Romantic Breakup Distress, Betrayal and Heartbreak: A Review

Distress that occurs can be explained in part by depression and feelings of rejection and betrayal. These may lead to physical problems including heartbreak or the broken heart syndrome and immune dysfunction. The broken heart syndrome has notably mimicked heart attacks, but it has been differentiated from a real heart attack by angiograms revealing unclogged arteries and no permanent heart damage. Reduced vagal activity and increased cortisol and catecholamine levels (dopamine and norepinephrine) accompanying heartbreak are thought to be potential underlying mechanisms for the broken heart syndrome and for immune dysfunction including increased inflammatory cytokines and reduced natural killer cells. fMRIs following breakups have revealed increased activity in the cingulate cortex and the right ventricular prefrontal cortex. These data highlight the complexity of breakup distress, betrayal and heartbreak and the need for multi-variable research. This narrative review involved a literature search on the terms romantic breakup distress, betrayal and heartbreak on PubMed and PsycInfo. For the selection process, the inclusion criteria were: published empirical studies, systematic reviews and meta-analyses. Exclusion criteria included: non-English papers, case studies, under-powered samples, and non-juried papers. Following these screening criteria, the publications selected are briefly reviewed here.