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.
"Help me ... help you. Help me, help you."
That famous line from the film Jerry Maguire may be the best advice a
doctor could give his or her patient.
"Some patients have the attitude, 'I'm putting myself in the hands of a
professional,'" says Stephen Permut, MD, chairman of family and community
medicine at Temple University School of Medicine in Philadelphia. "They want
you to make all their decisions for them."
Permut prefers to have patients get involved in their own care and engage
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