election anxiety Psychology Stress

Election Anxiety Actually

November 2016, I wrote a post titled Election Anxiety, just days before the election to help others name and address this non-DSM V set of anxious thoughts and actions tied to the hotly contested run for U.S. president.

The rest is history.

Until then, I had never experienced so many clients and community members taking the initiative to talk about their hopes and fears tied to the perceived outcomes they associated with each candidate. I was even interviewed on the local news about Election Anxiety. And now, in October 2020, we are here again: Election Anxiety, Actually.

Let me remind my readers, I am a Licensed Mental Health Counselor and a Registered Nurse (A-R) in good standing. As a matter of course, I do not initiate conversations about politics with my clients, nor is it any part of my therapeutic ethics to persuade, manipulate, validate, or dismiss the views of my clients.

What I do is assess how the world of my client manifests through actions, behaviors, thoughts, and feelings, all of which have positive and negative outcomes for them, their families, and communities.

If you haven’t already done so, I invite you to click on the link above and read my words from 2016, most of which apply today. And is there anything I want to add that could be helpful for this round of Election Anxiety?

You ‘betcha.

Election Anxiety on Steroids

If you experienced Election Anxiety in 2016, this year may feel like more of the same except on steroids. If you were angry, depressed, or frightened then, many of the same concerns are still on the docket in 2020: healthcare for all, racial equity, gender equity, the economy, immigration law, environmental concerns (public lands, national parks, natural resources, climate change).

Let’s add two more issues: 1) a global pandemic, of which the United States is among the top countries with high counts of COVID-19 positive cases and leading in the number of deaths from the coronavirus, and 2) racism as a pandemic (declared by Public Health as such), with ongoing violence and unnecessary use-of-force by authorities against BIPOCs as a whole (Black, Indigenous, and People of Color) and Black people in alarmingly higher proportion.

Our nation is divided, and not necessarily just along party lines, about how to address both of these pandemics. Across both sides of the aisle are those who feel that economic stimulation is the general answer to resolving the ills of systemic racism and keeping our countrymen/people intact. Granted, that means that a lot of people may die, but their argument is that they feel that the people who die from the coronavirus are generally older and have co-morbidities that would prevent a more straight-forward recovery from a coronavirus that preys on weakness. This let them die attitude does not take in account that the virus also kills young people and may leave many with chronic illnesses that don’t know how long it will take to recover, if at all. The SARS-COV-2 virus has disproportionately affected BIPOCs. And I am beside myself with grief the number of healthcare workers who have died while doing their job to save the lives of others during the pandemic.

Across both sides of the aisle, there are citizens who feel that the current administration has not been forthright about its stance against the coronavirus since the first day it hit the shores of the U.S. (and in the Greater Seattle area, no less). We have learned as a nation that the pandemic was downplayed. And despite efforts from healthcare workers like myself and local Public Health authorities to prepare our communities to mask up, wash hands, test if you have symptoms of the virus, stay home and stay healthy, initiatives to act as a nation was fragmented, left up to individual states to do as they felt best, to obtain PPE where they could, and to mobilize resources, volunteers, medical professionals, and institute strategic planning.

Some states did better than others. Yet as of Sept. 29, 2020 (date of this writing), the U.S. still has more than 20 states with increasing numbers of coronavirus cases.

If you ask why Election Anxiety is high again, it’s all the issues of 2016, and these two pandemics piled on top of them. Americans will be heading to the polls, mailing their ballots*, or placing their ballots in secure ballot boxes, answering the question of who they feel will provide the leadership to tackle the most deadly pandemic to hit us in over a century.

Bystander Trauma

As a clinician, I have been given few, if any, diagnostic tools, tests, or measurements to describe and treat what we are collectively calling Racial Trauma. There is no category for systemic racism in our billing codes for sessions. Yet trauma is trauma. Trauma has features that we can name, point to, and identify, such as:

  • Shock, denial, or disbelief.
  • Confusion, difficulty concentrating.
  • Anger, irritability, mood swings.
  • Anxiety and fear.
  • Guilt, shame, self-blame.
  • Withdrawing from others.
  • Feeling sad or hopeless.
  • Feeling disconnected or numb.


Among those who talk about Election Anxiety and Post-Election Anxiety, I see the same symptoms. The severity of symptoms can be off the charts when you add in the chronic cycles of systemic racism and the exhaustion of trying to fight against it for oneself, one’s children, and one’s community. For some families, the fight against racism can be traced back across hundreds of years.

Bystander Trauma is also real. We usually think of Bystander Trauma in the context of a first-responder who witnesses and attends to a victim of a traumatic event, such as a vehicle accident or a violent crime. Yet those of us who witness via Social Media, News Feeds, television, and radio broadcasts of traumatic events can also experience another type of Bystander Trauma. The exposure to seemingly endless news stories of violent acts done against BIPOCs, deaths of loved ones and community members to the coronavirus, and a conflicted and contentious election can stir up similar feelings of loss, anger, hopelessness, denial, hopelessness and helplessness.

You may not be left physically bleeding by any of this, but in terms of your emotional health, you might feel like someone has nailed a spile in your soul. If you find yourself asking why you feel so emotionally spent by the end of a WFH (Work from Home) work week, you may want to learn more about the effects of “witnessing” a firehose worth of news stories related to the elements that are shaping our current U.S. elections.

Because my 2016 post outlined some guidelines about managing Election Anxiety, I won’t rewrite them here. Yet what I want to make clear is that the answer isn’t found in turning away as much as it does in managing the stream while finding the balance with appropriate action.

Your vote matters. As many of us have seen for ourselves, what we do in one moment in time is remembered years later. Our words, actions, and thoughts — even our recanting, apologies, and amends for wrongdoing — make a difference.

And, if it’s time to turn down the volume and turn up the action — like taking care of your mental health, following up on your physical health, and advocating for the health of your family members, community members, and state, we’re here to help you do that with all the continuing education, skill, and care that is a part of our profession.

If you’re struggling with anxiety — and Election Anxiety in this particular season — we’re here to help.


  • It may be a felony to vote more than once in an election. If this has been suggested to you, please consider the legal ramifications and fines for doing so.

By Imei Hsu

Imei Hsu is a mental health counselor, active retired RN, AIP Coach and PN1-NC, writer, triathlete and arts promoter in the Seattle area and through online services. With 30+ years in healthcare (22+ years in mental health), Imei has a commitment to helping people discover insight into their health, relationships, and connecting. She is the owner of Seattle Direct Counseling and the blog, a presenter and speaker on a variety of psychological topics, and a positive force on the Internet. She launched her personal project, My Allergy Advocate, in 2018. Imei is a two-time Ironman Finisher (Mont-Tremblant 2016, Ironman Canada 2018); she also finished her first ultramarathon in 2017 and has gone on to race the 100K distance while preparing for 100 Mile trail races and a backyard ultra. You can find her running everywhere and eating all the thingz, watching movies, camping under the stars, and cooking real food.

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