When grief becomes a way of living
The loss is real. So is the life still available to us.
PERSPECTIVE
There are losses we know we are grieving. A person dies. A relationship ends. A future we had counted on disappears.
Then there are losses that are harder to name: the childhood we did not have, the health we expected to keep, the years spent surviving instead of living, the apology that never came, or the version of ourselves we thought we would become.
Life continues after these losses. We work, care for people, answer messages and make plans. From the outside, we may appear to be getting on with it. Yet part of our attention remains fixed on what happened, what should have happened, or what we still wish could be different.
The loss is real. So is the life still available to us. Grief can make it difficult to inhabit that life fully.
A woman I coached came to me after the death of her husband. She had been through a great deal and felt stuck, inhibited in her capacity to live freely. She wondered whether taking care of her health might be a place to begin. She asked me to coach her, and we took on the fundamentals of restoring her health and vitality.
A matter of weeks later, I asked her how she was doing.
“Dean, I’m not grieving anymore,” she said.
I do not take that to mean she had forgotten her husband, or that a few weeks of health coaching can resolve everyone’s grief. Those were her words, describing a profound change in her own experience. Over time, I watched her give herself more fully to the life in front of her. She travelled and went on adventures. She pursued new career paths and began positioning herself as a global leader in her field. She started dating. Eventually, she told me she was in a new relationship and excited to experience the roller coaster ride of it.
It was extraordinary to watch her come alive again.
Her experience also had me look at my own grief. I have lost my dad, my brother, my best friend, business colleagues and my mum. I have grieved futures too: the ones I thought I would have, the ones I felt I should have had, and the ones I imagine might have been possible if circumstances had been different, if other people had behaved differently, or if I had done better myself.
That last kind of grief can be especially difficult to recognise. We may call it regret, disappointment or self-criticism. We may keep trying to solve a past that cannot be changed.
Grief is not a weakness or a failure of perspective. It is a human response to losing someone or something that matters. It moves differently for different people, and no one owes the world a deadline for feeling it.
But sometimes grief remains so consuming that it narrows a person’s world. Sleep becomes unreliable. Concentration takes effort. The body feels tired or on alert. Invitations are declined. Activities that once brought pleasure feel strangely remote. A person can still love life and struggle to feel connected to it.
This has consequences for health. Bereavement research describes changes in sleep, stress physiology, inflammation and health behaviours, alongside associations with cardiovascular illness.¹⁻⁴ These findings do not mean grief inevitably causes disease, or that every physical symptom has its origins in an unresolved loss. They do mean that grief deserves to be taken seriously as part of a person’s health.
A colleague recently shared a conversation he recalled having with someone he described as a former head of neurology at UCLA. They were discussing cognitive longevity. As my colleague remembers it, the neurologist named vascular health and “unrequited grief” as two things he had come to regard as important in dementia.
I cannot verify the wording, and I would not present that observation as an established account of dementia. But the phrase unrequited grief stayed with me: grief that has had no place to be expressed, understood or integrated. What might that do to the way a person lives?
Dementia has many contributors. The evidence for vascular and other modifiable risks is substantial;⁵ the evidence that prolonged grief itself causes dementia is not. A prospective study has reported an association between prolonged grief and cognitive decline,⁶ but an association cannot establish that grief was the cause. The observation does, however, ask us to consider the brain within the whole life of the person living in it. How are they sleeping? Are they connected to others? Are they moving, eating and caring for themselves? What occupies their attention? What have they lost, and have they had the support to face it?
Anyone who has grieved may recognise the immediate cognitive cost: reading the same paragraph three times, forgetting why they entered a room, or finding a simple decision unexpectedly exhausting.
We need not claim that grief causes dementia to understand that it can affect our capacity to think clearly and participate fully today. What concerns me most is the quiet contraction of a life.
When we cannot bear to feel a loss, we may organise our days around avoiding it. We stay busy. We withdraw. We keep rehearsing an old conversation. We postpone joy until we feel entitled to it again. We tell ourselves that moving forward would mean leaving someone behind, excusing what happened, or admitting that what we hoped for will never be.
It is possible to live this way for years without realising how much of life has become conditional.
The loss can be exactly the way it is, and exactly the way it is not.
So what would it mean to bring grief to completion?
I do not mean forgetting. I do not mean deciding the loss was acceptable, finding a lesson in it, or reaching a point where it never hurts. Some losses remain painful because they mattered profoundly.
I mean becoming able to tell the truth about what happened:
This is what I lost.
This is what I wanted.
This is what I did not receive.
This is what cannot now be changed.
The loss can be exactly the way it is, and exactly the way it is not. We can stop negotiating with reality about whether it should have happened. We can honour what mattered without requiring our lives to remain organised around its absence.
And then we can recognise another truth: My life is happening here, today.
For some people, that movement begins in conversation with someone they trust. For others, it means giving words to anger, regret or longing they have never felt free to express. It may mean seeking professional help. It may also begin with the basics of caring for a body that has been carrying a great deal: eating well, sleeping, moving, rebuilding strength and reconnecting with people.
There is no single pathway and no guaranteed timeline. When grief is persistent, intense and seriously disrupts daily life, grief-focused therapy has evidence behind it. A randomised trial found that people receiving grief-focused cognitive behavioural therapy had greater reductions in prolonged grief symptoms at six months than those receiving mindfulness-based cognitive therapy.⁷ Both groups improved.
My work through Simplr Health is to provide more than information about biology or coaching support. I want to provide a space in which people can transform their relationship with their health and with their lives. A space where they can be supported, tell the truth about where they are, take meaningful action and discover what becomes possible as their vitality returns.
For one woman, taking on her health was part of finding her way back to herself. I cannot separate precisely which changes made the difference, and I would never promise another person the same experience. But I can honour what she told me and what I saw: she was no longer living as though her life had ended with the life she lost.
There is no promise here of permanent happiness, a life without pain, or immunity from illness. The science cannot make those promises, and neither can I.
What I will stand for is the possibility of freedom: the freedom to remember without being trapped in the moment of loss; to feel sadness without making it the whole of who you are; to love what was, accept what is, and participate again in what may yet be.
The person you miss may always matter. The future you wanted may always matter. Your grief may still visit you.
And there can also be room for laughter, satisfaction, intimacy, curiosity and joy.
Room to use your mind, care for your body, connect with others and be moved by the extraordinary fact that you are alive.
You do not have to resolve every feeling before you begin. You can begin by telling the truth, letting someone hear it, and taking one step towards the life that is still yours to live.
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Because you and your life matter.
Dean Kilby
Founder and Interim CEO, Simplr Health
REFERENCES
Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. The Lancet. 2007;370(9603):1960–1973.
Fagundes CP, Wu EL. Matters of the heart: grief, morbidity, and mortality. Current Directions in Psychological Science. 2020;29(3):235–241.
Fagundes CP, Brown RL, Chen MA, et al. Grief, depressive symptoms, and inflammation in the spousally bereaved. Psychoneuroendocrinology. 2019;100:190–197.
Mostofsky E, Maclure M, Sherwood JB, et al. Risk of acute myocardial infarction after the death of a significant person in one’s life: the Determinants of Myocardial Infarction Onset Study. Circulation. 2012;125(3):491–496.
Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet. 2024;404(10452):572–628.
Saavedra Pérez HC, Ikram MA, Direk N, Tiemeier H. Prolonged grief and cognitive decline: a prospective population-based study in middle-aged and older persons. American Journal of Geriatric Psychiatry. 2018;26(4):451–460.
Bryant RA, Azevedo S, Yadav S, et al. Cognitive behavior therapy vs mindfulness in treatment of prolonged grief disorder: a randomized clinical trial. JAMA Psychiatry. 2024;81(7):646–654.
The conversation about cognitive longevity is recounted as a colleague recalled it and has not been independently verified.
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