I say ‘be kind to yourself’ or be gentle with yourself’ a lot to people who are grieving. I was typing it on Twitter/X and I thought – what do I actually mean?
 
It’s about being as nice to ourselves as we would to our friends or family. It’s about self-care that’s more than just a bubble bath. It’s about wanting the best for ourselves, not pushing our needs to the back. It’s about understanding that we are just as important, just as amazing, just as worthy as everyone else. But it’s also about understanding that we are hurting and a bit fragile.
 
So – please – be kind to yourself today. 

My day job is writing about science and medicine, and over the past decades I have read hundreds, if not thousands, of scientific papers. They rarely start with a Shakespeare quote and a discussion of poetry and fiction. The text above is taken from a 1986 letter to the British Medical Journal by Dr Brian McAvoy, then a senior lecturer at the University of Leicester.
 
The letter, called Death After Bereavement, talks about the increased risk of death after losing a partner, with a higher risk for men, and for people who are bereaved young. Dr McAvoy found the risk to be higher in the first six months for women, and in the second year for men.
 
This increased risk of death has become known as the widowhood effect, and has been confirmed in other studies and in meta-analyses (scientific papers that combine the results from a number of previous studies). A study from March 2023, in people over 65, showed that the risk of death was highest in the first year after bereavement, and higher in men than women. Overall, the risk of death was 70% higher for men aged 65–69 years, and stayed higher for six years. For women in the same age group, the risk was 27% higher in the first year.
 
Widowhood effect causes of death include cancer, cardiovascular disease, infections, accidents and suicide.
 
Why does this happen?
It’s not clear why the widowhood effect happens, or why the impact is greater in men. There are a number of potential reasons:

• Grief can affect the immune system, making people more likely to pick up infections
• Increased levels of inflammation have been seen in people who are grieving, and inflammation has links with heart attack and stroke
• Self-neglect, which may date back to time spent as a carer before the partner’s death – this can include neglecting hygiene, not eating properly, not taking medication or seeing a doctor. It also includes drinking or smoking more than is healthy
• Loneliness and lack of social support – this is linked with mental and emotional ill health and a higher risk of suicide
• Broken heart syndrome, also called stress-induced cardiomyopathy or Takotsubo cardiomyopathy, where sudden stress affects the heart

 
What to do
Self-care is important after bereavement, and it’s more than just a bubble bath. It’s about getting sleep, eating as well as you can, keeping in touch with people, and seeking medical care when you need it. Psychotherapy and counselling can also really help if you are struggling.

'Self-care' is a bit of a buzzword. It's become about 'me time', bath bombs, scented candles, manicures, facemasks, herbal teas, touching trees and drinking a lot of water out of an enormous plastic water bottle. While none of these are wrong in themselves, they offer a fleeting moment of care, and may not appeal to everyone. They can also become a pressure, leaving grieving people feeling worse when the solutions don't make everything better.
 
In grief, self-care is actually about caring for our mental and physical health and keeping ourselves safe and well.
 
Caring for ourselves
The most important part of self-care, which sounds easy but is actually quite hard, is being kind to ourselves. It's about being as good to ourselves as we would be to others in the same situation, giving ourselves permission to feel sad, to say no, to take breaks and to get things wrong sometimes. Remember, we are doing our best in a situation not of our choosing.
 
Self-care can include:

• Accepting that you are grieving, and accepting all the complicated feelings that come with this
• Accepting that grieving takes time, and can be different every day
• Celebrating our accomplishments, however small they are
• Accepting help from people around us
• Doing things we enjoy
• Keeping an eye on our physical and mental health, and seeking help when we need it
• Caring for our bodies:
  • Getting as much sleep as we can
  • Eating as well as we can
  • Exercising as much as we can – even just a little bit can help
  • Showering, bathing, cleaning teeth
• Keeping in touch with friends and family, whether face to face or online
• Joining a support group
• Writing your grief
• Continuing the bonds with the people we have lost

 
Meditation and mindfulness may help. However, as someone with ADHD, these allowed too much space for intrusive thoughts; it was too much for me but some people find it very useful.

​Going back to work after losing someone, whether it's back into a physical workplace or working from home, is a really tough thing to have to do. You may need to go back to work because you need the money, or it may be to provide structure, company and support.
 
As a freelancer I didn't have a lot of choice about going back to work. I also found that doing a job I loved meant that I got up in the morning with something to do. I started back a week or so after the funeral. One of the first stories I had to write (I'm a medical writer) was about heart disease in diabetes, which was the cause of Tim's sudden death. Even now I struggle to write on that topic, with the only consolation being that the medical research I cover could stop someone else being in my situation.
 
I did take on too much too soon, and that kicked me in the butt around six months after Tim's death, when I had a crash in my grief and mental health and had to pull out of two major projects. I've tried to be more measured about my workload since then (which I don't always manage), and to take on smaller rather than larger projects.
 
There is no specific right time to go back to work – it's whatever works for you. It may be days, weeks or months. You have the right to time off when a partner dies. However, depending on how much bereavement leave you get, you might need to take holiday or unpaid leave as well, or get your doctor to sign you off. You may go back to work and then find out you need to take more time off. This isn't a failure, it's what you need.

​Unfortunately, not all employers are as good as they should be. You may need to be determined in asking for what you need, and you may experience your coping strategies being dismissed or undermined, and your self-care plans belittled. Talk to your boss (or your boss' boss) about what you need, and if you have an HR department or a union, you might want to get them involved.
 
Some people don't go back to their old job, go back and leave, or don't go back to work at all, after bereavement. This may be because their workplace doesn't provide the support or adjustments they need, the travelling is too much, or the experience of bereavement has changed priorities. 

How you might feel

• Different – how can everything be the same here when the whole of my life has changed?
• Lonely and disconnected
• Teary and fragile
• Fuzzy-headed, slow and widow-brained
• Tired
• Unable to concentrate
• Low
• Concerned about making mistakes
• Little confidence in your abilities
• Worried about what people might say, or weary from dealing with the things that people do say
• Unmotivated – what's the point of work?

 
Hints & tips

• Claim bereavement support payment
• Have a self-care box at your workspace – tissues, chocolate, lavender or other essential oils, notebook and pen, something soft to touch or hold, headphones, a fidget toy or stress ball, favourite teas and snacks, hand cream, lip balm
• Ask your boss, your HR department, or a friend to let people know what has happened before you go back – the more people know, the less time you will need to spend breaking the news
• Create a plan with work
  • Arrange back to work discussions
  • Understand what your employer expects of you
  • See if you can work fewer hours or flexible hours, work on fewer tasks, cut back on management responsibilities or get extra support for a while or permanently
  • See if you can return to work on a phased basis, increasing your hours each week until you are back to your previous hours
  • See if you can work in the office/work from home/split your time – whatever works best for you
  • See if your company provides bereavement or trauma counselling or psychotherapy, or will allow you to take time out to attend sessions
  • Suggest a buddy system, so that you have someone to turn to should you need help with no judgement
  • Encourage your company to put on bereavement training courses for management, and to put a bereavement policy in place
• Be open with your colleagues and ask for help when you need it
• Rehearse what you are going to say to people about your loss. You don't have to give them all the details
• Be prepared that some people may make too much of a fuss of you or ask to many questions, and other people may avoid you because they don't know what to say. Some people might surprise you though, and be the support that you absolutely need
• Get people to check your work if you are concerned that you are making mistakes, or if you have lost confidence in your abilities
• Be aware of the number of spoons different tasks will require
• Be kind to yourself. You may well make mistakes, burst into tears, get frustrated or irritated. It's natural. Talk to your boss and your colleagues and explain how you feel. Being as open as possible can make things easier.
• Create to do lists and notes and use reminders to help you keep track
• Have somewhere you can escape to – your car, a toilet or coffee room on a different floor, a local park, the gym or swimming pool

Widow's experiences of going back to work, both good and bad.

The darkness of winter can be hard for some people. I don't like it, and I found it even harder when I was living alone. Here are a few hints and tips for making the winter feel more comfortable. ​​

• If you go out, have lamps and radios on timers so there is light and sound when you get in. You can use plug timers, smart light bulbs and sockets, and smart phone apps.
• Smart heating systems mean that you can make sure the heating is on when you get in. 
• Keep moving – exercise warms you up and can pick up your mood.
• Hot water bottles are old school but comforting.
• Have a lovely snug blanket on the sofa, and buy yourself a cosy dressing gown and pair of pyjamas or onesie. 
• Draughtproof everything you can.
• Candles or bio-ethanol burners make rooms feel cosier.
• Fairy lights aren't just for Christmas - LED ones indoors and solar ones outdoors give an extra glow.
• A fleecy electric over-blanket means you can be snug, even when the rest of the house isn't.
• Being ill on your own is rubbish - create an 'I'm not well pack', with cold and flu remedies and nice things too.

Someone once said to me to think of this time of year being when the seeds are in the ground waiting for spring. This helps me feel a bit more positive about the dark mornings.
​
Seasonal affective disorder
​Many people get affected by changes in the seasons, but if the winter blues are lasting a long time and really affecting your life, you might have winter seasonal affective disorder (SAD). This is a low mood that gets worse in the winter. According to the NHS, symptoms of SAD (sometimes called winter depression) include:

• a persistent low mood
• a loss of pleasure or interest in normal everyday activities
• irritability
• feelings of despair, guilt and worthlessness
• feeling lethargic (lacking in energy) and sleepy during the day
• sleeping for longer than normal and finding it hard to get up in the morning
• craving carbohydrates and gaining weight.

Our sleep patterns, appetite, mood and activity are linked to levels of light, and for some people the levels of light in the winter just aren't enough. Lower levels of light can also affect our sleep-wake cycles. There a few things that might help:

• Spend as much time in natural daylight as you can.
• Take regular exercise, outdoors and in daylight if possible.
• Plan ahead – stock up on things, such as ready meals, if you know you won't have the energy to cook.
• Self care is really important - create a self-care box, with favourite books or films, things to pamper yourself with, a cosy wrap or blanket.
• Rest when you need to.
• Try light therapy – change some of your lightbulbs for brighter ones (the higher the lux the brighter the light), get a light box or SAD lamp, or try a sunrise alarm clock.

Vitamin D may or may not help SAD, but the NHS recommends that people in the UK should consider taking a daily vitamin D supplement during the autumn and winter.
​
If SAD is really affecting your life, talk to your GP. For some people, cognitive behavioural therapy, counselling, psychotherapy or antidepressants can help.

Christmas can be such an emotional time, but it can be even more challenging for widows, because it brings up a lot of memories, happy or sad. As with so many things about being a widow, there is no right or wrong. No rules. Do what you need to do. And do it as one moment, one step, one breath at a time.

Avoid the hype
Christmas is everywhere, and you can cut down your exposure to it by using ad blockers online, unsubscribing from marketing emails, watching DVDs, streaming services or BBC to avoid ads, listening to albums, podcasts, spoken word radio such as Radio 4, Radio 4 Extra or Radio 5 Live or music streaming services to avoid Christmas music on the radio, or recording live TV so you can fast-forward through ads. Shop online (at independent shops if possible) to avoid Christmas fluff, furbelows, jumpers, tinsel and endlessly looping Christmas music. 

Taking the last couple of days off work before Christmas can get you out of all the Christmas talk.

Give yourself permission
Give yourself permission to laugh, cry, go out, stay in, or go to things and leave early. And whatever you plan to do, you are totally allowed to change your mind.

Say no
Don't do anything you don't want to. Fib if you need to, but just say no. You don't have to go to the party, wear the jumper, or get involved in the Secreat Santa if you don't want to. 

Announce your intentions early
The first year I decided to spend Christmas afternoon with friends. The second, I decided to head off to a shepherd's hut in the Lake District. Both years I told my family early, to stop the well-intentioned invitations. I love my family, and I love spending time with them, but I just didn't want to be part of a family Christmas without Tim.

Be aware that things can get overwhelming
If you are part of a big celebration, it can get too much sometimes. Take a breath, try grounding (five things you see, four things you hear, three things you touch, two things you smell, one thing you taste), or find a quiet corner for a moment. 

Prepare people
Let people know that you might have tough moments, and let them know whether you want to be fussed, ignored, hugged or distracted. And if you are spending it alone, you can ask someone to check in on you at some point of the day if that would help.

Have an exit strategy
If I go to a big event, I like to arrive early so that I can find places to hide if I need them, and so that I'm not walking into a full and busy room. Driving or having a taxi booked means that you can leave early if you want to – taxis can always be rescheduled if you find you are having fun. 

Ignore Christmas completely
It's allowed. Buy nice non-Christmas food, stock up on non-Christmas films, binge on box sets. Shut the door on Christmas Eve and ignore the world, and then emerge on Boxing Day. Switching off social media can help you to keep Christmas away too.

Don't give in to pressure from others
Spending Christmas alone, with friends, with strangers, working, volunteering, whatever – if it's what you want to do, then just do it. Don't feel that you have to fit in.

Volunteer
Volunteer if you want to, bit don't do it because you feel you ought to.

Create new memories
Do something totally different. I have amazing memories of the year I went and stayed in a shepherd's hut. I stocked up on goodies, stacked my Kindle full of books, saw a friend for Christmas lunch, but for the rest of the time I looked at the view, pottered around, ate my body weight in chocolate, and slept. You can have a tradition of not having a tradition.

Buy yourself something nice
A big present, a little present – it doesn't matter what it is, but have something special just for you on Christmas Day. You can say it's from you, or from your partner, or from your cat. Whatever you want.

Enjoy it
You are allowed to enjoy whatever it is that you are doing. Don't feel guilty.
​
Make plans
It might be a good idea to have some plans made, otherwise you might just drift and feel worse. But don't plan so much that you feel guilty about not doing it all. Stock up on the food you need, decorate the house and tree if you want to, plan to catch up on some hobbies or some reading, go for a walk, pamper yourself with a long bath. Whatever you really fancy that you don't normally have time to do.