I’m alone in the kitchen when I double over. Moaning in protest, I grab the counter, though I know I’ll be dragged under. Rogue waves of grief have slammed me before. The sensation, in fact, simulates drowning: I can barely breathe for the sobs and dry heaves, as my gut disgorges a sea of wretchedness.

Within seconds the convulsions recede. Then my brain begins spewing.

“Please, Honey, please?” I implore—even though Chris is dead; even though, when someone asks if I’ve felt his presence, I answer, “If only,” while thinking the person a flake.

My conjuring of Chris is different, as it’s rooted in Cartesian logic: Je pense, donc je suis. Having shared a body part—thus blurring our corporal boundaries—I’m entitled to think-therefore-I-am so bloody hard we both are.

After a brief silence, I issue a command. “Come. Home. Now!” As if Chris were an otherwise-obedient dog with his nose in the neighbor’s trashcan.

I’m not sure what I expect to happen; nothing does. So I summon him again, this time sounding congenial. Without waiting for a reply, my mind rifles through the stages of his dying, like a bank teller speed counting bills, hoping the first tally was in error. I still come up short.

My last recourse: bargain with the Big One. I’m lucid enough to realize that a full-time, all-inclusive resurrection package—no blackout dates apply—is too much to request. I ask only that Chris be allowed to visit one day each month. No? How about one week each year? Okay, okay, make that a weekend. What? Not one weekend every twelve months? Then, lord almighty, give us an overnighter biannually!

With any prospect of success comes the prospect of losing Chris again and again. This doesn’t trouble me. Demeter managed, having accepted a similar arrangement with Hades in order to see dear daughter Persephone. If each grim good-bye is followed by the promise of vernal reunion, I can handle the serial loss of Chris.

And so the haggling goes. My body feels as hollow and frail as the chitin ghosts of cicadas left clinging to the backyard tree. I’m junkie-needs-a-fix desperate. As hard as I try, though, I cannot close a deal. Like Jack in the movie Brokeback Mountain, who tells his reluctant lover, Ennis, “I wish I knew how to quit you,” I cannot fathom quitting Chris.

Grief. What a sucker-punching, crazy-making state of deprivation. Until you have experienced it—not your mother, your brother, your best friend, but you—you cannot imagine how grueling and grotesque the condition of irrevocable love-loss can be. No matter how large your circle of family and friends, you feel desolate, forsaken, unmoored. Like a rogue planet ejected from its system to orbit the galaxy alone.

In having delusions that Chris would return, that desire could resurrect him, I’m not alone. Joan Dideon, for one, entertained the possibility of reconnecting with her husband after he died of a heart attack. In The Year of Magical Thinking, she recounts how, as she was packing his shoes for the thrift shop, she suddenly stopped, for he would need them “if he was to return.” She’d regressed to the thinking of young children, “as if my thoughts or wishes had the power to reverse the narrative, change the outcome.”⁠

Through fantastic logic, the bereaved can process the derangement of their lives on their own terms. They can pretend hope is alive, even if the loved one is not.

That said, my kitchen crumble went beyond primitive thought processes or fairy-tale conceits. I was not wishing for a revenant Chris, I was begging—while doubled over in pain.

In scores of articles and books about grief, I found no mention of my acute reaction. Call it Gaped-mouth and Dry-heave Syndrome (GaDS). I know GaDS exists in the general population; I’ve seen the telltale mini-maw of Hell in news photos of those traumatized by war or natural disaster. (Picture someone in a wind tunnel swallowing a tornado-force blast.) I’ve also heard survivors describe their grief as “physical.” I even stumbled on a full-blown case of GaDS, albeit in the form of a sculpture. The robed figure of a grieving woman stood hunched and—this was artistically done—hurling.

While GaDS is a behind-closed-doors sort of thing, so is sex, yet there’s no end to discussions about that in the media. Why the information black out on grief’s unseemly aspects? Even as we crave news of death—Pandemic Fatalities Top 5 Million! Premier Assassinated! Man Killed When Bird Drops Turtle on Head!—we disavow death’s aftermath. Even as we relish shock-jocking, we regard the muck of mourning as unShareable, unLikeable.

I had ample warning of what was coming: Chris spent weeks on life support. Yet I was blindsided when a parcel stamped “Welcome to Widowhood” got dumped on my doorstep the morning he died. “I had no idea,” is a common refrain among the widowed. They’re not referring to the arrival of death so much as the anguish shipped with it, same-day FedEx.

GaDS was but one of several items in my anti-preparedness disaster kit. Equally unwelcome were cases of Executive Function Failure (EFF), which ensured I’d be missing car keys, appointments, and exit ramps on a regular basis; and Spontaneous Uncontrollable-crying Canisters (SUCs), one of which released in a café while I lunched with a friend and continued discharging even as I laughed in embarrassment. A king-size blanket of anxiety about my health and safety, due to fear of orphaning the children, came wrapped with a multipack supply of anhedonia, the inability to experience pleasure. When the family’s grief counselor, aware of my career in museums, suggested seeing an exhibit to boost my spirits, I almost laughed, derisively. If she’d ever suffered a body-blow loss, she’d know that the first order of business wasn’t dragging oneself to the National Gallery but dragging oneself out of bed.

What the hell was happening to me? I read memoirs of anguish ending in enlightenment, or eHarmony accounts; self-help columns about finances or friends that drop you from their guest list; and expositions on what grief is, when enough is enough, and—in case you had doubts—why life is still the Hostess with the Mostest. Yet no mention of existential retching.

Finally, scientific journals provided answers, explaining that grief is equal parts psychology and physiology; that loss plays havoc with neurochemistry, which affects emotions and behavior; that our brains evolved to link social pain with physical pain, so grief truly hurts. Grief can actually break your heart.

The concept of grief as a physical affliction doesn’t sit well with people; most prefer to view it as a bout of sadness resolved by time and fortitude. Condolers—my friends and relatives included—resist hearing grief-stricken truths, because they don’t know what to say; don’t really care; or don’t want to imagine themselves in such ill-fitting shoes. Since they can’t stand dealing with death, they want you to stop dealing with it, too.

Even the bereft might maintain that letting emotions get the upper hand is unbecoming, unproductive, un-American. Recasting a “natural process” as some sort of physical condition that might require professional treatment strikes them as absurd. The thing is, tooth decay, high blood pressure, and diabetes are natural processes, too. Letting nature run an unimpeded course can be ill-advised.

While not a leading cause of death or disability, grief is linked to a gamut of health problems. According to an American Journal of Public Health study, wives widowed between ages sixty-seven and ninety-eight experience an increase in mortality of 16 percent, husbands, 18 percent. The “widowhood effect” occurs because loss of a mate “triggers a broad set of bio-psychosocial mechanisms that affect mortality,” particularly the ability to manage chronic conditions or avoid accidents and infections. It’s not restricted to the elderly. Widowed males eighteen and older are 60 percent more likely to commit suicide than their married peers, with the risk for twenty- to thirty-four-year-olds seventeen times greater for whites, nine times greater for African Americans. Middle-aged men and women who lose a partner are at significantly higher risk of death from all causes, particularly cancer and cardiovascular disease.

Grief deserves more than stock slogans: Think positively. Stay strong. Remember the good times. Grief deserves to be taken seriously. The bereft should not be told, as I was months into the ordeal, to “move on,” or, after passing the one-year mark, that further mourning was a “sin.”

To understand grief, one must understand love. Whether due to death, divorce, or breakup, love deprivation is what produces the sorrow, yearning, and other agonizing effects of loss. To understand love, one must put aside the sonnets and reach for the science texts, for the “chemistry” between couples is neurochemistry.

Our brains control our muscles, organs, and nervous system by issuing directives in the form of compounds called neurotransmitters and neuromodulators. When the brain sends a message, the impulse travels through a specific network of nerves. One network might warn us to back off from a flame on an outdoor grill, while another draws us to a different type of flame at our college reunion. Whether they inhibit or incite a response, neurotransmitters provide instructions for all bodily functions: the coordination of movement, the sensitivity of skin, the elevation or depression of mood. Neuromodulators enhance or diminish these effects.

In the case of love, the brain creates feelings of pleasure by signaling its “reward system,” an evolutionary mechanism for encouraging life-enhancing behaviors, such as eating and mating. Addictive drugs activate the same circuitry. One neural signal, dopamine, produces the motivation and drive to pursue sexual intimacy, as well as the feelings of gratification that follow intercourse.

In the heady, early stages of attraction and lust, surges of dopamine boost lovers to euphoric levels of energy, confidence, and passion. This empowers them to woo and win the object of desire, not to mention chase after other life goals. As one proverb states, “Who has love in his heart has spurs in his side.” New love is as exhilarating as snorting cocaine, a psychostimulant that also raises dopamine levels. In fact, functional MRI imaging of subjects gazing at a truelove’s picture show brain activity similar to that of people on snow.

Lust does not equate with love, however. Carnal desire can lead to romance, but choosing a lifetime companion is more complex than choosing a one-night stand. To facilitate pair bonding, the brain deploys two neuromodulators, oxytocin and vasopressin. The hormones are released during non-sexual tactile stimulation, like hugging or massage, as well as sexual foreplay and intercourse.

Among a host of effects, oxytocin and vasopressin facilitate social interaction by suppressing negative emotions and judgment and increasing peace of mind. In most people, oxytocin also fosters empathy and recognition of social cues. Under the hormones’ influence, adults lower their guard with strangers to form relationships that may develop into lasting unions. Call them the bait-and-don’t-switch neuromodulators.

Because areas of the brain packed with oxytocin and vasopressin receptors overlap areas packed with dopamine receptors, feelings of connection are associated with feelings of pleasure, thereby promoting attachment. The reinforcement is no accident. Since the offspring of humans require years of nurturance to become independent, long-term bonding of mates helps ensure survival not only of the young, but also the species.

Establishing a bond is one thing, maintaining a relationship is another. Neurotransmitters called endorphins may be key to preserving unity. ⁠ Released during many of the same tactile and sexual intimacies as oxytocin, endorphins are the body’s naturally produced opiates. Like morphine and heroine, they inhibit the perception of pain and induce a state of well-being. Indeed, according to the Journal of Neuroscience, brain scans of men experiencing orgasm resemble those of men on heroin. ⁠ Endorphins may provide the abiding sense of joy, security, and fulfillment that ushers couples from erotic desire to long-term attachment. As passion ebbs, contentment rises.

There are other brain signals that contribute to love’s emotions and behaviors. Suffice it to say that love may be a fountainhead of sensual delights and poetic musings, but first and foremost, it’s a feat of evolutionary engineering that ensures the propagation of Homo sapiens. Love is hard-wired to make us feel fabulous—psychologically, physiologically—when we forge an intimate union for procreation. Love is a Darwinian imperative, rooted in pleasure and dependency. And love is highly addictive.

Now erase love from the picture. Cancel the “romantic fix” in perpetuity. No more conquer-the-world stimulants. No more one-plus-one-equals-us relaxants. No more life-is-good opiates. In this state of chemical deprivation, love’s intoxicating effects aren’t simply curtailed, they’re reversed. Symptoms vary, but a hard-core case of grief might be mistaken for delirium tremens, with stupor, mood swings, crying spells, irritability, agitation, depression, insomnia, and delusions.

Let’s start with dopamine withdrawal. Initially, when an anticipated pleasure—like a second date—fails to materialize, the brain pumps out more of the stimulant, boosting motivation to attain the reward. Motivation spurs action: you text to arrange another meet up. Yet dopamine surges even when—especially when—a beloved ends the relationship. In Why We Love: The Nature and Chemistry of Romantic Love, Helen Fisher describes the rejected lover.

How ironic: as the adored one slips away, the very chemicals that contribute to feelings of romance grow even more potent, intensifying ardent passion, fear, and anxiety, and impelling us to protest and try with all our strength to secure our reward: the departing loved one.

Substitute dear departed for departing, and my fervor to summon Chris makes sense.

Long before neurochemical research offered such insights, Freud observed similar effects in clinical practice. In “Mourning and Melancholia,” he asserted that the deceased’s existence is “psychically prolonged” for the bereaved, who may cling to the dead through “hallucinatory wishful psychosis.” Decades later, leading authorities on attachment and loss explained that search-and-recovery efforts might include calling out the departed’s name and looking for signs of presence in the likely spots.

As the loved one remains absent, though, dopamine recedes; hope and determination give way to dejection and languor. Low levels of the neurotransmitter are correlated with decreased motivation, libido, and enjoyment of life, as well as anxiety and poor cognitive functioning.

As for oxytocin, the so-called love drug or cuddle chemical, higher levels correlate with reduced stress and depression. Since the hormone accrues through physical affection and intimacy, a beloved’s departure cancels your most-dependable source when soothing fixes are needed more than ever. The inability to share the trauma of losing a partner with the one person who could best console you—the deceased—is the ultimate catch-22.

Oxytocin depletion can also cause social blunting. Blocking its release renders mice unable to recognize comrades—until a dose restores their social memory. That explains my fugue at Chris’s memorial service. I greeted a man who clearly knew me, yet I did not recognize him—despite having talked, dined, and even danced the Macarena with Chris’s boss at company events over the course of a decade. Months later, when I bumped into one of my former colleagues, I had to ask, to my enduring shame, “How do I know you?”

Losing a partner also lowers one’s routine supply of endorphins. Even without a predisposition to the blues, life after loss feels lousy. Back-up endorphins may be just a brisk walk away, but to someone biochemically stripped of motivation, crossing the kitchen is a trek.

Unlike people with substance-use disorder, those experiencing love D.T.’s can’t seek treatment with opiate nasal sprays. They must rely on an unreliable supply of hugs from family and friends, who may prefer to send flowers. Flowers are lovely, but flowers don’t touch. After Chris’s service, when my friend Marie handed me a gift certificate for a massage, I had yet to grasp the value of her offering.

Given grief’s derangement of brain chemistry, a sudden death can prove especially painful: The bereaved goes cold turkey. At the same time, even when a loved one is grievously ill, we deny that the Reaper is our dreadful neighbor—the one who might drop by, unannounced, to borrow our sugar. In that sense, every death is unexpected.

Loss not only stems positive signals, it also sends distress signals through cerebral circuits. During a lengthy separation, stress hormones like cortisol and adrenaline can cause energy, mood, and cognitive function to dip and dive; after a death, they can simulate a plunge from a ten-meter platform into a drained pool. In fact, a surge of stress hormones can shock the heart, inducing Takotsubo cardiomyopathy, or “broken-heart syndrome.” Occurring primarily in women over fifty after physical or emotional trauma, such as loss of a mate, the condition mimics a heart attack. While most recover, broken-heart syndrome can cause serious complications and sometimes death.

Damage from prolonged stress after loss—due to protracted illness, financial insecurity, single parenthood, major lifestyle changes, or all of the above—is subtle, yet corrosive. Chronic stress is implicated in a range of health concerns, from digestive- and immune-system dysfunctions to heart disease and cancer. Chronic stress also degrades quality of life by disrupting sleep and withering neurons in the brain’s memory center, the hippocampus, while inhibiting the growth of new cells.

After seeing Chris through years of medical crises related to his Type-1 diabetes; after giving him a kidney and rejoicing in his resurrection; after watching him struggle four months later with a spate of infections and complications during a grisly ordeal in intensive care, I was at risk—per the Holmes and Rahe Stress Scale—of having the emotional turn physical. His death conferred 100 bonus points, the most assigned to any life-change event (divorce, the next highest, earns 73, imprisonment, 63). I qualified for a major illness.

Fortunately, being memory-challenged was my most troubling concern, and I was lucid enough to know I had a problem. To buy a cart of groceries, wheel them to the pick-up lane, and then drive home without them would make anyone worry about early-onset Alzheimer disease—which also damages the hippocampus.

Loss of a mate is inherently stressful because the mammalian brain evolved to not only encourage attachment, but also avoid separation. Leaving the orbit of the family or herd could pose a mortal danger for any member of a group, but especially the young. Consequently, the sense of physical threat became linked to the sense of social isolation, with distress signals fired when the threshold of “safe proximity” was crossed.

The interplay, and blurred lines, between mental and bodily distress was revealed in a study of women who’d terminated pregnancies due to fetal abnormalities. According to the American Journal of Psychiatry, when the women viewed pictures of happy babies, their brain scans showed “extensive overlap in neural networks of grief and physical pain.” Similar results occur when people gaze at photographs of sweethearts after a break-up.

Social support can assuage grief’s distress, yet conjugal loss not only destroys one’s primary bond, it weakens other bonds, for a negative ripple effect. Couples with whom the two of you socialized may not welcome a third wheel at their table; personal friends who are dating or married are seldom available on weekends. A friend that I phoned one Friday night wanted me to call back on Sunday, when her husband was leaving on another business trip and she was “sure to be depressed.”

Not every widowed person suffers the effects of grief that I did. Many maintain full cognizance and composure; some return to work within a week, or start dating within months. The varying depths and durations of romantic relationships make every bond unique, and every bereavement, too.

Even more consequential is what one brings to grief in terms of temperament, personal history, and biochemistry. Extroverts are less likely to suffer depression than introverts when they lose a partner late in life, if there’s forewarning of the death. Die-hard optimism also serves a protective role, even if it borders on repression of negative thoughts and feelings. People who have suffered a serious childhood loss are at risk for rougher sailing, however, as are those with mental-health conditions, notably anxiety and depression.

Context is also critical. After a death from suicide, homicide, accident, or war, the bereaved has a harder time making sense of a loss than if a loved one dies of natural causes. Whys and what-ifs accumulate in the mind like plaque, while trust in humanity or basic assumptions about life are upended. The news is rife with tragedies that can overwhelm a survivor’s coping skills: a relative is responsible for the death; a child is murdered at school; several family members are lost simultaneously; one’s home and livelihood are casualties, too. As tribulations multiply, emotional reserves dwindle, leaving one vulnerable to grief’s more-debilitating effects. For years after the World Trade Center attack, as pieces of one young man were genetically matched, calls to his mother “kept coming and coming and coming.” She lamented to a New York Times reporter, “Nobody gets it. They don’t understand why I’m stuck in such an awful place.”⁠

Whatever its depth or duration, grief is not an all-or-nothing proposition. Retrofitting your identity does not produce a new pain-free you; moving on does not mean leaving everything behind. The bereaved can press ahead, crafting new lives, even as they eye the rearview mirror and yearn for the one receding in the distance.

Months after Chris died, I started a class, took the children on vacation, and cultivated new friendships. By all criteria, I was healing. Yet when I reached the first anniversary of his death and realized it was a milestone, not a finish line, the drudgery of bereavement hit me. Forget resting on the oars: I had to row my single scull back through the straits of birthdays, holidays, and family celebrations without him. Forever.

Years later, I sometimes feel longing, sadness, and regret. As Yulia Chentsova Dutton and Sidney Zisook explain in “Adaptation to Bereavement,” published in Death Studies, success for the bereaved “is marked not by the absence of negative feelings, but by an individual’s ability to manage the ‘ebb-and-flow’ of distress and to focus on positive emotions.”⁠

Grieving is a long process because the brain must not only quit the lover like a drug, but also like an ordinary habit. Billions of neural connections must be unraveled; customs, affections, and memories must be unlearned. Otherwise, on a daily basis, the survivor will have expectations that are dashed.

Old habits die hard; love dies harder. Like Pavlov’s dog, the children and I were conditioned to expect a treat every evening around seven: the click of Chris’s key in the front-door lock. For weeks after his death, one of us invariably remarked during dinner that he was still a no-show. I can’t believe Dad’s not coming home. He’s supposed to be here.

Like learning, unlearning takes repetition. Lots of repetition. After months—or years—alone in bed, however, one night your foot slides to the emptiness beside you, and the coolness feels as natural as your partner’s bygone warmth, so natural that he is not supposed to be there. Likewise, the absence of touch becomes a lack of sensation, rather than a deprivation. And Valentine’s Day, well, it’s a purgatory, but it’s no longer a six-tissue hell.

Healing does not mean you forget; no, you never forget. Yet you don’t think to text him to pick up tomatoes or buy her a birthday present, and each oversight goes unnoticed on your part. That is what love-recovery looks like.

I’ve imagined founding a Betty Ford-style clinic for love detox. The program would comprise lectures on grief; acupuncture and exercise to stimulate the release of endorphins; massage to elevate oxytocin levels; and daily showings of comedies to curb stress. Productive reminiscing would be encouraged, with free rein on cutting deals for reunions with the dead.

If anyone can arrange an otherworldly visit, I want to be the first to know.

August 15, 2023

About the writer

Gaye Brown's work has appeared in the Washington Review, Georgetown Review, Nathaniel Hawthorne Review, Months to Years, Lowestoft Chronicle, and Adoptive Families magazine, among other periodicals. She received a Travel Writing Award, with publication in The Best Travel Writing 2010 (Solas House), and was a finalist for a Maine Literary Award in short non-fiction in 2023, 2020, and 2016. Formerly, she directed the publishing programs of the Smithsonian Institution’s American Indian and American Art museums, and later was a writer-researcher for Time-Life Books.