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The Science of Heartbreak: Why It Does Really Hurt

This article is written by a student writer from the Her Campus at St. Andrews chapter.

The anguish of heartbreak is a phenomenon that those who experience it will likely never forget. The loss of love can be a painfully unforgiving ordeal, with one’s thoughts, behaviours and emotions relentlessly dominated by the sometimes unbearable turmoil of rejection, self-doubt, and perhaps a feeling of being entirely lost. Over the centuries, heartbreak has been conceptualised, explored and expressed by countless artists, poets, and storytellers, often seen as the cruel juxtaposition to true love.

But why does heartbreak hurt so badly?

Research now suggests that the experience of heartbreak isn’t merely psychologically distressing, but can have significant physiological consequences. The idea that loss can both figuratively and literally break one’s heart was first supported by the identification of Takostubo Syndrome – a sudden and acute form of heart failure. The condition was first identified in Japan in 1990, with women presented to hospital reporting severe chest pain and shortness of breath, resembling the symptoms of a heart attack. These presentations coincided with a major earthquake that shook Japan, killing many and causing significant adversity. The doctors working in these hospitals posited that the stress of this traumatic event had suddenly weakened and changed the shape of one of the heart’s chambers, affecting its ability to pump blood to the rest of the body. Effectively, these women had developed “broken heart syndrome.”

Helen Fisher, a biological anthropologist, has studied the neuroscience of love, likening the neural activation of love as that of craving cocaine. In her highly successful TED Talk, Fisher describes how her research found that the brains of those who recently experienced a breakup were showing activation in areas associated with addiction. She concluded that those who had been rejected felt the same psychological, and sometimes physiological pain and craving, as those withdrawing from alcohol or drugs. In effect, these people were experiencing the agony of withdrawal from love. A breakup could also lead to reduced levels of the brain’s feel good hormones such as dopamine and oxytocin, which are often released during rewarding and pleasurable experiences. The reduction in these hormones can contribute to withdrawal symptoms such as tremors, heart palpitations, and even depression. Moreover, areas of the brain that respond to addiction can be reactivated by reminders of ex partners, causing people to “relapse”, and feel the overwhelming compulsion to make contact. No wonder we’ve all felt the urge to make a late night call to an ex.

Rapper, singer and writer Dessa also made a TED Talk, describing her venture to map the coordinates of love in the human brain, and even if there is scope for the brain to fall out of love. Encouraged by Helen Fisher’s work, and with the help of the University of Minnesota’s Center for Magnetic Resonance Research, Dessa had MRI scans of her brain performed which revealed activation of specific areas of the brain, such as the ventral tegmental area and caudate nucleus, when shown photos of her ex-boyfriend. These scans were compared to others which were carried out when Dessa looked at photos of similar looking male strangers. Essentially, the neuroscientists had provided an image representing the love for the man she dearly missed. Referring to her heartbreak, Dessa said “yeah, it’s all in my head, but now I know exactly where.” Later in her Ted Talk, Dessa then went on to describe her journey on “neurofeedback” treatment, which involves training the brain to be flexible in its response to different circumstances, such as engaging with long term romantic relationships, but deactivating when no longer in these relationships. In other words, teaching the brain to fall out of love. In Dessa’s case, follow up scans revealed she had been successful in achieving this, a fact that she reflected on with nuanced perspectives.  

So, can this new understanding of the science behind heartbreak help those suffering? Some would argue discovering that the mechanisms underpinning heartbreak and rejection are similar to those of addiction withdrawal is perhaps startling, if not disturbing. After all, likening withdrawal from love to withdrawal from drugs is a little surprising to say the least. However, reframing this newfound science could be seen as helpful for some, providing clarity, validity and justification of the very real pain of their heartbreak and loss. When referring to love, Dessa comments, “it isn’t a neat, symmetrical Valentine’s heart. It’s bodily, it’s systemic”. Still, understanding love, including its compulsive, turbulent, and painful complexities, offers a new and privileged insight into what it is to be human.

Madeleine Caven

St. Andrews '25

Madeleine is a Graduate Medicine student at the University of St Andrews in Scotland. She is passionate about women’s health and rights, feminism, psychology, and healthcare accessibility. In her spare time, Madeleine enjoys music, photography, hiking, fashion, travelling, and looking after her plethora of houseplants.