Isolating While Sick
When you’re sick, you feel terrible and you really don’t want to interact with anyone. But you have obligations to work, school, family, community, and so on. You’re supposed to be places and do things, but you just don’t feel up to it. Why do you feel bad when you’re sick, why do you want to isolate, and how do you navigate those important decisions to do the right things when feeling ill?
Why do you feel bad when you’re sick?
Scientists used think that you feel tired when you are sick because all of your energy was going to your immune system. That’s partly true…. but not enough to account for what we know as sickness behavior.
What’s actually happening is a little more complicated. Your immune system and brain are talking to each other… and they are changing your behavior. Here’s a bit of detail if you want to get sciencey with me for a minute.
The leukocytes (white blood cells) of your immune system are releasing proinflammatory cytokines. Cytokines are tiny proteins that have a bunch of functions in your body, and are important for the immune response and cell-cell communication. One of the things cytokines do is trigger the release of prostaglandins, which are a special kind of hormones involved in illness and injury response.
Prostaglandins can be released from almost any cell in the body (and that is 37.2 trillion cells per human body, in case you’re counting!) and they are small enough and special enough to cross the blood-brain barrier. The blood-brain barrier keeps most substances in your bloodstream out of your brain (which is good, because it protects your neurons from drugs, poisons, infections, and all sorts of damaging things). Prostoglandins can get into the brain and talk to your neurons, and they head (pun intended!) straight for the hypothalamus.
The hypothalamus is a small command center deep in your brain. Imagine if you went from the top of your ears straight into the middle of your head—the center is where the hypothalamus would be. The hypothalamus has control over many of your bodily functions, and when it is stimulated by prostaglandins, it can produce fever, sleepiness, lack of energy, lack of appetite, loss of sex drive, and more.
Quick summary: your immune system releases chemical signals to tell your brain that you’re sick, and a control center in you brain (the hypothalamus) changes your behavior to produce symptoms like sleepiness, lack of appetite, low energy, fever, and so on. So it’s not a particular virus or germ that makes you “feel sick”… it’s your immune system that causes those feelings.
Why do you want to isolate when you’re sick?
Since the immune system is energetically expensive—meaning you have to spend precious internal resources on it—scientists thought for a while that sickness behavior must have an evolutionary advantage. “Feeling bad must mean that my body is fighting extra hard. Or that I’ll be extra healthy after this infection. Or it must improve individual fitness.”
But it might not. Instead, scientists now recognize that an individual’s sickness behavior doesn’t make that individual better, but instead it protects others.
It’s called the Eyam Hypothesis, after a community in England that isolated itself in 1666 during a bubonic plague outbreak. This action resulted in 75% of their population dying but it protected surrounding communities. (Research has suggested this concept for a long time, but it wasn’t formally named until 2015.) If you stay huddled in your room because you feel too awful to interact with others, then relatives don’t get sick and will survive. Kin selection suggests that even if you die, your genes (including the genes for sickness behavior) get passed on better because you've protected your family. So that means sickness behaviors are actually a form of biological altruism: you feel terrible and hide out so others don’t have to get sick.
Sickness behavior exists in many species and scientists have observed it throughout the animal kingdom. The study of illness behaviors spans a number of disciplines, including sociology, psychology, and biology.
Your body wants you to stay home when you are sick to care for yourself and for others. Too often we fight that inclination. For generations we have forced ourselves back into circulation before we’ve fought off the infection. We pop pills to override those natural functions. Aspirin and ibuprofen work by inhibiting prostaglandins, so they decrease fever and other signs of illness. By doing this, we spread those colds and flus rampantly at workplaces, schools, restaurants, stores, and parties. Despite our medical knowledge and technology, tens of thousands die annually from complications of these viruses (and manyfold more deal with financial burdens due to caregiving responsibilities related to these illnesses).
Action items for the workplace (and school, family, community events, and other obligations)
It seems like an easy concept: you’re sick, so stay home and prevent others from getting sick. But realistically, that’s hard to do.
In many industries, presence is required. You’ve got to be there doing the work- serving others, interacting, engaging. They need people in the place doing the things. These may be first responders, service professionals, and similar industries where humans are needed onsite to do the job. How do you make decisions about overriding your sickness behaviors and determining when to come in to work?
There are some jobs and industries that lend themselves easily to hybrid or remote environments. Workers can connect virtually, complete work from remote locations, and can stay isolated. The challenge here is how to take time off from work to just rest and be sick when it is easy to connect and complete work from home.
In many other jobs, it’s a much blurrier line. These are workplaces where you miss out on a lot when you’re absent. For example, when a student misses school it’s possible to make up the work, but there are lectures and conversations and classwork that cannot be recreated. You’ll always have missed out on some things. In a similar fashion, some workplaces function through live meetings, impromptu conversations, completing work within short time frames, and so on. Those kinds of workplace environments make it really challenging to be away, and can really increase stress on employees who find themselves wondering how to deal with the days they wake up feeling ill.
Each of these situations comes with its own stresses and decision making issues. And chances are very good that when you're feeling your worst, it’s not a good time for making good quality strategic decisions. Instead, individuals and team leaders can thrive through challenges by having conversations, improving communication strategies, and planning for potential problems ahead of time.
Reach out to Franssen Strategies for workshops and coaching specifically catered to your situation to create plans and think about how to navigate the regular challenges that arise!
I originally researched and wrote portions of this blog for the Science Museum of Virginia blog on Sickness Behavior: Why Do I Feel Sick?.
