The human condition: What really does become of the broken-hearted?

Losing the one you love not only makes you feel like death, it can literally make you ill. Jane Fitzgerald on the physical effects of heartbreak

Is it possible to die of a broken heart? Thirty years ago it was unremarkable for a coroner to write this rather unscientific cause on a death certificate, but lately the medical profession has tended to find a more rational explanation. But with health becoming ever more holistic, public opinion at least might just be turning the other way.

"My mother died of a broken heart last year," says Lucy Fellows, 35. "The death certificate might call it a heart attack, but after my father died, she literally pined away. He died in the February and she went into a severe decline. She had been an active 70- year-old, she was out all the time doing voluntary work at an old people's home - she didn't see herself as old. They had been married for over 50 years and when he was no longer there she could see no reason for living. She would never have committed suicide, but she killed herself slowly. She lost interest in everything. She was very tearful. She stayed in. She avoided everybody. She didn't eat properly. Ten months later my brother found her dead in her armchair."

Death from a broken heart, if it happens, could be a result of the body losing its ability to fight when it is engulfed by woe. A study by the University of California's San Diego School of Medicine recently found that a group of depressed or bereaved men in their forties had immune levels that had dropped to the normal level for men in their seventies. Dr Michael Irwin, Professor of Psychiatry at the university, agrees that bereavement can lead to a depressed immune response. "Viruses that our natural killer cells protect us from are more common in the depressed or grieving. This will be partly accounted for because one of the principal symptoms of depression and grief is neglect. We stop looking after ourselves, eating properly, taking exercise, we may well drink too much. The new bad habits make us more vulnerable to disease." There is also some evidence that misery can stimulate arteriosclerosis, the build up of fatty deposits on artery walls which is a contributing factor to coronary heart disease, according to work done at the Human Population Laboratory of the California Department of Health Services.

The medical establishment is hesitant to draw a direct link between grief and serious illness. "There are physical symptoms of grief," says Roger Look, a clinical psychologist working for Solihull Health Services, specialising in depression and relationship break-ups. "But it is unclear as to whether these are harmful in the long term. The biggest long term study of depression and cancer, published a year ago, found that in the long term people who suffered from depression were no more likely to get cancer than the rest of the population."

What may account for the anecdotal evidence of death from a broken heart is that, when we are at a low ebb, we are more likely to develop diseases that we, unknowingly, had a genetic predisposition to develop at some point. Tina Baker, principal clinical psychologist at Jersey general hospital says: "Grief-stricken patients can lose faith that they have control over their own lives and health, and they are more likely to develop disorders of the auto-immune system, like asthma and diabetes."

Short-term misery can certainly make you ill. Peta Sutherland, a counsellor, psychotherapist and specialist in trauma, based at the London clinic Natureworks, says: "People suffering grief and trauma are more vulnerable to low level infections. They often suffer from stomach problems, headaches, backaches. Sometimes the problems may be described as 'psychosomatic' but it doesn't make it any less real. When it comes to whether grief and trauma can cause long-term illness however, the evidence is unclear. It makes a lot of sense that the body would turn against itself physically if grief were not being dealt with outwardly, but the medical profession is reluctant to look at a phenomenon like grief holistically. There is a yawning chasm between medically trained people's attitude to grief-related illness and people like myself working with the whole person. If the body reacts to grief, giving sufferers physical symptoms to accompany their mental anguish, then this is exacerbated if, as is very common in our society, we try to stifle our suffering."

Sutherland says that if, some months after the end of a relationship or death of a loved one, people around you are implying that it really is about time that you "got over it" while you still feel dreadful physically or mentally, then that is the time to think about seeking professional help - not because you are in anyway abnormal in your grief, but because the lack of understanding might make you worse. Treating broken-hearted patients, according to Sutherland, by letting them see that they are not going mad or losing control, often brings an immediate improvement in their physical health. Grieving doesn't follow a typical path but there are recognisable symptoms. The initial impact of emotional loss may be physical devastation. The sufferer may feel very ill, be unable to eat or sleep. This can be followed by a denial period, running scenes through one's mind of how it might have been different. There can then be months of ill-health.

Tina Baker, at Jersey general hospital, believes that in order to overcome the physical problems that grief brings, the patient must start having emotional faith in themselves again. "People need to overcome the belief that they will never meet anyone again like the person they have lost. They need to set new targets and goals. You deal with the crisis first and then gradually build up a stronger defence system for the future."

MARK, 31

'When my girlfriend dumped me, it was like constantly waking up and remembering something awful that happened the night before. Every time I was enjoying myself it would hit me; that the person I had thought of as my soulmate wasn't there anymore. I would imagine scenarios where I saw how it could have been different, if only ... The real misery lasted four or five months, during which time I seemed to be constantly ill. I had flu, or what seemed like flu, temperatures, backache, diarrhoea, constipation. I felt guilt, rage, and sorrow. I felt desire for her and hatred of her and the different stages seemed to bring about different symptoms. My doctor got sick of the sight of me. He decided that I had some kind of stomach virus for which he had apparently no cure. About six months after we split up, I began a sort of nihilistic trail of one night stands, having really bad sex with strangers - which did seem to make me feel better, although I spent most weekends ill in bed. It wasn't until two years later that I was able to have a relationship again and got my full health back.'

ANGELA, 40

'When I was diagnosed as having cancer, I knew just what had caused it. The previous year my life had fallen apart. My happy marriage was blown apart when my husband left me for another woman. This happened a month after my best friend had been killed in a car accident. I cried for literally days on end. I didn't eat. I didn't sleep, I didn't tell anyone what had happened. I was a completely broken person. As the weeks went on I began to pull myself together on the outside and I went back to work. But I didn't confide in anyone. I just couldn't face talking, so I held it all in. After a while, people stopped asking. Then a year later I discovered a lump on my breast. I knew right away that it was cancer. Up until that point I had been completely healthy. I was convinced that it was triggered by the months of hating myself. I had a lump-ectomy and radiotherapy but I also went to see a psychotherapist and healer that I heard about through a friend. The cancer shook me into action to deal with my depression. The counsellor made me let the pain out at last. She agreed that the cancer was the physical manifestation of the grief that I had not let out emotionally. I actually began to feel a lot more positive as I hooked up to the world again and talked to my friends about everything for the first time. I continued to see the healer for several months and the cancer went into remission and hasn't come back. I've been clear for three years now. I feel sure that the cancer was caused by my emotional problems. Cancer is when the body attacks itself and that was exactly what I had done.'

TAM, 28

'When Giles, my boyfriend, left me, he said he was afraid I would want a commitment from him that he couldn't give. I was so ashamed, I felt like I had been run over by a bus, my body was in total shock. I don't remember stopping eating completely, but I think I forgot to eat properly for a number of weeks. I had been with Giles for 10 years and it was as if I couldn't function without him. I had dreadful stomach pains. I was inexplicably sick a number of times and for a while I was convinced I was pregnant, especially when my periods stopped. Obviously it was because I was losing weight. In just a couple of months I lost two and a half stone and looked like a skeleton. I spent long periods in bed because I had no energy. It was my mother who pulled me through. She was convinced I was going to die and kept making me bowls of soup. There wasn't one crucial moment, but over a number of months I slowly recovered. I still wake up in hot sweats now, a year later, but basically I got over it and am angry for having let myself get in such a state over such a worthless bastard.'

when the love is gone

Why does the sun go on shining/ Why does the sea rush to shore/ Don't they know it's the end of the world?/ Cause you don't love me any more

Skeeter Davis

O that 'twere possible/ After long grief and pain/ To find the arms of my true love/ Around me once again

Alfred, Lord Tennyson

I can pretend each time I see you/ That I don't care and I don't need you/ And though you'll never see me cryin'/ You know inside I feel like dying

Gloria Estefan

There is no greater pain than to remember a happy time when one is in misery

Dante

I wish you could invent some means to make me at all happy without you. Every hour I am more and more concentrated in you; every thing else tastes like chaff in my mouth

John Keats (right) to Fanny Brawne, just months before his death

Hearts that we broke long ago/ Have long been breaking others

WH Auden

You've disappeared somewhere/ And I miss you/Like deserts miss the rain/ Yeah I miss you/ Like the deserts miss the rain

Everything but the Girl

A widow bird sat mourning for her love/ Upon a wintry bough/ The frozen stream kept on above/ The freezing stream below

Percy Bysshe Shelley

I deck myself with silks and jewelery/ I plume myself like any mated dove:/ They praise my rustling show and never see/ My heart is breaking for a little love

Christina Rossetti

What becomes of the broken hearted/ Who had love that's now departed?/ I know I've got to find/ Some kind of peace of mind/ I've been looking everywhere/ Just to find someone who'll care

Marvin Gaye

TAKE HEART

Allow yourself to be miserable, angry, self pitying. Let it all out.

Talk to trusted friends and families - those who will still be around.

Don't blame yourself or be overly critical if you feel you are reacting badly.

Try to obtain a healthy physical regime. Eat well, try to take exercise, even if just a bracing walk with a friend.

Keep busy, don't spend too much time on your own.

Don't rush into finding a replacement for the lost relationship. You have to recover first.

Go to see something funny, watch anything that will get your facial muscles moving in the right direction. Evidence suggests that even enforced smiling somehow makes us feel more cheerful.

Write down your woes on paper, this may allow you to distance yourself from them.

Don't try to drown your sorrows. You'll only feel worse.

Don't be afraid to seek professional help.