© Brian Shand 2020

Brian Shand is an analytic psychotherapist, based in Guildford, who works with groups and individuals.  Among other things, he has worked in the past as a BBC local radio producer and presenter.

Trainee psychiatrists are famous for believing they’ve got every serious psychological condition under the sun because they’ve read about them in a textbook.  One minute they’re suffering from multiple personality disorder and the next they’re a grade A psychopath.  Why they never spot that they’re actually exhibiting hypochondria and delusion I don’t know.  Anyway, with all this in mind I want to issue a public health warning for what you’re about to read.  It’s gloomy but a lot of it won’t apply to you.  Parts of it might, however, and it’s meant to help you.

You’re doing very important work for our country but the pandemic may well mean that you’re doing it at a real cost to yourself.  Working long hours under pressure for a long period with little time off takes its toll.  On anybody.

In the first of these two blogs,I want to look at some of the emotional effects of the COVID-19 crisis and then in the second one to think about what we might do to make things a bit easier.

Britain’s mental health crisis

A big first step in surviving the pressures of COVID-19 is to be aware of what those pressures are and what they’re doing to us. 

In a recent YouGov poll, 43% of people said that the pandemic was having a negative effect on their mental health.  Across Britain, people are reporting – among other things – depression, anxiety, nervousness, insomnia, vulnerability, loneliness, relationship difficulties, irritability, anger, loss of control and powerlessness.  Problems that are either not there normally or are being aggravated.  Our minds are having to process quite a bit more than usual.  One manifestation of that can be bad dreams.  Although unpleasant, remember that they may be your brain’s way of dealing with the stress you’re under – a stress which has probably leapt considerably. 


The experience of stress varies from person to person.  Some stress improves performance.  Too much reduces it.  We may fail to achieve tasks and find ourselves covering up mistakes.  We may no longer pull our weight.  We may lose the capacity to think and concentrate and lose a sense of proportion. We may be less communicative or cooperative.  We may become overly critical of ourselves and others.  The person at the door or on the phone is suddenly a damn nuisance.  We may indulge in backbiting or gossip and be prone to sickness and absenteeism.  We may rush and make mistakes or become forgetful or feel like crying.   Stress can cause panic attacks as much as heart attacks and exacerbate phobias, drinking and hypochondria.  It can lead to breakdowns and to depression.


We need to be aware of all this and not least of the symptoms of depression.  They include a blunting of our feelings, poor concentration, a lack of enjoyment in anything, a drop in motivation and in sexual libido, difficulty in sleeping and, in more severe cases, thoughts of taking one’s own life.

Stress versus burnout

The effect of excessive and prolonged stress – of being out of control and powerless to change it – is that it can lead to burnout.   The difference between stress and burnout is that stress is characterized by ‘too much’ and burnout by ‘not enough’. 

By that I mean that in stress we feel there’s too much pressure.  We’re  over-engaged and perhaps over-reacting emotionally.  We may become hyperactive and possessed by a persistent sense of urgency and anxiety.  Above all, though, we’ll probably be aware of it.

But not necessarily with burnout.  That can be more insidious precisely because we may not be conscious of it.  But if we look carefully within ourselves we may discern its warning sign:  a sense that there’s not enough in us to do whatever’s required.  People often describe feeling that the tank’s empty, that they’re beyond caring and devoid of emotion.  Over-engagement turns into disengagement along with a sense of helplessness and hopelessness.  Stress can kill prematurely.  Burnout makes it feel that life’s not worth living.  The anxiety of stress is replaced with detachment and a loss of hope and ideals.  You can see in all this a relationship between burnout and depression.

Public health professionals

The COVID-19 pandemic is stress on stilts – with long-term exposure and an accompanying sense of diminished control.  I think, for example, of Health Directors squeezed between the demands of central government for centralized test and trace and the demands of local government for localized test and trace.  That’s stress.  So too is the feeling that you have to work even harder because there has been an increase in the number of deaths in your area.

If you’re on the front line the pressures will be different and you’ll have your own stories.  But you’ll probably be working with people who are themselves victims of the crisis and who will unconsciously put their own turbulence into you.  Literally, you may end up feeling just what they’re feeling.  It’s called projective identification but I won’t go into that now because you can only have so much fun.

The strangeness of COVID-19

As if all this wasn’t enough the Coronavirus has done other strange things to us.  You could argue that it’s been a national bereavement in the sense that we experience some bereavement symptoms with any significant loss and in the pandemic most of us have lost something.

COVID-19 has also been an attack on our very humanity.  To function properly we all need human contact because we’re social animals and connected to each other at levels that are way beyond our awareness.  So, as the former Bishop of Guildford and of Chelmsford, John Gladwin, has pointed out, the pandemic has brought two words into our vocabulary that are pulling in opposite directions: ‘social’ and ‘distancing’.

The cavalry’s coming

But that’s enough of the dark side.  In my second blog we’ll consider what practical things we can do to lighten the load a bit.  Taking back some control will be the name of the game.

UKPHR’s Chief Executive commissioned this blog from Brian Shand, who is a registrant on another Accredited Register. If any reader wishes to seek help through therapy, and has no other contact, David offers to help you to find the right help through his contacts with relevant Accredited Registers.