Should you exercise if you have a chronic illness?
A bereavement can bring a range of extremely difficult emotions and everyone copes with losing a loved one differently. But for some people, exercise provides a way to face grief and keep moving forwards at a time when it is most challenging.
In 2017, Nicola Jane Simmons lost her 23-year-old daughter Hannah in an accident shortly before Christmas.
Nicola began yoga, which she had never done before, as a tool to process her grief.
"I was thrown into a situation where I was working full-time as a solicitor and dealing alone with my grief for my daughter, supporting my mother who had lost her first grandchild, my teenage son who has lost his wonderful sister, and her friends who had lost someone very special in their life, and I needed something to help me," she says.
"Yoga has been my solace. I am doing exercise and learning a new physical skill that is keeping me physically fit and releases happy hormones," she adds. "I also find that my yoga and meditation provide me with a safe place to exercise my grief. It has become my lifeline and I want to be able to offer this solution to others who may be in this situation."
Nicola has now set up the Hannah Whitley Foundation in her daughter's name to provide free yoga and meditation to help others who are struggling with loss and grief.
'A positive tool'
Exercise may not extinguish grief but it can play a valuable role in helping people adapt to loss.
Physical activity releases brain chemicals such as endorphins, which help to relieve discomfort and boost our mood. Although grief is not the same as depression, 'complicated grief' - a form of bereavement that triggers strong emotional and physical reactions that can take years to work through - can lead to depression.
A 2017 study by the Black Dog Institute found regular exercise of any intensity can help prevent depression - and just one hour a week can help.
"Exercise is a very good and positive tool that people can use while grieving, mainly because it triggers that release of neurotransmitters and the release of endorphins," explains counsellor Sharon Stallard, who is trained in helping people cope with bereavement.
"Exercise helps regulate a person's mood and can prevent them from going into a low phase which can trigger depression."
It can be difficult to think of anything else when dealing with grief, which can be all-consuming. Things that should be simple - eating or going to the shop - can suddenly seem impossible.
"What tends to happen to people going through the grieving process is they tend to eliminate all aspects of self-care, and that can be exercise, diet or socialising with others," Stallard says.
Having space and solitude to work through difficult emotions and feelings can help people process grief but it also risks isolation.
"People can become withdrawn. So exercise can also be a good way of engaging socially."
Losing a loved one is emotionally draining and grief can take away energy and focus. Dealing with the flood of different emotions - which can unexpectedly re-emerge at any time - can feel relentless and exhausting.
Engaging in exercise can help clear the mind, even if it is just for a few minutes.
"It allows people to have a focus," Stallard says. "While people are doing exercise, you tend to focus purely on that exercise - whether it's a class, or gym or swimming - so it brings a feeling of calmness.
"It can be a motivation to do other things, to just get moving, that gets you back into society and integrates you back into life."
Exercising can also help bring back a feeling of control, which is often lost after someone passes away - and the grieving person is thrust into a world they didn’t want to be in.
"Just being able to take a little bit of control back can sometimes be that first step to feeling a bit better, or being able to go back to work, or something like that," Stallard explains.
This might mean going on a short walk every day - or it might even mean running a marathon. This, Stallard says, can help people reframe their grief so it may benefit others - for example, if they have lost someone to cancer.
"There's a lot of sponsorship that goes around and that's a great motivator to bring something positive and celebrate that person's life as well," she says.
These sleep problems, in turn, can impact our mental health and exacerbate grief - as well as contribute to other problems such as obesity, heart disease and type 2 diabetes.
"One of the things I see a lot of the time is people don't sleep, they're awake during the night, they're not engaged in things during the day," Stallard says.
Research suggests exercise can help introduce a healthy regime and improve sleep, which may help mitigate the negative impact of grief.
There is no one-size-fits-all approach when it comes to grief and loss, but there is support available for those who need it.
Going to counselling can help some people, but when you decide to go is up to you - it could be after a few weeks or a few months.
"The first point of contact is your GP, just to make sure there are no underlying health conditions or mental health problems," Stallard says.
Your GP will also be able to advise you if you are struggling with sleep problems.
There are several bereavement charities which can help people deal with different types of grief, such as the Lullaby Trust, which offers support for families coping with the loss of a child due to sudden infant death syndrome ,and the cancer charity Macmillan.
You can access local support services via the national bereavement charity Cruse.
For some people, talking to a friend, family member or health professional can help begin the healing process and work through challenging emotions. It can also help prevent isolation.
Grief is not an easy subject to talk about, but it is something we all experience at some point.
"The thing with grief is that we just don't talk about it, until it is thrust upon us," Stallard says. "As a society, we really make grief and death such taboo subjects that it's very difficult to know how to handle it."