It’s All in Your Head, and That’s OK

February 8, 2016

By Julia Colborn

For much of recorded history, the heart pumped more than blood. The ancient Egyptians believed it would be weighed in the afterlife to determine if you were a good person or not. Philosophers like Aristotle thought the heart governed both emotions and logical reason. Some of the first recorded uses of a “broken heart” metaphor for suffering can be found in the Bible.

We now know that the brain, not the heart, controls our emotions, but almost anyone who has lost a loved one or a lover could agree they felt their heart break.

Although the heart may not be responsible for the pain, it very much can be affected by mental stress. Dr. Pamela Perkins, a psychologist in Wake Forest, likens the experience to a panic attack, for which she sees many of her patients.

She says both have roots in the fight-or-flight response, that is, the body sensing danger and getting ready to either fight the danger or run away from it. The brain will release a multitude of chemicals, such as adrenaline and epinephrine, to amp up the body for physical exertion. The blood flow will be redirected away from the heart and into the feet and hands for either running or defending. The digestive system will also shut down temporarily to conserve that energy and use it somewhere else.

Panic attacks can set in when the body is sensing an immediate danger and preparing for it; however, the danger is not a physical one that can be fought or outrun.

“Imagine a car, on but still in park, and just pressing down on the accelerator. You can hear how hard the engine has to work. Even with unlimited gas, eventually the components of the car will start to break down because that’s just not how the machine is meant to run,” Perkins said.

She knows and has heard stories of people who were having panic attacks but went to emergency rooms thinking they were having heart attacks instead. Tingling sensations in the arms and a tight, heavy chest are common symptoms in both conditions. Similar stresses occur with the often-sudden loss of a loved one as the body responds to the intense emotions and assumes danger.

There is no right nor wrong way to grieve. Your body is going to react in generally the same way regardless. And the stress can last anywhere from a few days to a few years. Perkins fondly remembers a patient of hers, “a little old French lady” who had lost her husband. When Perkins met her, she had been widowed about a year and was still deeply depressed. However, this woman also adamantly refused medication to help her cope. So she took up boxing and would sometimes go multiple rounds a day to get her sadness, and stress hormones, cycled out of her system.

Broken heart syndrome, or stress-induced cardiomyopathy, is indeed a real condition, but sadness isn’t the killer. Multiple factors are at play, namely the condition the heart is in before the sudden shock of loss affects it. said, “We typically associate only unpleasant or undesirable events (such as being laid off or losing a spouse), with stress, but happy or joyous events (such as the arrival of a new child or getting a promotion) can also be quite stressful.”

If the heart is working overtime from high cholesterol and accelerates further from joyous news, it can, in effect, break.

Well-being may be more than just a number on a scale or consistently normal check-ups year after year. Perhaps that’s why they say laughter is the best medicine.