Clare Finney | Contributor | Tuesday, 31 March 2015

broken heart

Ask An Adult: What Physically Happens When You Have A Broken Heart?

The Debrief: When your heart is in pieces and everything's gone to shit - but what's actually going on in your body?

Yes, you know your heart is not actually breaking. GCSE Biology tells you it’s not actually breaking. The mere fact that you’re alive, and not bleeping in an intensive care ward is a pretty sure sign. So why is it hurting so bad? Sure, your relationship has ended, and it’s the END OF YOUR WORLD, but there’s nothing physically wrong with you – is there?

Well, the bad news is that, according to Dr Susannah Baron, consultant dermatologist at East Kent Hospita; Robin Dunbar, professor of evolutionary psychology at Magdelen College Oxford; Kirstie McEwan, psychotherapist and general member of The College of Sex and Relationship Therapists; and Dr Balvinder Wasan, consultant cardiologist at London Bridge Hospital, the distinction between emotional and physical pain is not as clear-cut as you’d think.

The good news is, it’s temporary. A break up can wreak havoc on your brain and body, but you’ll get over it. Eventually. Anyone whose heartbreak is still a raw, open wound should therefore take – well, take heart. Yes, your cortex is currently experiencing the equivalent of nicotine withdrawal, your heart muscle is under genuine physical stress and your skin is breaking out like Miley Cyrus – but these are not indefinite side effects. They’ll pass, and in the meantime, this non-exhaustive list is a brilliant comeback to anyone who dares tell you ‘its all in your mind.’

It’s not ‘like’ a craving. It is a craving

In 2007, two psychologists scanned the brains of those in love while the subjects looked at a picture of their beloved. To their surprise, they found the area of the cerberal cortex which lit up (aka where blood flow increased) was not so much the emotional zone as the caudate nucleus – the bit associated with motivation and reward.

The feelings of love stimulate a hormone called dopamine, which floods your brain along EXACTLY the same pathways as nicotine and cocaine – and, like them, it makes you feel good. As that drops away, explains Kirstie McEwan, you want more.

‘During heartbreak, your levels of dopamine fall below what you are used to – hence the increase in anxiety and stress,’ she says.

‘It’s likely the dopamine system that gives us that initial kick, and that’s also all about the system of reward,’ adds Professor Dunbar.

Even if cognitively you know that ‘reward’ has long since buggered off, your caudate nucleas is still primed to receive his attentions.

‘The symptoms of withdrawal are like opiate withdrawal symptoms’ says Professor Dunbar – loss of appetite, headaches, insomnia, depression and so on.  A craving for the guy who really hurt you is thus exactly the same as a craving for that cigarette you know will cause you serious harm in the long run.

Love genuinely does hurt

In 2000, the same two psychologists followed up their study on those in love with those who had been recently rejected. In it, the brave rejectees viewed photos of their rejectors while having their brains scanned. The scans showed that the breaking of a relationship triggers activity in the same parts of your brain involved in physical pain.

‘Psychology and physical pain are one and the same thing,’ says Professor Dunbar. ‘Both involve the endorphin system, the brain’s natural painkillers.’

Another recent study compared brain scans on subjects who touched a burning probe with those who looked at pics of an ex-partner. The results supported their theory that rejection and physical pain are both rooted in the same regions of the brain.

One theory goes that, back in our hunter-gatherer days, our social awareness was inherently bound up with our physical survival: we needed to be in with the in-crowd to stand a chance of being alerted to the presence of predators. Neural circuitries of physical and emotional pain may well have evolved to share the same pathways because, when there are sabre tooth tigers around, you need to know someone’s got your back.

Broken heart syndrome is actually a thing 

According to Dr Wasan, ‘broken heart syndrome’ (or stress cardiomyopathy, if you’re being unsensational) is a condition brought about by acute stress in the body. It doesn’t necessarily involve losing the love of your life, but as a risk factor that’s up there.

‘The exact mechanism is not known but it is thought to be caused by high levels of circulating adrenaline,’ says Dr Wasan. ‘The symptoms and signs mimic that of a heart attack.’

In the acute phase, people have even been known to die from the condition – making dying of a broken heart not quite the hyperbole it seemed initially. But, before you totally freak out, please note that ‘the condition often reverses within a few weeks and heart function returns to normal. Your job is to avoid the other risk factors associated with heart disease.’

Stress is dangerous

And not just to all those friends and family you keep snapping at grouchily. ‘There’s a well-documented link with loss to depression and stress,’ Dr Wasan says. ‘Deterioration in mental health is more likely to give rise to less healthy diets, less exercise and reduced motivation to take medications.’

In addition, the stress depresses your immune system and gives rise to inflammation. Add those nights you spend hitting the ‘bottle’ (case) with your ‘friends’ (self) into the mixture, and you’ve a recipe for  headaches, loss of appetite and – in the worst instance – cardiac problems. His solution? Seek help from your GP or a bereavement counsellor if there’s any impact on mental wellbeing – and if you’re on regular medication, keep taking the drugs.

Spots are not just God’s way of shitting on you

‘The skin is the mirror of the emotions,’ says consultant dermatologist Dr Baron – and she isn’t just talking about white knuckles or red faces. Just as your skin is affected by hormones when you’re on your period, so too is it affected by stress hormones. Such treasures can trigger skin problems, exacerbate contributory factors such as smoking, insomnia and picking, and make existing conditions – including eczema and psoriasis – worse.

‘It’s the largest organ in the body,’ Dr Baron points out. ‘It makes sense that it’s affected.’

What’s worse, because your skin is obviously visible, when these conditions emerge we get more stressed, exacabertating them further – it’s a bit of a vicious cycle, she says. But on the plus side, it will probably break once you get over the bastard.

One of the most interesting areas Dr Baron studies is psychoneuroimmunology – the study of the interaction between your psychological processes and your nervous systems. ‘It’s an emerging field, but we’re beginning to understand more about how we think affects us physiologically,’ she says – and that’s got huge implications for both when our heart is breaking and, more importantly, when it starts to mend.

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Artwork: Eugenia Loli

Tags: Relationships