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Journalism of Courage
Written by Dr Astik Joshi
A 34-year-old woman, with a prior history of anxiety, had extreme panic attacks after unexpectedly separating from her fiancé just weeks before their planned wedding. Her meltdowns and emotional outbursts were such that it impacted her daily functioning. Some around her thought she was over-reacting, some were judgmental about letting one episode in her life blinding her to the big picture of life’s possibilities. So, she came alone for the consultation, seeking help.
A last-minute relationship breakup — particularly one close to major life milestones such as marriage — can feel like a sudden adversity. Psychiatrists describe it as a crisis event: unexpected, emotionally destabilising, and capable of disrupting one’s mental, social and occupational functioning. How one responds in those first few days and weeks often determines whether the experience becomes a source of long-term distress or an opportunity for growth and resilience.
Any sudden adverse life event requires thoughtful crisis management. In the immediate aftermath of a breakup, individuals commonly experience grief, shock, anxiety, emotional dysregulation, and even panic. Sleep disturbance, loss of appetite, racing thoughts and feelings of helplessness are not uncommon.
At this stage, psychosocial support plays a critical role. Support from friends, family, or trusted colleagues can help contain emotional distress. In some cases, medications may be indicated to manage acute anxiety or panic symptoms. Importantly, seeking professional help from a mental health professional is advised when symptoms begin to interfere with daily functioning, work, or relationships.
Since the 34-year-old woman was in acute distress, we prescribed her medication and then gradually tapered it and began psychotherapy or talk therapy to process the churn of emotions and then stabilise them. Once her anxiety and emotional dysregulation were brought under control, we developed a structured crisis-management and contingency plan to prevent relapse and help her regain emotional balance.
As her mood stabilised, therapy helped her reflect on the relationship more objectively. Over time, it became clear that persistent communication difficulties between the couple had led to a series of misunderstandings that ultimately culminated in the separation. With the support of her social network and ongoing therapy, she gradually emerged from the crisis. Today, she continues to thrive both professionally and personally, having transformed a painful experience into a period of significant personal growth.
The therapeutic approach used in this case focused on three core goals: acceptance, emotional regulation and skill-building.
Key areas of therapy included:
1) Staying in the present (“here and now”), rather than ruminating over the past or catastrophising about the future.
2) Learning healthy coping mechanisms to deal with emotional distress without avoidance or self-blame.
3) It is okay to not be your best, give yourself time to regroup and heal. Take up an unfamiliar activity so that the mind is challenged to do something new.
4) Seek help from friends and family to get through this period.
5) Reduce emotional intensity through self-soothing strategies and deep-breathing techniques.
6) Develop assertive communication skills, enabling individuals to express needs and boundaries respectfully in future relationships.
Acceptance does not mean approval of what happened; rather, it allows individuals to stop fighting reality and redirect their energy toward healing and growth.
Public discussions around celebrity breakups, such as that of Smriti Mandhana, can serve a larger purpose if they encourage compassion and awareness around mental health. Sudden relationship endings are not signs of personal failure. When managed with timely support, professional guidance, and self-compassion, they can become turning points that foster resilience and wisdom.
(Dr Joshi is child, adolescent and forensic psychiatrist, Fortis Hospital, Delhi)
