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The psychological impact of coronavirus

In The Briefing Room, David Aaronovitch looks into the psychological impact of the coronavirus pandemic and life in lockdown. Just how are we coping? What strategies can be put in place to reduce mental hardship now and in the coming weeks. And when normality resumes, how changed might we be? Here are 12 things we’ve learned.

1. Anxiety and fear are normal

When it comes to dealing with this sort of crisis, “anxiety and fear are very, very common effects,” says Dr George Hu, a clinical psychologist at the United Family Pudong Hospital in Shanghai. The fear of contracting a life-threatening illness, or a loved one contracting the virus, can have an additional effect. “There’s another reaction called acute stress reaction, which refers to the type of reaction that people have in the initial stages after a traumatic experience,” says Dr Hu.

2. We might experience a β€œdecreased frustration tolerance”

If you find yourself taking things out on your family or housemates, there’s a simple reason for this. “Frustration tolerance really is our ability to tolerate frustration in our lives,” explains Dr Hu. “If we utilise our frustration tolerance abilities on one thing (being locked down), there’s less of it left over for other things: managing our families or managing our work or managing our social relationships or managing our finances. And so people find that they experience other difficulties related to frustration tolerance and temper.”

3. 15% of us are finding lockdown “extremely difficult”

King's College London has collaborated with polling company Ipsos MORI to examine how we are coping with lockdown measures. 15% of us have admitted to finding it “extremely difficult” and a further 14% said it was “very likely or certain” to become more difficult over the next one to four weeks. Six percent of the population said they’ve phoned counselling or support services due to the lockdown.

4. Older people find the lockdown easier than young people

“The thing that stands out is, it’s quite generational, with younger people finding it more difficult than older people,” says Professor Bobby Duffy from King's. A quarter of people say, regardless of how long it went on, they wouldn’t find lockdown extremely difficult. “That is much more likely to be older groups,” he says. At the other end of the spectrum, four in ten teenagers and young adults say they’re already finding it extremely difficult or expect it to be within a short period of time. In agreement are those with financial constraints, and many of the self-employed, perhaps because lockdown affects their income more directly than those who are employees.

The lockdown is exacerbating the issues that vulnerable children already experience day-to-day.

5. Seven in ten of us support the lockdown

Another finding from the poll was that nine in ten of us support the lockdown measures, and seven in ten of us strongly support them. You never find seven in ten Brits strongly supporting anything, says Professor Duffy – apart from the NHS. “That lockdown support is directly related to the love and connection we have with the health service.”

6. Vulnerable children are at increased risk

For some children, home is not a safe environment. With schools closed, there are new risks for these young people, says Helen Westerman, a safeguarding expert drafted in to help Childline. “Children are telling us that they’re experiencing anxiety, depression,” she says, as well as self-harm and suicidal thoughts. And there has been an increase in calls about domestic abuse. The lockdown is exacerbating the issues that vulnerable children already experience day-to-day. “It will be a case of providing ongoing support – intensive support perhaps – for those children once we come out of it.”

7. We respond better to the carrot than the stick

Stephen Reicher is Professor of Psychology and Neuroscience at the University of St Andrews and he’s been advising the UK and Scottish governments during the coronavirus outbreak. A government’s approach shouldn’t be to wave a big stick at people, he says. They should think about the practical restraints people face and how to help them achieve what they need to. For example, when it comes to managing our parks, rather than reprimanding people for not keeping a distance, we need to facilitate opening up more green spaces like private golf courses or playing fields. “I think there is a role for much more creative thinking,” says the psychologist.

8. Keeping in touch is crucial

“The thing we know very clearly is isolation is bad for you,” says Professor Reicher. “In fact, it’s been estimated the physical effects of isolation are roughly equivalent to smoking 15 cigarettes a day. So, the question is, how can we physically distance without socially isolating?” All sorts of creative ways to stay in contact are emerging: from online choirs to virtual conference calls. But not everybody has got the technology they need to connect online, so how will the government support those people? “It would be a good idea, for instance, to approach the telephone companies and make sure nobody is cut off for not paying their bills for the period of the lockdown,” he says.

9. When normal life resumes, we’ll need increased mental health support

Prof Neil Greenberg is a consultant occupational and forensic psychiatrist, currently working at the NHS Nightingale Hospital. “There definitely is going to be a need for increased mental health support,” he says. Particularly vulnerable people are those who suffered from mental health problems before, people who have been seriously ill and recovered, and those who are key workers doing really challenging tasks. “In terms of going forward, they are going to need plenty of care.”

There will be a gradual realisation that the world is not the same as before the pandemic.

10. We can’t just return to “business as usual”

“When we look at traumatic events, we know that the most important predictors of whether people do well or not is not actually how nasty the trauma is, but how well people are supported as they try to recover from the trauma,” says Professor Greenberg. Within the NHS, he believes there should be a graded return to work over the weeks and months, or we risk damaging staff. The same applies to other occupations, where employees might be under pressure to make up lost revenue. “As a nation, and as employers of essential workers, there’s going to have to be some thought put into not just returning to normal as if this didn’t happen,” says the psychiatrist.

11. When lockdown lifts, euphoria might be followed by melancholy

When lockdown lifts, and we’re able to frequent our favourite restaurants and see family and friends again, it may not be plain sailing. “There is an initial sense of elation or euphoria,” says Dr Hu, “but, it can be pretty quickly followed by a sort of sense of sadness or melancholia.” There will be a gradual realisation that the world is not the same as before the pandemic. “Life is likely to profoundly change in many ways,” says the psychologist. “There’s a certain amount of grief and sadness and mourning associated with that.”

12. Many of us will come out of this feeling stronger

People have been doing remarkable work under extremely challenging circumstances. It’s easy to imagine the mental health problems that will emerge. However, many people actually cope well with adversity. “There is a concept which is known as post-traumatic growth,” says Professor Greenberg. Many frontline staff doing this amazing work will find they weren’t entirely sure they could do it beforehand but, having done it, their personal resilience and sense of self-satisfaction is elevated. “Many may actually come out of this, if done properly, feeling much stronger than they were before.”

Coping with the coronavirus