Introduction

Establishing what exactly is causing those awful feelings of being tired all the time is important, given that there are many reasons why students can feel low. These reasons include the effects of stress, the "winter blues", burning the candle at both ends without fully realising the physical consequences, and even more seriously, carbon monoxide poisoning. However every year a few students do discover that they have Glandular Fever.

Glandular Fever (infectious mononucleosis) is caused by the Epstein-Barr virus and is accompanied by serological changes in the blood of those affected by it. Most people with glandular fever present at the doctor's surgery with symptoms which include a sore throat, swollen tonsils, swollen and tender lymph glands in the neck and general fatigue. It seems to occur more frequently in the autumn and winter months.

The virus could well be described as a "hit and run" virus because the actual infection is usually over within a couple of weeks but it leaves your body in a very vulnerable state. It's almost as if your body becomes programmed to have a glandular fever response to any future viruses, knocking you back to feeling exhausted and vulnerable again and again. However, it is self - limiting and it is not life- threatening. Even though you may feel that it will never end, it gradually fades so that you are eventually able to recover from these episodes, more and more quickly. This response can last for six months and in some cases much longer.

Patient UK website for fact sheets


Flu viruses are associated initially with common infections such as coughs and colds or the more debilitating full blown flu (influenza) with high temperatures, headaches, aching limbs, sweating and feeling exhausted.

Coping with Fatigue due to the effects of glandular fever or flu viruses

What Can Happen
The Fatigue that may result from glandular fever or flu may or may not abate within a few weeks. Plenty of rest, lots of sleep and no stress certainly help and "there's the rub" - a few crucial weeks away from academic deadlines can mean the loss of a terms' modules which in itself is a very stressful experience.

Sleep - The need for sleep may extend to 10-15 hours per day in bed. This is not an uncommon phenomenon. As one student said: "After 2 weeks in bed I restarted lectures, but found I could not concentrate for more than 20 minutes at a time. Studying in the evening was virtually impossible, as all I wanted to do was to go to bed and sleep for days."

Appetite - Often your appetite is affected and can result in chaotic eating patterns.

Concentration - Unfortunately, the very activity you are here for is one of the hardest to achieve as your ability to concentrate for long periods diminishes. As another student said: "the mental effort involved in thinking clearly, learning, writing and reading (even novels or a newspaper) was such that on some days these activities were impossible."

Introspection - fatigue can effect the way you see yourself in relation to others and in relation to your academic abilities. Waves of self-criticism and self-doubt can radically alter your perception. You may start to doubt your ability in all sorts of areas from personal relationships to why you're at Brookes at all, thus losing confidence in yourself.

Mood Swings - are quite common as periods of energy give way to overwhelming fatigue and episodes of feeling good give way to feelings of depression.

Over tiredness - If the symptoms of fatigue do persist beyond a few weeks, students may be tempted to try and go back to previous levels of activity and try to make up for lost time. However, if this is you, listen to your body, adjust to your new, much lower, energy levels, before over tiredness takes you over leaving you feeling frustrated, unable to cope, depressed, tearful and pessimistic about future efforts. It is also important that you don't compare yourself and your energy levels to others or to how you were before your illness - work with how you yourself feel now and listen to what your body is telling you. Don't be tempted to over exert yourself. As one student said: "The main thing I learned and have had brought home to me since by some re-occurrences, is this: I must accept that unless I am sensible and avoid overdoing things the virus could re-occur. Accepting this involved altering my ideas on time, in that it was no longer necessarily time-saving to try and complete a lot of things in a short space of time. Trying to do so meant that I would end up in bed for the following few days and take twice as long as I otherwise might have done..."

Retreating from life - Your low levels of energy tend to mean that all normal social activities become such an effort that you retreat into your room/bed with little or no social contact: friends find it difficult to understand just what a post-viral fatigue can mean. It is easy to lose sight of your normal healthy self as the term moves swiftly on and you feel left behind. This can leave you feeling very vulnerable, easily stressed and anxious about things that would not have stressed you in the past. As one student said: "Being unable to participate in student life made me feel very isolated and lonely."

Managing Post Viral Fatigue

Medically -

1. See your G.P. and if your symptoms persist see him/her again - the support can be invaluable but don't expect your symptoms to be greatly alleviated by medical treatment. The doctor will issue you with medical certificates if appropriate.
2. Try to accept a slower lifestyle, and take each part of the day a bit at a time. Patience and a determination to be constructive and positive will keep your feelings of despondency and frustration under control. When deciding what to do set yourself realistic tasks and avoid doing anything that will drain you of all your energy, either mentally or physically.
3. Don't compare yourself to others. Just listen to what your body is telling you. Just do what you feel you can manage at that time and don't plan too far ahead. Frequent breaks away to visit sympathetic and supportive parents, relatives or friends can help to recharge your mental and physical batteries.
4. Have small amounts of nutritious things to eat, frequently, rather than large meals which are tiring to prepare and eat.
5. Have a number of short rests planned throughout the day. Tiredness encourages depression and then things get out of perspective Destructive self-criticism only serves to sap energy levels further, so is best avoided.
6. Take small amounts of exercise such as a very short walk and over time gradually increase the length of the walk as you feel able. Remember not to tire yourself by being too enthusiastic one day if it means being forced to do nothing the next. Energy levels will fluctuate so it will be tempting to try and catch up on lost time. The more active you have been the harder it will be to accept your new limitations but try to say to yourself that you are doing the best you can at the moment and don't compare yourself to how you were before you became ill.
7. Find quieter more restful social pastimes - rather than dashing out to crowded pubs or large social events, try the cinema or listening to music. Conserve the energy levels that you do have.
8. If things are getting out of perspective and you are feeling low - use the services available to talk to someone: This might be your G.P., the nurses at the medical centre, student counsellors, the chaplain, student advice centre.
9. If your are able to start work again work for short bursts of say 20-30 minutes followed by lots of rest.
10. Don't waste time trying to concentrate! if you're not able to concentrate on what you are doing switch to something else or have a break.
11. Talk to your tutors, course leaders, Head of Department and keep them informed about your progress, give them your medical certificates and update them about your current medical position. If the need arises and you find you are unable to fulfill your academic requirements the Examination Committee require medical certificates as evidence of "causes outside his or her control" when considering extensions or credits.

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