Placebos have long been found to ease physical pain, but how about an emotionally wounded heart?
In a side trip from the main game of looking at the management of physical pain, Michael Mosley’s Placebo Experiment asks if placebos could be used on something non-medical, like heartbreak.
With Valentine’s Day just around the corner, we take a deeper look to see if it’s actually possible.
Firstly, can you literally have a broken heart?
Yes. It’s very real, and in some cases it can be deadly.
The condition is aptly named “broken heart syndrome” and can be brought on by emotional stress, such as a breakup or divorce, or loss of a loved one. According to NBC News, it could be the reason why one half of a long-term couple dies just days after the other.
More formally known as takotsubo cardiomyopathy, or stress-induced cardiomyopathy, it’s when the heart muscle becomes weak and can’t pump blood properly. It mainly affects women – 90 per cent of all cases are women aged 58 to 75 – but it is becoming more common.
Patients with broken heart syndrome can present with symptoms of a heart attack (and suddenly after a traumatic event) – commonly, shortness of breath and chest pain. This could be caused by a rapid onset of stress hormones, like adrenaline.
And yet, as cardiologist Dr. Satjit Bhusri, of New York’s Lenox Hill Hospital tells NBC, these patients have “completely clean coronaries” and “their heart pumps resolve in anywhere from eight hours to two months.”
While most will recover from the syndrome, some patients have died in severe cases.
Although experts still don’t have a complete understanding of why emotional and mental stress causes broken heart syndrome, Zachary Goldberger, cardiologist and associate professor of medicine at University of Washington’s School of Medicine, says there’s “a very significant brain–heart connection.”
“The heart has many receptors that take commands directly from the brain,” he tells NBC. “While our understanding of the condition is still growing, the general hypothesis is that under stress or trauma, the sympathetic nervous system releases a lot of neurotransmitters that are very much like adrenaline.”
“These hormones may be cardiotoxic, and may injure the heart muscle.”
If your heart is metaphorically broken, could a placebo help?
It’s more than likely you won’t literally have a broken heart, but let’s face it, a breakup feels just as bad. Is there anything you can really do but ride it out?
A more complex study than appears in the documentary suggests so. Published in the Journal of Neuroscience in 2017, the University of Colorado, Boulder tested 40 volunteers who in the last six months had had “an unwanted breakup”. It’s reportedly the first study to measure whether a placebo can alter the emotional pain of someone experiencing a breakup.
Participants were shown an image of their ex and asked to remember breaking up with them, then shown an image of a good friend of the same gender. And if that wasn’t confusing enough, they were administered physical pain – heat on their left forearm. Their neurological responses were measured in a functional magnetic resonance imaging (fMRI) machine, and the subjects were asked to rate how they felt on each round of the exercise – from 1 (very bad) to 5 (very good).
Researchers found that the regions in the brain that were illuminated were similar as the emotional and physical pain played out, making the assertion that being heartbroken is “neuro-chemically real”. The subjects were then shown shots of their ex and administered physical pain, but before they re-entered the fMRI they were given a nasal spray. Half were led to believe it was a simple saline solution, the other a “powerful analgesic effective in reducing emotional pain”.
In the placebo group’s brains, the dorsolateral prefrontal cortex (used for emotion modulation) had a great jump in activity, and areas registering rejection decreased.
And here’s where the results of testing a placebo to treat a non-medical condition prove surprising: The subjects in this group also experienced a change in the periaqueductal gray (PAG) in the middle of the brain that controls pain, with increased activity in this area. So the placebo group’s physical and emotional pain was somewhat alleviated, thanks to the fake nasal spray.
“Breaking up with a partner is one of the most emotionally negative experiences a person can have, and it can be an important trigger for developing psychological problems,” said postdoctoral research associate Leonie Koban.
“In our study, we found a placebo can have quite strong effects on reducing the intensity of social pain.”
If only there was a cure to stop it all together...
Michael Mosley’s Placebo Experiment airs on Monday, 11 February at 8:30 pm on SBS.