Stress and Immune Response: Is the 'Let Down Effect' real?

Today we're looking at the let down effect, including what we know about the effect of psychological stress on the immune system. Neurotransmitters, Hormones, and Cytokines, oh my!

Further Reading:
Gao, X., Cao, Q., Cheng, Y., Zhao, D., Wang, Z., Yang, H., ... & Yang, Y. (2018). Chronic stress promotes colitis by disturbing the gut microbiota and triggering immune system response. Proceedings of the National Academy of Sciences, 115(13), E2960-E2969.

Chiharu, K. U. B. O. (2003) Stress and Immune Function. JMAJ, 46(2), 50–54.
Schakel, L., Veldhuijzen, D. S., Crompvoets, P. I., Bosch, J. A., Cohen, S., van Middendorp, H., ... & Evers, A. W. (2019). Effectiveness of stress-reducing interventions on the response to challenges to the immune system: a meta-analytic review. Psychotherapy and psychosomatics, 88(5), 274-286.

Lipton, R. B., Buse, D. C., Hall, C. B., Tennen, H., DeFreitas, T. A., Borkowski, T. M., ... & Haut, S. R. (2014). Reduction in perceived stress as a migraine trigger: testing the “let-down headache” hypothesis. Neurology, 82(16), 1395-1401.

Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychological bulletin, 130(4), 601.

[damongibson]

Great video! I've been struggling with this question myself and also came across only that one paper. I suspect the let-down effect is indeed a real physiological phenomenon, given the overwhelming amount of anecdotal evidence. Maybe it's just really hard to accurately research 🤔

[shawnaford]

I had an extreme let down effect. I was burned out from work, got a divorce ( one reason was I was always sick on a day off and I worked too much) got cancer. Even with modified work to only Monday to Friday. In a November got the divorce final, great new work contract, good news the cancer surgery was low grade, clear margins, had a vacation and then came back to insomnia and migraines, in the end turned out to be depression. TRD depression. Glad I found your YouTube.
My alternative is that chronic stress is disruptive. And being sick on days off was just acknowledging the flu like symptoms and need for rest.

[samlikesninjaturtles]

I read about the letdown effect but didn't realize it wasn't actually scientifically tested! Thank you for helping me make an informed decision. How did this get so popular when there is so little proof?

[Thoughtpologetics]

I think it’s a more study thing…

Web MD cites interviews with 2 different doctors Marc Schoenberg and Paul Rosch, who attest to this being a real phenomenon

Now Marc Schoen has his own site and has done other interviews about this in publications like US News… but he isn’t the only doctor who claims this phenomenon to be real based on their own and patient experiences in practice

Anita Wang, Erin Barrett, Mark Loafman and others support this let down effect… but the hard evidence isn’t there… and unfortunately it may never be there…

So to me and other doctors, it makes sense, I’ve seen it, they’ve seen it and experienced it… I think something is there…

[samijust]

My daughter could be in a scientific study!
I’ve been trying to help her monitor her activity level because she gets physically ill the day after a busy day.
Shes pale, vomits and is an emotional wreck if she can’t sleep an excessive 14 hours to regain her health.
I wish I could help figure it out- she’s suffering.

[krystopherlee]

I got sick in December after classes and I finally got a break. And then AGAIN three days ago when my break between terms started. I also work two jobs so this makes sense why I’m so stressed out and keep getting sick. Next time, I’ll request the next break off from both jobs and see if I get sick

[claytonyoung]

I don't like that this is presented like kids getting stressed from studying. I have an extreme reaction after a stressful situation and it has nothing to do with school whatsoever as I am not a student.

[cdavis]

I've had weekend migraines for years. I could never figure it out. They never showed up except on weekends. I got to a point where I dreaded the weekends. Not sure where to turn for these. I've been taking Imitrex, it stops them but makes you feel like crap as a side effect of taking them. HELP!