After a tree fell on her house, her depression lifted. But then came the ‘let-down effect.'

During a March nor’easter last year that hurled heavy snow and high winds at the Philadelphia area, a humongous oak tree crashed onto our house in Bala Cynwyd, destroying much of the top two floors. My husband was at work, and my children were at school. I was home working in a part of the house that went unscathed, and as always, our dog was with me.

In another stroke of luck, the tree fell during the day. Had it happened at night, my children would have been asleep in two of the bedrooms that were destroyed.

We bunked with friends while looking for an apartment to rent and starting to deal with insurance and rebuilding.

Nearly all my life, I have battled major depression and anxiety. For the first few days after the storm, I alternated between weeping on the floor and rational thought. But I never despaired; I actually felt called to action and handled our circumstances competently.

There’s a persistent belief that you must feel depressed if you have something to feel depressed about. That can be true. I was hardly jubilant to have an enormous tree slice through our home. But I wasn’t hiding under the bedcovers all day.

In less than a week, I had found a big enough apartment for all five of us and our dog. I had rented furniture. I retrieved plants, throw pillows, and blankets that escaped damage to make our new space feel as much like home as possible. Friends rallied around us, providing clothing, books, and meals -- and I was wise enough to accept all of this help, rather than hide behind a fear of burdening others.

I did not break down. I functioned well. With the unflagging assistance of my husband, I got our family back on track as quickly as possible.

I have often felt far worse, far more depressed and anxious, for no apparent reason. I have even felt suicidal and been hospitalized, the reasons for my suffering hidden in the deepest recesses of my mind and/or chemistry. This is despite more than 20 years of therapy, multiple rounds of antidepressants and antianxiety medications, and even a yearlong pursuit of transcranial magnetic stimulation (TMS). During TMS, magnets are applied to the scalp over the parts of the brain associated with emotion, in the hopes that activating those receptors will jolt a person back to life.

All of these protocols have worked -- until they no longer did. Each time a treatment failed, I was back to the starting line. This is where I find myself now, just as the outward crisis has passed and we are very close to moving back into our house.

I have felt more depressed and anxious recently than I have in a while. It’s like being back in college and graduate school when I would push and push and push to get through finals. Then, inevitably, I would crash, exhausted, sick, and often depressed, just when the pressure was finally off.

I am not alone.

An actual phenomenon exists called the “Let-Down Effect,” also known as the “Let-Down Syndrome” or “Post-Stress Illness,” which describes exactly what I am talking about: people’s ability to get through a particularly stressful period, only to fall apart once it is over.

A Taiwanese study revealed that more people visit emergency rooms for peptic ulcers on weekends and holidays than during the workweek. In another study, researchers at Albert Einstein College of Medicine at Yeshiva University found that periods of relaxation after stressful interludes were associated with more migraine attacks than were the stressful periods themselves.

Psychologist Marc Schoen, assistant clinical professor at UCLA’s Geffen School of Medicine, specializes in boosting performance and decision-making under pressure. Schoen has written a book about post-stress illness, When Relaxation Is Hazardous to Your Health, and why we manage to stay healthy during stressful periods only to break down later.

The “goal” of cortisol and many of the other adrenal hormones “is to mobilize us under times of pressure or fear,” Schoen said. “They have adaptive functions. For us to survive as a species, we really had to mobilize rather than just curl up in a corner. The problem is now when it’s all done, and the mind says, ‘Well, OK, back in there,’ then what happens is these hormones from cortisol to adrenal hormones as well as sugar levels start leveling off and the effect is you start to feel like you’re going through withdrawal. And that feels depressing.”

In addition, during post-stress illness experiences, “having been in a chronic state of inflammation and stress, the immune system begins to down regulate so any virus we’ve been exposed to has an open door to come in,” Schoen said. That is why it is not uncommon for people to get sick on the back side of particularly stressful periods.

Schoen recommends preventing the let-down effect by practicing meditation, breathing techniques, and exercise – but not when the symptoms of downturn have already begun. In that case, Schoen says people should do short bouts of exercise, such as climbing stairs several times a day, and pursue activities that keep the brain in a state of alertness, such as playing games with time constraints and/or working on a stimulating project. After about three days of this, you should be out of the post-stress illness danger zone. “You want to go from 80 mph to 60 mph to 40 mph, and so on,” Schoen said.

So while the next phase for me may be a monoamine oxidase inhibitor (the first antidepressants ever developed), or possibly electroconvulsive therapy to address my depression and anxiety, I am also going to look into meditation and possibly just the simple breathing techniques Schoen has developed.

In fact, I can already feel myself starting to rev back up as we prepare to move into our house that is nearly finished. I am calling movers, organizing the contents of our apartment, digging through belongings that were put in storage. I am starting to feel less depressed as I engage in these activities, but also wary that the let-down effect may follow this surge of energy accompanying our imminent move.

So I have been thinking a lot about the techniques Schoen recommends, and have been increasing the frequency and length of my early-morning runs. I’m not very good at meditation, though now might be the time to try. And since researching and writing this piece, I now know it is crucial that I try to decrease my adrenaline slowly to stave off a deeper and more destabilizing dip into the let-down effect.