Mono And Mental Health: The Interplay Between Stress And Physical Health

Physical and mental health are often connected. When one contracts a long-term viral disease or viral infection like mononucleosis (mono), coping with everyday life can be more challenging than it would be for healthy people. It may cause exhaustion, fatigue, pain, body aches, and other symptoms that make it challenging to go about daily life. To understand the connection between mono, stress, and mental health conditions, looking at the current research on this topic may be beneficial.

What is infectious mononucleosis (mono)?

Infectious mononucleosis is a highly contagious physical illness caused by the Epstein-Barr virus. The Epstein-Barr virus (EBV) is described by the Centers for Disease Control and Prevention (CDC) as, “one of the most common human viruses.” Once contracted, the virus stays in the body indefinitely, often inactive, but in some cases the EBV DNA is able to be detected during periods of reactivation, shown by the expression of lytic gene products, including viral capsid antigen. In addition to mono, an EBV infection can has also been linked to autoimmune disorders, such as rheumatic fever or rheumatoid arthritis, or complications such as anemia or a ruptured spleen. 

Mono is often called "the kissing disease" as it may be spread through saliva. While mono most commonly occurs in adolescence and for young adults, it may affect individuals of any age. 

The physical symptoms of mono can be challenging and may last a few weeks or several months. The long-term nature of this condition can also lead to significant stress and anxiety, as individuals might struggle to manage their daily lives while feeling unwell.

The physical symptoms of mono

Although both mono and the bacterial infection strep throat can cause similar symptoms, mono symptoms differ in several ways, which can be important to note in order to obtain a proper diagnosis. If you get mono, it could cause various physical symptoms, including but not limited to the following common symptoms.

Fatigue

Fatigue is a common symptom of mono that is often cited as the most severe. Individuals living with this condition are often exhausted, even after getting proper sleep. They may experience extreme fatigue or complete exhaustion and struggle to stay awake at work or school, which may make it challenging to carry out everyday activities, leading to stress and anxiety.

Sore throat

The sore throat associated with mono is often uncomfortable, and it might make it difficult to eat and drink. For some, the tonsils and throat may swell during mono, leading to difficulty breathing. This symptom may also contribute to the fatigue that individuals experience during this illness.

Swollen glands

Mono might cause the glands in the neck, armpits, and groin to become swollen. Swollen lymph nodes can be uncomfortable and may cause stress throughout the day. 

Rash

During mono, a rash can develop on the chest, back, and legs. This rash may be painful and might cause itching and discomfort.

Pain and weakness 

Muscle aches and weakness may occur when diagnosed with mono. In addition, a fever often accompanies this condition, which may last several days or weeks. Severe headaches are another common cause of pain during mono. 

Loss of appetite

A loss of appetite is another potential symptom of mono, as the condition can make it difficult to eat and drink. 

Chronic fatigue syndrome (myalgic encephalomyelitis)

In some rare cases, a few people may experience other illnesses related to a mono infection, such as chronic fatigue syndrome (myalgic encephalomyelitis), which could be extremely debilitating or life threatening. If you believe you might have myalgic encephalomyelitis, speak with your healthcare provider for an accurate diagnosis and treatment plan.

The mental health effects of mono

The physical symptoms of mono may significantly impact mental health. Individuals living with mono or similar infectious diseases often experience the following:

• Depression: Mono might cause sadness and thoughts of hopelessness and worthlessness. These thoughts can be symptoms of a depressive disorder in some people. 
• Anxiety: Some people with mono experience nervousness, worry, and fear about their condition. In addition, they may worry about health, relationships, and daily responsibilities due to the illness's impacts. 
• Irritability: Physical discomfort and fatigue could lead to irritability, frustration, and mood changes.
• Difficulty concentrating: The fatigue, headaches, and other physical symptoms associated with mono could make it difficult to focus and concentrate at work or school. 
• Insomnia: Discomfort and stress may make falling or staying asleep difficult, which may exacerbate fatigue and worsen other symptoms.

The importance of managing stress during mono

Given mono's significant physical and mental health effects, finding practical stress management tips can be essential to minimize risk factors. Consider the following strategies:

• Get adequate rest: Getting enough sleep and taking breaks can be essential for recovery. Try to get at least seven to nine hours of sleep each night, and take naps when needed.
• Practice relaxation: Techniques like meditation, mindfulness, deep breathing, and progressive muscle relaxation may reduce stress.
• Eat a healthy diet: Eat a balanced diet with plenty of nutrients to support your immune system. Stay hydrated and consider nutritional supplements if recommended by your doctor. 
• Limit activities: Try not to overexert yourself. Take time off work or school and avoid stressful activities when possible. Ask others for help with daily tasks if it helps. 
• Seek professional support: If you are experiencing significant or persistent mental health effects, contact a mental health professional for assistance. Therapy and counseling are often effective in managing stress.

Can mono come back with stress? The connection between stress and physical health

Stress refers to the nervous system's natural response to challenging events and threats. However, when stress is chronic, it can have physical and mental health consequences and could even lead to a weakened immune system. Chronic stress has been linked to several health conditions, including heart disease, stroke, and certain types of cancer.

The physical symptoms of mono can sometimes be exacerbated by stress, as the body's immune system can be compromised. Stress could also interfere with the body's ability to recover from mono. When the body is under stress, it might produce cortisol, a hormone that suppresses the immune system. Cortisol makes it harder for the body to fight off the virus. Additionally, stress could make the physical symptoms of mono more severe, as the body may be already struggling to cope.

Someone with a compromised immune system who contracts the virus has an increased likelihood of the virus affecting immune cells, such as T cells, which could lead to reinfection. According to the Journal of Clinical Pathology’s Epstein-Barr virus (EBV) reactivation and therapeutic inhibitors, those with high stress levels also have an increased risk of reinfection or EBV reactivation. Even when symptoms subside from the initial infection, the virus remains inactive in the body until it encounters a trigger. In many cases, the body can create EBV antibodies during this dormant period, but total immunity is not always the result.

Support options 

You're not alone if you're experiencing mono and your mental health has been impacted. Speaking to a licensed therapist about your experiences and learning stress relief exercises in a safe environment may be helpful. However, being sick can present challenges, and some people may not be able to make it to in-person therapy. In these cases, online counseling through a platform like BetterHelp may be an effective option. 

Online therapy can provide individuals with a safe and supportive space to discuss their experiences with mono and manage stress. Through an online platform, you can work with a provider from home and choose between phone, video, or live chat sessions. Your therapist can also send you worksheets and extra resources to use without having to leave your house. 

Studies also back up the effectiveness of online therapy for individuals living with prolonged stress. One study found that online cognitive-behavioral therapy (I-CBT) could reduce stress significantly, with participants reporting sustained impacts six months after the treatment.