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Broken heart (also known as a heartbreak or heartache) is a metaphor for the intense emotional stress or pain one feels at experiencing great and deep longing. The concept is cross-cultural, often cited with reference to unreciprocated or lost love.[1]

Failed romantic love can be extremely painful; sufferers of a broken heart may succumb to depression, anxiety and, in more extreme cases, post-traumatic stress disorder.[2][3]
Contents
1 Physiology
2 Psychology
2.1 Uncomplicated grief
2.2 Depression
2.3 Psychological trauma
2.4 Post-traumatic stress disorder
3 Medical complications
3.1 Broken heart syndrome
3.2 Endocrine and immune dysfunction
4 Cultural references
5 See also
6 References
7 Sources
7.1 Printed
7.2 Online
8 External links
The intense pain of a broken heart is believed to be part of the survival instinct. The “social-attachment system” uses the “pain system” to encourage humans to maintain their close social relationships by causing pain when those relationships are lost.[1] Psychologists Geoff MacDonald of the University of Queensland and Mark Leary of Wake Forest University proposed in 2005 the evolution of common mechanisms for both physical and emotional pain responses and argue that such expressions are “more than just a metaphor”.[4][5] The concept is believed to be universal, with many cultures using the same words to describe both physical pain and the feelings associated with relationship loss.[4][5]

The neurological process involved in the perception of heartache is not known, but is thought to involve the anterior cingulate cortex of the brain, which during stress may overstimulate the vagus nerve causing pain, nausea or muscle tightness in the chest.[6] Research by Naomi
Eisenberger and Matthew Lieberman of the University of California from 2008 showed that rejection is associated with activation of the dorsal anterior cingulate cortex and right-ventral pre-frontal cortex, areas established as being involved in processing of pain, including empathizing with pain experienced by others.[6] The same researchers mention effect of social stressors on the heart, and personality on perception of pain.
A 2011 study showed that the same regions of the brain that become active in response to painful sensory experiences are activated during intense social rejection or social loss in general.[5][8] Social psychologist Ethan Kross from University of Michigan, who was heavily involved in the study, said, “These results give new meaning to the idea that social rejection hurts”.[5] The research implicates the secondary somatosensory cortex and the dorsal posterior insula.[5]

Psychology
Uncomplicated grief
For most bereaved individuals, the journey through grief will ultimately culminate in an acceptable level of adjustment to a life without their loved one.[9] The Kübler-Ross model postulates that there are five stages of grief after the loss of a loved-one: denial, anger, bargaining, depression and acceptance.[1][10] And while it is recognized that mourners go through initial period of numbness leading to depression and finally to reorganization and recovery, most modern grief specialists recognize the variations and fluidity of grief experiences differ considerably in intensity and length among cultural groups, individually from person to person[9] as well as depending on the amount of investment put into the relationship.[11]

Ruminating, or having intrusive thoughts that are continuous, uncontrollable, and distressing,[12] is often a component of grieving. John Bowlby’s concept of searching for the lost object is about the anxiety and mounting frustration as the mourner remains lost, frequently sifting through memories of the departed, and perhaps fleeting perceptions of spectral visitations by the lost individual. When the loss involves ‘being left’ or ‘unrequited love’,[13] in addition to the above, this mental searching is accompanied by obsessbreakup, and possibilities for reuniting with the lost individual.[14] When rejection is involved, shame may also be involved – the painful feeling of being inherently unacceptable, disposable, unworthy.[15]

The physical signs of grieving include:[16]

Exhaustion, muscle tightness or weakness, body pains, fidgety restlessness, lack of energy
Insomnia, sleeping too much, disturbing dreams
Loss of appetite, overeating, nausea, “hollow stomach”, indigestion, intestinal disorders like diarrhea, excessive weight gain or loss
Headaches, short of breath, chest pressure, tightness or heaviness in the throat
Depression
A broken heart is a major stressor and has been found to precipitate episodes of major depression. In one study (death of a spouse), 24% of mourners were depressed at two months, 23% at seven months, 16% at 13 months and 14% at 25 months.[2]

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