It could be the death of a dear one, the end of a romantic relationship, a shattered dream or a traumatic loss. The resultant heartbreak can lead to long-lasting shock and other detrimental effects on the mind and the body.
Loss, rejection and heartbreak affect one’s life deeply and adversely. “The language of heartbreak may sometimes sound mundane, but the havoc it inflicts on our brains and bodies is trenchant, profound, and until recently, understudied,” says Florence Williams, author of ‘Heartbreak: A personal and scientific journey’. “I think we often relegate heartbreak to popular songs and teen literature. But it is one of the most serious, grievous and imperilling experiences we face,” she says.
Williams is a US journalist, fellow at the Centre for Humans and Nature and a visiting scholar at George Washington University. Her work focusses on environment, health and science.
She believes that people often dismiss the adverse effects that a heartbreak can have on one’s body and mind.
Brain feels the pain
For her research, Williams had her nervous system monitored while viewing pictures of her former husband. They were married for over two decades and have two children.
“There are acute nervous system changes that lead to sleeplessness, weight loss, restlessness or alternately lethargy, anxiety and immune system damage,” says Williams. “Internally, the brain registers emotional pain much like physical pain, but it can last much longer. We lose some ability to express language, focus and self-regulate. The frontal cortex suffers while the fear-based area of the brain gets more activated during this phase.”
The feeling of love is said to turn on the neurotransmitter dopamine, which stimulates the brain’s pleasure centres. When in love, the brain gets served a generous dose of dopamine, oxytocin and serotonin. Pumping of these neurotransmitters stops almost completely when love is lost. The brain gets into shock and, this, in turn, can impede efficient functioning of other hormones and organs.
Her divorce left Williams an emotional and physical wreck and made her turn to science for answers.
It started with sleeplessness, anxiety and significant weight loss. She also developed heart problems and had a toxic affair with a wrong person and which ended badly.
“I was diagnosed with an auto-immune disease (adult-onset Type 1 Diabetes) after the marriage fell apart,” Williams says. “I wanted to find out what was happening to my brain and body, and how to get better. I found that much had been written about the science of falling in love, but not about the science of falling out the other side.”
Williams started to investigate threat-mediated biomarkers of inflammation and broken heart syndrome. She calls loneliness a greater risk than smoking. “One of the interesting and under-recognised things that happens is that our immune system really listens to our social state,” she says.
“If we feel abandoned in love, our body reacts as if we have been literally abandoned out in the jungle. We become hyper-alert to danger, and our white blood cells respond by pumping out more inflammation factors in preparation for being attacked. Chronic inflammation, however, can lead to a host of serious diseases like cancer, auto-immune diseases, cardiovascular problems and neurological decline.”
Broken heart syndrome & a losing fight
Broken heart syndrome, also known as stress cardiomyopathy or takotsubo cardiomyopathy, is a condition that mimics the symptoms of a heart attack. It is usually caused by sudden physical or emotional stress, mostly after a loss. Interestingly, this affects women more than men.
Kochi-based psychiatrist Dr Elsie Oommen says that there are many factors that trigger a stress cardiomyopathy. “When someone goes through loss, grief or loneliness, the body releases stress hormones into the blood stream like adrenalin, noradrenaline, epinephrine and norepinephrine. This also leads to increased cortisol levels which can temporarily interfere with one’s heart function,” she says. “High levels of cortisol also interfere with the production and regulation of insulin, leading to diabetes.”
In her book, Williams quotes Ohio State researchers on how stress can encourage our DNA to “start expressing diabetes promoter genes” and how people struggling with an emotional crisis after a divorce “produced fewer natural killer cells”, which are important for fighting major diseases.
How the body expresses grief
Mumbai-based clinical counsellor Sharon Lucy Prasad says that the stages of heartbreak are like that of grief, mainly after the loss of a loved one. “The change one experiences physically include loss of appetite or excessive eating, throbbing headaches and fatigue,” she says. “The drop in dopamine and serotonin levels lead to depression and constant low mood, which is opposite to the euphoria one experiences when in love.”
A therapist psycho-educates people during their crisis, that is, provides them ways to cope with mental health conditions and return to leading a normal life.
“We help people to explore the emotions related to the heartbreak in a safe environment,” says Prasad. “I used an approach combining different behavioural and cognitive systems, and customised it to the need of the individual. It starts with helping people to stabilise both mentally and physically, by encouraging them to get back to their routines. We also use this vulnerable phase to inform them of their condition and how they could tackle setbacks.”
Williams lists anxiety, obsession, loss of self-esteem, feelings of rejection and poor self-regulation as part of heartbreak stages. “Among the documented effects of rejection, grief and loneliness are fragmented sleep and fatigue, increased anxiety, poor impulse control, depression, cognitive decline, altered gene expression and early death,” she says.
Stopping the slide
Dr Oommen says it is important to regulate the neurotransmitters and prevent physical damage caused by increase in stress hormones. “Anti-psychotic drugs that alter the level of neurotransmitters are prescribed. One must also be cautious of their side-effects such as increased appetite and weight gain,” she says. Counselling is slow but effective.
Prasad believes that it is important for one to completely heal physically and mentally before getting into another relationship – or `cycle of love’.
Williams stresses that one should understand heartbreak and find ways to get over it sooner rather than later. In her own case, she saw that being single helped her self-discovery. “There is a surprising antidote to heartbreak and loneliness — learning to become more sensitive to beauty and awe.”
The 7 stages of grief
There are seven stages of grief, says Dr Elsie Oommen, psychiatrist, Medical Trust Hospital, Kochi.
Shock: This happens because of the sudden plunge in the levels of the ‘feel-good’ neurotransmitters. For some, it could be mild, like mental numbness, while for others it can mean extreme panic.
Denial: People try to figure out ways to refuse to accept the reality and tell themselves they can still make amends.
Anger: Frequent outbursts mark this phase. Pain, worry and despair reflect as extreme anger, probably involving physical violence.
Bargaining: People reach a point of burnout and try to find a way out of the grief. Some get into compulsive eating, a few others may start excessive workouts, but both can suffer detrimental effects on the body.
Depression: After a lot of internal battle, people give up hope. Extreme sadness, suicidal thoughts and aloofness are some symptoms.
Testing: People try to find practical ways to cope with the loss. This requires a lot of will and often, a therapist to guide.
Acceptance: In this phase of healing, the affected people face the loss, acknowledge and accept the reality and start moving on.