‘It’s okay to not be okay’: A Harvard psychiatrist talks about why anxiety around this election feels different

The 2024 election is upon us and anxiety levels are running high. The polls seem to swing back and forth, while campaign pleas from both candidates are increasingly fraught. Yet, despite the anxiety, most of us have to carry on with life as usual—showing up at our jobs, showing up for our families, all the while knowing that some of our friends and neighbors don’t share our political views. Not helping, we don’t even know when we’ll get the results. (In 2020, it took five days to have a clear outcome.) What’s a person to do?

Fast Company asked Dr. Ashwini Nadkarni, a practicing psychiatrist at Mass General Brigham and an assistant professor at Harvard Medical School, for tips on how to cope with election anxiety. She notes this election in particular has stood out in terms of triggering anxiety. Below is an excerpt from our conversation, edited for length and clarity.

What is anxiety? How is election anxiety similar or different?

In general, we define anxiety as a persistent or intense worry that people experience which begins to affect their medical health and interferes with their functioning. Now, when it comes to election anxiety, it’s related to a very specific trigger with a specific outcome for many individuals.

I would also say that election anxiety is different, too, because it has this dynamic interaction with the media that we consume. When people consume too much media, or consume media which is particularly rife with scorn or emotion, they may be more likely to experience some of that election anxiety.

What is your advice for coping with anxiety in the days before the election?

First, we’re all in this together. We’re all feeling it. There are some people out there who are excellent at not thinking about it, but there are many people out there who are really affected by this. Opening up to likeminded people is one important strategy.

A second piece of this is doing something we call perspective taking, which is this idea of really drilling down and understanding what the specific fears or concerns are. You know, in this survey that the American Psychological Association conducted, 77% of individuals were really deeply concerned about the future of the country. People also had concerns about the possibility of violence and the end of democracy. It’s important to drill down and really understand the full context or how one’s fears may be individualized to be able to really assess the threat.

A third piece is trying to gain a sense of agency. There’s a type of therapy called dialectical behavior therapy. An important concept within that is radical acceptance, which is this idea that even if we can’t control the world out there, we can control ourselves. We can control how we react, and we can control how we adapt. This is a great time to be civically minded, vote, and encourage people to vote.

Finally, it’s really important to take some breaks from media and take good care of ourselves and engage in some self-care. For some people, that may mean getting outside enjoying the last of the nice fall weather. It may mean taking a break during the work day just to take some space.

I want to circle back to number two. Some of the threats feel more imminent than with prior elections. In a recent Gen Z poll, Gen Z was split on candidates, but 77% agreed the country is headed the wrong direction. A lot of people are afraid of violence, others are terrified of what will happen to the economy. Some groups have seen policies implemented that impact their health and well-being.

I want to acknowledge the importance of this point because you’re absolutely right to note that with this election, there’s going to be impact on important policies related to things like reproductive rights, the economy, climate change, and access to healthcare.

It’s okay to not be okay and call it out, too.

At an individual level it’s about figuring out what your concerns are, how realistic they are, thinking through what could happen and having a plan. It may help to talk to others who may be in the same situation, and find out what specific resources are available.

Sometimes, even when we’re dealing with a crisis, it becomes important to set boundaries on how much you are focusing on that issue. There are aspects of this that are within our control.

My family has a plan, but it’s emigration. That makes me so anxious. Hydrating is doing nothing.

You’re really not the only one. I’ve heard similar thoughts among peers.

What happens if there’s an election outcome you didn’t want? How do you live with colleagues and loved ones who might have voted in a different direction?

This is genuinely hard. I want to acknowledge that point because people tend to make decisions about politics that are really personal to them, and yet they feel personal to the rest of us.

But realistically, all our relationships with people in the world are not based singularly on election outcomes. It’s important to remind ourselves of that. It may be helpful to consider boundary setting. You can refrain from engaging on the topic in certain settings because it may be too emotionally triggering.

Also, look for ways to bridge the divide and recognize there are other factors that bind us together. Reconciling some of these differences is also important.

There’s a lesson in that for all of us.