tends to lead to others, building our motivation as we go along.  In contrast, “waiting until we feel like it” is a recipe for disaster, as inactivity feeds upon itself, generating more of the same.

4.  Fitness pushes back against the health risks of bereavement.  Research suggests that having a regular exercise regime helps introduce a healthy structure into life, making mealtimes and bedtimes more regular, and contributing to better nutrition and sleep patterns.  In this way exercise promotes positive health outcomes directly, as well as indirectly mitigating the negative impact of eating poorly and relying on caffeine, cigarettes or alcohol to perk us up or calm us down, often creating two problems in the place of one.

5.  Some forms of exercise can promote mindful stress reduction.  Yoga, for example, shows promise in reducing our reactivity to catastrophic thinking or avoidance-based coping in bereavement, as we breath through feeling states that rise up and fall away, or focus on the demands of a challenging position rather than a preoccupying image or thought.  The key to this is a kind of non-attachment to a particular impression, emotion or cognition, just observing it with an attitude of, “Oh yes, there’s that fear again.  That’s interesting.”  Viewed dispassionately with no intention to elaborate on or resist the thought or feeling ultimately reminds us that these are simply subjective states that rise and fall, like the waves of the sea.  Watching them as if from the beach, we can come to recognize that we need not wade in and drown in them.

And so what are a few useful tips for pursuing exercise as a constructive dimension of your self care in bereavement?  Here are some practical ideas.

1.  Start small.  Walk a block.  Set your step counter or exercise monitor for 3,000 steps a day.  Meet your goal, and then increase gradually as you become more active.

2.  Meet the need.  Do you need help getting moving?  Start walking, or commit to 20 minutes in the gym.  Do you need help slowing down, and making peace with silence?  Take a yoga class.  Craft a routine that works for you.

3.  Double the payoff.  Walk to the store on an errand, killing two birds with one stone.  Or take a hike with a friend, building social support and fitness at the same time.

4.  Add meaning to your moving.  Work up to a road race for charity in honor of your loved one.  Imagine him or her walking or talking with you as you stroll through the park.

5.  Practice self-compassion.  If you miss a day or fall short of a goal, cut yourself some slack, but give yourself encouragement to return to the program the next day.  Consider what advice your loved one might have from you in that circumstance.

In sum, working (out) through grief doesn’t solve all the challenges we face in bereavement, but it can provide a key platform in our self-care plan that can connect us to others as it also improves our emotional and physical wellness.  Consider how you can best make exercise work for you, and take a step in that direction today.

–Dr. Neimeyer