Mononucleosis: What Causes And Flares Mono?

By BetterHelp Editorial Team|Updated July 8, 2022
CheckedMedically Reviewed By Aaron Horn, LMFT

There are many infectious viruses and illnesses that we should be aware of, like hepatitis a and rubella, especially when in close contact with others. Learn what you can and can not do to stay safe.

Stress Can Negatively Impact Your Life And Lead To Illness

Mono. What is it? Mono’s longer name is mononucleosis, and it is an infectious virus transmitted through saliva. You may have heard mono referred to as the “kissing disease.” When you kiss someone, you’re taking in and passing on saliva; technically, you can catch a mono infection this way. However, you can also catch mono by being around someone who is coughing, sneezing, sharing toothbrushes, or if you share a drink or food. Mono is contagious; however, it’s not as infectious as some other things. For example, did you hear the news that the common cold is more contagious than mononucleosis? It’s true! That said, having mono is difficult. It can be exhausting and stressful to your mental and physical health. Let’s take a look at the link between mental health and physical wellness, and learn how online therapy can help if you are affected by mono.

Who Is At Risk For Mono?

Certain people are more at risk of contracting mono than others. Those who have compromised immune systems and weak antibodies are more likely to contract the condition than others. Mono is exhausting, and stress can contribute to feeling fatigued. Can mono symptoms reappear randomly? You may be wondering who is at risk for mono, and could it be you? People who contract mono are typically young adults or adolescents. Children with mono often have fewer symptoms, and it can go unrecognized. With adolescents, the symptoms are more surface level. According to the Centers For Disease Control And Prevention, here are some common mono symptoms:

  • A pervasive sore throat that doesn’t get better with antibiotics or other treatment
  • Extreme fatigue
  • Exhaustion (not just fatigued, but too tired to conduct normal daily activities)
  • Swollen lymph nodes in an individual’s neck and armpits
  • Tonsillitis or swollen tonsils
  • Headache
  • Swollen or sensitive spleen
  • Fever

The mononucleosis virus does have an incubation period. That period lasts from around 4-6 weeks. However, when it comes to children and teens, this period is significantly shorter. The initial symptoms of mono can be as simple as a sore throat or fever. The most persistent and visible sign of mono is exhaustion or fatigue. The combination of a sore throat plus exhaustion can lead a physician to test for or diagnose mononucleosis. If you think that you may have mono, it’s essential to see a medical professional. Getting these symptoms looked at is crucial. Perhaps you have mono or it could be something else. Regardless, knowing what you have will guide you on how best to take care of yourself during this time. What causes mono to reactivate? Most cases of mono are caused by EBV, and EBV can reactivate; therefore, it is possible for mono to reactivate. 

The Sore Throat

One of the hallmarks of mono is the intense and debilitating sore throat. You might think you have strep throat or a severe infection. However, if your sore throat persists and the strep test is negative, it may be worth getting tested for mono. Having a sore throat could mean that you also have tonsillitis, which is often extremely painful. Talk to your medical provider if you have a persistent sore throat. There is a blood test that works to confirm if you have mono. Sometimes the test will come up negative, but if the symptoms persist (including that painful sore throat), it may be worth getting retested in a few weeks. Remember to consult a trained medical professional to discuss these matters rather than trying to diagnose your symptoms by yourself with online tests or sources. What are the symptoms of recurring mono? If the infection returns, you'll likely notice similar symptoms-the same sore throat, swollen lymph nodes, and fatigue from before.

Are Mono And Epstein Barr Connected?

Mono is associated commonly as the result of the Epstein-Barr virus. The Epstein-Barr virus is also called human herpesvirus 4. It’s one of the human herpesvirus types. Epstein-Barr is in the herpes family and is one of eight common viruses. It’s seen in many people and commonly associated as a pre-cursor to mono. The Epstein-Barr virus can cause infectious mononucleosis, but it’s not the only cause of mono. Other infections can trigger it, but Epstein-Barr is the one that directly connects to mono most often. Symptoms of mono can be excruciating; however, no medicine cures mono. The treatment for mono is just time and rest.

Does stress reactivate Epstein-Barr? It is possible for Epstein-Barr to be reactivated, and this commonly occurs due to stress. What does reactivated EBV feel like? Reactivation is not always easy to detect, but the symptoms generally last between two and four weeks. Many of the symptoms of reactivation are the same as Epstein-Barr symptoms. Can anxiety trigger EBV? While anxiety cannot directly cause EBV, it could be responsible for increased stress, which can, in turn, trigger EBV. 
Can a person have mono flare ups? Mono flareups can occur in the months and years following initial infection; managing stress can be one way to try to curb these flareups.

Rest As Medicine

What happens if you get mono twice? Stress can make mono worse, which is why it’s crucial to take plenty of time to decompress when you have the condition. How do you treat a mono flare up? There’s no formal medicine that treats mono. It’s up to you to treat your body well by consistently resting. If you listen to your body, it will tell you when you need to take it easy. Lots of rest and hydration will give your body the tools to heal. People who have mono often have to limit their physical activity for the first couple of weeks of the infection. They find that their exhaustion levels are high, and their body wants them to take it easy. Typically, mono resolves by itself after some time when people take care of themselves and rest their bodies. However, relapse is possible. There are potential complications that can occur after having mono. Here are some of them:
  • Enlargement of your spleen
  • Anemia
  • Liver problems
  • Hepatitis
  • Jaundice
  • Encephalomyelitis
  • Rash
  • Nervous system complications such as Guillain-Barre syndrome
If you have an autoimmune condition or a compromised immune system, mono can be more severe and it's important to understand your medical rights. When you’re discussing these conditions with your doctor or healthcare provider, it’s essential to be transparent about what medical issues you have besides mono. That way, you can get the best treatment. The Epstein-Barr virus might cause severe symptoms in people who have compromised immune systems. That includes individuals who have HIV or AIDS, and people taking immunosuppressant drugs. Do you always test positive for mono after having it? While you can test positive within one year of infection, it is not common to always test positive for mono after having it.


Unfortunately, mono is difficult to prevent. You may take precautions regarding exposure to germs that cause the infection. Still, it’s hard to prevent mono. You may not know that someone has it unless they share that information with you. They might also be unaware of it. That said, there are some preventative measures that you are able take. Don’t share drinks with people as well as forks, spoons, and so on. If you know that you have mono, don’t share utensils or kiss people during this time because you don’t want to give it to someone else. In addition, you should discard of any infected items, like lipsticks or toothbrushes, to prevent recurring infections. 

How Come Stress Plays A Role?

Stress can exacerbate many different physical conditions, including mono. People have found in various studies that stress can make people more susceptible to catching a virus and that in addition to making you more likely to get sick, it can also make you stay sick for longer. Stress can mean a lot of things. It can be anxiety, grief, relationship breakups, or divorce. It can even be physical stressors like excessive exercise performed without taking the time to rest and recuperate. Chronic stress has a likelihood of causing mono relapse. There was a study where 276 healthy adults were evaluated to determine why they have chronic stress. In that study, it was noted that these adults experienced cold-like symptoms and that stress made their infections worse. It’s known that stress can make pre-existing infections worse. You put pressure on your immune system during periods of stress and it can reactivate infections that were previously present such as mononucleosis. Viral infections get cleared by a body response called cell-mediated immunity. In human stress studies, researchers noted that psychological stress directly hinders the function of your immune system. There is a risk, if you already have an infectious illness, that stress could cause it to relapse. That’s why it is important to manage your stress levels as much as you can during recovery from an illness and in your general daily life.
What is Stress?
There’s a difference between anxiety and stress. Anxiety is a chronic medical condition that impacts a person’s ability to function socially and on a day-to-day basis at school or work. Stress is a condition that is directly related to situations and transitions in a person’s life. According to the American Institute of Stress, stress is one of the leading health problems in the United States. Stressors are a normal part of life; you might feel stress as a result of your job, relationships, family, or financial issues. Symptoms of stress can vary depending on the individual, but it’s important to note that you can have physical symptoms as well as mental and emotional ones. When you’re stressed out, you may feel the fight-or-flight response, which happens when adrenaline and cortisol release into your body. During this time, your blood flow increases, your heart rate increases, and your blood pressure and blood sugar could also increase. If sustained over some time, this response can cause adverse health effects. Be mindful of what’s happening in your mind and body when you’re under stress. That way you can mediate the effects. You don’t want to reactivate the mono virus or any other viruses as a result of stress.

Some people find it difficult to gauge when they’re under stress. How do you know? Here are some symptoms of stress:

  • Insomnia, trouble falling asleep, or trouble staying asleep
  • Headaches
  • Gastrointestinal issues such as stomachaches
  • Body pain and tension
  • Fatigue
  • Anxiety or nervousness
  • Depression or depressive mood
  • Food or eating issues
  • Substance abuse problems
  • Addictive behaviors, obsessions, or compulsive behaviors
  • Rage or anger
  • Feeling apathetic or overwhelmed
  • Being irritable

Causes of Stress

Stress is a natural part of our lives, and it’s unavoidable. There could be many different reasons that a person experiences stress. There are daily life stressors that most of us have felt such as issues involving interpersonal relationships, jobs, and school. There are other stressors, too, such as getting a divorce, moving, being diagnosed with a severe mental or physical illness, having a baby, planning a wedding, and so on. Various life changes – even good ones – can contribute to stress. Regardless of what the trigger is, it’s important to be able to identify your stressors and work to manage your stress. Stress is always going to be a part of our lives, and without natural human stress responses that we experience, we wouldn’t be alive. That said, the effects of overabundant stress responses in a person’s body are authentic and can cause long-term issues, so it’s essential to learn how to cope.

Stress Symptoms

It’s not easy to manage stress levels, and some individuals struggle to find healthy ways to cope with life stressors. Some people have difficulty dealing with their stress and they turn to maladaptive ways of managing it. It may not be their fault that they’re picking behaviors that are toxic and unhelpful. They might not know how to handle these stressful life moments. However, there are ways that they can stop choosing these self-destructive patterns with the right interventions and help from a mental health professional. Certain things can be more harmful than helpful when it comes to dealing with your stress levels.

Here are some unhealthy ways to cope with stress:

  • Substance abuse such as coping through alcohol or drug use
  • Compulsive spending
  • Self-harm
  • Toxic relationships
  • Gambling
  • Reckless behavior
When you find that you’re involved in using these maladaptive behaviors to deal with stress, it’s vital to seek help. That’s where therapy is of great use to people. When you’re dealing with long-term stress, whether that’s anxiety, interpersonal relationships, substance abuse, a death in the family, or a divorce, stress can be extremely debilitating. You may seek the help of a therapist. That person is there to help you navigate those stress levels. Maybe you’re trying to deal with a chronic condition like mono, and you don’t want to become sick again. Talk to your therapist and develop a wellness plan.
How Stress Affects Your Mind and Body

Stress Can Negatively Impact Your Life And Lead To Illness

recent study looked at how effective eHealth mindfulness and relaxation tactics are in reducing stress, including speaking with a therapist, in regard to patients with medical conditions. The content looked at 17 studies from 1990-2015 and found that such techniques often have positive effects on patients’ general health and psychological well-being.

In addition, the study pointed out that eHealth, such as online therapy, is highly accessible, meaning that you have the ability connect with a therapist in the comfort of your own home as long as you have an internet connection. Another advantage is that online therapy tends to be cheaper than traditional therapy, which may alleviate potential financial stress. Read below for some reviews of BetterHelp therapists, and tips from people experiencing similar issues:

BetterHelp Therapist Reviews

“This was my first time experiencing counseling, and Mr. Santaella immediately hit the nail on the head with the issues I’ve been dealing with. His suggestions and guidance was really helpful and many things he said to me will stick with me for a very long time. He made me change the way I think about work and my own health, both mental and physical, and helped me see the connection between those two.”

“Tracy Hollingsworth has played an instrumental role in my constant journey to take good care of myself both mentally and physically. She has a great sense of humor which I love and is extremely creative in her approach to offer strategies for things I struggle with in my life, especially during COVID when EVERYTHING is constantly changing. I struggle with my motivation, mood swings, anxiety and sometimes my relationships with people. When I feel a ‘mood; coming on I can often use some of the tools Tracy has taught me so that I don’t fall deeper into one of my moods that in the past would have destroyed my entire day or even week. I always feel awesome after a session with her no matter how I felt starting the session!”

Get Back To Health

Chronic stress often affects your mind and body. You may feel that there's no light at the end of the tunnel. You do not see the relief on the horizon, and that's scary. You're afraid to feel like this forever. You might have anger problems, chronic pain, or depression. It's imperative to confront these issues. Online therapy is a great place to start dealing with stress and find ways to cope. Search the network of BetterHelp therapists today, and find someone ready to support you in getting help for your stress levels.

Frequently Asked Questions (FAQs) And Advice

What causes mono to reactivate?
Mono can reactivate in your system as an immune response to many things-- weakened immune system, bacterial infection, stress, transferring of bodily fluids, or hormonal changes. This viral infection is a common virus that reappears as recurrent mono as an immune response to other external factors at play, although this is rare. Usually, with time and rest, that will get make the infection disappear.

Can mono symptoms come back randomly?

In rare cases, some doctors do see recurring mono. Usually, mononucleosis are caused by infection with the epstein barr virus (EBV). This chronic fatigue syndrome can lead to a weak immune system (as is common in autoimmune disorders), infection fighting immune cells flare up, and other symptoms that are common symptoms of mono as well. An EBV infection or epsteinn barr virus infection requires a proper diagnosis.

What are the symptoms of recurring mono?

In rare cases patients may develop severe symptoms of mono include enlarged liver, rheumatic fever, and inflammation of the kidneys. There is no need to call infectious diseases or disease control, as for the most part the body will be able to fight this infection off.

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