Why It Hurts So Much When Someone You Love Dies
By: Brian Hoeflinger, MD
October 18, 2026 | #99
Forwarded this email? Sign up here
Disclaimer: Opinions are my own. Not medical advice.
Medical Trivia of the Week
Where is the smallest bone in the human body? (the correct answer is at the end of this email)
- A) The middle ear
- B) The fingertip
- C) The nose
- D) The little toe
In Today's Newsletter
- Why your brain handles the loss of someone you love in many of the same regions that process physical pain.
- How stress hormones, tense muscles, and your immune system make grief something you feel in your body.
- Why the yearning slowly eases as your brain learns to live without the person who is gone.
When My Son Died, I Felt It Physically
Have you ever wondered why it hurts so bad when someone close to you dies? When my son Brian died suddenly in a car accident 13 years ago, I was in immense emotional anguish and physical pain. I could understand my emotional reaction, but I couldn’t understand the actual physical pain. I just knew it hurt.
So I thought I would delve into this topic to shed some light on it, as death is universal and at some point we are all going to deal with it.
Why Grief Causes Physical Pain
After researching this a bit, the findings are fascinating. Firstly, the main reason that you feel physical pain when you experience loss is because your brain processes emotional pain and anguish in many of the same regions that register physical pain and injury.
For instance, there is an area of the brain known as the anterior cingulate cortex. This specific region in the brain is highly active regardless of whether you slam your hand in a door or experience the sudden death of a loved one. Your brain does not fully separate emotional suffering from physical pain. Much of the information travels along the same paths. But that is not the end of the story by any means.
Additionally, loss triggers a massive release of stress hormones like cortisol and adrenaline into your body. This sudden surge of stress hormones can temporarily stun the heart muscle, leading to chest pain and shortness of breath. This reaction has been coined “Broken Heart Syndrome” and is an actual medical condition. This explains why your heart can physically hurt when somebody close to you dies.
Simultaneously, these same hormones can lock your muscles into a constant state of tension, causing aches and pains throughout your body.
Even further, grief causes your immune cells to release substances called cytokines, which heighten your body’s overall response to pain.
What Loss Does to the Rest of Your Brain
Now switching gears away from actual physical pain, there are other regions in the brain that are affected by loss. With loss, the reward system in our brain keeps reaching for the person who is gone, causing our brains to continually search for them. It’s like losing the reward you might experience with addiction. It feels great when it’s there and horrible when it’s gone. This explains the intense yearning we feel with loss, because our brain is craving and searching for the “emotional fix” that is no longer there.
Grief is also thought to reduce activity in the prefrontal cortex, which is the part of the brain known for focus, decision-making, reasoning, and planning. This reduction in brain activity results in what is known as the “brain fog of grief,” where people have difficulty concentrating, focusing, and making decisions.
And lastly, the loss of a loved one triggers fear, anxiety, restlessness, and sleeplessness. This is due to the area of our brain known as the amygdala being alerted and set into action.
How Your Brain Learns to Live Without Them
Your brain works on a prediction model, meaning that if someone you have known and loved for a long time is suddenly gone, your brain is initially predicting that the person is still there. That’s because the neural pathways associated with that person are still in place and functioning.
In the first few days and weeks after a death, people often deny the fact that their loved one is actually gone. This is because the prediction model in their brain of the person being there is still strong and functioning.
As time goes on, the brain will gradually rewire itself with new pathways that now exist without that person. It’s a very slow process and varies from person to person. But with enough time, your brain begins predicting on a more consistent basis that the person is no longer there, and subsequently the heartache and yearning gradually ease.
Obviously my explanation is fairly simplistic, but I think you get the point. The connections in your brain which pertain to your loved one being there need to be replaced with new ones without the person being there. Your brain needs to learn how to “live” without that person in its prediction model.
These Reactions Are Part of Healing
So as you can see, our reaction to loss is quite complex, and our brain plays a crucial role in how we react both emotionally as well as physically. But most important is to realize that these are normal reactions that we all experience, and they are part of healing.
Do not try to escape your feelings. Let your brain process these emotions.
Impactful Quote of the Week
"All that we love deeply becomes a part of us."
- Helen Keller
All my best,
Brian Hoeflinger
P.S. - Please reply to this email and let me know if you have ever felt grief physically, and what helped you through it. I strive to read and reply to as many as I can.
Medical Trivia Answer:
The correct answer is A) The middle ear
Want to read my top newsletter articles? Read them here.
*Disclaimer: This newsletter and blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter and blog or materials linked from this newsletter and blog is at the user’s own risk. The content of this newsletter and blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay seeking medical advice for any medical condition they may have and should consult their healthcare professionals for any such conditions.
