When Elizabeth R.’s husband passed away from bone cancer in 2016, she felt grateful that her employer offered generous bereavement leave.

Now 40, she worked in the development department of a large nonprofit cancer group at the time and felt ready to go back when her leave was up. However, about two weeks into her return, she realized it was too much, too soon.

“Every time I would hear a cancer survivor or caregiver story, I had a reaction,” she recalled. Elizabeth, who asked that her last name not be used, decided to resign and has since remarried and started a second career as a massage therapist in Grand Rapids, Mich.

But not every widow or widower who works has these options, and those who don’t may face increased physical and mental health challenges, a new study suggests.

People who returned to work within three months of losing a spouse had higher perceived stress levels and greater systemic inflammation than retirees who had lost their partner. The less these folks earned at their job, the worse the mental health effects, the study showed.

“It is important to recognize that widows and widowers have twice as much to deal with as other people who work and are not grieving a spouse,” said study author Jensine Paoletti. She is a postdoctoral research fellow in the Biobehavioral Mechanisms Explaining Disparities Lab (BMED) at Rice University in Houston.

Widows and widowers who worked after losing a spouse reported more stress on a standard questionnaire measuring stress levels. They also had higher blood levels of several inflammatory proteins, including interleukin-6, tumor necrosis factor-alpha, and chemokine ligands 4, the investigators found.

“If you have high levels of inflammation, you have a much higher risk of heart disease, dementia and certain cancers,” Paoletti said.

This could be what drives the well-known “widowhood effect,” added researcher Chris Fagundes, a professor of psychological sciences at Rice and director of the BMED lab. The widowhood effect suggests that older adults who are grieving a spouse have an increased risk of dying compared with people whose spouses are still living.

One of the best ways to reduce inflammation and stress and improve health is to engage in regular physical activity, Fagundes said.

It’s also important to understand the leave policies where you work and take advantage of those that exist, Paoletti advised.

Still, changes are needed at the federal policy level to ensure that everyone has these benefits, she said. There is no federal law that mandates employers provide bereavement leave, but the tide may be turning. Growing numbers of companies are starting to offer some type of bereavement leave, according to research from the Society for Human Resource Management, and a handful of states have mandated bereavement leave in recent years.

The study was published online recently in Psychoneuroendocrinology.

“If you are widowed and are working within the first three months of losing your partner and not at a high level of income, you are not in great shape,” said Sherry Cormier, a psychologist and bereavement trauma specialist based in Pittsburgh, Pa., and Santa Cruz, Calif.

You are more stressed out, and your inflammation levels are higher, said Cormier.

“We really do need to recognize that when we lose a family member, some of the main implications may be income or social or economic status,” said Cormier, who has no ties to the new research.

Most people have to work to support themselves and their families, and they feel like they can’t show grief at work, she explained. This is called emotional asking, and it makes everything worse. “We need to feel grief, and we need to cry,” Cormier said.

Find a safe place to grieve outside of work, she suggested.

And, Cormier added, there are other ways to help yourself through this difficult time.

“Try to talk to a financial counselor or find someone willing to volunteer to help you sort out your finances so you understand your options,” she said.

Joining a support group or speaking with a bereavement counselor can also help you cope with the loss of a loved one. “Think about people in your life who you can count on and let them know what you need,” Cormier said.

In the first year following the loss of a spouse, you are also at increased risk for a major health issue, so see your health care provider for a checkup. “Don’t wait to do this,” she stressed.

Self-care also helps reduce stress and can improve overall health. It’s important to eat a healthy diet, get regular exercise and get good quality sleep. These all work together.

“If you are not eating well and not moving your body, you are not going to sleep well, and not sleeping well impacts your appetite and whether you can exercise,” she said.

Acupuncture, massage or meditation can also help reduce stress and inflammation. “It’s time to take care of yourself,” Cormier said.

More information

The American Psychological Association has more on coping with the loss of a loved one.

SOURCES: Elizabeth R., massage therapist, Grand Rapids, Mich.; Jensine Paoletti, PhD, postdoctoral research fellow, Biobehavioral Mechanisms Explaining Disparities (BMED) Lab, Rice University, Houston, Texas; Chris Fagundes, PhD, professor, psychological sciences, Rice University, and director, BMED Lab, Houston; Sherry Cormier, PhD, psychologist, bereavement trauma specialist, Pittsburgh, Pa., Santa Cruz, Calif., and author Sweet Sorrow: Finding Enduring Wholeness After Loss and Grief and Counseling Strategies and Interventions; Psychoneuroendocrinology, April 2023