No calm after the storm: psychologist explains post-exam syndrome, why you feel anxious or depressed

Posted by Aldo Pusey on Wednesday, May 1, 2024

Even after Patrick Gale had achieved stellar results on the International Baccalaureate (IB) exam and enrolled in Hong Kong’s top university last year, he was still having stressful dreams about the assessment.

“The plot of one of [the nightmares] was I needed to take a new maths test or else I wouldn’t receive my diploma,” said the 19-year-old, who has now finished his first year at the University of Hong Kong (HKU).

“It would take me a little while to realise: ‘Wait, no, I already graduated – I don’t have another maths exam’.”

Those recurring dreams are a sign of post-exam syndrome, which is the anxiety or depression that can remain after the extreme pressure of an important exam.

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Adrian Low, a chartered psychologist who specialises in stress research, explained that this syndrome was connected to the intensity of exam-preparation season.

“If the process of studying for exams is a bad experience, it will contribute to the trauma,” he said. “When you are trying to sleep, it will keep showing up in your dreams, especially when the experience is very adverse.”

The scholar added that post-exam blues could be attributed to a sudden decrease in stress hormones.

“These hormones are likely to be high during the exams due to anxiety and stress, and the drop in these hormones likely account for ... feeling flat,” Low explained.

The Diploma of Secondary Education exam is one of the biggest challenges most Hong Kong secondary school students will face. Photo: Handout

He noted that high achievers, perfectionists, and those with high expectations from parents were more prone to emotional distress. They are likely to experience a larger increase in stress hormones during exam periods, with a steeper drop afterwards.

The psychologist pointed out that students in Asia – where many countries have highly competitive university entrance exams – feel guilty when they have downtime.

“Doing nothing was probably unacceptable,” he explained. “We have been conditioned to believe that unproductivity is laziness.”

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Vivienne Tsui, a student at Diocesan Girls’ School who took the Diploma of Secondary Education (DSE) exam this year, echoed this sentiment.

The guilt from studying for her exams persisted even after she finished, and it kept her from unwinding – the 18-year-old immediately enrolled in an investment course after she finished her assessments earlier this year.

“For me, this exam mindset did not entirely go away even now as I am still trying to find a balance between work and leisure,” the Form Six graduate shared.

“When you have studied most of the day, it’s quite normal to relax,” noted Gale. “But when that guilt continues nagging at you ... and starts to impair your sleep, not only is it unhealthy, it’s counterproductive.”

The HKU student recalled how the constant pressure to be productive spilled into his post-exam life: “I think it became the new normal. Even now, I still feel guilty if I’m not doing something that I feel is academic or meaningful.”

Post-exam blues can make it tough to return to normal life. Photo: Shutterstock

While the drive to be constantly productive is one common symptom after a high-stakes exam season, on the other side of the coin can be a sense of emptiness and lack of purpose – something Tsui experienced first-hand.

“In secondary school, most of us [in local schools] had a clear aim ... to score well in the DSE. But now that the public exam is finished, we are trying to find a sense of purpose and clarity on what we are going to do,” she said, adding that the end of exams made her anxiously question her career planning.

Gale agreed with Tsui, saying: “Grades are a big part of how I used to define myself. Without that, I lost one avenue of quantifying self-worth. I did feel that I had lost a sense of direction.”

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To address post-exam stress, Low encouraged students to celebrate their accomplishments, reconnect with friends and family, and revive old hobbies and routines – especially exercise, which has many benefits.

“Exercise will not only help improve physical fitness but will also increase important hormones like serotonin that improve their sense of well-being and help them get over their post-exam blues,” he said.

Heather Irvine, a Chinese International School graduate who took her IB exams in May, shared that she created new goals to deal with how aimless she felt.

“I replaced organising my revision periods with organising meetings and hang-outs with my friends. That way, I was able to feel productive just by having fun with my friends,” the 18-year-old said.

Make plans with friends, and try your best to focus on being in the moment. Photo: Shutterstock

With the Joint University Programmes Admissions System (Jupas) Office set to release university application results on August 10, Low urged this year’s DSE candidates to “embrace the psychological concept of the here and now”.

“Calm yourselves by doing deep breathing practices and accept whatever will appear,” the psychologist said.

“Think about the pros and cons of every situation. Do what we call a ‘mental rehearsal’, so there will not be any surprises when the actual results appear.”

Additional reporting by Sue Ng

Click here to download a printable worksheet with questions and exercises about this story. Answers are on the second page of the document.

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