Michael O'Sullivan is a Cognitive Behavioural Therapist in the Derbyshire Healthcare Foundation Trust.

Buy Michael's book "A Practical Guide to Working with Depression: A cognitive behavioural approach for mental health workers"



In the course of a few weeks it feels the world has changed. 

A world turned upside down

Coronavirus is having - and will  continue to have - profound effects on all of us. Within mental health services, the effects so far have been staggering. My presuppositions as a therapist practising cognitive behavioural therapy (CBT) have been turned upside down.

For years I have been pointing out the tendency for people to think catastrophically.

For years I have been pointing out the dangers of social isolation for people with anxiety and depression.

Now it appears as if the catastrophe has arrived; self-isolation is exactly what we have to do in order to control the spread of COVID-19. 

Uncertainty prevails

We know a little of what to expect. The long-term mental health impact of quarantine was documented in a study published by the Lancet. These effects will include the uncertainty over how long isolation will be, continued vigilance over health, and anxiety with the belief that every cough will be the start of something sinister, the inevitable feelings of frustration and boredom of self- isolation as well as fears about inadequate supplies of food.

"Now it appears as if the catastrophe has arrived".

It might be helpful at this juncture to think of some of the issues which may help all of us get through this time.

We can end up listening to the news all of the time in situations like this. Whilst this is important, the continued exposure to what we know will be “bad” news will have an impact on our moods.

In CBT, education is given on the physiology of anxiety in order to demystify a condition which can be experienced as terrifying. In a similar way, knowing the “facts” can demystify something like coronavirus. Rather than browse the internet looking at websites where the information may not be accurate, always use reputable webpages.

Disruption of routines

Being at home all of the time will inevitably disrupt our usual routines.

Behavioural activation is a therapeutic approach that teaches us about the importance of small activities for our mental health: activities which give us a sense of confidence or pleasure. An awareness of these activities and programming them into our days will be essential, and this will include using the one hour period of outside exercise. Our physical health will be important. If we feel more resilient physically then this will have an impact on our mental resilience, using past experience to inform our ability to get through difficult events. It can also be helpful to look at any mindfulness-based practices because mindfulness anchors us to the present. In the current climate this anchoring is important given our fears about what might happen in the future. 

During the period of isolation, it is important to make contact with others be it through social media or through telephone calls. In compassion focused therapy, good mental health is seen as feeling connected with other people as well as ourselves.

When the world regains some sense of our old normality, more people will know about how disabling anxiety can be and how devasting social isolation can be. Hopefully we will all come out of this with more empathy towards each other.   


The World Health Organisation advises people experiencing anxiety related to Coronavirus to put a daily limit on their consumption of news related to the pandemic.