A Guide to Heartbreak
Introduction
Heartbreak. The crushing weight in your chest. The racing thoughts. The inability to sleep, breathe, think. Heartbreak isn’t just in your head; it’s in your whole body. From racing pulses to hollow stomachs, heartbreak reveals the deep connection between emotional pain and physical health, triggering a surge of stress hormones, rewiring brain chemistry and even mimicking the symptoms of a heart attack. But what exactly happens inside us when our hearts 'break'? Stress hormones surge, neurotransmitter systems falter and the brain’s reward circuitry collapses, leaving us drained and disoriented. By understanding this, we can appreciate how heartbreak is not just 'in our heads' but woven into the very fabric of our being.
A broken heart
When people talk about a 'broken heart', they might not be completely exaggerating: Takotsubo cardiomyopathy, known as 'broken heart syndrome', is a perfect example of how heartbreak is more than just a metaphorical phenomenon. It’s a condition in which intense emotional stress weakens the heart muscle, mimicking the symptoms of a heart attack. The condition gets its name from the Japanese word 'takotsubo' meaning 'octopus pot' due to the shape the heart takes on during the episode, resembling the traditional Japanese fishing pot. This syndrome was first described in 1990 in Japan when researchers noticed a pattern of sudden and severe heart dysfunction with symptoms similar to that of a heart attack in patients following extreme emotional distress, such as the loss of a loved one, a breakup or even a shocking experience; however, unlike a heart attack, there was no evidence of blocked artery and the damage usually being temporary with recovery in a matter of weeks. The culprit behind such a phenomenon is thought to be driven by a surge of stress hormone, temporarily causing the heart muscle to weaken, in particular, the left ventricle can often balloon out, reducing its ability to pump blood effectively. Chemically, stress hormones like adrenaline and cortisol can cause the heart to beat excessively faster and harder, triggering reactions such as the constriction of blood vessels, affecting the heart’s blood supply and altering the function of heart muscle cells.
The Stress Response
Heartbreak can trigger a cascade of biological responses, primarily through the activation of the hypothalamic-pituitary-adrenal (HPA) axis. The HPA axis is the body’s central stress response system that coordinates the release of hormones, like cortisol, in times of emotional or physical stress. In distressing times, such as losing a loved one or a horrible breakup, the brain signals the hypothalamus, stimulating the pituitary gland which releases the adrenocorticotropic hormone (ACTH). The ACTH travels to the adrenal glands signalling them to produce cortisol, the primary stress hormone.
Cortisol plays a critical role in the body’s response to stress by helping mobilise energy reserves, making you more alert and modulating certain bodily functions; however, when cortisol levels remain too high for prolonged periods, it can lead to an array of symptoms having an effect on overall health, a significant one being its role in inflammation. While inflammation on a short-term basis is necessary for healing, chromic stress and sustained high cortisol levels can contribute to systemic inflammation linked to conditions such as cardiovascular disease, arthritis and gastrointestinal issues. Additionally, cortisol suppresses the immune system, making the body more vulnerable to infection, because it inhibits the production and function of certain immune cells. Furthermore, elevated cortisol levels can disrupt the sleep cycle, leading to insomnia or poor quality of sleep as well as a major loss of appetite, which is particularly concerning as it can perpetuate a cycle of stress, weakening the body’s ability to repair itself and recover.
When heartbreak strikes, the emotional turmoil can keep you awake at night, constantly replaying your painful thoughts. This isn’t just a mental struggle as the chronic stress keeps the HPA axis activated so the cortisol production is sustained. Over time, if left unmanaged, the risk of long-term health issues such as metabolic disorders, cardiovascular disease and mental health conditions – such as anxiety or depression – can increase. So, when you lie awake thinking about the pain, it’s not just an emotional response; it’s your body reacting to the relentless stress of heartbreak.
Fight-or-Flight
A bad break up can also send you into survival mode, activating the body’s fight or flight response preparing the body for immediate action. The emotional distress surrounding the heartbreak is processed by the brain which, similar to the HPA axis, signals the hypothalamus to initiate the the release of adrenocorticotropic hormone (ACTH). This hormone stimulates the release of adrenaline from the adrenal glands into the bloodstream which bind to various receptors throughout the body, triggering an array of physiological responses. One of the main effects is an increase in heart rate as the body starts to divert more blood to vital organs and muscles. This heightened circulation supports the body’s ability to respond to perceived danger, or in this case, leading to a racing heartbeat and intense palpitations as well as activating the sweat glands in an attempt to regulate the body temperature under such stress. Adrenaline also boosts mental alertness by increasing the activity of neurotransmitters, such as norepinephrine, in the brain, enhancing focus and attention. This increased sensitivity and heightened emotions make the distress feel even more intense, which is why it can sometimes feel like your heart is throwing a tantrum while your body is simply trying to keep up with the chaos.
If this stress response is prolonged – which, for those who have experienced heartbreak in the past, you know it usually is – it can mean your body is kept in a constant state of arousal due to the chronic exposure to high levels of adrenaline. A disruption in the normal balance of the autonomic nervous system like this can greatly increase the risk of panic attacks, characterised by a surge of fear, rapid heartbeat, shallow breathing and dizziness – symptoms that mimic a physical threat despite the absence of one. The constant biochemical cycle of stress hormones and heightened arousal makes it harder for the body to return to a state of calm, intensifying the emotional and physical toll of heartbreak. So, the next time you tell someone to just “calm down”, you might want to think twice.
Withdrawals
When a relationship ends, your brain goes through a major chemical shift, going though a withdrawal, strikingly similar to that of an addictive substance; however, instead of craving caffeine or sugar, it’s missing something much deeper: dopamine. During a relationship, dopamine, the brain’s 'feel-good' neurotransmitter, is constantly being flooded around your body, reinforcing the motional highs of love and connection, the same neurotransmitter responsible for rewarding experiences, providing those euphoric feelings of pleasure. So, when the relationship ends, the sudden drop in dopamine levels leaves you craving that emotional 'high' once more, triggering withdrawal-like symptoms. This drop may leave a person feeling emotionally numb, anxious or even obsessed about the lost, trying to regain the pleasure and satisfaction they once felt. The problem is that your brain’s chemical makeup of its reward system has been altered: activities that used to bring joy may feel boring and uninteresting as the brain struggles to experience that same rewarding feeling. Such a disruption in the brain’s dopaminergic pathways makes it difficult for a person to find happiness in other aspects of life, leaving you feeling stuck in a cycle of emotional distraught, reinforcing the pain or heartbreak and unable to fully just 'snap out of it'.
But it doesn’t stop there. As if the drop in dopamine levels wasn’t enough, serotonin -another key neurotransmitter crucial for regulating mood – also takes a dive. Low levels of serotonin make it harder to feel emotionally stable, leading to feelings of sadness, irritability and even the loss of interest for daily activities – essentially everything leading up to 'bed-rotting'. This drop in serotonin levels mimic symptoms of depression, inevitably providing a sense of hopelessness, and with dopamine and serotonin working against you, its no wonder heartbreak can be so hard to overcome. Together, they ensure the brain’s reward system is completely disrupted. Heartbreak isn’t just about missing someone – it’s about your brain scrambling to adjust and rebalance its chemistry and balance out the neurotransmitters. This is why getting over a breakup can feel like recovering from an intense, emotional hangover. Until then, it’s just a matter of riding out the emotional rollercoaster and waiting for the chemical storm up there to pass.
A Physical Toll
It’s not just nostalgia that’s keeping you awake at night after a heartbreak, which brings us back to our stress hormones – adrenaline and cortisol. Normally, cortisol follows a circadian rhythm: it rises in the morning to help wake you up and drops at night to prepare your body for sleep. However, during times of emotional distress, cortisol levels stay high, especially at night when all the thoughts come rushing back. Adding to the insomnia is the adrenaline which brings a lot to the table, keeping you awake and alert, as well as a rapid heartbeat, increased blood pressure and heightened anxiety – all of which aren’t making sleep come any easier. Your body is in a constant state of hyperarousal, so instead of relaxing, you’re tossing and turning, replaying everything in your mind, wide awake and unable to hit the 'off' switch.
Now onto appetite – or lack of it. When cortisol, once again, is chronically elevated, it can either suppress appetite or trigger cravings. For some, increased levels of cortisol lead to craving high-calorie foods as the body looks for quick energy in the form of sugar and fat. This is due to the fact that cortisol signals the release of glucose of glucose for immediate energy, so those sugary foods can temporarily boost serotonin and dopamine levels providing that short-lived relief; however, this unhealthy cycle of overeating can lead to bad habits and intense feelings of guilt. On the flip-side, intense stress can suppress appetite altogether due to the 'fight-or-flight' response, prioritising survival over digestion. Here, the gastrointestinal functions are suppressed leading to nausea, loss of appetite and digestive issues as the body’s focus shifts from eating to dealing with the emotional stress. So, whether you’re stuck in an endless loop of cravings or staring at the ceiling hungry for sleep, it’s not just your emotions at work – it’s the hormones throwing a tantrum behind the scenes.
The Healing Process
After a heartbreak, your body isn’t just left to drown in emotional chaos, it starts to bring everything back into balance, known as returning to homeostasis. This recovery involves a gradual recalibration of the chemical imbalances that had been thrown off kilter, such as the stress hormones and neurotransmitters, ultimately helping you regain emotional stability. Central to such a recovery are endorphins, our body’s natural analgesics, or painkillers. These are peptide neurotransmitters which bind to opioid receptors in the brain and reduce the perception of pain, thus promoting a sense of well being. The release of endorphins can be stimulated by physical activity, so the doctors weren’t lying to you when they said that exercise was an effective tool for emotional recovery. While they ease the emotional pain, endorphins can also help regulate the stress response, making it easier to recover from the physiological toll of heartbreak and maintaining a more stable emotional state.
Alongside endorphins, there is oxytocin, the 'love' hormone. Oxytocin helps rebuild connections after a breakup or emotional loss, whether through physical touch, social bonding or even new relationships. It helps you feel more connected and less isolated, so when they say "a mother’s touch is healing”, it is true literally. This plays a large role in counteracting the negative effects of stress by aiding in relaxation and emotional security, much like cortisol. All in all, your body has its own way of picking up the pieces of a broken heart and putting it back together, it just needs a little time, some self care, and maybe a few hugs along the way to help with the healing.
Conclusion
Heartbreak may feel like chaos, emotionally and physically, but it also proves how deeply wired we as humans are to connect, love and feel. While our biology explains the sleepless nights and empty feelings, it also reveals our amazing ability to heal. Our mind and body are built for resilience, even when it feels like the pieces broken are beyond fixing.
So let this be your takeaway: heartbreak isn’t a weakness, it’s our body doing its best to protect us and adapt. It’s messy, raw and painfully human; but like all storms, it passes. And once passed, you will finder yourself stronger and ready to embrace the next love and it provides us with a reminder that we are capable of intense feeling and love – even if we are still learning how to navigate the chaos it leaves behind.