Silent night and Christmas just doesn’t feel right
Pitt’s WELL Study hopes to find out if daily healthy behaviors and coaching can help grieving spouses avoid depression and other health risks
Christmas and Kwanzaa are almost here and most of us are feeling festive – but certainly not if we’ve lost our spouse or partner.
“It’s difficult to feel like celebrating when one of the most important people in your life – maybe the most important person — is gone,” says Dr. Sarah T. Stahl, Associate Professor of Psychiatry and Clinical and Translational Science at the University of Pittsburgh.
Holidays, anniversaries, and birthdays are hard, especially during the first year of a spouse’s death.
During that time of extreme adjustment and stress, the grieving partner is at high risk for developing major depressive disorder. This disorder may contribute to Alzheimer’s disease and other forms of dementia (Source: PLOS Medicine). The stress can also lead to other chronic diseases and even an early death.
DR. SARAH T. STAHL
Why does this happen?
One answer may have to do with the fact that the stress of losing a spouse/partner affects a person’s quality of sleep.
Using bloodwork and questionnaires completed by grieving spouses, researchers have found that these individuals experience serious sleep disruptions. These disruptions are linked to higher levels of bodily inflammation, which is associated with cancer, diabetes, heart attack, stroke, and more (Source: Rice University).
The disruptions also impact circadian rhythms, or your body’s internal biological clock. The clock consists of a 24-hour sleep/wake cycle. When it’s disrupted, you can suffer from chronic health problems like diabetes, cognitive decline, and depression.
“The difference is that people in the WELL group receive weekly motivational phone calls and feedback from health coaches. They’re also asked to record their daily sleep, movement, and eating behaviors on their own tablet or PC,” she adds.
That difference is what Dr. Stahl and her team hope will help participants deal with stress in a way that prevents clinical depression:
“Our thought is that weekly interactions with a trained healthcare provider, as well as being mindful about daily routines, will make a positive difference in people’s grief journeys,” she states. “We’re predicting that these additional tools will help a grieving person better adapt to the loss. It will hopefully make them more likely to live life on their own and to the fullest.”
A good way to deal with the intense loss of a spouse/partner is to establish new self-care routines quickly. That’s why WELL participants are encouraged to get regular sleep — including going to bed and getting up each day at roughly the same times.
They’re also encouraged to eat healthy meals at standard times and do some physical activity, such as walking.
This daily regularity helps the body to establish a good circadian rhythm, which can lead to better health outcomes, especially for the immune system.
“In addition to capturing some of the WELL participants’ behavioral information on activity watches, we ask them to enter that information into a daily online diary,” says Dr. Stahl. “We convert what they enter into graphics that affirm their good habits visually.”
Also affirming for the WELL group are the weekly phone calls and feedback from health coaches. The coaches encourage participants to choose their own health goals and come up with ways to meet them.
“We’re hopeful that if a participant sets a goal and takes steps to reach that goal — especially with someone who’s supportive — they’ll be more likely to fulfill the goal and set another,” notes Dr. Stahl.
Though the WELL Study is ongoing, Dr. Stahl and her team are already — cautiously — noting evidence of healthy behavior.
“We have participants who, after only two months, are saying that the recording of daily activity is becoming mundane,” she says laughingly. “That’s a good sign! It says to us that they’re beginning to go through the motions so well, the healthy behaviors of rest, food, and activity are becoming routine.”
Other things Dr. Stahl and her team are noting as they study spousal grieving are less measurable and more insightful.
“We continue to observe that grieving for a spouse is a highly personal journey,” Dr. Stahl explains. “It’s different for everyone and there’s no right way to grieve. While many people want to know when they’ll be ‘better’ or ‘finished’ with their grief, that doesn’t seem to happen.”
Instead, what does happen is that as time passes, grief begins to look less like pain and stress and more like love. “Grieving seems to be, for many of the surviving spouses we’re studying, the final way they express their deep love for the person they’ve lost.”
To try and lessen this stress, Dr. Stahl and her team of researchers are conducting the Widowed Elders Lifestyle after Loss (WELL) Study at Pitt. WELL’s purpose is to learn about older adults’ health behaviors and mood as they grieve during the first year of loss.
The ongoing study lasts 15 months for each participant, but it’s most intensive during the first 3 months.
“The study features seven virtual visits on Zoom or by phone,” explains Dr. Stahl. “Participants must be over 60, bereaved within the last year, have access to a phone, and have a mild level of depressive symptoms. If they meet these requirements, they’re randomly placed into one of two study groups: A WELL intervention group or a usual care (control) group.”
According to Dr. Stahl, both groups receive written information about healthy lifestyle practices. They also occasionally wear activity watches that monitor sleep and daytime activity, answer questionnaires, and complete interviews.
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