Leisure Sickness: Why High Performers Get Sick on Vacation?

By Sabine Bright, LICSW · Psychotherapist in Boston · Updated October 2026

You've been counting down the days for weeks. The inbox is finally quiet, the bags are packed, and the out-of-office reply is on. Then it hits: the scratchy throat, the pounding headache, the heavy fatigue that keeps you horizontal in a beautiful place you can't enjoy.

If you keep asking yourself why you get sick on vacation, you're not imagining it. The pattern has a name, leisure sickness, and it tends to hit people who run at full capacity the other 50 weeks of the year: executives, founders and professionals under sustained pressure. The short answer: Getting sick on vacation is usually a combination of three things. Accumulated stress has been masking symptoms, stress hormones drop once the pressure lifts (the "let-down effect"), and travel adds its own strain on the immune system. Chronic stress and burnout make all three more likely.

What Is Leisure Sickness?

Leisure sickness describes developing symptoms such as headaches, fatigue, muscle aches, nausea or flu-like complaints on weekends and vacations rather than during the work week. Dutch psychologist Ad Vingerhoets and his colleagues at Tilburg University introduced the term in a 2002 study in Psychotherapy and Psychosomatics.

The researchers surveyed a representative sample of 1,893 adults in the Netherlands, and around 3% recognized themselves in the description of weekend or vacation sickness. Most of them had lived with the pattern for more than ten years, and it typically began during a stressful or busy period of life. Vacation symptoms usually appeared in the first week off; weekend symptoms most often on Saturday, the day after the last workday.

A few honest caveats: leisure sickness is not a formal medical diagnosis, the original study relied on self-reports, and research since then has been limited. A 2025 survey by IU International University of Applied Sciences among 2,004 employees in Germany suggests the experience is widespread: about 72% said they had felt ill or exhausted on days off at some point, and roughly one in five said it happens always or often.

Who Gets Leisure Sickness: The High-Performer Profile

One finding from Vingerhoets' research is especially relevant if you lead a team, run a company or carry high-stakes responsibility. The people affected stood out for their heavy workload, a strong sense of responsibility for their work, perfectionism and difficulty relaxing. Many said they felt guilty when they weren't working and couldn't put work out of their mind on vacation. What they did on their days off made little difference. Their lifestyle during weekends and vacations was no less healthy than that of the comparison group, and they enjoyed their leisure activities just as much. The problem isn't the vacation. It's the way you operate in the weeks before it. This is the same profile that makes someone effective under pressure: you push through, stay on and handle what others can't. Those strengths turn into a liability when your body only gets permission to slow down once a year.

"As someone who's usually resistant to seeking help, I've really appreciated that she doesn't just nod and ask, 'and how does that make you feel?'; she gives you real, practical tools. [...] It's equal parts science, strategy, and genuine human connection" –Client review

If this sounds like you: the pattern can be changed without lowering your standards. Schedule your personal 1:1 consultation to get clarity on what's driving it and what the right next step looks like.

The Let-Down Effect: Why Symptoms Appear When the Pressure Drops

The most widely cited explanation is the let-down effect, and it centers on your stress hormones. When you're under pressure, your body releases cortisol and adrenaline. In the short term, these hormones help. They sharpen your focus, dampen pain and keep inflammation in check, which is why you can power through a deadline-heavy week without so much as a sniffle.

The theory goes like this: when the pressure finally lifts, cortisol levels drop and that protective cover fades. Symptoms that were simmering in the background, or a virus you picked up days earlier, suddenly come through. The same pattern can show up after a board presentation, a product launch, a closing or any intense stretch of work. Experts aren't fully settled on this. Some suggest we don't get sick more often on vacation at all; we simply notice symptoms once we slow down and there's finally room to feel them.

Burnout and Your Immune System

Short bursts of stress are one thing. Chronic stress is another, and it's where burnout enters the picture. The World Health Organization describes burnout as an occupational phenomenon that results from chronic workplace stress that hasn't been successfully managed. It is characterized by exhaustion, mental distance or cynicism about your job, and reduced professional effectiveness. It isn't classified as a medical condition, but it can quietly wear down your health. Here's how burnout connects to getting sick on vacation:

• Your immune system gets worn down. When stress hormones stay elevated for weeks or months, immune cells can become less responsive to them. Over time the body is slower to respond to early threats and takes longer to recover. • Stress hides your symptoms. Elevated cortisol raises your pain threshold, so you keep pushing through headaches, sniffles and sore muscles without really noticing. • Healthy habits slip. Burnout usually comes with short sleep, skipped meals and no movement, all of which your immune system depends on. • You arrive on empty. If you reach your vacation already depleted, your body has nothing in reserve for the changes in sleep, climate and routine that travel brings.

If this sounds familiar, learn more about burnout therapy for executives in Boston.

Signs Your Vacation Sickness Might Be a Burnout Warning

Getting sick once on a trip doesn't mean you're burned out. But if several of these sound familiar, your body may be asking for more than a week away: • You get sick at the start of almost every break • You feel exhausted even after resting • You can't switch off, or feel guilty when you're not working • You catch frequent colds or feel run down throughout the year • You dread returning to work before the vacation has even started • Your sleep is regularly disrupted This list isn't a diagnosis. If it describes you, a conversation with your doctor or a mental health professional is a good next step.

Why Travel Makes Getting Sick More Likely

Stress isn't the only factor. Travel brings its own set of immune challenges: • New germs. Airports, planes, trains and crowded attractions expose you to viruses your body hasn't met before. William Schaffner, professor of preventive medicine at Vanderbilt University Medical Center, has pointed out that mass transportation contributes to the spread of colds and flu. • Dry cabin air and dehydration. Both dry out your nose and throat, your first line of defense. • Disrupted sleep and body clock. Your internal clock helps regulate your immune system, so jet lag and late nights leave you more vulnerable. If your sleep is already fragile before you leave, sleep and recovery deserve attention in their own right. • Changes in food, alcohol, sun and climate. Each one is a small stressor, and they stack up.

7 Ways to Avoid Getting Sick on Vacation

You can't eliminate the risk completely, but you can stack the odds in your favor.

1. Start winding down before you leave. Build short breaks into your workdays in the week before your trip instead of sprinting at full speed until the moment you walk out the door. 2. Protect your sleep. Aim for consistent, adequate sleep in the days before departure rather than a late night to clear your inbox. 3. Give yourself a buffer day. Finish work at least a day before you travel so you're not packing, wrapping up projects and heading to the airport all at once. 4. Ease into rest. Treat the move from work to leisure as a gradual transition. Vingerhoets and his colleagues suggested that exercise at the end of your last workday may help your body shift gears. 5. Hydrate and eat well while traveling. Drink water before, during and after your journey, and don't let travel days turn into a string of airport snacks and skipped meals. 6. Mind the basics of germ defense. Wash your hands, keep up with recommended vaccines such as the flu shot, and give yourself time to acclimate after long flights or big climate changes. 7. Deal with the root cause. If chronic stress is the real driver, vacation won't fix it alone. Regular movement, breathing exercises, firmer work boundaries and professional support all help your body reset.

How Therapy Helps With Stress, Burnout and Leisure Sickness

Sleep, hydration and a buffer day help, but they work around a pattern that keeps your system in overdrive. Therapy changes the pattern itself. Vingerhoets' team made the same recommendation: when workload and an inability to relax are behind the symptoms, they suggested psychological support aimed at changing how people think about work, along with stress management. In their study, people who recovered from leisure sickness most often credited a job change or a change in their attitude toward work.

In my practice, I work with executives, founders and high-pressure professionals in a structured, outcome-driven process rather than open-ended talk therapy:

1. Assess: We identify the patterns, triggers and indicators behind your stress, including what happens in the weeks before you take time off. 2. Stabilize: We use targeted, evidence-based interventions such as cognitive behavioral therapy (CBT) to change the habits that keep stress running: perfectionism, difficulty saying no, guilt about resting. 3. Recalibrate: We translate those changes into your real schedule, so recovery becomes part of how you operate instead of something you get once a year. Getting sick every time you stop isn't bad luck, and it isn't weakness. It's a signal.

What to Do If You Get Sick on Vacation Anyway

If you're already feeling rough, rest, drink plenty of fluids and scale back the itinerary so you can recover instead of pushing through. Don't treat it as a failure; it's often a sign your body finally got permission to slow down. Seek medical care promptly for a high fever, trouble breathing, severe or unusual symptoms, or anything that worsens or doesn't improve.

Frequently asked questions

Is leisure sickness real?

The experience is real for many people, and the term appears in research and in dictionaries. However, it isn't recognized as a medical diagnosis, and scientists still don't fully understand how it works.

Why do I get sick on weekends?

Leisure sickness covers weekends as well as vacations. The mechanism is the same on a smaller scale: the pressure of the work week drops, and symptoms that stress held back can surface, most often on Saturday. If it happens most weekends, your recovery during the week isn't keeping pace with your workload.

Can stress and burnout really weaken your immune system?

Chronic stress is associated with a less effective immune response and greater vulnerability to common infections like colds and flu. Short-term stress is different and can temporarily boost certain immune responses.

The Bottom Line

Getting sick on vacation is rarely just bad luck. It's usually a mix of accumulated stress, a sudden drop in tension and the demands of travel itself. Treating vacation as the only time you rest asks too much of a single week. The more you build recovery into your everyday routine, the more likely it is that your time off will feel like time off. Struggling with stress or burnout? I work with executives, founders and professionals in Boston who want to stay effective without paying for it with their health. Schedule your personal 1:1 consultation.

About the author: Sabine Bright, LICSW, is a psychotherapist in Boston who works with executives, founders, high-pressure professionals and dual-career couples on stress, burnout, sleep and anxiety. Learn more about Sabine.

Sources • Vingerhoets et al. (2002), Leisure Sickness: A pilot study on its prevalence, phenomenology, and background, Volltext (Tilburg University) • PubMed • IU International University: Leisure Sickness, Pressemitteilung 24.06.2025 • IU International University: Studienseite Leisure Sickness • WHO: Burn-out an "occupational phenomenon" • sabinebright.com

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