• There are more than two million people in the UK suffering the effects of Long Covid. 

  • Counsellor Elizabeth Turp and Psychotherapist Wendy Bristow discuss the mental health effects of this little-understood illness

  • We have therapists specialising in chronic illness – find them here

"I've been writing and tweeting about Long Covid since April 2020," psychotherapist Elizabeth Turp shared with a group of Welldoing therapists at our recent Lunch & Learn. Liverpool-based Turp, who has personal experience of chronic illness, now specialises in working with clients with long-term health conditions. "The fallout from the pandemic was always going to include a large number of people sadly disabled by chronic health problems."

The symptoms of Long Covid are varied, but include post-exertional malaise (PEM), severe fatigue, loss of taste, full body pain, problems with memory, sensitivity to sound. Similarly to Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) – another debilitating condition that is commonly caused by viral infections – the symptoms of Long Covid show up in all the systems of the body. At the most severe end, people are bed bound. "After any viral infection, it's very normal to take a few months to return to full health. Part of the problem is that we live in a society where we expect to bounce back quickly, which can exacerbate problems."

The latest ONS figures suggest as many as two million people have Long Covid in the UK, and as many as 100 million worldwide, with 20% being severely affected and 70% being adversely affected. Middle-aged women, those with other chronic health conditions, and those that were hospitalised with Covid are more likely to develop Long Covid, however it has also affected otherwise fit people with no previous health conditions. "It's important to say that privilege comes into this 100%," added Turp. "It's a very different picture for those who are comfortable – those who might be able to afford taking some time off work, for example – versus those who are struggling financially."

The mental health impact of Long Covid

The mental health impact of Long Covid, like other chronic health conditions, can be severe. "It's very hard to find yourself suddenly plagued by symptoms, especially if they are hard to explain," explains London-based psychotherapist Wendy Bristow, who also works with clients with chronic conditions, "and on top of that, it's extremely isolating. The pressure to 'get better' is huge, friends and family asking all the time about whether you're 'back to normal'".

The inconsistency is hard to handle as well, explains Bristow: "Having to adapt to a life-changing condition is akin to a bereavement process, and part of what's so difficult about any chronic issue is that there is often no rhyme nor reason to it. Some days you will feel differently to others, you can't predict anything. It changes your relationship to your body completely – you have to listen more intently than you ever have before, and yet you can't trust it. You can't trust that it's going to be consistent."

The interplay between chronic conditions and mental health is complex. "The impact on the gut and other body systems can be enough to trigger anxiety and depression. And then the immense stress of dealing with the medical system – having to manage all of that is exactly the opposite of the healing conditions that are required for someone to get better," says Turp. "There is also the issue of people being misdiagnosed with depression when they actually have a fatigue-related condition. There's an important and subtle distinction to be made between not being physically able to do anything, and having no motivation and drive to do anything."

Getting support for chronic health conditions

Turp and Bristow both recommend a holistic approach to managing chronic health conditions, focusing on sleep and nutrition. They also both emphasised the healing nature of sharing your experience, and how powerful it can be to talk to a therapist. "This comes back to that isolation problem – your friends and family might appear to be tired of you 'not being better yet' – talking to someone objective can be healing in itself," says Turp. " Unfortunately, like with any chronic condition, people take a while to come for help with their mental health. They are out there trying to find information, answers, maybe a cure. It's often only when they are desperate, that all hope feels like it's lost, that they come to help from a therapist."

Elizabeth Turp is a counsellor/psychotherapist, a writer on the mental health impact of chronic illness and host of the How We Care podcast, collaborative conversations between helping professionals

Wendy Bristow is a London-based psychotherapist

If you are a Welldoing therapist member, you are invited to join our free CPD Wednesday Lunch & Learn sessions

Further reading

The emotional and psychological fallout of chronic illness

Writing a film about my invisible disability helped me grieve

After my cancer diagnosis, therapy helped me feel less alone

How living with endometriosis affects mental health

The link between chronic illness and depression