Contributed to EO by Shawn Johal, an EO member and former chapter president in Montreal, and Julia Pimsleur, a scaling coach, mindset expert, and best-selling author. Johal and Pimsleur also contributed 3 Ways to Strengthen Your Mental Health and Happiness Right Now.

Many entrepreneurs are now experiencing a second wave of Covid-fueled anxiety and depression as we realize that we’re no longer in survival mode. After being in fight or flight mode for 18 months or more, we now have to make it all work again―often with a smaller financial cushion due to hemorrhaging cash during the pandemic, a new sense of fear that this could happen again, and many employees not wanting to return to the office or dealing with pandemic fallout themselves.

If you don’t take care of your mindset, your body will send you a stern memo in the form of headaches, backaches, an upset stomach or worse. One of Shawn’s clients is Reza (not his real name), the CEO of a fast-growing distribution company in a wildly competitive space. He worked crazy long hours for over eight years, often missing important family events and skimping on sleep and healthy eating. He didn’t try to have any type of work-life balance, as he felt that he needed to “lead by example” and outwork his team each day.

When the pandemic hit, Reza’s sales came to a screeching halt. He began to seriously panic when he realized he had a team of 40 to support. This was before any government support was offered. Unwilling to show any sign of weakness or share his feelings with his team or even his wife, he buried his darkest thoughts. He became short-tempered and super impatient with his team and at home, and started saying he wished he could just “walk away.” He was exhibiting classic signs of depression but did not want to seek help or dial back his long hours.

Around that time, Reza began to feel a constant pain behind one of his ears. He thought it might be a bad headache or a migraine but after a week it was getting worse. When doctors ran a brain scan, they found an acorn-sized tumor behind his left ear. Thankfully it wasn’t cancerous, but it needed to be dealt with immediately. The doctor said the tumor was due to stress and anxiety, explaining he needed to immediately change his lifestyle in order to heal.

Faced with this life-changing moment, Reza finally decided to focus on personal well-being. He is taking a three-month hiatus from work and plans to integrate new wellness practices into both his personal and professional lives. He will be dedicating his mornings to a new routine that includes meditation, visualization and rigorous exercise. Spending time with his young children and wife is also a massive priority for him moving forward.

Even when we are not in or coming out of a pandemic, research shows that CEOs have higher than average levels of depression, drug addiction and drinking problems. Business owners are particularly susceptible to things that mimic the highs and lows of entrepreneurship such as gambling, drug use and other vices. As Jan Cavelle notes in her article, “Why Rates of Suicide And Depression Are So High For Entrepreneurs”, a study by a clinical professor at the University of California found that one in three entrepreneurs suffer from depression.

We want to make sure CEOs have access to the resources and tools to handle their own mental health and build a resilient mindset. This will help them enable their teams to do the same. During this time when everyone is celebrating a return to normalcy, we hope you will keep a lookout for CEOs who may be suffering silently.

Here are 5 signs you (or a CEO you know) need to focus on mental health:

1. An uptick in the use of alcohol, marijuana or other stimulants
2. Ruminating about all the things that could go wrong in your business or personal life
3. Verbally lashing out at staff or family members
4. Suicidal thoughts
5. Recurring feelings of hopelessness

As coaches who focus on increasing happiness (Shawn) and building a powerful mindset (Julia), we want to see more conversations about mental health in the entrepreneurial community. Especially now. Often, help is just one email, text or phone call away―but entrepreneurs are too proud, stubborn, or used to figuring it all out themselves to raise their hands for help. We want to make sure entrepreneurs who are struggling remember that just because they don’t have the answers, it doesn’t mean that no one has the answers.

If you agree, send a friendly text to a business owner who may be struggling: “Hey, I am thinking of you! Want to talk?” and share one mindset or happiness-boosting practice that has worked for you recently. It may just be the most important text you ever send!

Julia Pimsleur is a scaling coach, mindset expert and best-selling author. She is the founder of Million Dollar Women, a New York City-based social venture, which helps women entrepreneurs scale up their businesses and its nonprofit arm, The Million Dollar Women Fund. Pimsleur is the author of Go Big Now: 8 Essential Mindset Practices to Overcome Any Obstacle and Reach Your Goals. and Million Dollar Women (Amazon best-seller, winner of Axiom Business Book Award).

Shawn Johal is a business growth coach and Certified Scaling-Up expert, helping entrepreneurial companies achieve alignment and profitable growth. In 2009, he co-founded DALS Lighting, an LED lighting business where he implemented the Scaling Up Growth System and led the company to 3X its revenues. Shawn went on to found Elevation, a Scaling Up coaching firm, where he works with entrepreneurs and their teams to help accelerate their growth while helping them find personal balance and happiness. He’s also the author of The Happy Leader, a leadership fable about transformation in business and in life.