Shelby Carignan has dealt with anxiety before, with worry and fear that can overwhelm her, but what she is going through right now seems very different.

“In the past I’ve attacked it with logic, thinking about how much of my anxiety comes from irrational fears, from things that are far away or may never happen,” said Carignan, 28, of Scarborough, who works in marketing. “But right now the global has become personal and real. The pain is very visceral for people who’ve lost loved ones. The political climate feels very real. All this is making it harder to trick myself out of my anxiety, because it’s really happening.”

With a divisive and fear-inducing presidential election just two days away, Americans find themselves living under a permeating pall of anxiety that affects virtually everyone. Medical officials have declared a mental health crisis in the country, fueled by the combined effects of a pandemic that has killed more than 230,000 citizens in seven months, violent clashes ignited by racial and social unrest over the summer and the specter of a presidential election that could bring a major societal upheaval, with President Trump threatening to challenge a loss in the courts and hinting that, if he loses, he might not willingly give up power.

These events have weakened or dismantled the structures and certainties of daily life that are so important to maintaining mental health, including jobs, school and social interaction, health professionals say. The uncertainty has no clear end, as cases of COVID-19 are spiking dramatically around the country and no vaccine has yet been developed to stop the disease. There’s also the incredible uncertainty of the presidential election, leaving people to wonder if more of the conventions they’ve come to depend on will be smashed.

“I think what we’re experiencing, in terms of how people’s mental health is suffering, is something we haven’t seen before,” said Dr. Vaile Wright, senior director of health care innovation for the American Psychological Association, one of the groups that has declared a national mental health crisis. “What’s so unnerving and unsettling is the degree to which routines and structure have been shattered. People don’t have the safety of their structures to protect them.”

ISOLATING POLITICS

One of those structures is simple human interaction, altered dramatically both by COVID-19 and the election. The pandemic forced people to spend months without socializing and interacting the way they normally do, and the election season has compounded that. Because of the angry tone of political discussion on social media and TV – on everything from the economy to mask-wearing – many people are afraid that anything they say could start a conflict or offend someone. So they remain quiet and their isolation grows.

“I think that’s one of the toughest things now, you can’t talk about a lot of things,” said Candice Northrup, 48, a teacher and mother of two from Auburn. “I don’t know what to say sometimes, so I say nothing. Then it just builds up inside me with no outlet.”

Northrup, who teaches English as a second language in Turner, says being careful about what she says to people compounds the worries she has about her children’s health and education and the safety of her students and fellow teachers. She says she has very little time or energy to try to take care of herself emotionally, even for short meditations. She finds herself getting less sleep and being more short-tempered at home.

Sarah Fowler, a licensed clinical counselor and alcohol and drug counselor in Scarborough, said this year is the first time she can recall her patients talking about politics in sessions. She says people are angry and frustrated with how divided the country is and have anxiety fueled by the uncertainty of the election.

“It’s more than politics, it’s wondering, what happened to people being kind to one another?” said Fowler. “What is happening now with politics is very isolating. People don’t know who to trust, who has my back and who doesn’t? You can’t watch TV or go on social media for five minutes without someone being bashed.”

In an APA “Stress in America” survey of more than 3,400 adults released in October, about 68 percent of respondents said the upcoming presidential election is a “significant” source of stress for them, compared to 52 percent in 2016. About 60  percent of respondents found the myriad issues facing the country “overwhelming” and 20 percent rated their mental health as worse than last year.

The number of people reporting mental health conditions has shot up dramatically this year. In a survey released by the federal Centers for Disease Control and Prevention in August, 25 percent of respondents reported symptoms of an anxiety disorder this spring and summer, compared to about 8 percent during the same period in 2019. In the same survey of more than 5,400 people, 24 percent reported a depressive disorder compared to 6 percent last year.

Locally, counselors and therapists worry that this year’s events are compounding conditions people already have and that not everyone will seek or find help. Fowler said she’s not taking new clients right now and can’t keep up with the emails and calls from people looking for help. She said the No. 1 diagnosis she sees now is anxiety, followed by depression. She said anxiety often involves people having intrusive thoughts that aren’t logical, often about worst-case scenarios. But what makes things different now is that a lot of people are dealing with or facing their worst-case scenarios, like struggling to put food on the table or worrying about the real possibility of more civil unrest and conflict.

Young people may be feeling the anxiety of the moment more acutely, Wright and other mental health professionals said, as they have less “lived experiences” to allay fears and rely heavily on the structure and rules of school and society in general. High school or college students used to seeing friends and teachers every day are now having to do more on their own, while faced with doomsday predictions from political candidates, social media and others about what the world will look like when they reach adulthood or middle age. The unknowns about the presidential election only add to those worries.

“I worry about college, about not being able to visit colleges, about not being able to score high enough on tests. When I go to college, will I even be able to leave my house my freshman year?” said Alexandra Spiegel, 16, a junior at South Portland High School who is studying from home this year. “I feel like I have to be prepared for anything to change at any time, that anything can be taken away from us in an instant.”

TUNING OUT

Conor Wolff, a 17-year-old senior from Yarmouth High School, says he feels like “every political ad is a reminder that we cannot rely on our politicians to bring stability to our communities.” His senior year schedule – including college applications and essays, schoolwork and a job canvassing for the Maine People’s Alliance, a progressive activism group – have him frazzled. He has trouble sleeping and finds it hard to stop consuming news and social media.

“I often find myself up until 2 a.m,, not tossing and turning in the dark but rather glued to a screen scrolling through the depths of Twitter trying to find the latest story that might make me feel a little closer to understanding the mess that is our world right now,” Wolff wrote in an email during a break in his schedule. “I sometimes find myself avoiding hard conversations or difficult questions because it sometimes actually takes too much brainpower to engage with them.”

Hannah Peterson of Westbrook has had dreams that she went out in public without a mask and infected people with COVID-19. Peterson, 30, suffers from Lyme disease and doesn’t get out much anyway, but the pandemic, social unrest and elections have exacerbated the fact that she was “already susceptible to an undercurrent of fear” because of the chronic pain and isolation of her condition. Without much to do, she began keeping a journal shortly after the pandemic started, to have some routine to follow. She was trying not to follow the pandemic too closely at first, especially the angry and divisive ways people were responding to it. She also was jarred by news of the death of George Floyd, a Black man killed at the hands of Minneapolis police in May, which resulted in massive protests and violence. She wrote in her journal in June that she felt all that was going on, as well as the upcoming election, were inextricably connected in dangerous and unnerving ways.

With winter coming, Peterson decided she needed a mental escape. She doesn’t feel comfortable leaving home, where she lives with her parents, so she bought an insulated ice fishing shack for $75 and put it in the backyard. She’s converted it to a place where she can write, be alone and feel like she’s somewhere else.

For many people, the events of this year have come on top of difficult stressors they deal with daily, whether that’s having an illness, a sick or special needs child, elderly parents or an addiction. For Meredith Coffin of Gray, the pandemic hit soon after she found out she was pregnant with her second child. So as this year’s events unfolded, Coffin found herself dealing with the usual mental and physical stress of expecting a child, as well as feeling like she needed to shield herself and her baby from much of what is going on. She also owns a business, Springboard Pilates in Portland, which was shut down for a time.

“I was intentionally not watching the news, I didn’t want to get worked up and have that added stress. Knowing that I was growing a human inside of me, I didn’t want those stress hormones for me or her,” said Coffin, 39.

Her daughter Rowan was born Oct. 12, about 12 days overdue. Having a baby while all this is going on has spurred her to think more positively about the future, not just for her sake. She says that “having a baby is the ultimate optimistic endeavor because you have to believe the world can get better.”

But will it? That’s the question on most people’s minds as the presidential election looms, no matter which political side they are on.

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