There are plenty of reasons to be anxious these days, not least the election of a buffoonish conspiracy theorist with a tangerine tan to the nation's highest office. Each day brings a raft of new horrors. The man twice sued by the federal government for refusing to rent apartments to black people is planning to gut the Justice Department's Civil Rights Division and put a man deemed too racist to become a federal judge in the 1980s in charge of the whole agency. The man who is still pushing the lie that millions of people voted illegally in the election he won can now commission stacks of reports "substantiating" this fantasy to justify further restrictions on voting rights. The man whose lack of impulse control so concerns his staff that they are trying to keep him from seeing TV news that might upset him has access to the nuclear codes.

Author Aleksander Hermon writes in the Village Voice that on the night of the election he felt a strange and terrible sensation:

There is a certain kind of abdominal pain felt only when a catastrophe appears at the door of the world you know and proceeds to bang on it. The sensation could be likened to a steel ball grinding your intestines. There is nothing like it: There were times when I thought I could hear it revolve. The feeling is simultaneously familiar and totally unfamiliar; it is unquestionably familiar as boilerplate fear, intensified though it may be, but it is also unfamiliar in its specificity: It is the fear of an unimaginable future as seen from this particular terrifying moment.

Sound familiar

?

The days since haven't offered much relief for the majority of voters who thought electing Trump was a bad idea, but now have to live with him anyway. We reached out to Dr. Barbara Fisher, a psychologist in Long Island's Suffolk County, to hear what patients have been saying about the ascendance of Trump, and what advice she has for those of us who are freaking out about it.

New York City is relatively liberal—if you ask 10 people on the subway, seven are probably upset to some degree about Trump—whereas Suffolk County is more of a mixed bag [it went to Trump by 8 percent]. What has your experience been with patients coming in? Are you seeing a lot of anxiety related to the election and now presidency of Trump?

There is a lot of anxiety. It’s not always consistent within a family. I’ve seen a lot of people who tell me that they may have a very different opinion from their spouse, so that sometimes creates even more tension. Because they're not only dealing with their own anxiety, but sometimes when they have a discussion about it, there seems to be a lot of hostile interactions with spouses, and other family members at holiday dinners. There's been a lot of talk about that.

Is it fair to assume that anxiety is one of the chief responses to this event?

I do think that there is a lot of anxiety because of the feeling of uncertainty about the future, lack of control over the outcome. People are feeling, I think, a sense of devastation that they haven’t felt before with regard to concerns about the bigger picture: our democracy, the way our government will function, not just President Trump but the people who he surrounds himself with.

But in addition to anxiety, I’m also seeing some depressed moods, some hopelessness about the future, people feeling a sense of loss with the transition from the Obamas to President Trump. I don’t think it’s only anxiety, but I do think that's a big part of it.

And is it more pronounced than you've seen in past elections? People are generally excited about the outcome of an election or not, depending on where they fall on the political spectrum, but it sounds like this is a unique one.

I think it is. I’ve been practicing for about 30 years and I honestly don’t remember having so many conversations with people after an election. There are always people who wish that their candidate won, but I haven't seen the kind of intense negative emotional reaction that I have this time.

I read something recently that I could relate to as an experience with anxiety. The author was talking about the feeling of having a ball in your stomach, a sort of physical feeling of anxiety. Is that something rooted in your physiology that is related to your level of anxiousness?

There are different physical symptoms that manifest for different people. Typically when people are faced with situations that they consider dangerous in some way, the body reacts with that fight-or-flight response. We have various sympathetic nervous system changes that occur: for example, people find that their heart rate increases, or they sweat more. These are reactions that are typical when people get anxiety.

Not everybody gets every symptom, but those are some of the typical physical responses that you see.

170124TrumpTired.jpg
(Getty)

If you're feeling it physically, is that a sign that the anxiety is more pronounced?

I don’t really think that’s the case. I think people can experience physical symptoms of anxiety in milder cases. I think that’s just the body’s natural reaction. On the other hand, when there is severe anxiety and panic, sometimes those physical symptoms can really cause people a lot of distress.

I know there's not a one-size-fits-all solution, but what sorts of things do you recommend to people who are feeling overwhelmed by the election and the grind of the news cycle?

Some of the things that we talk about are, with any situation that causes emotional distress, you can’t always change the circumstances, but you can always change your reaction to the circumstances. That’s sort of a general way of dealing with it, but I think that it certainly applies in this situation. So if people focus on how they react to the situation and also what actions they personally can take, they feel a sense of empowerment and less anxiety, less hopelessness.

It could be something like writing letters to representatives. Obviously this weekend a lot of people felt it was important to get out and have their voice heard in the marches that took place. And in terms of controlling your own reaction, when people are more attuned to how they feel, and they recognize the thoughts that they’re having about the circumstances, they can then begin to be more mindful of their thoughts and observe them and understand that everything they're thinking may not be true. We create our thoughts and they're not always true, and we don't have to get overwhelmed by them.

I do a lot of work with people in terms of mindfulness and just trying to accept that negative feelings will be there and that that’s okay. We don’t have to get rid of them all in order to function. We can just acknowledge that they’re there and continue to go throughout our normal day without feeling immobilized by them.

So, for example, if someone were to see a headline that says, "China responds to Trump, saying it has 'irrefutable' sovereignty over disputed South China Sea islands," that's something that's clearly outside all of our control, but one's mind could immediately go to, "We're about to have a war with China." It sounds like you're saying that's not a healthy reaction.

Exactly. And it could be consuming then. That's a really good example of how our mind is squandered and just is all over the place. So you could start out—somebody might bring up something that they heard about China and one thought leads to another, and next thing you know you’re visualizing World War 3. The more we become aware of how we can be carried away by thoughts, then we can observe and acknowledge, "Okay, I’m having this thought, but it’s a thought. It’s not a fact. It’s not something that I know is going to happen. I don’t have to ruin my entire day about this. I can recognize that I feel some anxiety and it’s uncomfortable."

People sometimes get really, really immobilized by negative emotions like anxiety. So we have to learn being able to tolerate living with that uncertainty.

And is this bringing up old issues for people who were bullied as children, or victims of sexual assault?

I’ve actually heard people say things specifically like that. For people who have been victims, it brings up a lot of old memories and it really just highlights that feeling of fear and not being in control, and dealing with somebody being dangerous and violating—all those feelings it does seem to bring up to people.

Are there other groups of people whose specific experiences have caused them to have stronger reactions, be they gay, or racial minorities?

I do think survivors of sexual abuse have strong reactions, but I would say that I've seen a lot of negative reactions across various groups of people. Different races, different socioeconomic groups, male, female, different types of professions—that's why I think it's so significant.

I do think that that was reflected in the crowds of people who were marching. We did not see that it was all women or all minorities or that it was all anything. It was a very, very diverse group of people who went out and felt the need to make their voices heard. I think that really says something.

When you encounter people who have an interfamilial conflict over this, what do you advise them to do when they're going to that family dinner or preparing for that conversation with their spouse?

I think it is important to try to avoid these hostile interactions, because they just aren’t constructive. I recommend to people that everybody is allowed to have an opinion. Two people can be right; nobody has to win. It’s okay to walk away. It’s okay to decide not to have these kind of discussions with people.

What if one side is not in therapy, and knows that you're trying to avoid the subject but brings it up anyway to get your goat?

That’s where assertiveness comes in, because if people can remember that they always have a choice, nobody can make you react, and whenever there’s a trigger you can make a decision whether to respond this way or that way. So it's a very, very good opportunity to practice being assertive. It’s a teachable moment when somebody does something to get to you and provide that trigger. It’s a good opportunity to say, "Okay, I have a choice. I can decide how I want to respond to this."

Being assertive sometimes requires repeating something more than once and just saying, "I don’t want to discuss this, and that’s just the way it is." It doesn’t have to be aggressive. It’s just expressing yourself in a direct and firm way.

Is it something that you've had to struggle with in terms of personally having strong reactions to the election and trying to compartmentalize that, or figure out what to share with your patients?

No, I don’t do that—discuss my personal views with patients. I don’t think that is helpful. I try to keep it separate.

Is it something that you talk to your colleagues about: where to draw the line, or how to separate politics from work in this particular time period?

I haven't really had that discussion. The discussion I've had with other professionals has been more about the volume of patients who have been experiencing these distressing situations, but not so much how they handle it personally.

170124TrumpRallyBethpage.jpg
Scene from an April 2016 Trump rally in Bethpage, New York. (Andrew Renneisen/Getty)

Is there distress on the other side, among Trump supporters?

Yeah, it's on both sides. People are feeling attacked. People are feeling misunderstood and disrespected. It absolutely is not one-sided.

Is it one-sided in terms of only one side is anxious about what Trump will do?

I don’t really know now that he’s taken office if the people who voted for him feel hopeful or positive. I suspect that everybody has some uncertainty because a lot of things are just different now. We’re entering a different way of doing things. Usually with change there is some anxiety, even if it’s something you think is a positive change.

For example, people get married: they look at it hopefully as a positive thing, but there's still a lot of anxiety about what they look at as a new way of life.

On a related but somewhat separate note, we've just had the three hottest years on record, and we're seeing a lot of 50-degree days in December and January. Have you seen much anxiety related to climate change, which is another big issue that people don't have a lot of personal control over?

Yes, I do think a lot of people have been talking about that as well, not only in the past few months—that concern has been going on for several years already.

Do the same principles apply, as far as mindfulness and dealing with anxiety?

Yeah, I think mindfulness—which is something that does guide a lot of what I do with my patients—mindfulness is about living in the present moment and directing your attention to what’s going on in the present moment. A lot of the things that you and I have been talking about obviously are more like 'what ifs' about the future. So mindfulness helps us not to ruminate about what has already happened and not to also focus on what might happen, but to try to live with present-moment awareness so that you don’t miss out on the moments of your life.

Do you have any sense of what the repeal of the Affordable Care Act will mean for your business?

That’s a whole other discussion, to be honest. The insurance situation with mental health treatment has been pretty terrible. Let’s just say it’s been a struggle for people to gain access to mental health treatment.

I imagine that you are prohibited from giving an armchair diagnosis of our new president—

Oh, yeah, I wouldn't go there.

Fair enough. I have some theories.

I’m sure there are many that have been circulating but I would not want to take that on. But one thing I would say as another aside is that I think it’s helpful for people to limit or distance themselves from social media, because I do believe that creates at times a lot of anxiety. In the same way that we spoke about the hostile interactions among family members, people say that it’s a problem and they get consumed by it and they feel the urge to enter and comment on every posting. It’s overwhelming and I don't really know that it's constructive.

Yeah, it does feel like the internet and the development of it into something you can carry around in your pocket is a mass psychological experiment—not in the sense that there's a conspiracy, but in that all of this technology has been rolled out without anyone really considering what effect it would have on people.

That’s true. It’s like we didn’t really know what we were getting into.

And now we have our first social media president...

Is there anything else that you wanted to share in the way of tips for dealing with anxiety or depression that is exacerbated by current events?

The top ones I guess would be limit time on social media and also on watching the news. It’s a little bit addicting for people and it doesn’t give people a chance to do other things, because they just are glued to the TV. It’s good to set aside a specific time, and to go about your normal day and make sure you do the things that are positive and nurturing. We don’t get anywhere by watching the same thing over and over again.

And again, just try to focus on the things that are within your control, and to recognize that we have to try to take things day by day, and even moment by moment and stay in the present. Change is a natural part of our lives and change is difficult for people to deal with, but that’s something that we have to deal with in all aspects of our lives.