Physical Signs of Grief in Children: When the Body Speaks What Words Cannot
Understanding somatic grief responses and when to be concerned
Every Monday morning for six weeks, eight-year-old Marcus complained of stomach aches. Terrible ones. Debilitating ones. His mum took him to the GP three times. Blood tests. Urine samples. Abdominal scans. Nothing.
"There's nothing physically wrong with him," the doctor said. "Perhaps it's anxiety?"
But Marcus's mum knew it wasn't just anxiety. It started exactly two weeks after Marcus's dad died. And it only happened on school mornings - never at weekends, never in the evenings, never during holidays.
Marcus's body was doing what his eight-year-old mouth couldn't: screaming that leaving his mum felt terrifying. That school felt impossible. That he needed to stay close to what was left of his family.
The stomach aches were real. The pain was genuine. But the cause wasn't medical. It was grief.
This is what somatic grief looks like in children. And it's far more common than most parents and professionals realize.
What is somatic grief?
Somatic means "of the body." Somatic grief is when emotional pain manifests as physical symptoms.
Adults do this too - tension headaches during stress, stomach upset before important events, chest tightness during panic. But children, especially younger ones, experience this more intensely and more frequently.
Why? Because children don't yet have the emotional vocabulary or cognitive development to process complex feelings verbally. When overwhelmed by grief, their bodies become the messenger.
The pain is not imagined. It's not "just in their head." The child genuinely feels ill. The headache hurts. The stomach genuinely aches. The exhaustion is real.
But the root cause is emotional, not medical.
Understanding this distinction is crucial. Because responding to somatic grief with medical tests alone misses the point entirely. The body is asking for emotional support, not medicine.
Learn more: How children grieve differently at each developmental stage
Common physical symptoms of grief in children
Grief can show up anywhere in the body. Here are the most frequent presentations:
Stomach problems
What it looks like:
Stomach aches, especially in the morning
Nausea without vomiting
Loss of appetite or refusing meals
Complaints of feeling sick before school or activities
Actual vomiting triggered by anxiety
Diarrhea or constipation
General digestive upset
Why it happens: The gut and brain are intimately connected (the gut-brain axis). When the nervous system is in distress, digestion is one of the first systems to be affected. Stress hormones slow digestion, create nausea, and cause genuine physical discomfort.
For many children, the stomach becomes the primary site where anxiety and grief are felt.
Headaches
What it looks like:
Frequent headaches with no clear medical cause
Tension headaches (feeling of pressure or tightness)
Headaches that worsen during emotionally difficult moments
Complaints of head pain before school, bedtime, or separations
Headaches that mysteriously resolve during distraction or play
Why it happens: Grief creates muscle tension, particularly in the neck, jaw, and shoulders. This tension radiates upward, causing headaches. Additionally, crying (even internal, suppressed crying) creates pressure in the sinuses and head.
Children who are "holding it together" often develop tension headaches because their bodies are literally holding tension.
Sleep disruption
What it looks like:
Difficulty falling asleep (lying awake for hours)
Frequent night waking
Nightmares or night terrors
Early morning waking
Sleeping more than usual (using sleep as escape)
Refusing to sleep alone or in their own bed
Bedtime becoming a battlefield
Why it happens: Sleep requires a sense of safety. When a child's world has been upended by loss, their nervous system remains on high alert even at night. The brain scans for danger. Separation at bedtime triggers fear (what if something happens while I'm asleep?). Dreams process the trauma, creating nightmares.
Sleep disturbance is one of the most reliable indicators that a child is struggling with grief.
Read: Why bereaved children avoid school and separation
Fatigue and exhaustion
What it looks like:
Constant tiredness despite adequate sleep
Lacking energy for activities they used to enjoy
Falling asleep during the day
Complaining of feeling "heavy" or "tired all the time"
Physical lethargy - moving slowly, lying down frequently
Why it happens: Grief is exhausting. The body is in a constant state of stress response. The mind is working overtime trying to process something incomprehensible. Even when children appear to be functioning normally, their internal systems are running on overdrive.
This isn't laziness. It's nervous system depletion.
Unexplained aches and pains
What it looks like:
Leg aches, arm aches, or generalized body pain
Chest pain or tightness (in older children)
Back pain
Joint pain
Pain that moves around the body
Pain without obvious injury or medical cause
Why it happens: The body holds emotional pain as physical tension. When there's no verbal outlet for grief, it becomes stored in muscles, connective tissue, and joints. This is particularly true for children who are told to "be strong" or who witness adults suppressing their own grief.
The pain is a physical manifestation of emotional holding.
Changes in appetite
What it looks like:
Complete loss of appetite
Eating significantly more than usual (comfort eating)
Food refusal, especially for previously enjoyed foods
Only eating "safe" or bland foods
Complaints that food "doesn't taste right"
Using food for emotional regulation
Why it happens: Stress affects appetite hormones. Some children lose all interest in food when grieving. Others use food as comfort and control. Both are normal grief responses.
Additionally, digestive upset (nausea, stomach pain) naturally reduces appetite.
Regression in physical development
What it looks like:
Bedwetting after being dry for months or years
Accidents during the day
Thumb sucking after having stopped
Wanting a bottle or dummy again
Loss of motor skills (clumsier, less coordinated)
Baby talk or younger mannerisms
Why it happens: When overwhelmed, children sometimes revert to earlier developmental stages where they felt safer. Regression is the nervous system's way of seeking comfort in familiar, simpler patterns.
This is temporary and resolves with patient support.
Understand: Why behaviour changes after bereavement
Immune system changes
What it looks like:
Frequent colds, infections, or minor illnesses
Taking longer to recover from illness
Getting sick more often than usual
Complaints of feeling unwell without specific symptoms
Why it happens: Chronic stress suppresses immune function. Grief keeps the body in prolonged stress response, making children more vulnerable to infections and slower to heal.
If a previously healthy child becomes frequently ill after bereavement, grief may be weakening their immune resilience.
Hypervigilance and physical tension
What it looks like:
Constantly tense muscles (especially shoulders, jaw, fists)
Startling easily at loud noises
Difficulty relaxing physically
Sitting or standing rigidly
Grinding teeth (especially at night)
Nail biting, skin picking, or hair pulling
Why it happens: The nervous system is stuck in threat-detection mode. The body remains braced for danger. Muscles stay contracted, ready to fight or flee, even when there's no immediate threat.
This chronic tension is exhausting and often painful.
How to tell if physical symptoms are grief-related
Not every stomach ache or headache is grief. Children get genuinely ill. So how do you distinguish somatic grief from medical issues?
Patterns that suggest grief
✓ Symptoms started after the bereavement (within days or weeks)
✓ Symptoms worsen during emotionally difficult moments (anniversaries, bedtime, school mornings)
✓ Medical tests come back clear despite persistent complaints
✓ Symptoms improve during distraction or when the child feels safe
✓ Multiple vague symptoms rather than one clear medical issue
✓ Timing correlates with separation or transitions
When to suspect a medical cause
✓ Symptoms existed before the bereavement
✓ Symptoms are getting progressively worse rather than fluctuating
✓ There's a clear medical pattern (fever, vomiting, rash, weight loss)
✓ Symptoms don't change based on emotional context
✓ The child is in genuine distress and nothing soothes them
Important: Always rule out medical causes first. See a doctor. But if tests come back clear and symptoms persist, consider grief as the root cause.
What helps: Responding to somatic grief
1. Validate the physical experience
Never dismiss the pain as "not real" or "just anxiety." To the child, it IS real.
Don't say:
"There's nothing wrong with you."
"Stop making excuses."
"You're fine, you're just worried."
Do say:
"I believe you when you say your tummy hurts."
"Your body is telling us something. Let's figure out what it needs."
"Sometimes when we're sad or worried, our bodies feel it. That doesn't mean the pain isn't real."
Validation reduces shame and opens the door to addressing the emotional root.
2. Connect body sensations to emotions
Help children develop the language to link physical feelings with emotional states.
Try saying:
"I notice your tummy hurts on school mornings. I wonder if your tummy is trying to tell us you're feeling worried or sad?"
"Where in your body do you feel the sadness? Can you point to it?"
"When you think about Daddy, what does your body feel like?"
This teaches interoception - the ability to notice and name internal experiences. It's a skill grieving children desperately need.
Discover: Somatic tools for helping children process grief
3. Use body-based regulation tools
Because the symptoms are physical, physical interventions help.
Grounding techniques:
Deep breathing (belly breathing, square breathing)
Progressive muscle relaxation
Hand on heart, hand on belly
Feet firmly on the floor
Movement:
Gentle stretching
Walking
Dancing
Shaking out the body
Stamping feet
Sensory soothing:
Warm baths
Weighted blankets
Soft textures
Gentle massage (if child is comfortable)
Explore: 20+ somatic techniques for grieving children
4. Address the underlying fear or sadness
Somatic symptoms are messengers. Listen to the message.
If stomach aches happen every school morning, the real issue is likely separation anxiety. Address that.
If headaches appear at bedtime, the issue might be fear of being alone. Address that.
If exhaustion is constant, the child might be emotionally depleted. Address that.
Treating the symptom without addressing the cause won't work long-term.
5. Maintain routine and predictability
Physical symptoms often worsen when children feel unsafe or uncertain.
Consistent routines provide a sense of control and safety, which can reduce somatic stress responses.
Keep mealtimes, bedtimes, and daily rhythms as predictable as possible.
6. Don't punish the symptoms
Children are not choosing to feel ill. Consequences for "faking" pain create shame and make symptoms worse.
If a child genuinely cannot attend school due to physical distress, forcing them will increase panic and entrench avoidance.
Instead, work collaboratively: "I see this is really hard. Let's figure out how to make school feel safer."
Learn: School refusal after bereavement and what helps
7. Teach emotional vocabulary
Give children words for what they're feeling so it doesn't have to live only in their bodies.
Use feelings charts, emotion cards, or simple check-ins:
"How big is your sad today - small, medium, or huge?"
"If your worry was a colour, what colour would it be?"
The more children can name emotions, the less those emotions need to shout through physical symptoms.
When physical symptoms require professional help
Most somatic grief symptoms resolve over time with patient, informed support. But some presentations need specialist intervention.
Seek medical attention if:
Symptoms are severe and worsening
There's unexplained weight loss
The child is in genuine acute distress
Symptoms don't fluctuate at all (constant, unrelenting pain)
There are concerning physical signs (fever, rash, blood, etc.)
Seek mental health support if:
Symptoms persist beyond 6 months with no improvement
The child cannot function (cannot attend school, participate in life)
Physical symptoms are accompanied by self-harm or suicidal thoughts
Parents feel completely overwhelmed
The child shows signs of severe anxiety or depression alongside physical complaints
Read more about when to seek professional support
Age-specific presentations
Toddlers and preschoolers (ages 2-5)
Most common physical symptoms:
Stomach aches
Sleep disruption
Regression (bedwetting, accidents)
Clinginess and separation distress
Changes in eating
What helps:
Physical comfort (cuddles, carrying, closeness)
Simple language connecting body and feelings
Play-based expression
Consistent routines
Learn: How to talk to preschoolers about death
School-age children (ages 6-12)
Most common physical symptoms:
Headaches and stomach aches (especially school mornings)
Fatigue and exhaustion
Sleep problems
Frequent minor illnesses
Unexplained aches and pains
What helps:
Somatic tools and breathwork
Connecting physical sensations to emotions
Creative expression (drawing, writing)
Gradual exposure to feared situations (like school)
Peer support groups
Teenagers (ages 13-18)
Most common physical symptoms:
Chest tightness and breathing difficulties
Headaches and migraines
Digestive issues
Fatigue and low energy
Changes in appetite and sleep
What helps:
Respect for autonomy (don't force talking)
Body-based practices they choose (yoga, running, music)
Psychoeducation about grief and the nervous system
Peer connection
Professional support if symptoms are severe
Understand: How grief shows up differently across ages
Case study: When the body tells the story
Jamie, age 9
Jamie's mum died from cancer. For three months after her death, Jamie seemed fine. No tears. No tantrums. Just quiet.
Then the headaches started. Daily. Severe. His dad took him to specialists. MRI scans. Eye tests. Nothing.
A school counsellor asked: "Jamie, when you get the headaches, what are you thinking about?"
Jamie said: "I'm trying really hard not to cry."
The headaches were the physical result of suppressing enormous grief. His body was holding what his mind wouldn't let out.
Once Jamie was given permission and tools to express his sadness, the headaches decreased. Not overnight. But gradually. Within two months, they were gone.
The pain was real. But the cure wasn't medical. It was emotional.
What parents and professionals need to know
For parents:
Your child's physical complaints are genuine, even if tests come back clear
Grief lives in the body, especially for children who can't verbalize emotions
Medical investigation is important, but so is emotional support
Somatic symptoms usually improve with time, patience, and addressing underlying grief
You're not failing if your child's body is expressing what their words cannot
For teachers and school staff:
Frequent nurse visits may indicate emotional distress, not manipulation
Stomach aches on Monday mornings often signal separation anxiety after loss
Physical complaints shouldn't automatically result in being sent home, but do need compassionate response
Work with parents to create a support plan that addresses both physical comfort and emotional safety
Understand that behaviour and physical symptoms are often grief communication
Learn more about supporting grieving children
For medical professionals:
Always rule out medical causes first
But when tests are clear and symptoms persist, consider grief
Somatic grief is not "faking" - the pain is neurologically real
Referral to grief support or mental health services may be more helpful than further medical testing
Validate the physical experience while exploring emotional causes
The body remembers what the mind cannot say
Children's bodies are incredibly honest. When their mouths can't find the words, when their minds can't process the enormity of loss, their bodies speak.
The stomach ache on Monday morning says: I'm terrified to leave you.
The headache at bedtime says: I'm scared to be alone in the dark.
The exhaustion says: I'm working so hard to hold myself together.
The frequent illnesses say: My system is overwhelmed.
These aren't problems to be solved with medication alone. They're messages to be heard with compassion.
When we listen to what the body is saying - when we validate the pain, address the fear, and create safety - the symptoms begin to ease. Not because we've "cured" anything, but because we've finally heard the message.
And the body, no longer needing to shout, can finally begin to heal.
Frequently Asked Questions
How do I know if my child's stomach ache is grief or a real illness?
Look for patterns. Grief-related stomach aches typically: start after the bereavement, happen at specific times (school mornings, bedtime), improve during distraction or when feeling safe, and have no medical cause despite testing. Medical stomach issues: existed before the loss, are constant regardless of emotional context, worsen over time, and often have other symptoms (fever, vomiting, weight loss). Always see a doctor first to rule out medical causes.
Can grief really cause physical pain in children?
Yes. Grief activates the body's stress response system, releasing cortisol and adrenaline. This affects digestion, creates muscle tension, disrupts sleep, and can manifest as genuine physical pain. The pain is neurologically real - brain scans show that emotional pain and physical pain activate the same regions. Children aren't "making it up" - their bodies are responding to overwhelming emotional distress.
My child seems fine emotionally but has constant headaches. Could this still be grief?
Absolutely. Many children - especially those who've been praised for "being so strong" - suppress emotional expression. The grief doesn't disappear; it goes into the body. Headaches, stomach aches, and fatigue are common in children who appear emotionally fine but are internally struggling. The body holds what the mind won't acknowledge.
How long do physical grief symptoms usually last?
Most somatic grief symptoms improve within 3-6 months with appropriate emotional support. However, some children experience physical symptoms for a year or more, especially if the grief is complicated by trauma or if they lack safe outlets for expression. Symptoms that worsen over time or persist beyond 6 months without any improvement warrant professional support.
Should I keep my child home from school when they complain of feeling ill?
This is complex. If the child is genuinely distressed and forcing them worsens panic, keeping them home occasionally may be necessary. However, chronic absence can entrench avoidance. The best approach: validate the pain, use grounding tools, and work with the school to create a support plan that makes attendance feel safer. A trusted adult at school, permission to visit the nurse, or shortened days can help transition back.
When should I take my child to a doctor vs a therapist?
Always start with a doctor to rule out medical causes. If tests come back clear but symptoms persist, consider grief counselling or coaching. Ideally, work with both: a doctor to monitor physical health, and a mental health professional to address emotional roots. Many children benefit from collaborative care that recognizes the body-mind connection.
Can physical symptoms from grief cause long-term health problems?
Chronic stress in childhood can affect development and health long-term if left unaddressed. However, with appropriate support, most children's physical symptoms resolve without lasting damage. The key is addressing grief early, teaching emotional regulation, and creating safe outlets for expression. Unresolved childhood grief that manifests somatically can contribute to chronic pain conditions in adulthood, which is why early intervention matters.
My child's pain seems to "move around" their body. Is this normal?
Yes. This is very common in somatic grief. Pain that migrates (stomach one day, head the next, legs another day) typically indicates emotional distress rather than a single medical issue. The body is trying different ways to express the same underlying grief. This pattern strongly suggests the need for emotional support rather than medical intervention.
Are some children more likely to experience physical grief symptoms than others?
Yes. Children who: are naturally anxious or sensitive, have limited emotional vocabulary, have been told to "be strong," are younger (under 10), have witnessed adults suppressing grief, or have experienced trauma are more likely to express grief somatically. Additionally, children with alexithymia (difficulty identifying emotions) often experience grief primarily through physical sensations.
What if I've been dismissing my child's complaints and now realize it's grief?
Don't feel guilty - you didn't know. Start now. Apologize if needed: "I'm sorry I didn't understand before. I see now that your body has been trying to tell us how hard this is." Begin validating their physical experience and connecting it to emotions. Children are remarkably forgiving when adults acknowledge and adjust. It's never too late to start responding with compassion.
Professional Training and Support
If you're a teacher, care worker, school nurse, or wellbeing professional supporting bereaved children, understanding somatic grief is essential.
Our Child Grief Coach Training includes comprehensive teaching on:
The neurobiology of somatic grief responses
How to recognize body-based grief presentations
Practical tools for helping children regulate their nervous systems
Scripts for talking with children about body sensations and emotions
Working with schools and medical professionals when physical symptoms appear
A complete 6-week programme for supporting bereaved children
This accredited training equips you with the knowledge and practical skills to support children whose bodies are speaking what their words cannot.
Learn more about Child Grief Coach Training →
Additional Resources
Read next:
Somatic tools for helping children process grief - 20+ practical body-based techniques
How children grieve at different ages - Developmental patterns from toddlers to teens
School refusal after bereavement - When separation creates physical distress
Why angry children are often grieving - Behaviour as communication
More resources for supporting grieving children - Complete resource hub
Explore our services:
STILL Early programme for ages 4-7 - Emotional regulation for young children
Anxiety support for children - Grief and anxiety are closely connected
Part of our Childhood Bereavement Resource Library
Explore more evidence-based guides for supporting grieving children:
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Also training to support adults? Life After Loss adult grief training →
