36 | New Scientist | 6 February 2021
being able to avoid the virus by working at
home, feelings of lack of control can come
from elsewhere. The fact that lockdowns are
imposed rather than voluntary seems to be an
important factor. A recent review in The Lancet
looked at the effects of enforced quarantine or
social isolation during outbreaks of SARS and
Ebola. It found that voluntary quarantine is
less likely to cause emotional stress and long-
term mental health problems than restrictions
that are mandated by law.
This is probably down to the
psychological impact of having freedom
of choice taken away, says Lynden Miles, a
social psychologist at the University of
Western Australia in Perth. Because we are
no longer able to choose how often we go
out and who to meet, lockdowns may lead
to the psychological phenomenon of
“learned helplessness”, he says, where a
person “gives up once they realise their
efforts to improve the situation are futile”.
Learned helplessness is associated with
depression and post-traumatic stress. And
in terms of Maslach’s definition of burnout,Mikolajczak at the Catholic University of
Louvain (UCL) in Belgium has found that
people experiencing parental burnout
can have higher stress levels than those
experiencing chronic pain.
What is more, while burnout isn’t a mental
illness, it can leave people vulnerable to more
serious mental health problems. “We know
that burnout, even within the classical work-
related literature, is a major risk factor for
depression and anxiety,” says Pariante. There
are a number of factors that we know put us
at risk of both burnout and mental illness.Out of control
The first is control, or more importantly, a lack
of it. In the pandemic, front-line workers in the
medical profession are likely to be feeling this
the most keenly. Dealing with infected people
every day isn’t only exhausting, it also takes
away much of the control over their personal
chances of catching the virus and of protecting
their loved ones from exposure.
For people who have the relative luxury ofStill feeling tired
after a good
night’s sleep is
a classic sign
of burnoutBurnout in the medical profession
was a concern long before covid-19
threw it into the spotlight. Now
there are fears that, for many, the
pandemic could be the last straw.
There is some evidence that,
when in the thick of a crisis, focusing
on the task rather than emotions
can help to protect the mental
health of medical practitioners.
A study of Italian doctors during
the first wave of the epidemic there
found that those who used practical
strategies to get through their
workload were at lower risk of
burnout than those who attempted
to manage their emotions as they
went. The researchers concluded
that this was because, in the early
days, “emotions related to the
pandemic [were] too intense to be
regulated and used productively”.
The worry is that once the
immediate threat passes, this
tendency to push emotions aside
will backfire. “My fear is that once
we come out the other side and
have a chance to realise what
we’ve survived, the impact will
be monumental,” says National
Health Service anaesthetist in
England and mental health
advocate Christina Hoskins.
In a recent article in the NEJM,
Jo Shapiro at Harvard Medical
School, who studies clinician
burnout, and Timothy McDonald,
a Chicago-based medic and lawyer,
made the case for a large-scale
effort to safeguard the mental
health of clinicians from the
pandemic’s impact. They suggest
peer support and a system of
monitoring and interventions to
assist front-line staff as they come
to terms with the past year. Actions
aimed at encouraging people to
help themselves, they note, have
been shown not to work.Front-line
burnout
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