There's a joke my colleagues and I make with each other, and it took me years to notice that it speaks to something deeper.
We finally get to take a break, we go away, and when we come back, there is so much waiting for us that within a few days we say to each other, "I need another holiday." Everyone laughs, everyone means it. And I used to be exactly that. I'll come back from a week away and I'll be straight into heavy stressful work.
And the rest I had would fade so fast that within a few days it felt like it had been months since I had the holiday. Not days, months. This is not to say that holidays are pointless. They aren't.
There's actually good evidence that they help, but there is also evidence for what happens next after a holiday.
So for today's episode, the question is why the breaks don't hold.
And what that actually tells us about how we manage our nervous systems
and what I do differently now.
Welcome to Brain Health FM, neurologist's practical guide for energy, focus, and performance with me, Dr. Sui Wong.
I'm a consultant neurologist and neuro-ophthalmologist in the UK, and this podcast is part of my mission to inspire a brain health movement because better brain health means better wellbeing, and that ripples outwards to families, to communities, and beyond, and it starts with you. In the last three episodes, we looked at how running wired could cost you and what you can do in 90 seconds.
Today, the answer almost everyone reaches for first and why it doesn't do the job you're asking of it
Let me start with the research because it's unusually clear. There's a meta-analysis, which pooled seven studies and asked exactly this question: Do we recover from holidays?
The answer is yes. Holidays have a positive effect on health and wellbeing, a small effect, but a real one.
And the same analysis measured what happens after you get back to work. The effect fades, and here's the part I find striking. It fades at almost exactly the same size as the benefit. The holiday gives you something. Going back to work takes it away again, roughly pound for pound There's a second study that puts a timeline on it, and it's more brutal than I expected.
Fifty-four employees were measured before a long summer holiday, during it, and then one, two, and four weeks after.
Their sense of wellbeing rose during the holiday. That's great. And then it returned to baseline immediately after they went back. Not by the second week, not gradually, directly after.
one thing lasted though, and that was rumination. Rumination, that churning where your mind keeps turning work over, dropped during the holiday and stayed below baseline for almost two weeks on return from the break.
So something did persist for a bit longer. It just wasn't the feeling of being rested.
Now, the finding in that study that I most want you to hear.
The rise of well-being during the holiday and the fall afterwards were both greater in people who worked most compulsively.
Listen to that again. The harder you drive yourself, the bigger the holiday high and the bigger the crash when you go back. If you have ever wondered why your friends seem to come home from a week away merely refreshed while you come home transformed and undone within days, that may not be your imagination.
The people who need it most get the sharpest version of both halves.
Here's how I'd explain it, and this is my opinion rather than something a research trial has proven. A holiday is usually about a fortnight long. Your nervous system, however, is responding to your day-to-day, your baseline. Think back to the recent episode where I give the analogy of stress and a bowl of soup.
The bowl is your capacity. The soup is the stress. A holiday empties some soup out. It doesn't make the bowl any bigger, You come back to the same bowl, and the same amount of soup starts going straight back in.
And there's something else which nobody talks about. What are you coming back to? If your work sat untouched for two weeks and is now waiting for you in a growing pile, then the first three days back on the return to normal, they are worse than normal.
You've taken a fort- You've taken a fortnight off work and come back to it compressed into your first week, which may be part of why the benefit disappears on contact. So thinking in advance about how to avoid this, if possible, is something that may help Here's something I heard somewhere years ago, and I wish I could remember exactly where I heard it so I can give it proper attribution.
The idea was this: sometimes we avoid making a decision, but by not deciding, it is a decision too.
and I wanted to link this with the concept of how we deal with our diaries. Having said that, I acknowledge that I know your diary is not entirely yours. Mine isn't either. Clinics may get overbooked. Email queries keep piling in without sufficient time allocated in our work week to reply to them all.
Well, as a doctor anyway, we don't seem to have time allocated in our work week to look at emails. So there is indeed a great deal in a working week that you did not choose.
But we seem to accept some of it without ever really looking at it. And I say that as someone who did exactly that for years without consciously considering my week. For a long time, my answer to a hard year was a holiday. That was a decision. I just never made it on purpose.
Here's what changed for me, and it's the whole point of this episode. I used to treat a break as an escape, something to run to when you can't take it anymore.
And escape has a problem built into it. If rest is what you do when you can't cope, then the pressure has to build all the way to breaking point before you're allowed any, like a cycle of boom and bust. Now I think of it differently. Rest is part of the rhythm, not something I flee to, something that's already in the week.
It's the difference between waiting for the pressure to overflow and releasing it on schedule. For example, here are three things I do. There are much more, but I'll just share three for now. One is that I do my hardest thinking first thing in the morning. That's when my focus is best, when I'm likely to achieve the most impact, and I'm least likely to be interrupted.
The difficult work, the data analysis for my research studies, the writing of the books, the research papers, they get done early in a quiet space before I leave for work in the hospital. Not when I can fit it in, but first thing in the morning.
Another example is pre-planning gaps between meetings. I schedule in a 10-minute gap to close the loop before moving on to the next meeting. I admit it doesn't happen always, but I do the best I can to schedule it into my diary.
This is because I know exactly what it costs when I don't do it. For example, if I have to click straight from a work meeting onto a webinar, I know it's harder for me to be present for the first few minutes of the teaching because it's like a little residue from the last meeting taking away the full focus, from being in the webinar
And my third example is scheduling movement as breaks. For example, after three hours of deep work writing a tough paper, I plan for a walk or a run to clear my head, not because I'm flagging, because I planned it, and the movement itself clears my thinking in a way that pushing on through never does.
I'll give you a little bonus. I also love my mindful movements in the morning. It does two things: the movement for my physical health, better brain resilience, and the mindfulness practices helps with grounding,
preparing me for the day ahead.
If you look back at these examples I've given, every one of them is decided in advance, not taken when I'm already depleted. That's the difference between an escape and a rhythm.
That's why relying on a holiday only isn't the full answer. A fortnight away in August can't compensate for a year with no gaps in it.
Now, none of this is me telling you not to take a holiday. Plan the holiday. Look forward to it. Think of it, though, as one of the rhythms of your year. Just don't push flat out by the time you reach it,
Because when your day-to-day rhythm is sustainable, the holiday isn't a rescue. It's something you enjoy more , and return from more easily. Now over to you. How could you make one intentional change to your daily rhythm that gives you a breather so the big breaks, the holidays, become something you enjoy rather than something you're desperately waiting for.
At the end of this episode, I'm going to ask you for something small. It takes a minute. It makes a big difference to a new podcast. But first three quick-fire questions I often get asked first question, what's the best type of holiday? Do I need to be doing something restful or is an active holiday better?
My answer is either, but the key thing is to move. As a general principle, it's a good idea to move, but vary according to how hard and to listen to your body. For example, one of the things I suggest to many patients is to walk every morning, and how vigorous they walk depends on the energy they have that day on a day when they feel energetic, go for it, make it brisk, go for a sweat.
On a day when they feel tired, just this gentle stroll, a mindful walk, noticing the surroundings, noticing the flowers, the garden, just having a slow mindful experience.
I suppose what I'm saying is the thing to avoid isn't activity, it's about avoiding being overly sedentary during a holiday.
Second question: Is it better to take one long break or several short ones? My answer is that the length matters less than what happens to your work while you're away. So rather than one rule, two questions are worth sitting with to answer this question. One, what actually happens to your work whilst you're away?
Does it get covered? Does it stack up? And number two, how long does it take for you to stop thinking about work? For some people, that's two days. For others, it's most of the week. So if you're taking four days off and it takes three days to switch off, that's effectively just one day off in your mind.
So that might be something to consider when you're planning a breaks. Third question, why do I always get ill on holiday? Well, can you believe it? This actually has a name, leisure sickness. In a Dutch study of nearly nineteen hundred people, About 3% recognized themselves in the description of getting ill at weekends or on holiday.
The commonest symptoms were headaches and migraines, fatigue, muscle aches, and nausea. And with holiday seasons specifically colds and flu-like infections.
And the part that surprised me about this study was that the risk factors weren't diet or travel or what people did on the trip. The risk factors were high workload, difficulty adapting to not working, and a high need to achieve and a high sense of responsibility about work which is a description of many of the people listening to this podcast.
But don't worry though, if this is you, as I want to state that the research was a pilot study, in other words, preliminary work based on what people reported about themselves.
And the authors also stated that the mechanism still needs proper investigation.
So the phenomenon is described, not explained.
If this keeps happening, worth asking yourself, is this a signal about your everyday and not just your holiday? That said, though, if you're getting these symptom often, please don't just file them away under leisure sickness.
Get them checked. Speak with your doctor
As you know, this podcast is for education purposes. It's not medical advice.
If you have a question you would like me to answer in one of these episodes, send them to me on a form at brainhealth.fm
What can you take from this episode? One small thing, and it's the smallest one yet. Look at tomorrow's diary. Find two meetings that run back to back
and put 10 minutes between them.
Just to create a little gap. If you want to add something to it, perhaps last episode giving you a 90-second breath option. That's it. One gap decided in advance. And one more thought before I let you go, Because I don't want you to leave thinking holidays are a waste of time.
The most recent break I had was a forest holiday in Norfolk with my sister and two nieces.
We cycled, we cooked dinner together, we played Jenga after dinner, which is a wooden tower block game if you're unfamiliar with it. I got to chat properly with my sister without rush. What was special about this time was that it was time deliberately carved out with family, connecting with those who matter to us.
So here's a reframe I'd offer. Stop asking your holiday to repair a year. It can't. It was never built for that. Ask it instead for what it can actually give you, time with the people you love and something you'll remember. Build the recovery into your weeks and let the holiday be about something better than recovery.
Three quick things before we finish. First, if this episode was useful, please leave a review wherever you're listening. It takes a minute, and it's how other people who need this find the show. If you're watching on YouTube, please leave a comment. Second, if someone comes to mind while you're listening, someone who comes back from every holiday needing another one, send them this episode.
Third, if you'd like something to use before next week, Thursday Tips is my free weekly newsletter.
The link to subscribe to it is on brainhealth.fm. I'll also put the link in the show notes.
In the next episode, we'll talk about the moments where your brain is not as sharp, Like the moment a name or fact won't come to you in a meeting in front of people, and the conclusion you quietly reach that this is just what happens now that it's age.
Sometimes it is, often it isn't, and next week I'll show you how to tell the difference. I'm Dr. Sui Wong. Thank you for spending this time with me on your brain. It's the best investment you will make all week.
