A study of individuals who experienced the death of a loved one due to COVID-19 found that complicated grief following such a loss can lead to adverse mental health outcomes, including depression and anxiety. However, feelings of connectedness to nature were found to mitigate this link, potentially serving as a protective factor. The findings were published in the International Journal of Environmental Research and Public Health.
Complicated grief is a prolonged and intense form of grief that persists for an extended period, interfering with an individual’s ability to function in daily life. It goes beyond typical bereavement, involving persistent yearning or longing for the deceased, difficulty accepting the loss, and feelings of disbelief or emotional numbness. People experiencing complicated grief may feel stuck in their mourning, preoccupied with memories of their loved one, or unable to engage in activities they once enjoyed. This condition can also lead to physical symptoms, social withdrawal, and an increased risk of depression and anxiety.
The 2021-2022 COVID-19 pandemic claimed 2.6 million lives worldwide, leaving a profound impact on their loved ones. In the United States, it is estimated that each COVID-19 death left, on average, nine people bereaved. While most of these individuals experienced general grief—a normal, non-pathological response to bereavement—some went on to develop complicated grief, which adversely affected their mental health over time.
Study authors Madison Schony and Dominik Mischkowski sought to better understand the association between grief—particularly complicated grief—and mental health. They also investigated whether a person’s relationship with nature (e.g., time spent in nature, feelings of connectedness, or residential greenness) could influence the link between grief and mental health.
The study included 153 participants who had lost a close loved one to COVID-19 during the 2021-2022 pandemic. Participants were recruited via mTurk, Research Match, and grief group pages on Facebook and Reddit. Of the participants, 109 were women, and the average age was 42 years.
Participants completed an online survey assessing complicated grief (using the Brief Grief Questionnaire), general grief (using the Bereavement Experience Questionnaire), anxiety (using the Generalized Anxiety Disorder Screener), depression (using the PROMIS Short Form v1.0 Depression 8a), and connectedness to nature (using the Connectedness to Nature Scale). They also estimated the amount of time they spent in nature. The researchers evaluated residential greenness using participants’ postal codes and satellite images of land surfaces.
The results showed that individuals experiencing higher levels of grief reported more severe symptoms of anxiety and depression. These associations were especially pronounced for those with complicated grief. Interestingly, participants with higher levels of grief also reported spending more time in nature.
Further analyses revealed that feelings of connectedness to nature attenuated the link between complicated grief and depression. For individuals with low or moderate levels of connectedness to nature, more severe symptoms of complicated grief were associated with more intense symptoms of depression. However, for individuals with strong feelings of connectedness to nature, the severity of complicated grief did not correlate with depression symptom severity. A similar pattern was observed with anxiety, though the connection between anxiety and complicated grief was weaker, rather than entirely absent, in those with strong feelings of connectedness to nature.
“We thus conclude that a sense of feeling connected to nature—not simply spending more time in nature or being surrounded by nature—may serve an important role in the mental health status of people experiencing complicated grief, perhaps because CN [connectedness with nature] replenishes general belonging when someone significant has passed away,” the study authors concluded.
The study sheds light on the relationship between nature experiences and grief. However, it should be noted that the study was conducted on a small online sample during a rare historical event – a worldwide pandemic and in the context of the way societies reacted to it. Results might not be the same in other historical periods or on samples more representative of the general population.
The paper, “Feeling Connected to Nature Attenuates the Association between Complicated Grief and Mental Health,” was authored by Madison Schony and Dominik Mischkowski.
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