The Pandemic and Brain Injury — Maintaining Emotional Health by Staying in the Moment

It's been almost ten years since my brain injury. Of all of the expectations I had for the future, living through a global pandemic was not one of them. It’s upended one of my most important tools for living with my TBI … routine.

Very early in my recovery, I learned the value of routine. To this day, seven days a week, I climb out of bed at 6:40 AM. My keys are always left in the exact same spot — next to my wallet and pocket knife on an open bookcase shelf in my office. I learned the hard way that if I am unable to see something, it no longer exists. If you have a brain injury, you will immediately know what I mean. Brain injury takes “out of sight, out of mind,” to a whole new level.

Back when we were able to head out to our local market, I would always park in the same row making it easy to find my Jeep again. Dinner was at the same time most every day, and bedtime rolled in between 9:30 and 10p.m. Routine created a feeling of normalcy. Routine was predictable. Routine left less room for the frustration of losing or misplacing things. Routine was healing and helped me to rebuild my fractured self-esteem.

A couple of months ago, my routines ended. The effects have been challenging on some days and completely devastating on others.

Like muscle memory enables you to complete repetitive tasks without even thinking, the old pre-COVID routines had enabled me to attend to life tasks without much thought. They did not tax my internal mental resources.

These days, having to think about most everything we do is completely exhausting. Just this past week we ventured into our local supermarket for the first time in two-and-a-half months. There was a heavily armed member of our local law enforcement guarding the door. Limiting the number of shoppers inside meant that Sarah and I had to wait in a “food line” outside the market until it was our turn. While most shoppers engaged in appropriate social distancing, many did not. Many also chose not to engage in wearing the type of PPE that keeps the vulnerable population safe.

Thirty minutes later, we checked out. Being on high alert for the entire time in the store would wear down just about anyone; but add a brain injury to the mix, and I was left with a level of exhaustion that was reminiscent of the first year after my injury. I’ve known for years that exhaustion is the enemy of brain injury recovery. We both agreed that it’s back to food delivery for us. This is a compensatory strategy — eliminate the source of high stress (in-store shopping) and replace it with a zero-stress substitution (home grocery delivery).

This is just the tip of the iceberg, a single example of the hundreds of ways that routine has been stripped away from everyday life. Developing new ways of doing even the simplest of tasks requires extra brain power, power that I clearly don’t have like I used to.

So what happens when everyday tasks require Herculean effort?

Over the last few weeks, numbers are beginning to emerge. A recent article in Time estimated that one in three people are now dealing with pandemic-induced crippling anxiety and depression. One article estimated that number to be closer to 39% — and this is for the general population. It’s an absolute certainty that these numbers are much higher within the brain injury community.

My own emotional health has suffered more than I thought possible. Thankfully, depression has not been part of my pandemic life. I walked through clinical depression many years ago and know it well. But the gnawing anxiety has been crushing. Tasks heretofore simple — like pumping gas at a self-service station — bring panic. Who knows who touched the handle last? Hand sanitizer has become my best friend. There has been a months-long, low-grade panic, punctuated on occasion by full-on panic attacks.

Thankfully, my wife Sarah and I are best friends. We do well together. But there has been a complete void of most any other social contact. Just last week I was going to join a few friends for a backyard get-together. You’ve seen them — everyone brings their own chair, we socially distance, enjoy a bit of time catching up, and all go home. But on the afternoon of our planned get-together, one by one, everyone cancelled. None were ready to take that first in-person social step.

Always one to look for solutions, I’m trying to take a “back to basics” approach to my mental health. I’m trying to cut down on my news consumption, but that has proven to be tough. “What if I miss something important?” That inner voice is not always my friend. I’m making a concerted effort to do things that bring me joy, things like gardening. Our yard has never looked better.

I still struggle with the uncertainty of how all this will end and wonder if I can keep going on for perhaps months (or longer) with the challenges that life continues to throw at all of us.  The reality is that the future is none of my business. I need to double-down on doing the best I can to simply live in the moment. Looking back in time, I mourn the loss of how innocent life was and how much I took for granted. Looking forward only elevates my panic and anxiety. Living in the moment is my emotional safety net.

In this exact moment in time, now long passed by the time you are reading this, in this moment I am at my desk. My office windows are open next to me. I can hear the waterfalls in our Koi pond. Bees buzz by, oblivious to what humanity is going through. The sun is shining, birds are singing, and a soft early summer breeze is blowing. In this moment, I am safe. In this moment, you are safe.

And isn’t that what most of us want these days — just to be safe?