Hi I’m Wendy Zukerman, your listening to Science Vs from Gimlet. On today’s mini episode - we’re pitting facts against feeling crushed... As we tackle heartbreak…. It turns out that science can help us with one of our most universal experiences: getting dumped.
Let's start with a tale of heartbreak from right here at Science Vs..it happened to our producer, Rose Rimler
I was completely devastated…
Rose’s big heartbreak happened when she was in college. She’d had a huge crush on this guy for a while, and he was a little unsure about it… but then one night it all came together…
RR: I remember there was like a meteor shower, I know we were sitting next to each other on lawn chairs, looking up at meteors, and then just up all night talking and kissing and stuff. And I was like omg it’s happening!?
They dated for about a year, movie nights… chatting for hours on AOL Instant messenger, hey it was the 2000s… it was all going great… Until one day when it wasn't.
RR One night he said, I’m going to come up and we need to talk or something. I knew what that meant but I was very nervous--- thinking maybe that’s not what he meant.
But it was what he meant. He said it’s over. And this happened just a few days after Valentine’s day…
RR So I had this balloon that said Happy Valentine’s Day, like hearts on it… it was a helium balloon. The day he broke up with me it was still in my apartment like floating, and then over the next few days I just watched it gradually lose and lose helium and become like shriveled and like fall to the floor - and I was like this is the perfect metaphor for my heart
Rose was devastated…. She was sad… of course… but it wasn’t just that. She felt awful throughout her body…
RR Yeah I remember feeling kind of listless, like sick. And I was in bed a lot…. Right afterwards whatever I was doing I was only half there… most of my mind was going over it and over it… indefinitely
Rose couldn’t study… couldn’t sleep. And she felt like she was going crazy. And many of us have heard heartbreak stories like Rose’s - friends who said they felt so bad they couldn’t go to work… or maybe they got a cold they just couldn’t get rid of. And lots of us have might thought -- c’mon, it can’t be that bad. But science is just starting to learn what happens to us during a heartbreak… and it turns out that it can be that bad..
Today on the show-- the new research on heartbreak. And what can science teach us about how to get over our exes.
When it comes to heartbreak there’s lots of…
I was just like completely devastated
But then there’s science… !
Today we’re finding out what science can tell us about heartbreak… And we want to start with what is happening in our brain? So for this we need…
LB My name is Dr Lucy Brown - I’m a neuroscientist!
Lucy is a professor at Albert Einstein College of Medicine And she said that when her colleagues found out she wanted to study heartbreak… there were a lot of haters.
LB Neuroscientists said o know it’s too messy, too much emotion, you can't study it scientifically, it seems magical ... We said, ehh we think maybe we can.
And so Lucy and a few colleagues took a crack at it. Their idea was that if you put heartbroken people into an MRI maybe you could see heartbreak in their brains. Like their brains would light up in a unique way. First step. The heartbreak squad needed a bunch of people who were heart broken. Being at universities… they put out flyers all over campus saying “Have you just been rejected in love but can’t let go?” Give us a call (!). And then as puffy-eyed college kids walked through their door… … the researchers asked them a tonne of questions to make sure that they were truly, truly heartbroken… like Rose-level heartbroken..
LB The main thing is that they can't stop thinking about the other person. That it’s really being obsessed with thinking about the other person. They’re crying a lot. They can't sleep.
15 sleep deprived sad sacks fit the bill for Lucy's experiment … Now. Step 2. The brain scan. To make sure that their guinea pigs would be all sad and heartbroken while in the MRI… the researchers asked them to bring in a photo of their once beloved's face, so they were looking into their dump-er's eyes while they were in the MRI...
LB Believe me, when you're in that machine and you open your eyes it’s like right there, you are immersed in that person, yeah.
WZ That must have been awful
LB Oh they were crying, you know remembering the heartbreak, yes. WZ they really came out crying… LB Oh yeah, yeah, tears in the scanner. Tears down their face. Yes.
To be able to see what was heartbreak and what was just regular brain… Lucy and her team needed to do one final thing. They had the same college kids -- go back into the MRI. But this time, they looked at a photo of someone else -- someone they weren’t emotionally attached to at all. Then the researchers compared the two, and Lucy remembers when the results from each scan started coming in
<i do I do…When I first put you know the first ten and then 12 and then 14… and I first looked at that, It was pretty amazing… haha
The experiment worked! And Lucy says told us she saw a few really curious things in those heartbroken brains
One of the things that was interesting, is that a part of the brain that registers physical pain was active. So we weren’t feeling the physical pain, like a pinch or cut or a broken bone . But that part of the brain that says this hurts, that’s active.
WZ That’s so interesting, i think about that as different things. To break my leg, to break up with someone. But it's not that different?
LB It’s not that different. It’s not just the physical pain, it’s not just the emotional pain, those two are interacting all the time.
Now, this is just one, small study, but it does fit well with a growing body of research which is showing this connection between physical pain and emotional pain … It’s all suggesting that when people say “I’m hurting” they literally are hurting. And this doesn’t just happen in heartbreak - it can also happens at other times when we are rejected like getting bullied or left out of a game  - it’s what science calls “social rejection”. 
Ok, so that’s the hurting part of a break up. But Lucy also saw that when these heartbroken saps looked at their Ex’s another part of the brain lit up - the reward system… this system gets triggers when we do stuff we like… eat chocolate, take drugs, you know the fun ones - and when we’re in love.
So it's this two thing, it's causing them pain, but ah there he or she is, that face that gave so much pleasure, so many good times, made me feel so good in my heart!
And during heartbreak… when our brain is hurting… and all these systems are getting triggered, what’s happening in our brain-- it can trickle down to the rest of the body
LB <The brain is influencing the body, And all these systems are interacting.
One thing that you see in heartbroken people… is that certain hormones related to stress like cortisol can start racing around their body…  ...And it's not just in sad-sack college kids. Researchers have found this same thing in coupled up prairie voles - which are like little potato shaped rodents - when scientists separated these critters from their partners their stress hormones jumped too.
And early research suggests this cascade of stress can cause real problems… surveys have found that it can affect your sleep… for months ..... It can mess up your immune system. And heartache can quite literally hurt your heart.... possibly even giving you a heart attack. The scary side of heartbreak… right after the break… the heart break…
Welcome Back. We’ve just told you that you can see the effects of heartbreak on in the brain, and this can trickle down … affecting your immune system and even affecting your heart. Here’s neuroscientist Lucy Brown again.
You do, you feel a deep sunken tight feeling in your chest.
And in some cases... That pain in your heart can become something quite serious … you can actually have a kind of heart attack. It’s known as Takotsubo [Tah-koh-tsu-boh] Syndrome… During Takotsubos, one chamber of your heart balloon up in this very specific way - which is actually where the syndrome gets its name from. Your heart starts to look like a japanese octopus trap called a Takotsubo… And Takotsubos isn’t just found after heartbreak, it can happen after other kinds of stress - like even public speaking.  
So where does all this leave us? From what’ve found out -- we know that heartbreak can cause, real effects throughout your body - like increased stress hormones, and sleep problems and chest pains.So our producer Rose and all you heartbroken folks out there -- you aren't crazy
LB You're not crazy. This is your brain, it's a physiological thing. You’re not to blame for this! Don’t blame yourself for all of this.
Alright so now that we know all this -- can science help us get over a break up?
Well Lucy reckons we can get some tips on how to deal with heartbreak … by looking at research into how to break bad habits. And one thing which has been shown to help people is to stay away from triggers, or cues. So for example, if you want to stop eating popcorn, don’t go to the cinema - there was actually a study on this… if you want to quit smoking… don’t have cigarettes around… . And when it comes heartbreak, applying the same logic: if you want to stop thinking about your Ex. Clear out their text messages. Block them on instagram.
LB Throw away all of the, ALL of the things associated with that person. You should get rid of them… Go live somewhere else entirely if you’re really having a big problem! Just get away from there.
But if you can’t uproot your entire life to get over someone we did find one another suggestion in the scientific literature… it’s called negative reappraisal. It’s a fancy science word for saying keep reminding yourself what a turd your ex was. I tried to get Rose, producer of our show, to give it a go with her Ex. The one who gives out valentine's day balloons to people right before dumping them. I wanted her to tell me what was wrong with him
RR: um….he….God, uh that’s funny, what was wrong with him?? uh
WZ: You’re too nice, you’re too nice.
WZ: Did he ever give to charity? Did you ever see him give any money to charity?
RR: Not once!
WZ Yeah. What about that time he kicked the dog?
RR: Oh my god, he was such a dog kicker. You know that trip he took to the arctic to club baby seals it really didn’t sit right with me …
Jokes aside, Rose said that actually hearing all the science stacked up made her feel much better about her heartbreak.
The feeling of heartbreak is so intangible, there’s not a cut, haven’t lost of a finger, and everyone can’t see it. it’s very lonely and it’s very hard to quantify from the outside. And I think that makes people trivialize it, you don’t know what the other person is feeling. The fact that science can measure and find this thing, this despair… it’s like it is really happening.
WZ yeah it is real
RR: That’s great. I wish I had known that at the time. I felt so screwed-up. Like such a screwed-up for being that upset -but that’s how a lot of people feel?
WZ: That’s what a lot of people feel.
RR: And the science can tell us that?
WZ: Science can tell us that.
RR: That’s very useful science.
That’s Science Vs Heartbreak
Next week… PANDEMIC. We’ve seen the blockbuster films… but what would really happen if a pandemic swept the globe today? We at… Science Vs created a fully fictionalised... but scientifically approved... pandemic. So how bad does it get?
“I’ve just snuck into the ward… I can see people looking a bit blue”
AF you did really well… your scenario was quite realistic
This episode was produced by Michelle Dang, with help from me, Wendy Zukerman, Rose Rimler, Meryl Horn and Lexi Krupp. Our senior producer is Kaitlyn Sawrey. We’re edited by Caitlin Kenney and Blythe Terrell. Fact checking by Diane Kelly. Mix and sound design by Peter Leonard. Music written by Peter Leonard, Emma Munger, and Bobby Lord. A huge thanks to all the scientists we got in touch with for this episode, including Professor Larry Young, Professor Tiffany Field, Professor Ethan Kross, Professor Sandra Langeslag, and Professor Naomi Eisenberger. A special thanks to the Zukerman family and Joseph Lavelle Wilson.
I’m Wendy Zukerman - fact you next week
RR: I remember the first time I felt back to my old self for a moment, was like maybe a few weeks later and went and had a burrito somewhere. I had this thought like “I can still enjoy burritos!” and that was a really nice feeling. If you know me at all you know that I feel really strongly about burritos. I remember really thinking, like actually seeing from the outside…oh this is me, I feel like my old self again.
 Ten women and five men were recrruited from the State University of New York at Stony Brook, Rutgers University, and the New York area by word of mouth and with flyers. The flyer highlighted the sentence: “Have you just been rejected in love but can’t let go?”
 Pg 8 The insular cortex regions where we found activity have been associated in other studies with physical pain and/or distress (Brooks et al. 2005; Dube et al. 2009; Treede et al. 2000). Also a large area of the anterior cingulate where we found activity is involved in pain regulation (e.g., Petrovic et al. 2002);
 insular cortex and pain regulation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2748680/; anterior cingulate cortex and pain regulation https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4017137/
 Physical pain sensitivity correlation w/ romantic rejection: Kross et al (2011) Social rejections shares somatosensory representations with physical pain
 Opposite-sex rejection produced greater overall MOR activation compared with acceptance. … The pattern of MOR activation in the amygdala, thalamus and ventral striatum during social rejection was similar to that during physical pain supporting the hypothesis that responses to social rejection and physical pain are regulated by overlapping neuronal pathways.
 Physical pain sensitivity and love: Love as a Modulator of Pain (review paper); also notes studies that suggest the perception of physical pain can be decreased by looking at photos of loved ones, though some studies suggest that other distractions work as well
 “growing body of literature suggesting a possible overlap in the neural circuitry underlying physical and social pain http://icpla.edu/wp-content/uploads/2016/10/Eisenberger-N.-The-Pain-of-Social-Disconnection-Examining-the-shared-neural-underpinnings-of-physical-and-social-pain.pdf
 http://sci-hub.tw//10.1016/B978-0-12-397025-1.00144-5 “social pain – the profound distress experienced when social ties are absent, threatened, damaged, or lost – is elaborated by the same neural and neurochemical substrates involved in processing physical pain ... hurts in a very real way because it recruits some of the same neural mechanisms that respond to physical injury”
 Physical pain sensitivity correlation w/social rejection:
Eisenberger Neural bases of social pain : ‘we often do so with physical pain words, complaining of “hurt feelings” or “broken hearts.” In fact, this pattern has been shown to exist across many different languages and is not unique to the English language [8’]; ‘In sum, the research reviewed here supports the idea that the pain of social rejection, exclusion, or loss may be more than just metaphorical by highlighting a common set of neural regions that underlie both social and physical pain.’
 Social Pain/Rejection review - http://sci-hub.tw/10.1146/annurev-psych-010213-115146
 Group activation specific to the beloved under the two control conditions occurred in dopamine-rich areas associated with mammalian reward and motivation, namely the right ventral tegmental area and the right postero-dorsal body and medial caudate nucleus (Fisher, Brown)
 Sympathetic adrenal-medullary activation is accompanied by the release of epinephrine, norepinephrine, and other catecholamines into the bloodstream, whereas hypothalamic-pituitary-adrenocortical activation results in the release of adrenocorticotropic hormone (ACTH) and corticosteroids (cortisol in humans and other primates). Both stress systems are often engaged during stressful encounters.
 The different results for loss and trauma mirror neuroendocrine effects of these two types of adverse events. Loss—maternal separation in nonhuman animals and bereavement in humans—is commonly associated with increased cortisol production (Irwin, Daniels, Risch, Bloom, & Weiner, 1988; Laudenslager, 1988; McCleery, Bhagwagar, Smith, Goodwin, & Cowen, 2000)
 20 premenopausal women going through divorce or separation were compared to 20 non stressed women, matched for age, ethnicity and education. Relative to the non-stressed control subjects, the stressed women had elevated evening (9 PM) salivary cortisols, a finding that was observed on both days (mixed effects model: effect 0.44; se 0.14, p .003)
 Students who experienced a recent romantic breakup were given several self-report measures and were then divided into high versus low breakup distress groups. Depression and sleep disturbance were related to sleep distress
 Although sleep complaints decreased over time, the average participant in this study continued to report clinically meaningful sleep problems at visit three, which occurred nearly 8 months after entry into the study and approximately a year after participants reported having physically separated from their ex-partner. (Krietsch et al 2014)
 An excessive release of catecholamines also seems to have a pivotal role in the development of stress cardiomyopathy." From Mechanisms of stress (Takotsubo) cardiomyopathy. https://www.ncbi.nlm.nih.gov/pubmed/20195267
 Meta-analysis of 300 empirical studies of psychological stress and immune system effects: Various types of stressors are shown to have effects on immune system regulation. This meta-analysis yields evidence of declines in natural immune response following the loss of a spouse.
 Women separated 1 year or less had significantly poorer immune function than a socio demographically matched married group, including lower percentages of NK and helper cells, poorer blastogenic responsiveness, and higher antibody titers to EBV VCA (Kiecolt-Glaser et al 1987)
 The separated/divorced men... reported more recent illness, and they had significantly higher antibody ti- ters to EBV VCA and HSV, suggesting poorer cellular immune system control over herpesvirus latency. Those who were rejected had poorer health than those who weren’t rejected. (Kiecolt-Glaser et al 1988)
 Followed 32 Swedish men for 8 years: The year of divorce and the successive three years were characterized by high sickness rates (average 21,7 days/year, variation 19,4–26,6) compared to a reference group (average 16,6, variation 14,9-18,1). Sickness absence lowered in next 4 years.
 The brain-heart axis in Takotsubo syndrome: For the first time, we demonstrate hypoconnectivity of central brain regions associated with autonomic functions and regulation of the limbic system in patients with TTS.
 The cardiologists from the Hiroshima City Hospital originally proposed the term tako-tsubo-like left ventricular dysfunction, because the typical shape on end-systolic left ventriculogram resembles a tako-tsubo (octopus trap) with a round (akinetic) apex and narrow (hyperkinetic) base.
 2014 Meta-analysis: The in-hospital mortality rate among patients with TTC was 4.5% (95% CI 3.1 to 6.2, I2 [ 60.8%). In the largest TTS registry to date (2018), death rates are estimated to be 5.6% and rate of MACCE (Major adverse cardiovascular events) 9.9% per-patient year
 Time to recovery ranged from as few as 8 days to as much as 2 months. Table 1: https://www.semanticscholar.org/paper/Takotsubo-cardiomyopathy%3A-a-new-form-of-acute%2C-Akashi-Goldstein/350fba281ab048efd35e96d0fce54d1430c3edec
 A successful strategy for controlling strong temptations, in contrast, involved limiting exposure to the hot stimulus properties that elicit automatic, impulsive responses. Thus, participants inhibited their strong affective impulses by removing themselves from the tempting stimulus.
 The results showed that participants ate more popcorn in the cinema context as compared with the meeting room context, supporting the hypothesis that environmental cues trigger habitual behaviour.
 The meta-analysis revealed that several brain areas show consistently greater activation in response to smoking cues than neutral cues, and that these areas are located primarily within the extended visual system of the occipital, inferior temporal, and posterior parietal lobes, and in the cingulate gyrus and prefrontal cortex
 Negative reappraisal decreased love feelings and made participants feel more unpleasant. Positive reappraisal did not change how in love or pleasant/unpleasant participants felt. Distraction did not change love feelings, but made participants feel more pleasant. Note: this method is not exclusive - studies have found other potential methods to cope with break-ups like managing beliefs about personal control and reperceiving the situation