Broken heart syndrome

5 minute read

“Aujourd’hui, maman est morte. Ou peut-être hier, je ne sais pas.” The opening lines of The Stranger by Albert Camus captivated me when I first read it [1] and still captivate me now. They are among my favourite beginnings to a book. Roughly translated as “Maman died today. Or yesterday, I do not know”, [2] these simple sentences set off a series of questions in the reader’s mind: *Why doesn’t he know? Is he overcome with grief? Or was it the opposite and is he incapable of feeling? Is he for real? Would I feel the same way?”

The main character Meursault’s indifference to life continues throughout the novel, resulting in an uncomfortable but enthralling read. Paraphrasing Camus, perhaps Meursault’s indifference was what condemned him in the game of life. We do not encounter many Meursaults, and hopefully we don’t turn into one. Let it remain a work of fiction.

In the world of non-fiction, and on the opposite end of the spectrum, Nautilus published an article about dying from a broken heart:

But can you really die from a broken heart? As it turns out, you can, from “broken-heart syndrome,” also known as stress-induced cardiomyopathy. […] But deadly grief is not about stress alone, scientists say. It shines a light on the physiological bonds of love, ceded to us by evolution, so often best understood when broken.

The article goes on to cite a meta-analysis of this so-called “widowhood effect”. I believe this is the 2011 paper referenced, though I can’t confirm it since Nautilus unfortunately didn’t include sources. The key findings are summarised in the table below. If I’m reading this right, the RR column implies the relative risk of death for that row, e.g. a male is 1.22x more likely to die following a spouse’s death compared to the average male. [3] [4]

Table

Apparently it happens on a semi-frequent basis:

The idea that grief can increase the risk of dying makes intuitive sense, especially among those who spend time with the ill, says Roy Ziegelstein, a cardiologist and vice dean of education at Johns Hopkins University School of Medicine. “I think that if you polled doctors, they’d overwhelmingly tell you it happens not infrequently.”

And the article gives a plausible explanation for why this happens:

Unlike a heart attack, broken-heart syndrome doesn’t stem from blocked arteries. It appears to be brought on by a sudden surge in stress hormones including epinephrine (more commonly known as adrenaline) and its chemical cousin norepinephrine. […] the sudden flood of hormones essentially shocks the heart, preventing it from pumping normally. On an X-ray or ultrasound, the heart’s left ventricle appears enlarged and misshapen. […] the condition can be deadly if the misshapen heart can’t pump enough blood to the rest of the body.

The bad news doesn’t stop there:

When you have chronic stress, you’re constantly degrading your ability to heal and fight off infection. That’s why chronic stress is associated with so many bad health outcomes.

The Mayo clinic discusses how chronic stress can put your health at risk, due to overexposure to cortisol:

The body’s stress-response system is usually self-limiting. Once a perceived threat has passed, hormone levels return to normal. As adrenaline and cortisol levels drop, your heart rate and blood pressure return to baseline levels, and other systems resume their regular activities. But when stressors are always present and you constantly feel under attack, that fight-or-flight reaction stays turned on.

But there are some touching findings from the original article:

Although medical researchers may not be able to pinpoint where that surge of willpower [to live longer] comes from, they have shown evidence for people’s remarkable ability to hold on and let go at will.

And other experiments that hint at how we view our partners. I believe this is the study being referenced below:

volunteers’ brain patterns were indistinguishable when the threat was directed at them or their partner. That wasn’t true when holding a stranger’s hand. “As far as your brain is concerned, a partner is not just metaphorically, but literally, a part of who you are,” he says.

That UVA experiment goes on to conclude:

“What we are finding here is that if our relationship is good and we are with someone we trust, we can say, ‘Hypothalamus, you don’t have to work as hard right now. Yeah, there is a threat, but chill out – the threat is not as threatening as if you were alone.’ Your friend will help you deal with that threat; therefore you can work less hard to deal with it, and that savings will keep you healthier in the long run.”

Back to the original article, there are three features of love:

Fisher describes three distinct features of that system: one for feelings of attachment, another for feelings of intense romantic love, and a third for sex drive. Attachment centers around oxytocin, a hormone that plays a key role in pair bonding.

Romantic love triggers the brain’s system for dopamine, a chemical messenger that plays an important role in brain pathways for pleasure and rewards.

Sex, too, activates the dopamine system, and orgasms send a flood of oxytocin into the bloodstream.

The loss of all three of these when you lose a partner is devastating, which could explain the “widowhood effect”. [5]

If you or someone you know has recently lost a partner, there are resources online on how to help or how to handle such a situation. [6]

Lastly, if you or someone you know is suicidal because of the loss of a loved one, please reach out for help! If you feel that even calling in the suicide prevention line is too difficult, check out the texting service Crisis Text Line!

Footnotes

  1. In english though! My french is so bad that when I try to introduce myself in French stores the other party immediately switches to English without prompting…
  2. People debate about how to translate this, the first sentence especially. A top ranked search result from the New Yorker’s Ryan Bloom prefers “Today, Maman died”. Others use “Maman died today” or “Mother died today”. I prefer “Mama died today” and think that it addresses the issue of “Mother” being too distant vs “Maman” being a foreign word, and also reads nicely with “Or yesterday” coming right after “died today”. But what do I know, I never took literature beyond middle school so this is all conjecture here.
  3. As I’ve stressed before, I’m not a scientist or statistician and could very well be reading this wrongly.
  4. Also, I wasn’t able to find a time period for when a death counted for the studies involved in the meta-analysis. I mean, presumably most of these people died by the time the meta-analysis was done, so what cutoff time frame was used?
  5. This reminds me of how the Greeks had 4 different types of love. Perhaps they were on to something? Total speculation here though.
  6. Thankfully, I’ve not needed to use the advice from these resources, but that also means I’m unsure if these are the current best ways of dealing with grief. Let me know if you find better ones.