The death of Debbie Reynolds just one day after her daughter Carrie Fisher passed away is a somber reminder of the crushing effect grief can have on the body.
The 84-year-old Oscar-nominated singer-actress reportedly suffered a stroke Wednesday. The official cause of death has not yet been disclosed.
“She wanted to be with Carrie,” her son Todd Fisher told Variety.
“Grief is so complicated because there’s physiology, there’s self-care and then there are a lot of unknowns,” Dr. Sharonne Hayes, professor of medicine and cardiovascular diseases at the Mayo Clinic, told TODAY.
“Medicine doesn’t entirely understand how grief and hope affect people’s life.”
“Broken heart syndrome” — or stress-induced cardiomyopathy — which can be caused by an emotionally stressful event, like the death of a loved one, has been well documented in recent years. It has been blamed in cases when one spouse dies soon after the other. Hayes has seen seen a number of people suffer from broken heart syndrome among her own patients.
Both acute grief, like the death of a loved one, as well as chronic sadness can affect the heart, Hayes said. Grief increases some stress hormones, and it can raise blood pressure and heart rate.
In broken heart syndrome, a part of the heart temporarily enlarges and doesn't pump well, according the American Heart Association, which notes the condition is usually treatable, and rarely fatal.
Stress in general can also play a role in strokes. It can make the platelets — the sticky elements in the blood — more sticky and more likely to cause a blood clot, Hayes noted. The more common kind of stroke, an ischemic stroke, is caused by a blood clot that blocks a blood vessel in the brain.
Stress also causes elevated blood pressure, which makes people more prone to strokes, and it has been shown to increase inflammation, which is also a risk for cardiovascular disease.
Self-care also plays a role. Hayes, who was not involved in Reynolds’ treatment, but commented on the effect of grief in general, said it’s unknown what chronic medical conditions Reynolds might have had. Caregivers often don't take very good care of themselves while at their loved one’s bedside.
“Did she skip medications? Not eat? Not stay hydrated?” Hayes noted. “That’s an element as well.”
Some of it may also be a will to live. People who are ill often have mental or emotional "targets" for living: “I want to make it through my kid’s birthday” or see them graduate or get married or celebrate Christmas. Take those targets away, and it’s a shock.
“I think spirituality and optimism and resilience has a part in this,” Hayes said.