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Emotional support for Health Care Workers

Posted by Ann Caluori | Fri, 27/03/2020 - 11:09

Guest blog by Dr Charlie Vivian, Consultant Occupational Physician at Icarus Health

COVID-19 is setting up to be the defining event of our lifetimes. Wars, disasters and tragedy happen with distressing frequency across the world - for most of us, it is others who experience these. But suddenly, we ALL face an existential threat, and as healthcare workers, we go to the sick, which increases our virus exposure and risk. This provokes an emotional response that is entirely predictable, comprising anxiety, depression and/or guilt.


Fear is a natural and healthy response to a threat. It provokes a ‘fight or flight’ response, increasing the chances of our survival. But when the threat is extended, we quickly become worn out, and need to adopt techniques that help to switch off this response.


One of the simplest is to change our breathing. Rather than hyperventilating, we need consciously to slow down our breathing. Breathe slowly, deep breaths, from the abdomen, for a few minutes. Rapidly this corrects chemical imbalances caused by over-breathing.


Other interventions help:

  • A problem shared is a problem halved, provided the other person will listen to us without judgment 
  • Laughter - it releases chemicals that are hugely beneficial 
  • Mindfulness or meditation allow us to quieten our minds. If you’re not used to this, there are lots of apps that can guide you. This can be particularly helpful before sleep
  • Practising our spirituality can bring calm
  • Physical exercise, hobbies, and treating ourselves keeps our minds distracted from fear
  • Control your consumption of news and social media. Have set times, rather than having it on all the time
  • Be wary of too much alcohol, which depresses your control mechanisms, and may disrupt sleep further
  • Be kind to yourself. Make time to nurture yourself. Treat yourself as well as you treat others
  • Be kind to others. Bear in mind that their irrational behaviour may be due to fear

Depression is part of a bereavement-type reaction. The loss of feeling safe can cause profound difficulties. There are typically four phases:

  1. Shock or denial. We carry on as though nothing has changed
  2. Anger, where we try and recapture what’s been lost. We may direct our anger at many different people or things, but the aim is to get back what we’ve lost. And unexpressed anger becomes low mood
  3. Despair. We feel stuck in the wreckage of our lives, unable to proceed
  4. Recovery. We become reconciled to what has happened, somewhat paradoxically feeling grateful for what has happened

But we also may simply feel angry and frustrated, where:


                  Frustration = expectation – reality


We may feel frustrated about lack of support, information, communication, equipment, and so on. What’s realistic, and what isn’t?


We may struggle with guilt, which is caused by setting ourselves unreachable goals. Is what we’re trying to achieve realistic, particularly in the current circumstances?


Sometimes, recognising these is enough, but if you are struggling to bring your symptoms under control, then it may be appropriate to seek further help and support through your GP, or talking therapy. Consider accessing CBT at:


But bear in mind the following:

  • The calm before the storm is often one of the worst bits. Once the peak is reached, a new ‘normal’ will be established - humans are incredibly adaptable
  • There will be amazing bits, where you’ll witness acts of kindness you’ll never forget
  • A simple act of kindness can reap huge rewards
  • The pandemic will be over one day. And each day, that day is one day closer.

With thanks to @imogenwall, a specialist in crisis response, for her posts on social media.


This is an edited version of the attached article by Dr Charlie Vivian.