Sick dog surrounded by medication

—Andrew P.*, Portland State University, Oregon

There are many kinds of sick. For example, there’s the combination of headache, nasal congestion, sore throat, cough, body aches, and fatigue. Other times, it’s an upset stomach, decreased appetite, diarrhea, or vomiting. Maybe some days you just feel tired and achy without a specific complaint to point to. Do these ring a bell?

Most of the time, symptoms of sickness are due to viral illnesses. But not all require a trip to the doctor. Seek medical attention when your symptoms become focused, intrusive, progressive, persistent, and/or are measurably abnormal. Here’s what I mean by that:

Focused symptoms

The more parts of your body that feel lousy, the more likely it’s a virus. Viral infections rarely have specific remedies (e.g., antibiotics won’t help); treatment is focused on symptom management. But when you have a specific focus of your complaint (e.g., “I have terrible pain in my right ear”), it’s more likely a bacterial infection at play. Bacterial infections tend to affect one specific part of the body and cause pain and other symptoms that are out of proportion to others. Bacterial infections are usually treated with prescription antibiotics, so they require a visit with a health care provider.

Intrusive symptoms

If you have pain that legitimately affects your ability to eat, sleep, get out of bed, concentrate, or otherwise function—especially after giving it some time or taking pain medicine—see a health care provider. The same goes for cough, dizziness, vomiting, diarrhea, and any number of other symptoms. Basically, if it’s all you’re thinking about for hours or days on end, it’s time to ask for help.

Sick girl sitting next to her bed

Progressive symptoms

Most of us know that sensation of waking up feeling like we’ve been gargling knives when we’re coming down with a cold. Drinking water or tea and taking a couple ibuprofen calms it down, and it doesn’t bother us too much through the middle of the day. Then it may start to aggravate us again late in the day, and we may wake up several mornings in a row feeling like we’ve tried to swallow a golf ball. This pattern of discomfort—typical of sore throat caused by post-nasal drip—is less worrisome because it follows a predictable pattern, responds to treatment, and sometimes disappears. However, if your symptoms worsen despite self-care, make an appointment with your doc. For instance, strep throat—something that requires a medical visit—causes a sore throat that steadily worsens over a day or two, making swallowing increasingly painful (even if you take meds).

Persistent symptoms

If symptoms aren’t getting better over the expected course of time, make an appointment at the student health center or with your primary care provider. The average cold lasts 7–10 days, and the average duration of a cough is 18 days, but if your symptoms stick around for longer, you should get it checked out. Having an upset stomach and decreased appetite for more than a few days is also a reason to be seen.

Measurably abnormal symptoms

If you have a temperature of over 100° F, especially if it lasts more than a few hours, call your health care provider to talk things over. Other examples include if your heartbeat stays rapid or slow, or your breathing pattern changes in some uncomfortable way; a rash on any part of your body; abnormal mental processing, such as confusion, disorientation, lack of coordination, or balance; and major changes in normal bodily functions, such as sleeping, eating, urinating, and defecating. These are all grounds for medical evaluation.

Final thoughts

Early in learning to care for yourself, always err on the side of caution. Make it a point, though, to learn from your visits. If you tend to hear from clinicians that you should have come in days before you did, then you need to lower your threshold for when to seek help. If, on the other hand, you’re often told you have a virus and are encouraged to get some extra sleep, take a pain reliever or other over-the-counter med, and continue to develop your stress management skills, then you can try waiting it out a little longer before you next seek care.

*Name changed