Does Your Depression Affect Your Ability to Move On After a Breakup?

Breakups and rejection are, unfortunately, part of life. A major breakup can cause feelings of despair, inadequacy, grief and self-loathing. Many of these are already felt by those battling clinical depression but become amplified by the breakup.

In 2004, a group of scientists studied a group of women who were processing heartbreak. They wanted to see if the feelings associated with heartbreak mimicked the severity of sadness experienced by those with clinical depression. They concluded that “this life event is a viable experimental model to investigate symptoms of depression in [women] without a psychiatric disorder.”

We already know that stressful or highly-charged emotional events can trigger depressive episodes, but can heartbreak worsen depression that’s already there? How does the brain anatomy of a depressed person influence their ability to move on after a breakup?

Going Through It

We all act out in different ways, but for the most part, rejection from someone we have romantic feelings for affects us in the same way.

For one thing, breakups throw off our routines, especially if we’ve been dating the person for a while. The way you spend your day has suddenly changed dramatically, often without warning, and you might find yourself listless, feeling frazzled, disorganized, and unable to sleep. This disruption of our routines can be especially hard for a person with clinical depression to cope with. A study done by Dr. Ellen Frank at the University of Pittsburgh School of Medicine found evidence to suggest that the maintenance of circadian rhythm and daily routines (along with medication and other preventative therapies) was more effective in maintaining a ‘euthymic state’ in bipolar patients than medication and behavioural therapy alone.

If you’ve ever pulled an all-nighter or travelled to a new time zone, you know how awful you feel after your sleep has been disturbed. What Dr. Frank and her team suggested was that those of us who are more susceptible to mood disorders tend to take longer to adjust to these changes, which in turn leads to more stress and could potentially trigger a manic or depressive episode in those with bipolar disorder.

What’s more, to be rejected by a lover makes you wonder what it is about you that made them want to leave, which amplifies the feelings of self-loathing and low self-esteem that clinically depressed patients already struggle with.

“Together, romantic rejection and clinical depression can (unfortunately) synergistically potentiate one another, leading to immense suffering, in which the already depressed individual can fall deeper into their symptoms,” says Dr. Paul Poulakos, a board-certified psychiatrist operating out of New York.

Love Drugs

When we’re in love our brains are flooded with dopamine, the hormone linked to motivation and reward-driven behaviour. We’re also getting a pretty consistent supply of serotonin when we’re in love, one of the most complex neurotransmitters that’s associated with much of our cognitive functioning, not least of which is mood regulation. People who struggle with depression often have decreased levels of serotonin.

When we go through a breakup and that stream of dopamine and serotonin is interrupted, we ‘withdraw’ from them much like how an addict withdraws. For someone with clinical depression, our brains are desperate to replace what we’ve lost, which is why we act the way we do the first few weeks after a breakup: shopping, eating junk food, drinking excessively, or having lots of casual sex.

Instinct Vs. Emotion

The early stages of falling in love actually involve more instinct than emotion. According to Aron et al, the brain systems involved when we're in love are the “subcortical mammalian reward/survival systems”, meaning our goal-oriented, motivational systems. This might help to explain why some of us are our ‘best selves’ around the person were dating: we hide our bad habits; we do our best to look nice and we’re willing to do quite a bit for that person. We are literally trying to ‘win them over’.

When researchers studying how our brains respond to being rejected in love, they found that the areas that ‘lit up’ when people were looking at pictures of their exes “occurred in areas associated with gains and losses, craving and emotion regulation”: the ventral tegmental area, the ventral striatum, the medial and lateral orbitofrontal and prefrontal cortex and the cingulate cortex.

A Depressed Brain is Built Differently

Interestingly, there is some cross-over between the areas that lit up when rejected lovers remember their ex-partners and the areas affected by depression.

“The dorsal and medial prefrontal cortex, the dorsal and ventral anterior cingulate cortex, and the orbitofrontal cortex of the insula are the areas of the cortical brain that are impacted by depression. This finding has been linked to a reduction in problem-solving abilities [and a] higher likelihood of acting on negative emotions,” says Dr. Poulakos. “These brain regions impact cognitive functioning such as conflict resolution of emotional stimuli and weakened stress response.”

However, it’s not only our cognitive reasoning that’s negatively affected. “Subcortical limbic brain regions are also negatively impacted, such as the amygdala, hippocampus, and dorsomedial thalamus.” The dorsal medial thalamus gets information from both the prefrontal cortex and the limbic system and plays a role in attention, among other things.

“Furthermore,” says Dr. Poulakos, “decreased hippocampal volumes, decreased amygdala core volume often occurs in clinical depression. In addition, increased activation of the amygdala is also found, indicating heightened processing of strong emotions such as fear and anger.”

When we process a negative emotion (like sadness after a breakup) the amygdala, which is already working overtime in a depressed person’s brain, is pushed even further.

What Do Heartbreak and Depression Have in Common?

“Finally, the basal ganglia and brain stem have been found to be involved, as they control motor response, response to reward, and motivation. While research lacks cohesive explanations regarding the exact happenings, the nuclei of neurotransmitters involved are to be found in the brain stem.”

So, how does this factor into a breakup scenario?

“The basal ganglia [have] been shown to play a significant role in executive functioning, motivation, and decision making. It plays a role in how one decides to take a specific action in response to rewards and trial and error learning.”

Remember the study of rejected lovers? The ventral palladium and the VTA (areas that lit up when dumpees gazed at photos of their lost loves) are sections of our basal ganglia.

“Neuroscience has revealed a correlation between depressed individuals and anatomically a decreased overall volume of the basal ganglia,” says Dr. Poulakos. He stresses that more studies are needed to better understand this connection, but it’s not outside the realm of possibility that these structural differences are what make it more difficult for someone who is clinically depressed to move on from a breakup.

“One may hypothesize that it is a decreased volume of the basal ganglia found in depressed brains that results in a disruption in the brain’s ability to make adaptive decisions when faced with choosing a response to a particular event [like heartbreak]. Whereas someone with normal volume basal ganglia may be able to more readily move on after being heartbroken due to stronger decision-making capacity and a more efficiently functioning trial and error/reward pathway, someone who struggles with depression, who may have a decreased overall basal ganglia capacity, may not be able to identify or make the connections necessary to recognize when it is time to move on or let go, and hence may remain in a state of feeling rejected and depressed.”

The brain of a depressed person is starkly different than that of someone who isn’t afflicted. “These changes make it very difficult to cope with various stressors, such as heartbreak,” according to Dr. Poulakos. “For example, depressed individuals experience heightened negative emotions due to increased activity in the amygdala, making the intense emotions involved in something as sudden and difficult as a breakup felt at extreme levels.”

“In addition, stress response, problem-solving abilities, and conflict resolution are diminished due to the impact of the cortical brain region, as well as the likelihood of experiencing strong negative emotion in the face of negative events.”

That doesn’t mean that you need to be at the mercy of your depression. Being armed with this knowledge can help you make better decisions in the face of a stressful situation. It won’t be easy; after all, you are literally fighting against your instincts, but that is arguably what separates us from animals and makes humans such adaptable creatures. Combined with talk therapy and medication if you need it, cognitive behavioural therapy can be a great tool for ending the self-destructive behaviour that keeps you trapped in the cycle of depression and coming back to thoughts of your ex.