Below this video is a partial transcription of the panel interview. Edits have been made to accommodate length and clarification. Some resources and strategies covered in this article are not part of the transcription.
I am Kyle Kittleson with MedCircle. No question that election anxiety is affecting many Americans. Regardless of which candidate you support, or if you even support either party—anxiety surrounding the race for president is pulsating through our country.
This is being filmed before the election before the votes are counted, and it is completely non-partisan. Here to shed light on this topic and provide tools and strategies are three world-renowned MedCircle Educators: First we have Dr. Domenick Sportelli, double board-certified child and adolescent psychiatrist.
We also have Dr. Ramani Durvasula, a clinical psychologist and who I call the “Maven of Narcissism Education.”
And, Dr. Judy Ho, triple board-certified clinical and forensic neuropsychologist.
Thank you all for being here, Dr. Ramani, let’s start with you.
Many are predicting that we will not know the winner of the race for many days or perhaps even weeks. How can people cope with anxiety if there is no clear winner?
All I can say to everyone in the United States is that you are all pros at uncertainty. Now with the pandemic, we are used to rules, changing goalposts, which moving on a daily—sometimes hourly—basis. This is just more of the same. As a result, I think everyone’s spent the last few months developing a muscle in terms of coping with uncertainty—and they don’t even realize how good they are at it. The other thing that I’m always going to prescribe this: mindfulness. Stay in the moment you’re in. Instead of trying to speculate, just stay in the moment you’re in—whatever is involved in that moment. One big piece of that is routine.
Routine is actually one of the better anxiety management tools we forget because [it gives you] some sense of predictability in your own universe. I tell all of my clients, look at it as a circle. What’s inside the circle—you can control. What’s outside of the circle—you cannot control. So, stick inside the circle. And that means you control who you talk to, how much time you spend on the news, and how you spend your time. Don’t spend too much time focusing on things that you cannot control.
Finally, be discerning and careful about who you spend time with during this time. I’m a big fan of people staying in their silos for just about another week [after the election]. Don’t try to mix it up. Don’t try to have conversations with people where there’s too much diametric opposition. You can have your conversations in about 7 to 10 days. For now, just stay in places where you feel safe and comfortable. I think a combination of all that might get you through to the other side.
Not knowing the results can cause a lot of anxiety as mentioned. Dr. Judy, what tips do you have?
Some things I’m advocating for my patients to do right now is to create a “Joy List.” We have to-do lists up the wazoo! But, how long has it been since you’ve had a Joy List? Even if it just gives you a five-minute break from that fear of the unknown—that fight-or-flight that we [feel] chronically stuck in right now—that [sense of joy] is going to add up. These positive moments are not only going to make you feel better in the moment, but they’re going to help you to build your confidence and your competence.
Additionally—more than ever, it’s important to find creative ways to socially connect. The more that we are in these oppositional conversations with people, the more we’re going to isolate [ourselves] as a result. We know that we can’t let that loneliness get to us. We know that human beings are social animals and that we need that connection. I’m going to suggest that you find something that you can do with the people in your life, where you have a shared experience. I have heard of people, for example, going to the same online class for exercise, or an online masterclass to learn something new. So, do things that bring you happiness, bring you a sense of connectivity, and introduce some new topics of conversation other than the political election.
Really wonderful. Dr. Domenick, as a child and adolescent psychiatrist, and also a father, would you suggest that a parent discuss this election and the results of the election with their young child? And if you do, how should parents go about that?
Dr. Domenick Sportelli:
Absolutely. Yes. This is a learning experience for these kids. Research shows, believe it or not, that kids do care about the election. I’ve seen some really interesting polls where children are more likely to get information from their peers and their parents as opposed to any other source. They’re not really watching the news.
However, interestingly, in some of these polls, kids, early adolescents, or late adolescents actually prefer to get their information from YouTube or blogs. So, the important thing is if they’re getting most of their information from peers, then you—as a parent—have to be the one that’s going to provide them with a structured and valid discussion.
Expectations are important. So talk to your children about the preparation of what to expect throughout the election [and] what they’re going to see. When they have those expectations, they can sort of prepare either emotionally or intellectually to try and understand what’s going on.
Dr. Domenick Sportelli suggests asking your child questions about the election. Some questions to ask your child could include:
- Is there anyone running for a position at your school?
- What platform are they running on?
- What do you like or dislike about their platform?
- If you were going to run for president (or another position) what would you stand for?
- What do you believe in?
- What are your values?
- Do you know how the election works?
- How do candidates market themselves to voters?
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This election cycle reports families divided by different political opinions. It seems to be reported all of the time. Stephanie asks,
‘My adult daughter and I voted for different candidates. We are both passionate about our choices. I worry that the results of this election will create a divide between us. How would you suggest I address this with my daughter?’
Dr. Ramani, let’s start with you.
I’ll share a personal experience. One of the people I most love in this world has a very different political view than me. I only learned this recently, but she is just as kind and empathic and compassionate a person as I’ve ever known. And we had different political views. And it was the first time I had been tested in that way, where it [was] resolved well, and I could see the real potential of respect and compassion. [I could see] the ability for us to both listen respectfully to each other. We never interrupted each other. It never became a character assault. [I was able] to look at her and say, “I love you so much. We’re going to have to agree to disagree.” I love her too much to let politics get in the way of my oldest friend in the world.
It may very well be that Stephanie and her daughter have to set their social media in a way that [where] they’re not seeing each other’s [content]. [It’s important] that they do find that point of connection around shared interests. In terms of love and compassion, I do think it’s possible—but my goodness, it is like having a piano on your back while you’re balancing on a tight rope—it is not easy. You [also] have to constantly check yourself and realize that not everybody’s up to this struggle, but I think it’s absolutely possible.
Anxiety is the most commonly diagnosed mental health condition, affecting about 40 million adults in the United States, according to the Anxiety and Depression Association of America (ADAA). Luckily, there are many anxiety coping strategies people can implement today. And these strategies do work. I use them myself. I would love to hear your favorite stress- and anxiety-relief exercises. Dr. Judy, let’s go to you.
Dr. Judy recommends the 5, 4, 3, 2, 1 grounding exercise.
- Identify 5 things you can see in your environment. Notice their color, shape, size, etc. Say each item out loud.
- Touch 4 things around you while paying attention to how they feel. Spend the time to engage with your present environment.
- Listen closely and identify 3 things you can hear. When you get quiet and listen, you can hear lots of sounds—from a running air conditioning unit, to a bird outside, to other external sounds from the environment.
- Notice 2 things you can smell. These can be anything from a candle, to the trees in your yard.
- Name 1 thing you can taste. Take your time to enjoy it, and describe the flavor of your favorite snack.
Dr. Dom, do you have any favorite anxiety-relieving techniques?
Dr. Domenick Sportelli:
What works for me is getting outside in nature. Just today, I saw 15 patients in the ER, and probably just as many on the inpatient unit. These are very, very sick people struggling with schizophrenia and bipolar disorder. And I was very, very stressed out when I came home today.
So, I went to a local park with an amazing hiking trail. Here’s what happens to me when I go out into the trail: I breathe in that crisp, fresh air; I look around, and it reminds me that all of these problems that I’m having in between my two ears and behind my two eyes are very, very small. And we are a part of something bigger. Eastern philosophy has helped me so much.
Dr. Ramani, anything you’d like to share?
Take a shower. Strip your clothes off.
It’s a strange kind of reboot. There’s a vulnerability to taking off your clothes. That’s where I tell people to cry. And I’m a big fan of making this a visualization oriented exercise. Think, “I am washing this away.”
Another thing that I would suggest is to connect with your body. An example of this is tapping your chest because it sort of connects you to your body.
Or, try taking your pulse. All of a sudden, what’s happened is this thing [pulse] that’s accelerating—you’re interacting with it in a different way—and you’re just counting it. And before you know it, you’ve “biofeedbacked” yourself, and you’ll notice [your pulse] come down.
I love that; Dr. Ramani just gave us permission to get naked!
I would like for each of you to share something you’re seeing in your practice as it relates to this topic. Why don’t we start with you, Dr. Judy.
Dr. Judy Ho:
In my private practice, I’m seeing people who are really used to managing “everyday” or “common” stressors. These are stressors that they’ve managed for years. All of a sudden, they feel like they’re starting to “lose it.” Some of them are experiencing clinically significant depression and/or anxiety symptoms for the very first time. They are worried and are feeling hopeless. They believe that things are not going to get better. But guess what? It does get better.
Additionally, the most common thing I see is that people are fearing their own emotional reactions. They’re putting labels and interpretations on those emotional reactions, and what those emotions mean. Which brings me to my next point:
I would like to remind people that emotions are transient. Emotions are a state. Emotions are productive, and emotions are helpful for us. They’ve been adaptive for us. They give us important information—what to pay attention to, what we value, et cetera.
Imagine yourself riding a wave—and just allowing yourself to ride that wave [without fear.] Know that at some point, the wave (or “emotion”) is going to go away, or it’s going to change. The funny byproduct [of this] is that the emotion that you feared so much actually does dissipate faster when you just don’t fear it as much.
I really recommend people look into emotion regulation strategies. I know MedCircle has a lot of series on these.
I also think that sometimes people forget the power of doing the “opposite action.” Although it may feel like you’re straining to do something that feels inauthentic at the moment—it’s not [inauthentic]. It’s actually a “wise mind” decision [which is] terminology taken from dialectical behavior therapy (DBT). So if you’re feeling angry, your emotional impulse might be to yell at your loved one because they don’t agree with you about the election. But instead, ask yourself, “what’s the opposite of this emotion—or what would I do instead?” The funny thing is—because of the model of thoughts, feelings, and behaviors—once you actually do something that is the opposite of your current emotional state, everything else actually follows. You start to feel calmer, you’re less angry, and then you feel better about yourself.
Dr. Dom, we have about a minute left for an answer from you. What are your thoughts?
Dr. Dom recommends mastering these five principles from The Better Argument Projects. Implementing these five principles for more effective communication on heated topics will help you and others.
- Take Winning off the Table
- Prioritize Relationships and Listen Passionately
- Pay Attention to Context
- Embrace Vulnerability
- Make Room to Transform
Dr. Ramani, anything to add?
I call this the +/- exercise. Some of your interactions during the day are wonderful activities or events. Those get pluses (+). Some of the events—they get minuses (-). And then some of your daily activities, like making a ham sandwich, are not so interesting, so it gets a zero. As your day goes on, monitor your pluses, minuses, and zeros. If your day is starting to tilt into the negative zone, you’re probably going to get more irritable. So, become a curator of your own day. You’re never going to have an “all plus” day. But on those days when I can actually look at my calendar and [determine my plus-minus days] I try to construct my days around that.
Not everything’s the same. Not every human interaction is the same. Not every meeting is the same. And by monitoring that at the end of the day, when you’re depleted, it won’t feel like such a mystery. You can actually track this a little bit more and also learn how to set up your days and schedules in a way that suits your energy level. You’ll actually feel like you’re “more on top of it” rather than feeling like your day is happening to you.
Wonderful. This was recorded at 3:00 PM Mountain Time on Tuesday, November 3rd, 2020.
For the first time time in my life, I’ve experienced this high level of anxiety.
I remind myself that the presidential seat is only one of many positions of power. I remind myself that local politics often have a greater impact on your community than federal policy.
I truly believe in the resilience of the American people, not to sound like a politician myself. And I also believe in my own resilience to navigate the natural obstacles that arise when living life.
And of course, I remind myself every day that no matter what I’m going through, I’ve got this. And I remind you, right now, that whatever you’re going through, you’ve got this. We’ve got this. Certainly the three of you are “The Dream Team of Mental Health.”
I am so honored that you joined us here on MedCircle.