Anxiety and depression after a breakup can trigger a mental illness you didn't have before. Here's one woman's experience.

By Sarah Bregel
Jun 13, 2019 @ 5:30 pm
Koen Meershoek/Stocksy

This past year, just before Christmas, I was utterly destroyed when my boyfriend broke up with me. We were both fresh out of marriages — our divorce papers hadn’t even been drawn up — and he thought the timing wasn’t right. That he seemed sad about it, too, made it harder for me to accept that the ending was even real.

He had stared at me with huge, weepy eyes and told me I was an anomaly, but then he made up his mind. He went cold, cutting me off completely, blocking my phone number and social media. I was shattered that someone I thought I’d be sharing my life with never wanted to see or speak to me again. I wasn’t just heartbroken, I was grieving. And then I got sick.

I had struggled, minorly, with anxiety before, but after the breakup I felt caught in a cycle of a very new-to-me depression and distress. The intense panic and racing thoughts felt like an assault on my senses. I couldn’t take a deep breath, I was shaky, and sometimes my limbs went numb. The anxiety made me feel like a shell of myself. The depression made it feel impossible to focus or stop crying, no matter how I tried to distract myself.

What a Broken Heart Can Do to Your Mind

I always knew breakups could be awful, but the extent of my emotional distress, and how long it lingered, didn’t make sense to me. I described my situation to Tina B. Tessina, PhD, a psychotherapist specializing in love and relationships, who has a private practice in Long Beach, California. She said that while breakups themselves can be extraordinarily painful, how well a person is able to cope with them has a lot to do with what else is going on in their life. Essentially, if the outside stressors are significant (mine were), it can intensify your pain, making it harder to recover from. “I think you projected all your other loss, grief, and out-of-control feelings onto the breakup, to compound the magnitude of the loss,” she wrote in an email.

Marisa Cohen, Ph.D., an associate professor of psychology and co-founder of the Self-Awareness and Bonding Lab, a relationship science lab in Long Island, New York, says breakups can absolutely trigger mental health issues to arise, or come out in full force, and agrees that surrounding circumstances are important. “There's a theory called the diathesis-stress model in which a person has a predisposition for the development of a disorder, and stressful life events are likely to make it surface,” she says. “These environmental stressors serve as the catalyst in a way.” In my case, getting dumped was an environmental stressor.

And I certainly felt that. I couldn’t eat, so I got in the habit of taking a few bites of cereal or nibbling on a graham cracker when I realized it had been hours since I’d put calories into my body. Still, I lost 20 pounds in just a few weeks, which was the least of my problems. Focusing on work, or anything besides my emotional distress, felt impossible. I’d wake up, get my kids off to school, then stare at my computer all day until pick up, unable to make my brain connect to my fingertips, which I had started picking at obsessively for hours of the day. Since I’m a freelance writer who has to self-motivate, this became massively problematic, and I would feel the crushing financial distress for months to come. The very worst part was not being able to be the mother I wanted to be. Not even close.

I imagined my pain would fade with time. Friends and family, podcasts, books on heartbreak, and my therapist all echoed this sentiment. But I felt like I needed more than time. I needed help. My grief didn’t move in a straight line. It got dull and distant, then came crashing down on me when I was least expecting it. I had nightmares about the man who had left me. I felt triggered when I dropped off my daughter at school, because it was close to his house. I had to actively distract myself from thoughts of him, in order to keep it together. I kept telling myself to get over it; it was "just a breakup," and I shouldn’t have been in so much turmoil. And while it may have been “just a breakup,” it had become much more than that. It had rapidly turned into a mental health crisis unlike anything I’d ever experienced. And I didn’t know my way out.

A Diagnosis: Adjustment Disorders, Stress, and Depression

My therapist diagnosed me with an adjustment disorder, which is exactly what it sounds like: a physical and emotional response when the stress of an event becomes too big to cope with on your own. It’s a stress response that can lead to situational depression, it usually takes hold within three months of a stressful event, and typically takes three to six months to resolve itself when the diagnosis is acute. It can move more quickly with treatment, which can include therapy and medication.

Having a name for what I was going through didn’t make it much easier to handle. I had a tremendous amount going on at the time of the breakup. I had recently ended a 10-year-relationship and was struggling to get along with my ex-husband; I had two kids to take care of, mounting financial stress, and an underlying mental health condition (generalized anxiety disorder, which previously only affected me when I tried to fall asleep). There were other jarring events around the same time, like my family cat died suddenly; my own health was shaky at best, and far from a priority for my attention. Basically, in the aftermath of the breakup, I felt like my entire life was crumbling from all angles and I was powerless against it. Ultimately, it was too much and my mental health suffered terribly.

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“A person doesn't exist in a vacuum. Therefore their surrounding environment influences — and is influenced by — their internal cognitions, emotions,” Dr. Cohen says. “An individual's personality is affected by the interaction between their thoughts, behaviors, and the surrounding environment.” To sum it up, when it comes to the pain of a breakup and whether or not it turns into something bigger, everything affects everything else.

Lauren DePino, a writer living in Los Angeles, has been there. She once found herself completely incapacitated after the end of a year-long relationship and up against a bitter mental health battle. “It happened on the heels of my grandmother’s death,” she says. “So, I’m sure that contributed to it.” Her grandmother had been a prominent figure in her life, and losing her relationship simultaneously became too much. She couldn’t sleep, lost weight, and acted out, begging her ex to come back. She started dating prematurely to help numb the pain. She hadn’t been diagnosed with any mental illness before, but says it’s likely she had anxiety, and it came out after the breakup. Adjustment disorder symptoms include anxiety, trouble sleeping or focusing on day-to-day tasks, and withdrawal from social activities, among others.

DePino worked with a therapist, who felt she was experiencing trauma from the loss of her grandmother — a multilayered response to an event that can bring on unpredictable emotions, including denial, or even physical symptoms — coupled with the difficult breakup.

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Eventually, she poured it all into a memoir which she is hoping to publish. “I felt that by writing about it, I was taking the pain out of me and putting it somewhere else,” DePino says. For her, the worst of it was over after about three months, but she says it took almost two years to feel completely emotionally healthy again. Now she’s in a happy, stable relationship, but is still wary of triggers, like certain songs, that bring her back to thinking about the breakup and the decline of her mental health during that time.

Moving Forward: How to Treat Adjustment Disorders After a Breakup

The most recent research finds that psychotherapy is the treatment of choice for adjustment disorders, and that’s what worked for DePino. Mayo Clinic adds that medication can be helpful in the short-term. For me, medication helped me find some distance from the grief, and get back to my life.

I also did quite a bit of walking in the woods, crying in my car without restraint, and, perhaps all too predictably, I had a fling with a hot mess bartender (emphasis on the hot, emphasis on the mess). But it took so much more than I imagined to feel free again: time, therapy, a two-month stint on antidepressants to cope with the adjustment disorder (which I ultimately decided to stop taking due to side effects). In the worst of times, I truly wondered if I would always be battling. I felt like the breakup had cracked me open and poured out a dark part of me that I had never known was there. And for a while, it had. But, while I might always struggle with my anxiety, my mental health crisis was largely situational. Like my psychiatrist had anticipated, it healed over, and wouldn’t require long-term treatment.

My fingernails grew back, as did my love handles. While the adjustment “disorder” is behind me, I’m still doing some adjusting. I’m trying to remember that plenty of people have once been so gutted by a breakup that it turned into something worse, or required help to get through. It doesn’t mean every discomfort is a crisis, or even “adjustment disorder.” But I’ve made space for that reality — that breakups can lead to breakdowns that require diligence to overcome. Sometimes, no amount of “this too shall pass” will do the trick or help propel someone forward. I needed more than that. But neither this breakup nor its aftermath means I was ever broken.

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