I bet we have all reached the age where we can say, with total confidence: my heart was broken. No idea how you lived through that period of life — mine was just straight-up crying, lying on the floor, because the ground felt softer than standing up did. But funnily enough, apart from all that, I remember also feeling fascinated: how can emotional pain possibly feel more severe than physical pain? That is wild, if you think about it.

So here we go — leaving the romantic drama of the “broken heart” behind and looking at what happens when emotional pain becomes physical. Why can grief, shock or intense stress make the body hurt so much? What is actually happening inside us — and, more importantly, what can we do to help ourselves through it?

We tend to talk about emotional pain in surprisingly physical terms. A heart aches. Grief hurts. Rejection can feel like a punch to the chest. And we aren’t just talking about romantic break-ups here — the same language follows the death of someone close, homesickness, the end of a decades-long friendship. So why does something happening emotionally end up feeling so unmistakably physical?

Try a little thought experiment.

Take two people. One goes through a devastating break-up. The other gets mugged in broad daylight. On paper, wildly different situations — and, of course, the brain recognises them as such. But both can activate the same basic stress machinery. When the brain reads something as a serious threat — and social or emotional threats can count — it can trigger a stress response: a physiological programme designed to ready the body for danger.

So what exactly happens inside the body? One of the first things to kick in is the fight-or-flight response. The sympathetic nervous system releases adrenaline and noradrenaline — the chemicals that help you react quickly to an immediate physical threat. Your heart may start pounding, your hands can tremble or sweat, your chest can feel tight, your stomach can turn and your appetite can disappear. Then another part of the stress system comes into play, involving cortisol, a hormone that helps the body stay alert and mobilise energy when a stressful situation lasts longer.

In very rare cases, extreme stress can even temporarily affect the way the heart pumps — a condition known as Takotsubo syndrome, or “broken heart syndrome”. But for most of us, the physical feeling of heartbreak has a much less dramatic explanation: emotional and physical threats may be very different experiences, but they can draw on some of the same biological machinery.

And scientists have actually tried putting the two side by side.

Researchers do seem to have a certain talent for quietly cruel experiments. And while I would never volunteer for this one myself, I can see the logic: talking about how much heartbreak “hurts” is one thing. Putting someone in a scanner, making them feel it again and watching what happens in their brain is quite another.

So what am I on about?

In 2011, researchers from the University of Michigan, Columbia University and the University of Colorado gathered 40 people who had been through an unwanted break-up — on average, about two and a half months earlier — and who still felt profoundly rejected. Then they were placed inside an fMRI scanner and put through two very different tests.

First came the emotional pain: they were shown a photograph of their ex for 15 seconds, alongside a short phrase reminding them of the break-up. But they weren't simply asked to look at it — they had to mentally return to the moment of rejection and remember how it had felt. Afterwards, they rated how they were feeling on a five-point scale.

Then things got rather more physical: a heating device was placed against their left forearm, with the temperature calibrated beforehand to each person's pain tolerance — around an 8 out of 10. The heat lasted for roughly the same 15 seconds, after which they rated the experience again.

Surprisingly, the two didn't feel all that different in intensity. On the five-point scale, the average rating while reliving the rejection was 1.72, compared with 1.88 for the physical pain.

But the ratings were only part of the story. The fMRI scans showed overlapping activity in several brain regions during both experiences. That doesn't mean your brain mistakes a break-up for a burning arm — the two remain distinct experiences. What it does suggest is that some of the systems involved in processing emotional and physical pain overlap. So when we say rejection hurts, the comparison isn't entirely metaphorical.

I know, I know — reaching for paracetamol after a break-up sounds faintly absurd. But after everything we have just seen about the overlap between emotional and physical pain, you can probably see where the question comes from. Could a drug designed for one have any effect on the other? A group of scientists decided to find out — and ran two experiments to test it.

Experiment one. 62 university students were randomly assigned to take either 1,000 mg of acetaminophen a day or a placebo for three weeks. None were being treated for a break-up or any particular trauma; instead, every evening they recorded the social pain they had experienced naturally that day — how hurt, rejected or left out they had felt.

And, well — there was a difference. Among those taking acetaminophen, self-reported hurt feelings gradually decreased, while the placebo group stayed broadly the same. Gradually is the important word here: there was no overnight emotional anaesthesia. The difference crept in over the three weeks.

Experiment two took things a step further. Participants took either 2,000 mg of acetaminophen a day or a placebo for three weeks, then climbed into an fMRI scanner to play Cyberball — a virtual game designed to create social exclusion.

In short, participants thought they were playing online with two other people. The game began normally enough, until the other two simply stopped passing them the ball and carried on without them. Petty? Absolutely. But rather effective if your aim is to make someone feel excluded while watching what their brain does about it.

And again, a difference emerged. During the exclusion, those taking acetaminophen showed less activity in two regions associated with the distress of social rejection — the dorsal anterior cingulate cortex (dACC) and the anterior insula — both of which have also been linked to aspects of physical pain.

So does this mean you should start dosing yourself with paracetamol every time someone breaks your heart? Not exactly.

The sample is far too small to draw any grand global conclusions from, and there is a whole separate article to be written on whether it is remotely safe to take painkillers daily. But within our own small investigation, the experiment is fascinating for a different reason entirely: a drug designed to relieve physical pain appeared to shift measurable responses to social pain too.

Heartbreak, as we have established, can mean many things. But let's be fair: most of us still instinctively associate it with relationships. And in that particular case, there is evidence that some of our own habits can make an already painful experience harder.

A 2026 study involving 762 people across four studies looked at one obvious example: keeping tabs on an ex online. Deliberately checking their social media was linked to greater break-up distress, while even coming across their content accidentally was associated with feeling worse that day.

And then there is what happens without a screen. Psychologists call it rumination: repeatedly going over the same painful event without getting anywhere new. Replaying the conversation. Rewriting what you should have said. Running through the same what-ifs again and again.

Simply telling yourself to stop thinking about it, however, isn't much of a strategy. Luckily for us, there are a few things that may actually help interrupt the loop:

None of this means you can think your way out of emotional pain. As we have seen, the body's response to it is very real. But while we may not get much say in whether something hurts, we can have some say in how often we return to the bruise.

Given the title of this article, I can't exactly leave without answering the question. And while we have approached it from just about every angle by now, the direct answer is: probably not. In rare cases, extreme emotional stress can contribute to serious physical complications, but it isn't quite as simple as being “too heartbroken to survive”.

What we probably shouldn't do, though, is take probably not to mean not serious. If there is one thing all of this tells us, it is that emotional pain isn't some lesser, imaginary version of physical pain. The two aren't the same, but they can overlap in surprisingly real ways.

And perhaps that should change how we treat it. When something hurts physically and doesn't get better, we don't usually expect ourselves to simply get over it — we ask for help. Maybe emotional pain deserves the same courtesy. Not paracetamol, despite what one particularly curious experiment might suggest, but time, care and, when we need it, professional support.