Feature Archive

Suffering From 'Let-Down Effect?'

Post-Stress Illness

By Richard Trubo
WebMD Feature

Reviewed By Charlotte Grayson

When Marc Schoen was attending college at the University of California, working toward his PhD in psychology, he repeatedly experienced a surprising health-and-illness pattern around the time of final exams. Although he survived and even thrived before and during the grueling exams, his body seemed to crumble as soon as those tests were over. Finally able to relax, he'd be preyed upon by one malicious infectious bug or another, most often causing colds or the flu.

"I managed to stay very healthy until finals were done -- and then I'd [collapse]," he recalls.

Later, when Schoen began treating patients at UCLA and Cedars-Sinai hospitals in Los Angeles, he'd never get sick himself -- until he went on vacation. Almost on cue, as his body transitioned from his hectic, stressful work schedule to times of relaxation, he would become ill.

That's when Schoen began studying the phenomenon of post-stress illnesses, only to find that his own experiences weren't unusual. While stress itself has been associated with health problems -- from high blood pressure to low-back pain -- another phenomenon, the so-called "let-down effect," may also be at work.

In the immediate aftermath of stressful times -- perhaps following an anxiety-producing project at work or a major family crisis -- when you finally have time to take a deep breath and unwind, that's when illness can unexpectedly strike. Just when you're letting down her hair, your ability to fight off illnesses may let you down.

"This effect has been associated with conditions such as upper respiratory infections, the flu, migraine headaches, dermatitis, arthritis pain, and depression," says Schoen, a psychologist and assistant clinical professor of medicine at UCLA.

Paul Rosch, MD, president of the American Institute of Stress and clinical professor of medicine and psychiatry at New York Medical College, concurs that while people respond differently to stress, "when individuals are subjected to chronic stress, some of them are going to show physical or psychological effects even after the stress itself is relieved."

How Does This Happen?

When you're straining and struggling under the burden of work or family pressures, your body releases a number of chemicals -- including stress hormones -- which mobilize your immune system against illness. But when the stressful period ends, your immune system pulls back its troops, and the body becomes less vigilant in weeding out invaders. At the same time, says Schoen, a reservoir of body chemicals called prostaglandins, left over from the stress response, tends to produce inflammation, and can trigger problems like arthritic pain and migraines.

"Illness during this let-down period may come in two ways," according to Schoen, author of When Relaxation Is Hazardous to Your Health. "It could be related to something we were exposed to in the throes of stress. Or it might be something that develops afterward through this open window, where any organisms around us have a far greater chance of infecting us."

Elizabeth Carll, PhD, clinical psychologist in Huntington, N.Y., ran support groups and stress-management programs for relatives of soldiers serving in the Persian Gulf War in 1991. "About 80% of these family members had continuous colds that they weren't able to shake, which in some cases persisted even after their loved ones had returned home."

While the let-down effect can cause trouble at any time, many people with pressure-packed jobs seem particularly susceptible to illness when they ease up on weekends, or when they finally reach retirement age and come down for good from their high-wire act. "For someone used to a high level of ongoing activity, who has their identity tied up in their job, retirement can be a real problem," says Carll. "It may become a source of stress in itself."

Defusing the Let-Down Effect

"Just as stress is different for each of us, there is no stress-reduction strategy that's a panacea," says Rosch. "Exercise, meditation, or yoga work great for some people, but prove dull and stressful when arbitrarily imposed on others. You have to find what works for you."

Here are some options to help fight off the ills of the let-down effect:

  • Schoen recommends techniques that activate the immune system a little, and thus keep it from slowing down too rapidly after a period of stress. Try short bursts of exercise -- even just five minutes in length -- which can trigger a positive immune-system response. "Walk up and down the stairs in your office building," says Schoen. "Or after a stressful day at work, instead of coming home and vegging-out in front of the TV, take a brisk walk for a few minutes."
  • Try some mental problem solving, like crossword puzzles, under time constraints. "Several studies show that doing math computations at a rapid pace actually increases immune-system activity," says Schoen.
  • Practice relaxation techniques such as deep breathing, which can give your mind and body a rest stop from the day's anxieties. Consciously make yourself breathe slower, inhaling deeply and exhaling naturally. Become aware of the gentle rising and falling of your abdomen. This deep breathing can lower your heart rate, slow your brain waves, and even reduce your blood pressure. Paying attention to your breathing is actually a simple, calming form of meditation.

Originally published Sept. 2, 2002.

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Last Editorial Review: 1/31/2005 4:41:26 AM



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