With one of the most contentious presidential elections in decades coming amid a once-in-a-century pandemic, tensions were already running high. Now, the rash of positive COVID-19 tests among White House officials, including the chief executive, has ratcheted up the collective stress even further.
“The stressors throughout this year have really just accumulated in terms of the emotional burden that they’ve caused everyone individually, but also as a nation,” says Jena Lee, MD, a board-certified psychiatrist and assistant professor of psychiatry at the David Geffen School of Medicine at UCLA.
“The pandemic, of course, affects everyone. And similarly, this election, because both have very direct, related effects,” she says. “The pandemic has set off so many ripple effects of required responses — politically, medically — and the election has direct bearing on that. So it’s very complicated. I think everyone just has less reserves left.”
Those reserves have been sapped over many months. A majority of Democrats and Republicans said the unpredictability in the country and the political climate were significant sources of stress back in July, according to a survey by the American Psychological Association.
In August, the Centers for Disease Control and Prevention found that symptoms of anxiety and depression increased considerably since last year, with more than 40% of survey respondents reporting negative mental-health effects, from anxiety and depressive conditions to substance use and suicidal ideation.
Now, with Trump’s battle with COVID-19 coming seven months into the pandemic and weeks before the November election — and the uncertainty surrounding these events — many Americans feel mentally and emotionally tapped-out.
“We find ourselves in a cumulative stress state that may lead to a sense of being depleted psychologically,” says Emanuel Maidenberg, PhD, a clinical professor of psychiatry and biobehavioral science at the Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA. “That feeling of having limited emotional resources to cope with stressors that we can typically cope with quite effectively.”
Effects of stress overload
That kind of cumulative, collective stress leads to frayed nerves, fatigue, mood swings, irritability and cognitive distortions that affect the way we perceive events, Dr. Maidenberg says.
So we’re subject to being more critical of others’ behaviors and motivations and more likely to personalize events as having some ill intent behind them. High levels of stress and anxiety also contribute to catastrophic or all-or-nothing thinking, Dr. Lee says, making us more prone to think in absolutes.
For example: What if schools remain closed all year? Will it always be this way?
“We kind of project our concerns into the future,” she says. “So we’re already thinking this way around the pandemic, and then you come to the election. It’s very easy to go from one topic to the other with the same often hurtful or maladaptive thinking patterns.”
Further exacerbating our collective and individual stress is the absence of routine, novelty and social connection, says Dr. Maidenberg.
The pandemic has disrupted typical life rhythms of going to work or school, seeing friends, playing sports, attending religious services and other activities that bring a predictable momentum to the days and weeks. Without these things, “our perception of time becomes a little skewed,” he says.
A lack of new experiences also contributes to stress levels, he says.
“The absence of novelty leads to a decrease or loss of positive emotions,” Maidenberg says. “Anticipation of excitement of some kind or a sense of mastery — these are things that are available to us if we have the opportunity to experience something new, like new interactions or new things to learn, a new task to attend to or new places to go. And it’s just something that is not available now.”
Perhaps most painful is the prolonged paucity of social connection. Human beings are social animals, and connecting with others is a major mood booster.
“The social isolation component is very significant,” Dr. Maidenberg says. “The COVID side of the current stress we’re experiencing is different because of its length — it’s just a very long period of being socially isolated and that deprives us of activities that tend to help us cope with stress in normal, regular circumstances.”
The myriad sources of stress and uncertainty are enough to push vulnerable people into diagnosable mental health conditions, he says: “It’s exactly the kind of stress that can activate vulnerability toward anxiety disorder or depression.”
Anxious or depressive feelings that interfere with everyday functioning merit medical attention, he says.
Steps for easing stress
Short of a diagnosable disorder, mitigating stress and anxiety — from the pandemic, the election or any other source — is generally within an individual’s control, doctors say.
“The good news is that we can build resilience through all these stressors, but it does take a lot of work,” says Dr. Lee. “My hopes are that with these ongoing stressors — whatever happens with the election and everything leading up to it — people are just more primed with self-care."
She recommends focusing on the basics of sleep, nutrition and exercise.
“It sounds simple, but it’s actually not. Optimizing these three things actually takes a lot of time, a lot of mental effort and self-control,” she says. “When you focus on these things, biologically it protects us from the anxiety getting too out-of-control and affecting basic functioning.”
It also serves as a sort of self-therapy, she says, because by attending to these basics, one teaches themselves to take breaks.
Prioritizing sleep, for example, requires taking time to relax before bed, which probably means turning off the news and turning away from social media an hour or two before turning in.
“Sleep is very sensitive to where our priorities are,” Dr. Lee says. “So it’s hard to make sure that you’re doing everything to make sure your sleep is protected and a sacred space, as if it was a prescription for your mental health.”
Nutrition and exercise, too, require carving out enough time to acquire and prepare healthy foods and get moving several times a week.
“Physical exercise is the first thing we go to in advising people,” Dr. Maidenberg says. “A regular, three-times-a-week cardio workout for 30 minutes is the minimum that one owes himself or herself these days to help themselves.”
Just focusing on what you can do to bring down your stress levels can restore a sense of control, Dr. Lee says.
“Anxiety, on the outside, looks like it’s about the pandemic, the election and all this, but really, it’s all a balance between a sense of control versus uncertainty,” she says. “This balance gets lost if we start focusing on all the externals. But if we can focus on the things we can control within us, your sense of control actually increases and anxiety decreases.”
Acknowledging that these are challenging times — and that they will pass — is also a profound act of self-care.
“I think maybe the most helpful is to recognize the symptoms as a valid and expected reaction to the circumstances,” Dr. Maidenberg says. “The idea of validating it to yourself is a great relief for many people.”
For more information on the Jane and Terry Semel Institute for Neuroscience and Human before, visit https://www.semel.ucla.edu
