How to Preserve Your Mental Health Despite the 2016 Election

Stephen Holland has practiced clinical psychology for more than a quarter century. He has done so in Washington, D.C., for more than two decades. He has never seen an election like this one.

“I’d say probably two-thirds to three-quarters of our patients are mentioning their feelings about the election in session,” he told me. Holland directs the Capital Institute of Cognitive Therapy, where 12 clinicians see more than 300 patients a week.

So it is, perhaps, with every election. Robert Leahy, director of the American Institute for Cognitive Therapy, said that therapist appointments anecdotally rise every election season. (They especially seemed to rise in D.C. when George W. Bush was elected, he told me.)

But 2016 is something else. Donald Trump, the presumptive Republican nominee for president, aspires to implement policies far more extreme than the ordinary candidate’s. He talks of launching a trade war with China, deporting millions of immigrants, and enacting a total ban on Muslim immigration. Either through sky-high prices or constrained religious rights, his plans would dramatically alter the lives of far more Americans—in a far more sweeping way—than the proposals of Clinton, Obama, Romney, or McCain.

Even Republicans fret about Trump. “I really believe our republic will survive Hillary,” Michael Vlock, an investor and major G.O.P. donor, told The New York Times this weekend. He wasn’t so sure it would endure Trump.

This angina is making its way to therapists’ offices.

“Among people who are not Trump supporters, we’re hearing a higher level of concern and dismay than I’ve probably heard in any election cycle, in 25 years of clinical work,” Holland told me. “Some of the highest levels of distress we’re hearing right now are coming from people who are involved and committed to the Republican party.”

He clarified that most of the political anxiety was not clinical—that is, patients could handle it without turning to significant help from their therapist, and it was not screwing with their life in a major way. But not all of it was so easily dispatched.

I, too, have been feeling some of this angst. I have had family members tell me they’re scared, and friends of friends—upon hearing I’m a journalist—ask me to assure them Trump’s election is impossible. (It’s not.) It feels like it’s going to be a very long five months until the election ends at last. And whether people are worried about Trump, or Hillary, or the general tone of the campaign, I thought people could use some practical pointers. So over the past two weeks, I talked to Holland and other psychological clinicians and researchers about how to address the political fears that you might experience during the summer and fall to come. Here are some of their tips.

Above all, many stressed the need for self-compassion. “It’s very important for us to have compassion for whatever it is what we’re experiencing,” says Renee Lertzman, a psychological researcher who studies climate change. That’s important even if what the feeling is a desire not to know about something scary. (My colleague Olga Khazan recently wrote about why self-compassion can be more effective than self-esteem.)

If you feel fear or hopelessness, Lertzman says you shouldn’t judge the emotion itself or “attack [yourself] for either not caring enough or not doing enough.”

“We need to find a way to relate to our own experience with kindness. That’s resonant with all sorts of Buddhist spiritual writing, but there’s a psychological basis for that. [Self-compassion] allows us to actually get in touch with what we’re really feeling," Lertzman told me. She adds that accepting our own emotions ends an energy-draining cycle, where someone’s mind has to defend itself from its own attacks.

To that end, experts stressed that anxiety about an outcome or existential threat is completely normal.

“If you are somebody who considers Trump to be a potential problem, I think there’s no way to not be living with some degree of anxiety right now. And if [his election] becomes more likely, I think there will be higher levels of anxiety,” says Holland.

Worry or anxiety about a scary outcome is often healthy—or, as he put it, adaptive. (Adaptive behavior helps us come to terms with, and function in, the world.) “We’re all biologically wired to worry,” Holland told me. The mind often tries to identify threats and plan for them, or it considers past losses or mistakes and considers what it could have done differently.

This tendency often helps us. At its best, rumination helps people use past experience to problem-solve or plan for the future. But it’s also possible for it to get stuck in a never-ending worry loop. The normally virtuous cycle of rumination can become a harmful vicious circle.

In states of clinical anxiety and depression, “the worry and the rumination goes into overdrive and [we] can’t turn it off,” says Holland. “The brain is going over and over again, trying to solve a problem that it can’t find a solution to.”

This obsessiveness itself reverberates, he said. “People find the fact that they’re worrying about something all the time, thinking about it all the time, to become distressing in itself. That’s what leads to insomina. The brain is basically going, you need to be awake, you need to be alert, you need to be thinking about this because there’s a problem you need to solve.”

Because normal worry can tip over into pathological anxiety, Holland said it’s important to differentiate between productive and unproductive anxiety.

Productive worry can push someone into taking a positive action. (More on that in a moment.) Unproductive worry, on the other hand, will just loop indefinitely without ever finding a positive object. Outside of a political context, a good example of this is a college student worrying before a big test. If a student uses her worry to make herself study for the test, then her anxiety was productive. But if she sits there fretting that she’s not smart enough to pass college—and has no plans to drop out—then she is experiencing unproductive worry.

How do you differentiate between the two? Holland said it’s good to ask yourself whether the worry is centering on something you can take some action about.

“Take concrete steps—like donating or volunteering—for your candidate and accept the limitations about what you can accomplish,” says Robert Leahy, the director of the American Institute for Cognitive Therapy, in an email.

If you’re worried about something ultimately beyond your control, focus on how unlikely it is that the worst case scenario may happen.

“People focus on the worst, most catastrophic possible outcome. And their mind starts spinning around about that,” says Holland. “One of the things you want to do is go, okay, wait a minute. What’s the range of possible outcomes here, and what’s the probability of those? What are the specific things I’m worried might happen, and what are the probabilities of those things?”

He admitted this was a tough exercise, since Trump’s lock on the Republican nomination has taken so many people by surprise. I would add that it’s also true that campaign promises aren’t made in vain. Political scientists find that most politicians keep most of their campaign promises.

Leahy encouraged worriers to focus on the structural limits of American government. “Think about the constraints or limits that all politicians face—for example, Congress and The Supreme Court. If you fear Trump, keep in mind that he won’t be able to do a lot of what he claims he wants to do,” he said.

He went on. “Keep in mind that there are some things that you personally won’t control and worrying about the will only make you feel worse. Focus on what you can control in your daily life.”

That is, focus on the present and make choices about what you pay attention to.

“You’re not going to try to make the anxiety not exist or try to not have the negative thoughts, because we know that when you try to suppress emotions, that actually backfires,” says Holland. “What you can choose is to notice them and to turn your attention to more useful, more productive, more satisfying things.”

Someone can decide for themselves, for instance, that although they are very worried about the election, sitting in the office at a computer worrying, or staying awake at night, is not helping them change anything.

Leahy added that people might focus on what will not change about their lives. "Think about how your life will remain the same," he said. “I suggest listing as many things that you do now that you will still be able to do regardless of who is elected.”

Meditation may also help. Indeed, anything that’s meditation-like can help people reduce their immediate worry, or move from unproductive anxiety to something more productive. Beyond normal meditation, Holland recommended prayer, yoga, knitting, or gardening.

“Anything where you’re turning your attention away from all the worries back to the immediacy of whatever you’re doing,” he said. “And the more you practice those things, the better you get at them.”

Talk about it. Yet even if you focus on what you can control, scary things may keep happening. Lertzman recommends that people address that with their friends and family members and have frank conversations about what worries them. (Talking it out is how she recommends people communicate ecological anxiety, as well.)

“We know from skilled psychological practitioners that, through interaction, we can both make sense of what we feel and know. We can also feel supported and validated,” she told me. “So you can say, let’s start talking about this from a very personal perspective, an honest perspective, and break the taboo.”

Holland agreed with that a “talking cure” can be effective. “When you talk about things that are emotionally distressing, you may actually have a temporary increase in stress because you’re talking about it, but you’ll feel better later,” he said.

Lertzman added that focusing on regular life and the present can itself cause anguish, especially if someone is exceptionally concerned about the news. It’s upsetting, she said, to be scared about the world and yet to be “seeing more people get drawn into distraction, whether it’s reality TV or celebrity culture or focusing more on their family and children.”

Ultimately, worriers may need to come to some level of acceptance.

“There are times in our life where we all need to accept things that we would very much choose to be otherwise. When we can genuinely accept ‘I don’t like this, but I can live with it," that can reduce people’s level of distress,” Holland told me.

I pushed—what if an outcome is horrifying to them, what if they could never condone it? Holland said that we only ever need to accept things that we could not condone.

Acceptance, he told me, is saying, “I wouldn’t choose this, but life goes on. Or it doesn’t, and that’s something I need to accept—but that’s another story.”

But acceptance doesn’t mean surrender or laying down. Holland, Leahy, and Lertzman all recommended that people let their worry push them to take action.

“It’s often very helpful for people to go, okay, I can actually take steps here. I can get involved with other people who feel as I do. I can be writing things in the media. I can be making donations,” said Holland.

The importance of taking action is critical to Lertzman’s approach. She said that it’s crucial to say that even if any one person can only have a small effect, it’s not futile to do so.

“We’re designed neurologically and cognitively to have efficacy—to have an effect,” she said. “When we’re learning and exposed to issues, particularly through the media, it’s very natural to just assume there’s nothing I can do, it’s out of my control. And then we just withdraw and disengage.”

But just because we’ve disengaged doesn’t mean we’ve ultimately stopped caring, she said. (Lertzman’s book, Environmental Melancholia, is a study of the tension between engagement and efficacy.)

And that’s why she stressed that it’s important to see action itself as valuable and worthwhile, no matter how limited the outcome.

“When I read accounts of people who are really engaged, who have really stepped up and are doing amazing things, that’s the thread that seems to run through it,” Lertzman told me. They see their own actions as inherently worthwhile, even if they’re aware of the limits of their own actions.

“You’re not denying the pain of recognizing the limits of what we can do. But you’re also not minimizing, not devaluing, the importance of what we can do,” she said. To this end, she encouraged people not to compare themselves to their heroes or to people who seem especially effective, but to focus on how much action they themselves can take.

She recalled the Serenity Prayer’s plea to have “courage to change the things I can.” But she added that this kind of resistance doesn’t require a belief in a spiritual presence working in the world. And I’d add that my colleague Ta-Nehisi Coates, an atheist, has voiced something similar to this ethic of resistance in his own writing.

“You are called to struggle, not because it assures you victory but because it assures you an honorable and sane life,” he writes in his most recent book, Between the World and Me. “Perhaps struggle is all we have. So you must wake up every morning knowing that no natural promise is unbreakable, least of all the promise of waking up at all. This is not despair. These are the preferences of the universe itself: verbs over nouns, actions over states, struggle over hope.”