Why does it hurt when I'm sad?

June 11, 2012 12:13 PM

What is the unpleasant physical sensation I sometimes get when I am profoundly sad?

Sometimes when I am feeling very sad or lonely I feel an actual physical sensation. It starts in my chest (maybe this is where the concept of heartbreak comes from?) and spreads slowly through my core and arms. It's a prickly sensation, not like foot-falling-asleep pins-and-needles, but more like the needles-inside-my-skin feeling I get along with the adrenaline rush(?) when I wake up suddenly from a bad nightmare. The post-nightmare feeling comes with rapid heartbeat and breathlessness, though, while the sad feeling comes with a more calm feeling.

I understand enough about the human body to get that this is probably my brain releasing some hormone or other chemical in response to something, but I'd like to understand more about what it is and what triggers it.

If it's relevant, I don't have a history of depression or other mood disorders, other than rare anxiety-related panic attacks, and my panic attacks don't feel anything like this.

posted by rhiannonstone to health & fitness (8 answers total)

Scientists are still working on it, using the standard arsenal of modern neuroscience tools. For what it's worth, I've read medical treatises from the 17th and 18th century -- at the very beginning of what you might call cognitive science -- identifying the phenomenon and speculating on the cause.
posted by holgate at 12:21 PM on June 11, 2012 [2 favorites]

That sounds a lot like the trigger for my anxiety attacks.
posted by Ruthless Bunny at 12:31 PM on June 11, 2012

I also get chest pain when I'm upset or sad, or remember something acutely upsetting, as well. I've always attributed it to adrenaline hitting my heart, but not in a fun exercise kind of way, but in an anxiety attack kind of way. With some googling that may not be too far from the mark.

Takotsubo Cardiomyopathy is a sudden temporary weakening of the myocardium, producing something similar to a heart attack. When the body becomes overwhelmed, primarily due to stress, hormones such as metanephrine and normetanephrine are released in excess with addition to proteins such as neuropeptide Y, brain natriuretic peptide, and serotonin.

"Our hypothesis is that massive amounts of these stress hormones can go right to the heart and produce a stunning of the heart muscle that causes this temporary dysfunction resembling a heart attack," says cardiologist Ilan Wittstein, M.D., an assistant professor at The Johns Hopkins University School of Medicine and its Heart Institute. "It doesn't kill the heart muscle like a typical heart attack, but it renders it helpless."
posted by Sayuri. at 12:34 PM on June 11, 2012 [1 favorite]

I'm reading up on narcolepsy, and one of the symptoms related to that is cataplexy, which can be triggered by intense emotions. Wikipedia.

The sensations you describe sound different from the ones for cataplexy, but if it's related to intense feelings it could be a place to start looking. Also hormonal related, it seems.
posted by monocultured at 1:01 PM on June 11, 2012

I'd guess it's a reaction of the sympathetic nervous system, as is the fight or flight response.
posted by hot soup girl at 5:03 PM on June 11, 2012

The sensations I'm talking about definitely aren't cataplexy, and they don't involve chest pain or tightness, either. But these give me a good place to start, so thanks!
posted by rhiannonstone at 10:38 PM on June 11, 2012

Just wanted to say I get this too, but it's only when my feelings are violently hurt. I'm guessing some stress flood for sure.
posted by agregoli at 7:49 AM on June 12, 2012

For what it's worth, I can deliberately trigger physical symptoms like this (as well as the 'lump in the throat' feeling you get with grief, and the 'scalp tingling, face flushing' sensation you get with anger, the 'loose limbed, stomach dropping' feeling you get with shock, the 'heart in your throat, lighter than air' sensation you get with elation, and a bunch of other symptoms) just by carefully focusing my attention.

I had always assumed that, like hot girl says, I was somehow consciously manipulating my sympathetic nervous system.
posted by skye.dancer at 8:46 AM on June 12, 2012