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Perhaps it's a case of 'leisure sickness'

December 31, 2007|Lindsay Minnema | Washington Post

It may not be the eggnog, the endless holiday music or even the pounds of sugar cookies that are making you ill. It may be the same thing that seems to set you back when you finally head for a weekend of winter sports or jet off for a week on the beach: You're off work.

Ad Vingerhoets, an associate professor of clinical health psychology at Tilburg University in the Netherlands, calls it "leisure sickness." Just when you take a break from your busy schedule to enjoy a little relaxation, your leisure time becomes anything but -- full of aches and pains, cold- and flu-like symptoms and other health complaints.


"The simple idea we have -- that when you are busy, your body is activated, and when you are not busy and have nothing to do, your body is relaxed -- is simply not the whole story," Vingerhoets says. "For some people, [a holiday or vacation] seems to be pathogenic."

Some say this is pop psychology, and there are experts who are skeptical. However, even some who dismiss leisure sickness as a wastebasket diagnosis concede there is science to support the idea that unwinding is difficult for many of us.

The underlying cause of the problem, according to Vingerhoets, appears to have a lot to do with stress. He has been fielding calls about the theory since 2001, when his team of researchers reported on their survey of 1,893 Dutch people in which about 3% of respondents indicated that they seldom felt ill during work days but got sick during weekends and vacations. Many attributed their symptoms to difficulties transitioning from work to non-work, to stress associated with travel and to balancing a heavy workload.

Respondents who identified themselves as workaholics or perfectionists tended to have a much harder time.

Most explanations for the phenomenon remain unproven.

Paul Rosch, president of the American Institute of Stress in Yonkers, N.Y., and a professor at New York Medical College who has been involved in stress research for more than 50 years, is one of the skeptics. An inability to relax on vacations and holidays has long been a well-known characteristic of Type A behavior, he says.

Leisure represents a time when Type A people are not in control, Rosch explains; the headaches, nausea and fatigue they might experience are a response to this stress. "It's all psychosomatic . . . not a bona fide diagnosis," he says.

But Esther Sternberg, a researcher of neuroendocrine immunology at the National Institutes of Health, disagrees. Sternberg, author of "The Balance Within: The Science Connecting Health and Emotions," calls leisure sickness real, tied to the release of hormones under stress.

In times of stress, the body's adrenal glands release adrenaline, which makes the heart beat faster and causes a person to feel sweaty and anxious. Adrenaline gives a boost to the immune system, the body's defense against infection, Sternberg says. But while adrenaline is pumping, so is cortisol -- a potent anti-inflammatory hormone also released by the adrenal glands.

"The reason [cortisol] works as an anti-inflammatory is because it's turning off the immune cells," Sternberg says. "You're no longer able to effectively fight infection."

The two hormones are timed differently, with adrenaline starting up and shutting down much faster than cortisol. "What happens when you stop doing what it is you were doing that stressed you is that the adrenaline shuts off first," Sternberg says. "You are left with this cortisol floating around. And if at that moment someone coughs in your face, you get sick."

Another hypothesis: Vacations and holidays involve greater exposure to germs that make you sick. Or another: Much of the year, busy people ignore the signals they are sick because they don't have the time to acknowledge them.

But Sternberg says stress hormones go a long way toward explaining why most people who suffer from leisure sickness on vacation experience their symptoms within the first couple of days after they stop work, as Vingerhoets observed in his survey.

"There is a biology to it," Sternberg says. "There is enough evidence in other settings. . . . to say that leisure illness is probably a real phenomenon."

Adds Vingerhoets, "I have spoken with people from many countries -- from . . . Brazil to Australia. In all of these countries, they recognize it."

Suena Huang, an instructor of psychiatry at George Washington University Hospital, says dealing with the syndrome may require rethinking your outlook on success. "Someone who's a perfectionist may impose higher expectations on himself and bring about higher anxiety on himself," she says.. "Instead of seeing perfection as the goal, perhaps seeing a balance as the goal would be one way to go -- working leisure activities and relaxation time into each day."

Huang says she sees many workaholic patients who are prone to leisure sickness. She encourages them to accept their imperfections.

Vingerhoets and Sternberg also recommend regular exercise. "If you're under such chronic stress that you're impairing your immune system, you need to pace yourself," Sternberg says. "You can't expect to push your body to the breaking point and not have it break."

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