The Brains of the Bereaved Following Loss of a Loved One by Sudden Death: Why Deadly Tragedies Hit Us So Much Harder

The unexpected death of a loved one is the highest ranking cause of trauma, actually linked to the development of psychiatric disorders. Any sudden death of someone close may cause anxiety and depression no matter who you are, and if you were tightly bonded (spouse, parent, or child), effects can be severe.

Primary attachment relationships like marriage or parenthood feature significantly within the brain’s motivational system. Such bonds actually contribute to our overall health, the body’s state of balance called “homeostasis.”

Cutting off primary relationships permanently removes them as an important source of our overall regulation, disrupting multiple major neurobiological systems all at once: the immune system is suppressed, stress hormones like cortisol rise, and symptoms of major trauma may emerge. Young people exposed to suicide sometimes develop major depression that lasts many months, and the murder of a child can cause post-traumatic stress disorder (PTSD) in parents.

Tragedy’s Grieving

Grief following traumatic sudden deaths has been compared to other big life losses, but effects on the brain do differ.

There are some similarities between them: the neuroanatomy regulating emotions like sadness and stress and memory are affected in both, as is the circuitry associated with reward-seeking, pain, and addiction.

But the permanent severance of a major emotional bond causes ongoing reward-system dysregulation, as well as neuroendocrine and structural brain changes like atrophy of the hippocampus — important to emotion — and effects of levels and production of oxytocin, the “love” chemical.

Such effects aren’t regularly seen with the loss of a job or a long-term dream.

Trauma as Threat

Expectation and anticipation are fundamental aspects of how safe we perceive our environment to be. Unpredictability affects our sense of threat and safety. On a neurological level, we’re all beings of routine; as long as we’re not surprised by unexpected danger, our sense of consistent safety runs as if on autopilot. If that underlying predictable “operating system” is disrupted, we perceive the involuntary loss almost like an assault, a threat.

Such unanticipated dissonance between “life as we knew it” and a “new normal” is jarring (think Covid-19), not only for the interrupted sense of our expectations of reality, but also to our own identities and personal roles. Over time, though, it’s possible that these circumstances may change — a very different prospect emotionally from, for example, the violent death of a spouse or child.

Tragedy resulting in death of one of our primary emotional bonds, especially from out of the blue, blasts us with not only unanticipated emotional grief, but a loss characterized by its permanently unchangeable nature.

Such loss works differently in many different parts of the brain. Ongoing complex grief of this caliber can cause atrophy and changes to structures and tissues over time, and moves differently through the brain’s regions and networks than normative grief.

Interpretation of the differences suggests a sort of frustration to the reward system, which had previously been “fed” by the deceased. Our brains only know a critical piece is missing, and keeps seeking for them… but can never land.

To say the grieving are not the same people after such traumatic loss is no exaggeration… some will quite literally never be the same.