top of page
  • Natasha J. Thomas, MD

I Wanted to Love You: Surviving and Thriving through Break-up Heartache

Over my years in practice, I've seen people try to cope with the bewilderment, lost self-esteem and humiliation a relationship break-up can cause. Most of us know that when relationships come to an end, sleeplessness, inability to eat or concentrate, and crying spells may occur. However, for some, the early days of heartbreak can roll into full-on depressive episodes, complete with hopelessness, despair, guilt and suicidal thinking - or attempts.

Today's blog post is for all those going through the emotional turmoil of a heartbreak. Though it may not feel like it right now, it is entirely possible to mend your heart, reconstruct your confidence, and glean wisdom from the experience.


Why Does it Hurt So Much?!

Emotions, time and money are just a few of the investments that contribute to the pain we feel after a relationship loss. People often wonder if they have the ability to pick the right partner - to find someone that will be compatible and loyal in the future. Not surprisingly, young women's break-up pain tends to be compounded by worries that it will take too long to find a mate with whom they can have children and a stable home.

Social rejection can be exquisitely painful to those who invested in a significant relationship, only to see it fail. A 2011 study by Dr. Edward Smith of Columbia University demonstrated that the rejection we feel from a break-up actually "hurts." In his study, people were asked to look at a picture of their ex while thinking about their relationship and its end. Then, they were subjected to physical pain (heat to the arm). Smith found that the parts of the brain that are activated when we experience physical pain were also activated when subjects thought of, or looked at photos of, their ex.

* In the diagram of the brain above, the carved out section reveals a structure called the insula. This is where scientists have found that a break-up registers like physical pain.

Dr. Lucy Brown, a neuroscientist at Einstein College of Medicine in New York, along with researchers Helen Fisher and Art Aron, pioneered studies of the neuroscience of romantic love. They have conducted fascinating research on how and why we fall in love - and what happens when it's over. Together, they have found that feelings of love are actually picked up by the brain's reward system and are therefore "addictive." Not surprisingly then, the brain activity in those that are coping with a break-up has a similar pattern to those withdrawing from nicotine and narcotics, complete with strong, strong cravings. We are hard-wired to love because of the evolutionary benefit of relationship. Relationships generate offspring. They protects us. They insure our survival. The loss of all these benefits is a shock to the brain (and heart) and can take significant time to heal.

Is it Just Me?

Despite the fact that a hurting heart can make you feel incredibly isolated, I hope you'll find solace in the fact that you're not alone.

Most people, especially in Western society, have gone through what Brown calls the "normal altered state" that occurs when swept up in the euphoria of falling in love. Unfortunately, most of us have gone through heartbreak, too. Whether you were the person "dumped" or the one who initiated the end of your relationship, we all can find ourselves sifting through the gamut of post-break up emotions. Are you guilt-ridden for your behavior in the relationship, do you fear being forgotten, are you riddled with regret, anger or fantasies of revenge? That can be typical (though it's definitely better not to act on feelings of vengeance). How about longing to reconcile, looking to rebound, feeling empty and lonely, or fuming over being used or betrayed? All that can be normal, too.


Broken Heart Syndrome is caused by a surge of stress hormones that are released in response to an emotionally taxing event, including things such as

separation, rejection or betrayal.


It really is true that a broken heart can be detrimental to our health. The American Heart Association describes a phenomenon called Broken Heart Syndrome, or stress-induced cardiomyopathy. Broken Heart Syndrome is caused by a surge of stress hormones that are released in response to emotionally taxing events, including things such as separation, rejection or betrayal. In this syndrome, victims experience symptoms similar to a heart attack, like sudden onset chest pain and shortness of breath. A medical work-up for Broken Heart Syndrome won't show the same lab abnormalities or EKG changes seen in a heart attack, and also will not show blockage of coronary arteries.

However, changes in heart rhythm and muscle weakness can occur - making it difficult for the heart to pump blood to the body effectively. Though recovery can be quick, if not managed properly, this syndrome can be fatal.

So, not only are you far from alone in facing heartbreak, it is so common, painful and potentially dangerous that researchers are making efforts to understand and treat it.

A Slow Burn: A special Word for Men

In my experience, women appear to be the catalyst for men seeking out mental health care. Either a man has been told by a woman he needs to "go talk to someone," or he's coming in because he's lost his woman altogether. I hold a special place in my heart for men who seek out psychiatric care. And that's because our culture doesn't make it easy for a man to reach out for emotional support.

Like many other women duped by cultural conditioning and stereotypes, I used to think men did not feel much pain when losing a significant relationship. However, my work as a psychiatrist has totally eradicated my misconceptions. I have found that my male patients struggle greatly with break-ups. Aside from the usual symptoms of sleeplessness, distractibility and general sadness we all experience at the conclusion of a failed relationship, I see a concerning pattern.

With man after man seeking out my counsel in the throes of heartbreak, I see the true toll rejection takes on them. Many demonstrate significant weight changes, have soaring blood pressure, drink excessively, turn to drugs or participate in self-destructive sexual relationships. When I ask what they're looking forward to in the future, they don't know. When I ask what their last meal consisted of, it's often something pitiful like a random bowl of ramen. When I ask about their general health, they admit they haven't even thought about it. When I ask how they're feeling about themselves, they come up with nothing good. Overall they feel like failures, are lost, bewildered, and some give up on life.

This pattern is very similar in men who have been in relationships as short as one year or decades-long partnerships that are coming to an end. And it doesn't matter if they feel their partner is to blame, was disloyal or even if they realize being with her isn't in their best interest. If they loved her, to lose her is crushing.

For divorced men, research backs my observations. It has been studied that men losing marriages are more prone to chronic disease, immune changes, substance misuse and depression, when compared to married men. And while women also have negative health outcomes post-divorce, the fact that women are socialized to rely more on their support network during a break-up or divorce may be one reason they eventually recover more completely than men do.

In fact, a recent, large study conducted by Binghamton University showed that men, unlike women, may never fully recover from a heartbreak. Why? They don't want to have to compete to replace a woman they felt was a suitable mate, despite her imperfections. What may hurt even more is the gradual realization that their ex-partner may truly be irreplaceable.

For men recovering from a break-up, I strongly suggest you be intentional about the following:

  • Getting regular, strenuous exercise

  • Spending time with friends

  • Learning to cook or using a meal service

  • Visiting your Primary Care Physician at regularly scheduled intervals

  • Trying to maintain good sleep hygiene (no using the TV to put you to sleep)

  • Finding someone you trust to talk to about your feelings

Leveling Up After A Break-Up

Last year, my little one would come home from school singing, "Believer" by Imagine Dragons, telling me all the kids in her class loved that song. When I listened to the lyrics detailing the transformative power of pain, I felt a little happy, and a little sad, that one day they'll come to know how true the words in that song really are. Indeed, pain can break us down, but thankfully it can build us up, too. The pain of a break-up doesn't have to be any different. Relationships, in their successes and failures, are the ultimate mirrors and labs for personal growth. If you've recently (or not so recently) suffered a heartbreak, try these tips. I don't guarantee that they'll immediately make you feel better. For that, you have to focus on self-care and putting yourself around your support network. But once the early stages of healing have taken place, these tips will help you get the most out of lost love.

  • Take inventory - First, be honest. How did you show up in your relationship? Were you being the best you? Were you possessive, petty, selfish? Always respect yourself by speaking the truth. If you didn't do your best, acknowledge that. No, you don't need to punish yourself once you see where you fell short. But learn your lesson and do better the next time around.

  • Learn your patterns - Are there any similarities between this failed relationship and others you've experienced? Did your significant other complain about traits your friends also dislike? Complaints in common may be telling you something. And what about maladaptive and messy habits? Do you pick people with whom success is impossible? Are you always the "side chick"? The savior? Are you regularly involved in chaotic relationships? Do your partners seem to ignore your feelings? If you've never had a romantic relationship to compare this one to, sometimes comparing our relationships to relationships with our parents show some common themes. Patterns are telling. Take note.

  • Dig deep - Remember, your life did not begin when you fell in love. Spend time reflecting on your strengths, and how they can propel you through the pain. One foot in front of the other, one step at a time - that's all it takes to reach any destination. No matter what, keep your head up. A relationship doesn't define you. Losing one does nothing to take away from your inherent worth or your life's purpose.

  • Accept what's real - Though fantasies of reconciliation, revenge or otherwise may fill your head, they're not going to be helpful. Accept that the relationship has ended. If you find yourself daydreaming about alternate endings for your relationship, find a healthy distraction or a friend to talk to. It may come as a shock down the road to realize this, but people aren't replaceable. If your heart still holds a space where your ex used to live, that's ok. It doesn't mean you need to pursue them or reunite. It just means they were special to you and were instrumental to a certain phase of your life.

  • Make amends - If you know that you wronged your ex, you may consider apologizing to them. To make amends for wrongdoing frees you to move forward with a clear conscience. And as powerful as that is, it's even more important to make amends with yourself. Forgive yourself for whatever you think you did wrong in your relationship, whether that was being neglectful or being too accommodating and not being true to yourself.

  • Flip the script - Dr. Brown, whose research we discussed earlier, suggests changing "people, places and things," when coping with a break-up. Her advice is based on the same wisdom helpful to those in substance abuse treatment. Consider changing something in your life, whether that be location or scenery, or even if it translates to picking up a new interest or hobby (note: I didn't say rebound relationship). Good change is good.

  • Don't count yourself out - Even though one relationship doesn't replace another, one failed relationship doesn't doom your future love prospects. Take the time to properly heal. You may be surprised to find at the end of that process, you're ready, willing and worthy of another great love.


If you're going through a break-up and can't see your way through it, please seek the help of a mental health provider in your area. Please contact your insurance company for a list of therapists.

You can also search Psychology Today for a counselor in your area. To visit their website, click here.


"Heartbreak Looks a Lot Like Drug Withdrawal in the Brain" by Drake Baer

The Anatomy of Love: Know Thy Brain, Know Thyself, Know Thy Partner - Website

Sobotta's Textbook and Atlas of Human Anatomy

"Is Broken Heart Syndrome Real?" by the American Heart Association

"Study: Women Hurt More By Breakups But Recover More Fully"

*If you or a loved one is going through a mental health crisis, call 1-800-273-TALK or 911, or go to the nearest emergency room. The information in this blog post does not constitute medical advice and should not take the place of an evaluation and treatment by a mental healthcare provider.

43 views0 comments
bottom of page