25-05-2025
Views From The Couch: When love ends
Despite heartbreak being a universal experience, most of us are utterly unprepared for it. ILLUSTRATION: CHEONG HUAN TING, ADOBE STOCK
No health without mental health Views From The Couch: When love ends – understanding heartbreak
SINGAPORE – A few months ago, a young woman sat across from me in my clinic, her eyes red and tired.
Just two weeks after her boyfriend of three years had asked for 'a break', she discovered he had erased all evidence of their relationship from his Instagram account.
Replacing those pictures were newly posted photographs of him with another woman, smiling in poses that mirrored ones he had once shared with her.
'How could he move on so fast,' she asked, her voice breaking. 'Did I mean nothing?'
As a psychiatrist who has experienced heartbreak, I recognised that raw pain.
She was not devastated just because she had lost him, but also because she felt erased, as if he had deleted her from his life along with those photographs.
In the years I have been practising psychiatry in Singapore, I have sat with countless patients experiencing heartbreak: the secondary school student sobbing over a first love, the professional mourning a decade-long relationship, the elderly widow facing life without her partner of 50 years.
Their circumstances differ, but their pain speaks the same language.
We often dismiss teenage heartbreak as melodrama, but research confirms what these young people already know: adolescents experience emotions with extraordinary intensity. Their neurological development literally amplifies feelings, making those first heartbreaks genuinely overwhelming. Many adults can still recall their first heartbreak with startling clarity – that absolute certainty that happiness would never return.
At life's other end, losing a lifelong partner carries profound grief and tangible health risks. The 'widowhood effect' shows that a surviving elderly spouse's mortality risk increases by 66 per cent in the three months following their loss.
The Holmes and Rahe Stress Scale ranks losing a spouse as life's most stressful event – more stressful than imprisonment or bankruptcy.
Heartbreak knows no age limit. The pain is valid whether you are 16 or 86.
Why it hurts so much: a psychiatrist's perspective
When patients ask why heartbreak hurts with such physical intensity, I explain that their brain is processing a genuine form of withdrawal. We form attachment bonds with those we love. When that bond breaks, our brains react as they would to physical injury.
I have witnessed this repeatedly in my practice – insomnia, loss of appetite, even chest pain. These are not imagined symptoms. Brain scans show that rejection and heartbreak activate the same neural regions that process physical pain and drug withdrawal. Your body floods with stress hormones, leaving muscles tense and immune defences weakened.
In extreme cases, heartbreak can even affect the heart itself. Takotsubo cardiomyopathy, also known as 'broken heart syndrome', is a recognised medical condition where sudden emotional distress causes the heart's left ventricle to weaken and balloon out.
First identified in Japan, this condition mimics a heart attack, with symptoms like chest pain and breathlessness, though without the arterial blockages seen in traditional cardiac events. While usually temporary, it serves as a stark reminder that heartbreak does not just affect the mind: It can literally weigh on the heart.
No one teaches 'Heartbreak 101'
Despite heartbreak being a universal experience, most of us are utterly unprepared for it. There is no class in school on surviving a break-up. In Singapore's achievement-oriented culture, where academic and career success often take centre stage, emotional education frequently falls by the wayside.
I see this knowledge gap clearly in my practice. Young people improvise their way through heartbreak guided only by pop culture, peers, online forums or instinct. Adults fare little better, often hiding their pain in a society that celebrates weddings lavishly but keeps break-ups behind closed doors.
This silence perpetuates harmful coping mechanisms – excessive drinking, obsessive social media stalking, impulsive rebounds – simply because healthier alternatives were not modelled or taught. I have treated patients whose initial heartbreak spiralled into destructive patterns because they lacked guidance during that vulnerable time.
When heartbreak threatens mental health
As a psychiatrist, I am particularly attuned to when normal heartbreak edges into dangerous territory. The line between 'feeling sad and depressed' and clinical depression can blur after a significant loss. Relationship problems are one of the leading triggers for suicide – something that haunts those of us in mental health.
After painful break-ups, many develop anxiety that makes trusting new relationships nearly impossible. Some experience panic attacks or intrusive thoughts, such as: 'Will I die alone?'
I have assessed patients who describe their divorce as trauma that shattered their identity. From a psychological perspective, they are not wrong. When we lose a partner, we often lose a version of ourselves.
I remember one patient, a successful executive in his forties, who developed severe depression after his wife left him for a colleague.
'I don't recognise myself any more,' he told me. 'I used to know who I was.'
His recovery was not just about processing the loss of his marriage but rebuilding his sense of self outside that relationship.
Today's heartbreak comes with complications previous generations never faced. Before social media, former partners could gradually fade from each other's lives. Now, digital connections keep wounds fresh through algorithmic 'memories' and mutual friend updates.
I advise patients regularly on digital boundaries after break-ups. I suggest temporarily removing or muting a former partner across platforms to create space for healing. For some, this feels impossible – what message will it send? What will friends think? The public nature of a modern split adds layers of performance anxiety to an already painful process.
Digital life also enables new forms of cruelty. I have worked with young adults who were devastated after their private, intimate moments were shared vengefully online following the end of a relationship. Singapore has strengthened laws against such behaviour, but the damage, once done, is difficult to undo.
From my own observation, those who disconnect digitally after a break-up tend to heal faster than those who maintain virtual connections. A clean break in the virtual world often helps recovery in the real one.
Healing in the community
Heartbreak is incredibly common, yet many who go through it feel as though they are struggling alone. In truth, it is one of the most widely shared human experiences, one that is quietly endured by people of all ages and backgrounds. As with grief, it might feel as a deeply personal affair, but it does not have to be borne in isolation.
Support can come from many places – close friends, family, religious communities, peer support groups or even dedicated helplines. Organisations like community centres and online platforms increasingly host talks and forums on emotional well-being. In schools, workplaces and social settings, there is room to normalise these conversations.
Even something as simple as checking in on a friend going through a break-up can go a long way. We may not always have the right words, but the act of showing up – sending a message, inviting someone out or listening without judgment – can remind a person that they are not alone. Healing happens faster when we feel seen and supported.
Learning to 'love better' – a new approach
Singaporeans are a practical people and might raise an eyebrow at the idea of a national campaign about break-ups. But that is exactly what New Zealand has launched with their 'Love Better' campaign.
Backed by NZ$6.4 million (S$4.9 million), the initiative encourages young people to handle break-ups in healthy, constructive ways.
Their message is simple but powerful: Break-ups hurt, but you do not have to hurt yourself or others. One slogan – 'Own the Feels' – encourages teenagers to acknowledge their emotions instead of bottling them up or acting out. The programme shares strategies for emotional resilience, seeking help and avoiding revenge behaviours or self-harm.
It is a model that can potentially be localised. While we have excellent family and youth counselling services in Singapore, there is currently no coordinated national approach to break-up recovery. An 'emotional literacy' programme here could teach valuable skills such as managing jealousy, setting boundaries and coping with rejection.
Finding your way through
What I tell my patients – and what I have lived through myself – is that heartbreak does heal, though rarely on the timeline we want. The human heart and mind possess remarkable resilience.
I encourage those struggling to be honest about their pain rather than rushing to appear 'fine'. Talk to empathetic friends who will listen without judgment. If your mood darkens significantly or anxiety becomes overwhelming, please reach out to a mental health professional. In Singapore, organisations like the Samaritans of Singapore provide crucial support when things feel unbearable.
Sometimes heartbreak, painful as it is, becomes a doorway to growth. Many later reflect that surviving a relationship's end made them more self-aware or resilient. I have seen clients transform as initial grief subsides: they rediscover neglected passions, strengthen friendships, or even pursue long-deferred goals.
One patient, eight months after a devastating break-up, told me, 'I thought I was broken, but actually I was breaking open'. That phrase has stayed with me as a beautiful reframing of pain's potential.
A closing note
That young woman who sat in my office with red eyes, devastated by her boyfriend's sudden erasure of their relationship? She returned to see me two months later. Her eyes were clear, her smile genuine.
'I never thought I'd feel normal again,' she said. 'But here I am.'
She had not forgotten him, but the memory no longer consumed her. She had found her way through. I did remind her that healing does not follow a straight path. Some days will still feel heavy, but over time, the weight lifts.
As a human being who has experienced heartbreaks and as a psychiatrist who witnesses it professionally, I can promise you this: You are not alone. Your pain is valid, regardless of your age or circumstances. While the hurt may feel endless, it is not. With time and support, the sharp edges soften.
So, be gentle with yourself. Surround yourself with people who care. Seek help if the weight becomes too heavy to bear alone. The end of a relationship is not the end of you. One day, perhaps when you least expect it, you will wake up and realise the ache has softened. And in time, you will love, trust and hope again.
Dr Jared Ng is a psychiatrist and father to three teenagers and four very enthusiastic dogs. He is the founder and medical director of Connections MindHealth, and was the founding chief of the Department of Emergency and Crisis Care at the Institute of Mental Health. Dr Ng believes that while heartbreak is painful, it is also part of being human, and that with time, support and self-compassion, healing always finds its way back to us.
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