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Virtual Reality and the COVID Mental Health Crisis

Depression and anxiety have risen amid the pandemic; immersive therapeutics can help

Article written by Brennan Spiegel for Scientific American.

I am being challenged daily. As a frontline doctor, I find that the COVID-19 pandemic has not only tested my clinical abilities but also strained my capacity to bear witness to grievous suffering. This suffering extends well beyond the physical distress of hospitalized patients battling the virus. The pandemic has also spawned a mental health crisis beyond anything I have seen in 25 years of caring for patients. The statistics are overwhelming: CDC research indicates that 31 percent of Americans have reported anxiety and depression during the pandemic, and 11 percent have considered suicide. A national shortage in mental health clinicians existed before COVID-19. Now, health care organizations must decide how to rapidly scale and deploy behavioral health care to a geographically widespread and increasingly isolated populace. There is no time to wait for expansion of the mental health workforce.

Doctors are now turning to an unlikely solution: virtual reality (VR). When most people think of VR, they think of a gaming technology—a toy for pent-up teens to play first-person shooter games in their parents’ basement. But for decades, scientists around the world have been quietly discovering the surprising health benefits of VR for ailments ranging from severe pain, to PTSD, to substance use, to existential anxiety. Over 5,000 studies reveal that VR has an uncanny ability to diminish pain, steady nerves, and boost mental health—and best of all, it can be administered at home without a trained clinician.

VR works by creating a sense of psychological presence. When VR scientists speak of presence, they mean the technology has a unique ability to convey a sense of just “being there,” wherever there happens to be. It might be relaxing by the ocean or soaring in a hang glider or swimming with dolphins without leaving their couch. VR can even cause people to think and feel like another person altogether. For example, using a headset can enable people with depression to assume the body of Sigmund Freud and engage in self-counseling through his persona, allow people with eating disorders to experience life by way of a healthy avatar, and teleport people outside their own body so that they may gain new insights about the nature of dying. In all of these cases, if the VR is any good, the user feels transported to a new virtual environment and temporarily accepts it as reality. When used in the right way, at the right time and with the right patient, these virtual journeys can change mind and body for the better, all from the comfort of home.

Until recently, VR technology has been too expensive, unreliable and unwieldy for doctors to prescribe home-based virtual therapeutics. Now that’s all changed, and the timing couldn’t be better given the mental health crisis of COVID-19. In the past five years, multinational companies, including Facebook, Google, HP and others, have invested billions of dollars into developing and expanding the VR industry. As a result, explosive advances have been made in delivering low-cost, portable and high-quality VR to the masses. We have now reached an inflection point where the technology is cheap enough, its quality good enough and the science voluminous enough to think seriously about leveraging VR to improve mental health at scale with home-based treatments.

My lab at Cedars-Sinai Medical Center in Los Angeles, and others like it, has been on a journey to study whether and how VR can improve mental health. We created one of the largest medical VR programs in the world and have now treated several thousand patients with immersive therapeutics. In my book, VRx, I reveal how our team is using VR in the emergency department for helping patients with panic attacks, treating women in labor who are seeking to avoid an epidural, and managing patients with painful injuries. I discuss the research on how VR can treat irritable bowel syndrome, support stroke rehabilitation, steady tremors, manage schizophrenia and engage patients with dementia.

But it was the COVID-19 pandemic more than anything that has pushed us to move VR outside the walls of the hospital and into the community. Now, with the help of research funding from the National Institutes of Health, our team is shipping VR headsets directly to patients where they can receive mind-body treatments in vibrant, three-dimensional worlds—all in the privacy of their home and without the need for a live visit. Instead of prescribing another pill through a traditional in-person session, we might recommend a virtual beach vacation at home to ease aches and pains, or prescribe a course of cognitive behavioral therapy for people suffering from anxiety or depression.

In one program, called EaseVR, patients with chronic pain learn to control their mind and body through VR biofeedback therapy in a whimsical forest of glowing trees beside a shimmering lake. As the patient breathes in and out in sync with beating drums, the microphone in the headset detects the respirations and uses the input to drive a metaphorical visual narrative, allowing the user to breathe life into a dying tree or cause the sky to brighten a lustrous shade of blue. Virtual trees expand and contract in rhythm with breathing, like a huge arboreal lung exchanging air in sync with the patients’ body. Evidence shows this type of therapy not only helps in the short term, but can also alleviate pain, anxiety and depression well after the immediate treatment is over.

VR does all this by radically changing our perspective of the world. We can imagine being somewhere fantastical and healing. We can practice being the person we want to become. We can see ourselves from beyond and regard ourselves in a new light. We can empathize with ourselves and with others. We can confront our inner voice. We can transform our minds drastically and immediately, and when effective, forge healthy cognitions that last long after the headsets are removed.

VR is not just for gamers anymore. It is a new type of mental health treatment that can make things easier when times are hard.

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Kindness can save the world

Finally, we have a reason to be optimistic about: at the end of the tunnel, there is a vaccine. But, is this the only antidote against sickness, let alone a pandemic? Don’t get us wrong we do believe in science- science is the backbone of Solas VR meditation app. But, it seems like our society has made a step forward, and organisations like WHO embrace the power of behaviour: “Be kind to yourself and others”, we read in this 5 points list on how to cope with the pandemic.

Kindness can save the world. Because being kind is the reflection of a calm and confident mind and a warm soul. Kindness is like the tip of the iceberg: what lies beyond is massive, it takes time to build, and it can change lives forever.

“Be kind to yourself and others”, we read. The first step is the hardest, though. How can we be kind to ourselves when our mind is filled with criticism, guilt and unfulfilled expectations? We have already discussed how conditioning shapes our understanding of the present: deep-rooted beliefs about ourselves uglify the perception of the lives we live. When we feel like we are not good enough, we develop a defensive posture against the world and other people. We feel that we deserve more, we tend to compare ourselves to others and sometimes even feel jealous. How can anyone be gentle amid this emotional turmoil?

If you want to be kind to yourself and others, start by creating some space between yourself and your thoughts. Don’t believe everything you think; your thoughts are not necessarily right because they are not necessarily yours. Take some distance and gently notice what passes through your mind. This is the essence of mindfulness: our ability to distance ourselves from our thoughts and emotions and be capable to separate what really serves us from the rest.

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The Business side of mindfulness

Business focus has shifted several times, and today we are living in the Relationship era: maintaining strong relationships among the brand and its stakeholders has become the main source of competitive advantage. Our business vocabulary corroborates this shift, with new terms like employer branding, brand love, brand trust etc becoming the new “keywords” for the business plans and zoom meetings.

What we have to do now, as managers and team leaders, is to align our approach towards our people to this new framework, in order to become the managers that we would love to work for.

In other words, the times of transactional leadership are over. We have plenty of research to support the importance of keeping our people satisfied and content and a new, more empathetic leadership style is called for. Especially as Millenials have taken over, work-life balance and profound job satisfaction have outdone monetary rewards, in the “what keeps me productive” list. Motivation replaced fear; empathy replaced strict rules; retention replaced turnover.

What makes a good employer today?

The ability of the managers to address what really matters to the employees and to create a friendly, rewarding work environment. The more empowered and cared for team members feel, the more productive and devoted to their job role they become. Satisfied employees pay more attention to detail, become better service providers and contribute to the positive word of mouth, according to academic findings. 

In this context, taking action to boost the staff’s mental well-being becomes self-explanatory: being individually balanced and calm is the cornerstone of team balanced performance. In fact, this is so important, that employers might need to address this issue before it emerges, and to act proactively: encourage employees to engage in mindful practices before they feel emotionally challenged.

When we started working on the Solas VR meditation app, Covid-19 didn’t exist, whatsoever. But, even then, we knew how important the implications of corporate mindfulness were. By the time we launched the app, things had changed and remote work made joint team activities even more urgent: teams need to introduce new rituals that would enforce the sense of community among the team member, that ceased sharing common working space. Sharing a VR mindful experience is among the few activities that:

  • nurture the employer-employee relationship,
  • deepen the sense of community
  • boost productivity
  • and enhance mental wellbeing, at once.
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Mindful during lockdown

It is a conscious effort that we need to make to stay balanced and mindful during the lockdown. According to the World Health Organization, this insecurity puts extra pressure on ourselves and stress rates have skyrocketed during the spring lockdown. It is no surprise that WHO has published a guide on how to stay grounded and mindful as the top cope mechanism for stress management amidst the pandemic. The main idea, to focus on the breath and create some space between ourselves and our thoughts and emotions is the backbone of mindfulness practice- and the Solas VR app, of course.

At the same time, mental health experts alert the management teams for burnout symptoms that might occur to first-line workers. During this Covid-19 era, health workers are under tremendous pressure, physically, psychologically and mentally. If they fail to manage their stress, this will have a profound impact on their mental health, relationships and work performance. Now, more than ever, microbreaks are so crucial to their daily routine. And, most of all, this is why we need to approach them with empathy, deep understanding and kindness. 

There is a silver lining though, even now in these unprecedented times. The world has slowed so we can rediscover ourselves. We have more time in our hands, and this is the greatest gift one can receive. We can spend more time with our family; we can set off a personal journey to find our inner peace, now that it is needed the most. We can rethink our thoughts, address our conditioned patterns, change our mindset hence our reality.

What we all need to do, in fact, is to be gentle to ourselves and to others. This challenge will make us stronger, as individuals and as communities, as long as we focus on the moment and try to make the best out of it.  So, take a deep breathe and as you exhale allow the anxiety and frustration to go away.

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Solas Sites: The Waterfalls

16mIn this powerful place we feel the force of nature. There is the flowing power of water and the sturdy strength of the boulders. We see and experience the elements we can decide to identify with and draw on.

We feel the cleansing power of water washing away old habits and emotions that no longer serve us.

This site also serves as a reminder of the potential perils of trying to control nature for our won amusement. In August 1821, during the visit of King George IV to Ireland, Richard Wingfield, 5th Viscount Powerscourt dammed the waterfall so he could release a torrent while the two stood on a new bridge built for the occasion below the falls. For reasons unknown, the king did not leave the banquet at Powerscourt House to view the waterfall, which was fortunate as, when the water was finally released, the bridge was washed away.
habits and emotions that no longer serve us.

Find yourself there, right now. Download Solas VR meditation app.

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Take a walk with your inner critic

inner critic

What is the role of the inner critic in your life? Is it an enemy or our best friend in disguise?

We return to the subject of inner criticism because here reside many of those beliefs that keep us from being more. Having a voice in our mind pointing out our recklessness or inadequacies, non-stop, is exhausting and counter-productive. So, how can we take some space from our inner critic?
Let’s see: have you ever wondered why our brain needs this inner voice that always highlights our shortcomings and mistakes? According to evolutionary psychologists, this is a very friendly mechanism designed to protect us from quick and unjustified decisions. This part of ourselves watches out for us and makes sure that, at any point, we are fully aware of our actions and their consequences. Unfortunately, throughout the years, as life became so much more complicated but the mind hasn’t yet caught up, this self-caring mechanism has become a tyrant in the mind. Things are not black and white anymore: they are mostly grey. Where certainly and clear thinking applied, now moral decisions and value systems need to be involved. But the voice isn’t ready for our fragile psychology: the inner critic keeps commenting as always, but now we are too stressed, too sensitive, too involved to listen.

So, the first step is to understand that ourself can never be the enemy; deep inside, everything is designed for our benefit and protection. As discussed in a previous blog post, personifying our inner critic will create some of the distance we need for everything to make more sense. The next time you realize that your inner voice talks like you are an imposter just say “Ok, it’s him/her again, being annoying”. This small sentence has so much power: we acknowledge that the voice is not necessary right and that you have, also, the power and the right to judge and dismiss its statements. This dialogue strengthens your self-confidence and it gradually allows you to grow into better decisions and less stress.

Don’t forget to read our blog post about the trick to tame your inner voice and to share your hacks on our Facebook group!

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How to make the right decision

How can you be sure to make the right decision when everything around us is so unstable? In these unprecedent times we don’t feel confident enough to make plans for the following weekend as a lockdown might turn our lives upside down, again. Covid-19 challenges our everyday habits, our personal and professional life and our mental health as well, as a recent article by The Sunday Times highlighted. We become more and more restricted and we get to feel that we have less time and less space to act.

But, decision making needs space: a clear mind to set the goals, to balance the pros and cons, to stand upon our conclusions and to be patient enough to wait for the outcomes. Because, decisions are hard to make, even in less unstable times. As the famous author and psychiatrist Irvin Yalom states it ”

Decision invariably involves renunciation: for every yes there must be a no, each decision eliminating or killing other options (the root of the word decide means “slay,” as in homicide or suicide).

Hence, now is when you need some mental space the most. You need to find, or even invent new ways to battle the stress and anxiety, to clear your mind and cope with everything. If you are an experience meditator, you already know where the answer lays. But, if you haven’t yet used these ancient, wise techniques to empty and focus your mind, start today. The simplest tool is a breathing exercise, like the one here, that teaches you how to focus on your breath and let everything else go. When you become familiar with this, you will realize that you can access your inner peace at any time, as long as you breathe.

 

By all means, nothing compares to a walk in nature where you can lay by a creek and enjoy the sounds of theh nature or the mere silence, that will allow your mind to make the right decisions. Just put your VR headset on and let the VR technology and our 360 videos from Irish landscape give your mind what it needs: some space.

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How Covid-19 has impacted leaders and their employees differently- Repost from Dan Schawbel

Even before Covid, there was a global mental health epidemic in the workplace yet corporations have been slow to address this ongoing problem. But now, Covid has both accelerated and worsened our mental health issues forcing companies, and their leaders, to make it a priority. While mental health has been on my Workplace Trends Forecast previously, it’s right at the top of the list for the 2021 edition.

While every worker has their own unique set of circumstances and experiences during Covid, some groups have suffered more than others. Covid-19 has disproportionately impacted the mental health of womenGen Z, and now corporate executives. It turns out that it is really “lonely at the top” and that in order to alleviate the mental health issues of employees, we have to help their leaders first. Even though leaders are compensated more than employees, that larger paycheck comes with more responsibility, additional working hours, less work-life balance, and fewer colleagues to confide in.

During episode 102 of the 5 Questions podcast, I had an enlightening conversation about mental health with David Chang, the famed chef and founder of restaurant chain Momofuku. David compared successful CEO’s to heroin addicts saying, “when you’re at the top of your profession, that is the peak of your addition and you bottom out by hitting the peak, whereas if you’re a heroin addict you might have lost everything and that would be bottoming out.” Our workplace cultures promote burnout instead of wellbeing because leaders continue to prioritize productivity over humanity. Ever since the 2008 recession, the corporate mantra has been “do more with fewer resources”, which has put a strain on workers, despite higher profit. Since then, burnout has been part of our work culture and a byproduct of higher productivity. David thinks that being a workaholic is not only part of a leader’s job description but a badge of honor in our society. “The weird thing about work is that it’s socially acceptable and seen as this as this prestigious thing,” he explained.

Leaders mental health has declined the most in 2020

Few could argue that this year has been the hardest and most disruptive for everyone, wherever you live and whoever you work for. But, leaders especially can’t wait until 2020 is over and we’re all finally passed the pandemic. In a new study in partnership with Oracle, we surveyed over 12,000 workers in eleven countries, with over 3,100 being c-suite executives. We found that 71 percent of executives say that this is the more stressful year ever at work compared to 63 percent of employees. In addition, 53 percent of executives say they’ve struggled with mental health issues at work compared to 45 percent of employees. It’s ironic that the people who have the most power to improve working conditions are the ones suffering the most.

Our data is further validated by research from Bupa, which found that 70 percent of executives have experience mental health symptoms since the start of Covid, mostly in the form of anxiety and sleep disorders. In addition, the Harvard Business Review discovered that half of CEOs experience loneliness on the job and 60 percent agree that it’s hindering their work performance. But, on the bright side, executives in both our study and Bupa’s are committed to making a positive transformation to their corporate cultures going forward by promoting work-life balance and investing in employee assistance programs.

The loneliest job just got lonelier

While it is said that the “loneliest job in the world” is being the U.S. president, all leaders suffer a similar consequence of the prominent position they’ve obtained. Back in 2016, Apple CEO Tim Cook was asked about running the company and he responded, “it’s sort of a lonely job.” We perceive leaders as “having it made” or “successful” on the surface, without awareness of the struggles they’ve had beneath. The nature of the job is very isolating and stressful because you’re constantly serving others, keeping your company afloat and the same internal drive that elevated you to a leadership role also drives you insane. The pursuit and attainment of leadership come with mental health issues as part of the package, not sold separately.

It’s lonely at the top part because of the power dynamic between leaders and their employees that reduces trust, increases complexity, and creates fear. Leaders have to be careful about what they say to their employees because they want to maintain their power, prestige, and respect, while employees are worried that their words may hurt their career prospects. Thus, leaders who have power and higher earnings can alienate their employees and create feelings of jealousy and resentment. Leaders are often less likely to confide in their employees as they feel they may lose their power by doing so, which naturally makes them feel more isolated and lonely.

This year with Covid, leaders are under more pressure to make decisions that have major implications for workers. And, it’s hard for a leader to be vulnerable because our culture praises the powerful, strong, and confident leaders. But, that’s changing during these times where vulnerability is power, empathy is critical and trust is the most important asset. When leaders and their employees don’t connect on a human level, it’s hard to create a deep and meaningful connection that enhances work culture. Now that so many people are working remotely, it’s the best time for leaders to be more vulnerable, listen to the needs of their employees, and improve working conditions for everyone.

When leaders improve their mental health their employees benefit

It’s time for leaders to be more vulnerable, open up their hearts, and make it culturally acceptable to talk about mental health at work, either in-person or from a distance. Your employees desperately need you to step up because in order to effectively lead your organization through a crisis (like Covid-19) you can’t ignore or discount mental health. When leaders communicate regularly about what they are going through, that vulnerability builds the trust required to connect the workforce in a meaningful way that improves productivity, retention, and overall success.

If remote work has taught up anything it’s that organizations can be flatter and corner offices are unnecessary and isolating. For this year’s World Mental Health Day, I want you to commit to having more conversations about mental health so we can eliminate the stigma, build deeper connections, and humanize the workplace together. Then, create or enhance your employee assistance programs so everyone can get the help they know they need but never had access to.

We have to put mental health on the agenda and it starts at the top!

Dan Schawbel

 

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Still is the new busy

When someone tells you that they work long hours and they can’t take a break, how do you label them? Well, if you belong to the majority,  then you probably think of them as successful. Being (too) busy has become a signal for success and responsibility. People are proud to have no time for themselves. But, let us tell you one thing: Overworking is yesterday’s news, the present wants us to be present. 

Staying still for a while is not laziness, it’s a skill. It takes time and effort to clear the mind from intrusive thoughts and allow the brain to be empty and still for some minutes. Connected to the breath, disconnected from any worries, still and refreshed.

Being busy is the outcome of a frustrated, overwhelmed mind. You have too many thoughts and triggers that it becomes hard to prioritize, and this causes confusion. In turn, it fogs your judgment and it raises the levels of anxiety, so in the end, this whole process is counterproductive.

On the other hand, taking some time off during the day, like a micro- break in our app, allows the mind to unwind, refocus and regain interest in the subsequent task. It is scientifically backed up, but if you want to test the theory yourself, just sign up for free in the app and take a walk in the irish nature. Stand still, notice what’s going on around you and inside you and be more.

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How to battle work stress during the pandemic

There is no getting away from the fact that 2020 has been an extraordinary year. Industry across every sector has been affected by the fallout from Covid-19 and, with curbs still being placed on various parts of society, the future continues to look uncertain. There is no denying that everyone has been feeling increased levels of stress, anxiety and even burnout as they try to make a living and bring their businesses safely through the crisis.

Mindi Caselden of CaseldenConsulting.com says that, while managing expectations during chaos can be difficult, it is important to set realistic goals and work step by step to achieve them. She says 1% nudging is the desired approach “over all-or-nothing”.

“This is especially so when adopting new habits, as these take practice and focused intention to really solidify. Each step is an achievement to celebrate as you are moving towards the goal, and continuous small steps lead to greater sustained change in the long term,” she says.

“This is an endurance game, and the finish line keeps moving, which makes it difficult to keep energy levels where they need to be to make progress. But awareness of your own energy is the first step. Give yourself permission to take time to reset and reflect back on your purpose and why you are doing what you do. Take small steps and celebrate achievements along the way. It really is about the journey to get where you want to be.”

Jean O’Neill of JeanONeillCoaching.ie agrees and says, while the much-lauded work-life balance is “probably a myth” for many people, there are ways in which the two can work in harmony.

“In my capacity as a neuro-wellness and performance coach, I prefer work-life integration, and encourage people to find an individual blend which works with their circumstances,” she says. “It is not ‘one size fits all’, but daily self-care strategies are crucial to your wellbeing, overall functionality and coping skills.

“The word ‘discipline’ can put people off, so I encourage terms like ‘daily self-care wellness’ or ‘rituals’, and a strategy which promotes routine and balance.”

O’Neill advises that anyone who is experiencing burnout should speak to their boss — or themselves if they are in charge — and attempt to find some flexible solutions and compromise.

“Explore new ways of managing stress and engage in conversations about daily self-care strategies with co-workers, friends and family to see what tips and insights they can offer you,” she says.

“Seek professional support and don’t wait for your stress symptoms to get worse. If your employer has an employment assistance programme, reach out to counsellors and coaches for safe and confidential support.”

While there may be many reasons for anxiety at work, having to impart unwelcome news to staff can be particularly stressful. Consultant Michelle O’Sullivan says the impact of this can be minimised by forward planning.

“The key is preparation, so be clear on the desired outcome, anticipate and prepare for potential obstacles,” she says. “Have a list of key points, be factual, and respond rather than react — because emissions are contagious, so be very mindful of being emotional.

“If you’re feeling anxious or need a confidence boost, I’d recommend looking at Amy Cuddy’s TED talk for great tips on how to build your confidence. And be careful of body language, as our bodies change our minds, and our minds change our behaviour, and our behaviour changes outcomes.”

O’Sullivan says the same is true when it comes to making decisions.

“Use all three intelligences — head, heart and gut — when making decisions,” she adds.

“Make sure you have considered all the choices and potential outcomes and also are clear on what you hope to achieve. Speaking to a coach can be beneficial, as they will help you see possibilities you might not be aware of.”

Staying calm is vital, and Stephen Pitcher of SolasVR.com has recently launched a meditation app which, he argues, can be beneficial for anyone suffering from work-related anxiety.

“The cause of so much of our stress, anxiety and discomfort is our disconnection,” he says.

“Living in urban areas, we are disconnected from nature, often from our families due to distance or lifestyle, and from our feelings as we feed on distractions. We are even disconnected from ourselves, as we fill our day with activity rather than sitting in silence.

“But Covid has laid all that bare. It has exposed what is already there, intensified and magnified it. In general we are ill at ease with the society we have created and often the life we live. So because of this environment we have created Solas VR, a virtual reality meditation app to harness the power of virtual reality to deliver a connection to nature, to ourselves and to the certainty that we have been missing.

“Whether we are transported to Glendalough cathedral or the stone circle at Athgreany, we can access guided meditations, music, drumming, nature sounds or silence.”

Taking time away from work is not only important for our mental and physical health but is also crucial when it comes to making good business decisions, as mental fatigue can lead to rushed or poorly executed judgements.

“We need to know when we are freshest and when is a good time to make decisions, and should try to schedule meetings and actions around that time,” says Pitcher.

“We also need to create space for decisions and allow for micro breaks within our day to return to our centre.”

Jean O’Neill agrees, and points out that the thousands of decisions we make each day — big and small — can lead to decision fatigue.

“So learn to raise your levels of self-awareness and recognise that, when you are stressed, you are less likely to make decisions which act in your best interest,” she says.

“And if stress is building up for you, factor a power nap into your day to recharge your batteries — rest and repair is crucial when you are stressed.”

How to avoid work stress

● Establish a consistent daily routine to help create a feeling of certainty and structure.

● Stop multi-tasking, and try to reduce distractions.

● Optimise your workspace when working from home, and create designated spaces for various members of your household.

● Build healthy boundaries around working hours and conditions, and try to avoid letting home and family life merge into one.

● Limit your media consumption.

● Look after your mental and physical health by engaging in regular exercise and taking frequent desk breaks to stretch your body and clear your mind.

● Have a healthy diet, keep hydrated, and avoid foods which bring an immediate high — as eating them will be followed by a low.

● Try not to worry — observe, accept, and change.

Getting back on your feet

● Record your successes, wins and achievements — big and small.

● Surround yourself with people who positively influence and inspire you.

● Get involved with valuable networks such as Ireland Together and create visibility for yourself.

● Surround yourself with people who have the expertise and knowledge to support you, and vice versa.

● Don’t be afraid to ask for help.

● Avoid people who have a negative impact on your mental and emotional health.

● Understand and identify your individual motivators and drives.

● Be kind to yourself and don’t waste time or energy on past failures.

● Put a daily self-care action plan in place, and also put together a plan of future goals and break it down into manageable tasks.

● Open your mind to consider new ways of thinking and have a back-up plan.

Source: The Sunday Times