Why High-Achievers
Get Sick on Vacation
by Giacomo Hatanaka, LAc, MAcOM | Hidden Summit Acupuncture
I’d been working a lot. More than a lot. The kind of sustained, head-down, breaks-are-for-quitters stretch that you tell yourself is temporary, then you look up six months later and wonder where you went wrong.
Then I got on a plane to Bali.
Bali is one of the more beautiful places on earth. Rice terraces, warm water, the kind of light that makes everything look like a painting. I had been genuinely looking forward to this trip for months.
Guess what happened when I got there (pretty easy, given the title)? I became the sickest I had felt in years. No fever, but a sore throat that felt like I was swallowing gravel, a cyclonic headache that moved in like it owned the place, and a general full-body sensation that I can only describe as hot garbage. Violent, comprehensive, this-might-actually-be-it-for-me sick. In Bali. Surrounded by rice terraces and beautiful light. It felt like the universe was messing with me.
Around the same time, a friend of mine went to Disney World. Don’t worry, my friend is a full-grown adult, and yes, I realize that requires some explanation. Except, I’m not going to give it. She just loves Disney World; leave it at that. Anyway, she’s a savagely hard worker, almost too healthy, the kind of person who doesn’t take breaks and doesn’t get sick. Someone who lives on iron will alone. It’s disgusting. She got on a plane to Orlando, walked into the Magic Kingdom, and developed a brutal sore throat and headache within two days. Hot garbage: her words. Not kidding.
Two very different destinations. Same exact story. Same phrase for it.
I started paying closer attention after that.
This Has a Name,
and It's Not Bad Luck
What we both experienced is sometimes called leisure sickness, a term coined by Dutch psychologist Ad Vingerhoets in the early 2000s after noticing that a significant subset of people consistently became ill at the start of vacations and weekends. His research found it was most common in people with high workloads, strong feelings of responsibility, and a tendency to keep pushing through fatigue rather than rest.
Which, if you’re reading this blog, might sound familiar.
The conventional explanation (you got on a plane, you got exposed to germs, your immune system couldn’t handle it) is not wrong exactly, but it’s incomplete. Because the more interesting question is why a person who barely gets sick during months of grinding suddenly gets floored the moment they stop. The answer has less to do with the airplane and more to do with what sustained stress does to your immune system, and what happens when that stress suddenly lifts.
What Stress Does to Your Immune System
(The Short Version)
Cortisol, which your body produces in large amounts under sustained stress, has a direct immunosuppressive effect. This is not a design flaw. In short-term, acute stress, suppressing certain immune functions is actually useful — it keeps your body from mounting an inflammatory response at a moment when you need all your resources directed elsewhere. Fight now, heal later.
The problem is that your body was designed for stress to be occasional and time-limited. When cortisol stays elevated for weeks or months because the modern workload never really stops, that immunosuppression becomes chronic. Your body keeps deferring the “heal later” part indefinitely.
During this period, you often don’t get sick, which people tend to interpret as evidence that they’re fine. They’re not fine. They’re suppressed. The immune system is there, it’s just been told to hold its work orders and wait.
Then you go to Bali. Or Disney World. Or somewhere adults go. You exhale for the first time in months. Your cortisol drops, sometimes significantly and quickly. And your immune system, released from suppression, gets back to work — processing everything it’s been holding, mounting responses it deferred, catching up on a backlog that built up over months of chronic stress.
That catching-up process feels a lot like getting sick. Sometimes it is getting sick, because the lowered immune surveillance during the high-stress period left you more vulnerable to things you picked up along the way. Either way, the vacation isn’t what made you ill. The months before it did. The vacation just gave your body permission to deal with it.
The Immune Shift
You've Never Heard Of
Here’s a layer most people don’t know about, and it’s genuinely interesting.
Under sustained stress, the immune system tends to shift its balance away from what’s called Th1 immunity, which handles internal threats like viruses and abnormal cells, toward Th2 immunity, which handles external threats like allergens and parasites. This shift is driven largely by cortisol and the sympathetic nervous system.
What this means practically is that during a long high-stress period, your antiviral defenses are running below capacity. Your body is biased toward a different kind of immune response than the one you actually need. When the stress finally lifts and the system tries to rebalance, the transition itself can produce symptoms. Inflammation that was being suppressed surfaces. Viral responses that were being muted get louder. You feel it as a sore throat, a headache, fatigue, the general sense that your body is settling a tab.
This is why the sickness tends to arrive on day one or two of a trip rather than day five or six. It’s not the destination. It’s the release.
Heart rate variability measures the variation in time between your heartbeats. Counter-intuitively, more variation is better. A heart that beats with some irregularity in the intervals is a heart whose autonomic nervous system is actively and responsively regulating it, shifting fluidly between sympathetic and parasympathetic influence. A heart that beats with metronomic regularity is one where the nervous system has essentially locked into a single state, usually sympathetic dominance, and lost its flexibility.
Chronic over-extension (too much demand, not enough genuine rest) suppresses HRV over time. What’s interesting is that the things that restore it are not, primarily, more sleep. They are genuinely low-stimulation, undemanding, non-goal-directed activities: slow walks, particularly in natural environments. Sitting quietly. Breathing without trying to optimize your breathing. Doing something you love with no outcome attached to it. The nervous system recovers its flexibility not by being unconscious but by being given extended periods where nothing is being asked of it.
This is why I eventually noticed that the nights I slept best were rarely the nights after my most productive days. They were the nights after days that had some actual spaciousness in them. Days where I’d taken a walk without a destination or a podcast. Where I’d cooked dinner because I wanted to and not because it was on the list. Where I’d sat outside for twenty minutes and done genuinely, completely nothing.
The Type of People
This Happens To
In my experience, this pattern belongs almost exclusively to a specific kind of person. Someone who functions at a high level, takes their responsibilities seriously, doesn’t particularly like asking for help, and has gotten very good at pushing through. Someone whose baseline has quietly shifted so far toward output and obligation that genuine rest feels mildly uncomfortable, like a shirt that doesn’t quite fit right. And someone who we see in our clinic in Boise an absurdly high amount.
This person often doesn’t think of themselves as stressed, which is worth noting. They’ve adapted to it. Stress has become the background hum rather than an alarm, and the body adjusts its entire physiology around it. The adjustments work, more or less, until the moment they stop — which is usually the moment the vacation starts.
Almost every adult patient at our clinic fits some version of this picture. Not coincidentally, this is also the same population that tends to have disrupted sleep, chronic muscle tension, hormonal irregularities, and digestive issues that seem to have no clear cause. These things are not separate. They are all running on the same underlying engine.
What To Actually
Do About It
I want to give you something practical here, not just an tidy explanation for why you ruined your own vacation. Unsolicited, yes. But practical.
The most useful shift is to stop treating rest as a reward you get to collect after enough output, and start treating it as something your physiology requires on a regular basis in the same way it requires food and water. Not one big vacation twice a year that your immune system uses to settle its debts. Regular, actual downtime woven into the structure of ordinary weeks.
This is harder than it sounds for people who function the way I’m describing, myself included. But the biology is fairly clear on it. A nervous system that gets genuine parasympathetic recovery regularly maintains better immune surveillance, better cortisol rhythm, better sleep architecture, and significantly better resilience than one running on fumes between annual exhales.
Before trips specifically, it’s worth starting to dial back the pace a week or two in advance rather than sprinting to the gate. Easier said than done, I know. But walking into a vacation with your cortisol already dropping is a very different physiological situation than dropping off a cliff the moment the plane takes off.
Acupuncture, practically speaking, is one of the more effective tools for supporting this transition. It’s reasonably good at bringing a chronically activated nervous system into parasympathetic balance before it has to do so abruptly, and at supporting immune function in ways that reduce the severity of the rebound when you do finally rest. We see this clinically, fairly regularly, in patients who come in before travel.
As for me and my friend: I eventually had a good trip, once I stopped feeling like I was dying. She found the Magic Kingdom significantly more magical once her sore throat cleared up on day three. Neither of us has fully solved the underlying pattern. But we’re working on it.
If This Sounds
Like you
If you recognize yourself in any of this and you’re tired of your body using your vacations to stage a rebellion, come see us. Hidden Summit Acupuncture is in Boise, serving the Treasure Valley including Meridian, Nampa, and Eagle. We work with people who are great at everything except slowing down. Book online here.
Giacomo is a licensed acupuncturist and co-founder of Hidden Summit Acupuncture in Boise. He has a complicated relationship with cortisol and croissants, and will spend an entire afternoon re-reading a blog that he said would only take 20 minutes (this one).