Today I went into my psychotherapy office to water the plants. I have been working from home during quarantine, and my weekly trips to my office have been eerie, to say the least. Little traffic on the road, an almost full tank of gas in my car, dark empty halls in my building, antibacterial wipes handy, a new office sign that was just installed outside to let people know where I am, and the red ribbon still hanging on my office door from the grand-opening celebration I held a few days before the coronavirus crisis began. All reminders of a big lesson we are now learning. Sometimes things don’t go exactly as we had planned!

I walked to the coffee shop and chatted with Mary Joe and other customers through our face masks. A solemnness filled the space, including the six feet between us. I felt a deep sadness, even harder for me to accept than staying at home the past six weeks. The idea of wearing a face mask for an indefinite period of time as we move out of quarantine made me feel very uncomfortable. It felt as if a very important part of human relationship was being sanctioned. Protecting ourselves from the coronavirus, or the invisible monster, as some have called it, we also now face (no pun intended) a mental health crisis of tremendous degree and complexity.

The other invisible monster. The one we don’t hear nearly as much about on the news, but indeed has reached pandemic proportions.
We are biologically wired for connection and touch. A newborn baby can’t survive without being held and nurtured and loved and seen. We innately not only desire it; we need it to survive. Attachment theorists who studied infants have given us conclusive evidence that the need for emotional safety, connection, and human touch are vital for optimal brain development and a healthy nervous system response to stress. Facial gestures are key components in all of that. Non-verbal communication gives us clues to emotional safety with other people. Wearing a mask creates a barrier to that.

Tears swelled in my eyes, not just for me, but for all of us having to endure this time. I thought of the plants I had just watered and the way they were drooping in quiet despair waiting for the love and nurturing that they so need to survive after the week of being alone in the empty space. Every living thing needs to be “watered” and cared for by physical connection with others.  None of us can survive alone without it. 
My next stop was the grocery store. I re-attached my mask and walked into the store. Again, saddened by the clear barrier of human connection witnessed above all of the face masks. The woman at the check-out helped me pack my groceries with a sullen look of despair and uncertainty, peering out from above her mask. These essential employees are exposed every day to both of the invisible monsters.
            There has been an 891% increase in calls to the National Mental Health Hotline since the pandemic started. Depression, anxiety, addiction, PTSD, domestic violence, abuse, and neglect are rapidly increasing as we social distance and live in fear of the coronavirus and all the resulting lifestyle upsets that have ensued. This neglected mental health monster existed long before COVID19. However, much like the invisible coronavirus, emotional distress lives in an invisible realm behind one’s closed doors. 
The stigma around mental health has increased the spread of that invisible monster for way to long. It, too, is deadly.  Suicide is the tenth leading cause of death in the United States. The CDC reported 48,344 suicides in 2018 up from 47, 173 in 2017. Overall the numbers have increased 35% since 1999. Yet the National Institute of Health spent a significantly lower amount of money on suicide prevention in 2018 than on breast cancer. As of April 28, 2020 there have been 55, 258 deaths from COVID 19 in United States. Clearly the coronavirus is extremely concerning and needs to be addressed, but let’s not forget the pandemic of mental illness that is also occurring at this time.
Prior to the pandemic pause, routines and distractions kept many people from clearly identifying mental health problems. Addiction, over-working, sleepless nights, financial pressures and other stressors were mounting with no imminent solution for many. Despair, uncertainly, hopelessness, anxiety, and depression have been part of our hectic lifestyles for a while. The pause button on these distractions is now putting our mental health under the microscope. 
There is much talk about the unfortunate shortage of PPEs (Personal Protective Equipment) in healthcare settings. Face masks are a part of what healthcare providers need to protect themselves and each other from contracting the coronavirus. All of us can  benefit from wearing masks and social distancing to help slow the spread of the coronavirus. However, as I looked at all the masks today and thought about the visible signs of protecting ourselves from the coronavirus, I couldn’t help but wonder how we can  protect ourselves from the impact this is having on our mental health. 

What came to me was the idea of PPEEs (Personal Protective EMOTIONAL Equipment.) Four ways to protect your emotional wellness during this pandemic are your PPEEs: Practicing Presence; Playfulness; Excavating Emotions; and Expressing Emotions. Here are some suggestions for ways you can access each of these PPEEs for emotional safety:
Practicing Presence. Practice presence by taking a deep breath and reminding yourself to be in the moment, suspending judgment. This is difficult because our brains are wired to solve problems, and when faced with a situation that seems unsolvable it is hard to stop the mind chatter. One tool I suggest is The Fantastic Five. Pay attention to what around you is safe in the moment, so that the body can find some stability. List five things that feel safe. Some examples might be—the sun, the birds, your pet, your comforter, a stuffed animal, etc. Name at least five and pay attention to them throughout the day when you are in fear. Daily meditation and mindfulness practices are also important every day. That is why they are called practices. We need daily repetition to change old patterns to reduce stress and anxiety

Playfulness. Brain research has discovered how important play is to emotional safety. When we are playful, we can’t be in fear. Look at toddlers when they are playing and then when they are scared. Play and fear can’t exist together. Play allows the body to feel safe and helps to rewire the brain and nervous system. Find some time each day to relax, laugh, and play. It is good medicine. Even if you feel there is nothing fun happening right now in this crisis, stretch yourself a bit to find at least a few minutes of playful presence. It is good elixir for your heart.

Excavating Emotions. Part of the mental health crisis in our country today is the lack of skills to access our emotions. Prior to the 20th century there was a belief that uncomfortable emotions were bad and needed to be shut down. “Stop crying before I give you something to cry about” is a classic example of this belief system. We have to excavate our feelings, similar to an archeologist digging for artifacts of earlier life. One way I suggest you do that is by taking a Deep-SEA Dive into the hidden treasure of emotions. There are three parts to your Deep-SEA Dive: The Situation, The Emotion, and The Awe-Inspiring Action. When you are feeling stressed, write down the Situation in a few sentences using observable, countable, repeatable language. Then look at a feeling word list to identify the Emotions you are feeling. Try to find words besides angry, frustrated, or sad. Although these are certainly appropriate, there are usually deeper feelings underneath, such as attacked, unloved, abandoned and unappreciated. Finally, think of what might have felt better instead, and what you truly desire. This is your Awe-Inspired Action. An example of a Deep-SEA Dive might be: When you neglected to call and let me know when you were coming home (situation,) I felt abandoned and unloved (emotion.) It would mean so much to mean if we could communicate more clearly about our schedules (awe-inspiring action.) You may or may not say this out-loud to the other person just yet. The most important part of this exercise is to allow yourself to see the SEA of your emotional treasures.

Expressing Emotions. Find a safe way to express the emotions that you excavated in your Deep-SEA Dive using activities such as journaling, creative arts, singing, dancing, yoga, exercise, talking to a therapist or coach, and if you are comfortable, share your Deep-SEA Dive with another person. Give yourself permission to feel what you feel, and allow the emotions (Energy in motion) to move out of your body with some form of expression that does not harm yourself or anyone else.
Using one or more of these PPEEs to protect you from the other invisible monster can help you stay emotionally well during this COVID 19 pandemic. We are all in this together, and we will get through to the other side. Stay safe, and know you are loved, and you are doing the best you can.