The Chemistry of Emotional Pain

When someone hurts our feelings or rejects us, we often feel emotional pain. Emotional pain is typically felt in the chest or tummy region. It thus makes sense that almost all cultures use terms for organs in the chest or tummy region to speak of a broken heart.

Emotional pain can no doubt be more painful than physical pain. But is it really a form of pain? To answer that questions, let’s take a look at how physical pain arises.

Both internal stimuli, such as, internal cell damage, and external stimuli, such as, a hit on the head, can cause physical pain. Before we experience physical pain, our body goes through a long process of producing chemicals and transmitting pain signals to the brain.

When cells are damaged, they release chemicals, such as prostaglandin, serotonin and histamine.  These chemicals transmit signals by binding to nociceptors (sensory receptors) on nociceptor fibers. The pain impulse transmits from these fibers to the spinal cord.  From the spinal cord, the impulse travels to the brain stem and then to the thalamus and higher areas of the brain. Here it gives rise to pain perception.

Emotional pain does not begin with cell damage. It begins with perceptual or cognitive processing in higher areas of the brain. The shock of hearing about the unexpected death of a family member, for example, triggers emotions, such as fear and sadness.

The processing of these emotions in the brain stimulates the sympathetic nervous system, which then releases a surge of stress chemicals into the bloodstream, including epinephrin (adrenaline), norepinephrine (noradrenaline) and cortisol.

All three stress chemicals assist in creating a fight or flight response. Norepinephrine increases blood sugar levels and opens the bronchial airways, cortisol prepares the muscles for action, and epinephrine, or adrenalin, binds to heart receptors.

The stress chemicals are responsible for the pain in the heart and chest muscles that is experienced after the loss of a loved one. In extreme cases, stress chemicals can completely stun the heart muscle. This is called “stress cardiomyopathy” or “broken heart syndrome”. It feels like a heart attack and can be as dangerous as a heart attack, but it is usually reversible. The levels of adrenaline that attack the heart in broken heart syndrome can be up to 50 times higher than normal levels. This can be deadly.

Emotional pain of the sort experienced after an unexpected breakup is a kind of pre-stress cardiomyopathy. When the body bombards the heart and muscles with stress chemicals, the cells of the heart “freeze” and the muscles “tense up”. This leads to a release of pain chemicals, which then travel through nocireceptor fibers to the spinal cord and then the brain. Finally, this triggers a pain sensation.

So, emotional pain of the kind that makes the chest and tummy region hurt is indeed real pain. It hurts because the stress hormones cause cell damage or dysfunction. Over-the-counter pain killers are unlikely to have much of an effect on this kind of pain, though stronger pain killers might.

Source: Acute Stress Cardiomyopathy andReversible Left Ventricular Dysfunction

Photo credit: Illuvia Nocturna

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