In Phoenix, the close of summer is normally a time to be celebrated. However, this year as temperatures begin to fall and the promise of touchable steering wheels returns once again, we’re also met with political lawn signs, smear campaign TV ads, and awkward dinner conversations with extended family. It is, after all, an election year.
If you’ve been feeling more anxious in the lead up to the presidential election this year, you’re not alone. In fact, the American Psychiatric Association’s annual survey found that 73% of adult responders reported the coming election as a major source of anxiety, with 43% reporting feeling more anxious than they had the year prior1. While unfortunate, this uptick in anxiety is an expected mental health phenomenon known as election anxiety, and it’s seen every four years in the United States like clockwork. Worse yet, the last two election cycles have affected more American people than it ever has before2.
If you’re like me, you may feel like you’re still recovering from 2020 for many reasons, but the election stands out as one of the key events contributing to what made that such an anxious time. In fact, in 2020 Americans reported feeling notably more anxious in the months immediately preceding the election than they did in April of that same year when most of the country was still under stay-at-home orders due to the COVID-19 pandemic. This resulted in both the number of medical appointments for mental health complaints as well as prescriptions filled for drugs intended to treat them increasing in the months leading to the election3. Thinking back on all the contention and hostility from four years ago, how can anyone help but feel uneasy about the next few months?
As people prepare to support candidates that most align with their views on issues such as the economy, reproductive rights, immigration policies, environmentalism, gun rights, healthcare costs, and so much more it’s easy to see why we can feel so much is at stake. As members of the healthcare community, perhaps you’ve noticed an increase of anxiety not only in the patients you see but in yourself as you think about the implications that policies could have on the way you practice medicine. For everyone, these concerns are legitimate, and we should always give our democratic process the time and attention that it deserves.
That being said, the line between investing the time needed to make an informed decision and becoming consumed by the election cycle is growing ever thinner, and our growing access to information makes it harder than ever to escape the constant contention elections bring4. Recognizing election anxiety, understanding the psychology behind it, and taking steps to mitigate it will help both us and our patients navigate the rest of this year as well as we possibly can.
What drives such a public mental health phenomenon? Some of the factors are common to all types of anxiety, as studies have shown that those with anxiety disorders or other diagnosed mental health conditions are more likely to be affected by election anxiety4,5. However, the impact of election anxiety affects many more than just those with official anxiety disorders. This is most likely due to many factors, and we’ll briefly touch on a few here.
First, elections bring out some of our most fundamental in vs. out group tendencies, leading to the type of contentious environment that breeds anxiety. The strong tendency to form group affiliations is termed tribalism, and can be based on anything from nationality, ethnicity, religion, sports, schools, social groups, or (you guessed it) political affiliation6. Much of this happens outside the realm of conscious choice, and our brain is wired to find these group associations and respond emotionally based on them7. From an evolutionary perspective, this was probably quite beneficial historically at keeping us safe, but in the year 2024 with much fewer primal threats this wiring can also be damaging.
This mindset makes us paranoid about others and leads to cognitive biases. For example, supporters of a political party may fall into the trap of thinking that a supporter or candidate from another party views every single thing about the world differently than they do. When stated this simply, the absurdity of such an all-or-nothing mindset is obvious. However, tribal tendencies can override the critical thinking that would protect us from these cognitive traps. Another example is confirmation bias, defined as valuing information presented to us more when it confirms our already held beliefs, as opposed to those that challenge them. And before anyone starts pointing fingers, research shows that both sides of the political spectrum are equally susceptible to it10.
Which brings us to another factor that is somewhat unique to election anxiety, that its media coverage is incentivized to dramatize the news to increase viewership. Data shows definitively that negatively spun news receives more interaction, especially in internet formats, than positively spun news8. Interaction is, after all, how news outlets make their money. Stated simply, news outlets have clear motivation to produce content that is more likely to make you anxious all the time, but especially around elections. Negatively angled coverage is more likely to stay with us9, making us ruminate and more likely to continue to engage with news outlets. It’s a vicious cycle.
That’s a lot working against our mental health this time of year. Luckily for us, just like every election that has come before it, this one will pass and we will all make it out on the other side. In the meantime, here are some suggestions from psychiatrists and psychologists of strategies that can be implemented either for ourselves or suggested to patients as we all try to navigate election anxiety during the next few months:
1. Be conscious about how much election coverage you’re consuming. It’s unlikely you’ll learn anything new after consuming hours of coverage as opposed to a few focused check ins. Where possible, try and read coverage instead of watching it11, so as to avoid over consuming emotionally charged commentary.
2. Maintain the activities that are most meaningful to you12. This is good advice all the time, but especially during seasons of high stress. By investing more time and mental energy into things we care about it leaves less to be invested in the things that cause anxiety, such as elections.
3. Stay socially connected. Studies consistently show that isolation has negative effects on both mental and physical health13. Reaching out to friends and family that can offer us support when we feel overwhelmed is key, so long as we don’t spiral together. Even during this time of year, not every conversation needs to be about politics.
4. Avoid a mindset of division. Political beliefs are not all there is to our identities. Try to make an effort to identify common ground with those who you disagree with, and don’t allow yourself to buy into the tribal tendencies that demonize those with opposing views. You can have meaningful interactions and relationships with such individuals, just try to avoid talking about politics until after November.
5. Channel your anxious energy. Instead of succumbing to fears and worries, try to channel your anxious energy into something positive. Whether that’s something physical like exercise or other activities you enjoy doing14, or mentally through positive political activism or expanding your own knowledge base, look for outlets for this pent up energy.
In case it’s not abundantly clear, experiencing election anxiety is increasingly common and incredibly valid. As a healthcare community, having a basic understanding of it can prepare us for the months ahead, both when thinking about our patients and ourselves. Perhaps if we can’t agree on political ideologies, we can agree to support those around us who may be struggling during this period of uncertainty.
Be politically passionate. Be engaged and go vote. But also be kind and aware of those who experience election anxiety. Hopefully, we can find some common ground in that.
1American Psychiatric Association. (2024, August 12). Annual poll: Adults express increasing anxiousness. https://www.psychiatry.org/news-room/news-releases/annual-poll-adults-express-increasing-anxiousness
2American Psychological Association. (2020, October 15). Election stress takes toll on mental health, survey finds. https://www.apa.org/news/press/releases/2020/10/election-stress
3Mukhopadhyay, S. (2022). Elections have (health) consequences: Depression, anxiety, and the 2020 presidential election. Economics & Human Biology, 47, 101191. https://doi.org/10.1016/j.ehb.2022.101191
4Caporino, N. E., Exley, S., & Latzman, R. D. (2020). Youth anxiety about political news. Child Psychiatry & Human Development, 51(5), 683–698.
5Krishna, P. J. S., & Uvais, N. A. (2024). Elections and mental health: A narrative review. Journal of Psychosocial Rehabilitation and Mental Health, 11(4), 275–281.
6Mackiel, A. (2020). Tribalism. In: Shackelford, T., Weekes-Shackelford, V. (eds) Encyclopedia of Evolutionary Psychological Science. Springer, Cham.
7Molenberghs, P., Gapp, J., Wang, B., Louis, W. R., & Decety, J. (2016). Increased moral sensitivity for outgroup perpetrators harming ingroup members. Cerebral Cortex, 26(1), 225–233.
8Bellovary, A. K., Young, N. A., & Goldenberg, A. (2021). Left- and right-leaning news organizations use negative emotional content and elicit user engagement similarly. Affective Science, 2(391–396).
9Salsano, I., Tain, R., Giulietti, G., Williams, D. P., Ottaviani, C., Antonucci, G., Thayer, J. F., & Santangelo, V. (2024). Negative emotions enhance memory-guided attention in a visual search task by increasing frontoparietal, insular, and parahippocampal cortical activity. Cortex, 173, 16-33.
10Ditto, P. H., Liu, B. S., Clark, C. J., Wojcik, S. P., Chen, E. E., Grady, R. H., Celniker, J. B., & Zinger, J. F. (2018). At least bias is bipartisan: A meta-analytic comparison of partisan bias in liberals and conservatives. Perspectives on Psychological Science, 1–19.
11Javanbakht, A. (2024, August 9). Dealing with election anxiety? A psychiatrist explains how to channel your fears and break out of tribal thinking. The Conversation. https://theconversation.com/dealing-with-election-anxiety-a-psychiatrist-explains-how-to-channel-your-fears-and-break-out-of-tribal-thinking-235623
12Hooker, S. A., Masters, K. S., Vagnini, K. M., & Rush, C. L. (2019). Engaging in personally meaningful activities is associated with meaning salience and psychological well-being. The Journal of Positive Psychology, 15(6), 821–831.
13Holt-Lunstad J, Smith TB, Baker M, Harris T, Stephenson D. Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspect Psychol Sci. 2015 Mar;10(2):227-37.14Carek PJ, Laibstain SE, Carek SM. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011;41(1):15-28.
Brady Anderson is a medical student at the University of Arizona College of Medicine-Phoenix, class of 2025. He loves writing and enjoys the outlet it offers, both intellectually and emotionally. When not studying or trying put his kids to bed, he enjoys chipping away at one of the several books he's reading, exploring Arizona's deserts, and overanalyzing art and culture. He graduated from Brigham Young University in 2020 with a BS in Psychology. Feel free to reach him at bradyanderson@arizona.edu.