KOJO NNAMDIThe election is a week from today, but we've been in this so-called election season for many months now. And this election is, well, stressing us out. A recent survey by the American Psychological Association found that nearly 70 percent of people said the election is a significant source of stress. The survey also found that 77 percent of us are worried about the country's future. All this added stress while we're still in the midst of a growing global pandemic.

KOJO NNAMDISo, how do we deal with election stress and all this uncertainty? How are you dealing with it? Give us a call, 800-433-8850. Has the election affected your mental health? Is it making you anxious or depressed? 800-433-8850. You can send us a tweet @kojoshow or email to Kojo@wamu.org. Joining us now is Dr. Pooja Lakshmin, a professor of psychiatry at the George Washington University School of Medicine. She's also a women's mental health advocate and a contributor to The New York Times. Thank you so much for joining us.

POOJA LAKSHMINThank you so much, Kojo, for having me. It's a pleasure to be here.

NNAMDIWell, have you seen an increase of patients stressed or anxious about the election?

LAKSHMINAbsolutely, 100 percent. You know, I think the combination of the pandemic, that we've been living through for the past seven or eight months -- I've lost track at this point -- (laugh) and the election is just a perfect storm of uncertainty and transition. So, I'm seeing increased rates of depression. I'm seeing increased rates of anxiety.

LAKSHMINAnd I think it's important to point out that, in particular, when it comes to the election, you know, the fear and the stress that folks are feeling isn't just hypothetical. You know, it's not abstract. People are feeling scared right now because, you know, lives are on the line. Human rights are on the line. Healthcare's on the line. So, there's real stuff at stake, here.

NNAMDI800-433-8850. Will you be relieved when the election's over next week? And tell us how it's affecting your mental health and how you're trying to deal with that. 800-433-8850. Joining us now is Karen Heller, a national features writer for the Washington Post. She recently authored the piece "'I've been crying for a few days': How voting became the latest of 2020's many anxieties." Karen Heller, thank you for joining us.

KAREN HELLERThank you, Kojo, for having me.

NNAMDITell us about the piece that you wrote. How are people being affected by this election, here in Washington and across the country?

HELLERYes. Well, this election season has probably been going on, it's safe to say, for a year. Our presidential election seasons get longer and longer, and so the anxiety sort of fills up the available time. We have the pandemic. We have an economic, you know, tumult. We have, you know, people who are already very anxious. We have postal service issues that were made public. We have a president who has said that he may not accept the results of the election.

HELLERAnd, you know, all across the country we have people really having to decide whether to vote early or vote in person or by mail because -- and, you know -- and there are a lot of questions. You know, do I vote by mail, given how the mail service is? Do I wait until Election Day, given how the pandemic is spiking? And, you know, as Pooja said, everyone has been calling this the most important election of our lifetime. That's a lot of pressure for a voter.

NNAMDIWhat is season elective disorder, or seasonally elective disorder?

HELLEROh, well, that's something I (laugh) -- that's a phrase I coined, but it had to do with, you know, all of the things I just, you know, spoke of. In other words, when you're told something is so important and you've had this much time to think about it, we have, you know, every day people who are watching social media, the news, you see, you know, challenges in courts, you see changes in voting rules.

HELLERI happen to live in Philadelphia, Pennsylvania. This is the first year that people can vote by mail with no, you know, excuses, like an absentee ballot. People are incredibly confused as to how to vote, because it's a first time, and the weight of this being such an important election. So, I actually coined that phrase, but it was sort of basically all of these things (laugh) coming at once.

NNAMDIHere is Nadia in Washington, D.C. Nadia, you're on the air. Go ahead, please.

NADIAHi, Kojo. I would also agree with the speaker that this current election, you know, coupled with the pandemic, is just causing so much anxiety. I work in communications and media, and I've completely just disconnected from the news -- except for you show Kojo. And, normally, I meditate and exercise to kind of get through it, and that's not even helping these days. So, it's been a really taxing time, and I cannot wait for this election to be over.

NNAMDIThank you very much for sharing the source of your anxiety with us, Nadia. That seems to be a reflection of what both Dr. Lakshmin and Karen Heller have been hearing. We got an email from Ken in Silver Spring, who writes: I turned 69 on October 19th. I've very concerned about preservation of the environment biosphere. I believe we need deep systemic change in this country. I fear that we are probably not going to get it.

NNAMDIAt this point, I feel that I will not live to see improvements. That is very hard to accept. I appreciate your time and consideration. Pooja Lakshmin, tell us whether that is a sentiment you've been hearing about, especially from older people who fear that they may not live to see the changes that they feel that they have been looking forward to.

LAKSHMINYeah, I think that that's something that's coming up a lot for folks, this sense of hopelessness and feeling of demoralization, you know, that we don't have control over what the outcome is going to be. And what does that mean for future generations?

LAKSHMINYou know, I would say the antidote there is to really look at trying to reflect on areas of your life, of your personal life, where you can make changes. Even if this election doesn't go the way that you want it to, what are ways that you can make change within your own family, influence, you know, young minds in your family or in the workplace, or things like that. I think we really have to connect with our values in times of transition, in times of stress, and look at finding meaning there, when we can't connect to meaning in the greater outside world.

NNAMDI800-433-8850. How do you cope with the constant news coverage of both the election and COVID-19? Give us a call, 800-433-8850. Karen Heller, despite the added stresses of an election happening during a pandemic, many people are still willing to stand in line for hours to cast their vote in person. Why is that, when there are often other ways to vote throughout the country?

HELLERWell, in reporting the story, I found that a lot of people were just distrustful. Part of that is because there have been so many lawsuits and challenges in the country. When I first reported this story, when it posted online two weeks ago, there were 365 voting-related lawsuits in this nation. Now, there are 418. So, almost every day, there is a lawsuit being filed that is challenging the current rules. If you vote in person, it means that your vote will be tallied that -- you know, on Election Day. In some states, there's early counting and tabulation.

HELLERSo, I think it's, you know, about control. One of the things we all feel during the pandemic, and then there is an economic crisis, is a lack of control. So, standing in line, I think that you get this kind of community, too. We've seen record early voting, and we've seen record lines. In Atlanta a couple weeks ago, people waited up to 10 hours to vote during the primaries when, you know, the coronavirus was really going strong. People waited six hours in many states.

HELLERSo, I think once you've sort of committed to it, there's sort of this spirit that raises -- you know, these people in line are not always upset. They really feel the community spirit of being a citizen and their, you know, civic pride of voting. You know, I think that we may well indeed see very, very high turnout in this election because of the stakes.

NNAMDIWell, we got a tweet from Lissy that might be kind of personal for you, Karen Heller. It says, could you talk about anxiety and depression for journalists who have had to cover this administration, the pandemic and the impending election? In order to deliver the news, their public service, they cannot turn it off for their mental health.

HELLER(laugh) Oh, that's a great question. I don't think that in the larger picture people care that much about journalists. The hardest thing for us, of course, has been that we've been reporting from our homes for eight months, seven months. But I did go out for this story, because I could talk to people outside. You know, I think our issues -- you know, it feels -- I will say the reverse is that you feel really actually like what you're doing is important. I have to say the country, in many ways, looks great, to see how invested people are in this election.

HELLERYou know, in 2016, more than 40 percent of this nation chose not to vote, which is incredible, given that this country was founded on the right, you know -- I mean, it took a while for all Americans to be able to vote, but we've worked so hard as a nation to get to that point. And so, I think, you know, people really see how important it is, and that's been actually encouraging and sort of a counterbalance to all the anxiety and news and the constant polls. I think that's another source of anxiety, by the way. I mean, we just have polls, constantly.

NNAMDIPooja Lakshmin, we've been talking about is the added stress COVID-19 and the election, but the normal stresses are still there. Work, family, getting married, breaking up, much of it with the added pressure of being stuck at home. What advice are you giving to patients who feel that they're at breaking point, that they just can't take it all right now?

LAKSHMINYeah, absolutely. I mean, I think it's this interesting tension, because you're absolutely right, Kojo. People are still living their lives. People are still getting pregnant, having babies, you know, quitting their jobs, starting new jobs, all these different things, plus all the financial stressors that are going on.

LAKSHMINSo, what I'm seeing with my patients is there is this kind of tension, and how much am I allowed to be worried about my regular life? You know, there's all this important stuff going on out in the world. And, of course, I'm really stressed and anxious about that, but I'm also stressed and anxious about what's going on in my own life. And so, how do you kind of parse those things out?

LAKSHMINI think if you're somebody who is not a journalist, (laugh) I am really advising to my patients to actually turn off the news and, you know, really set strong limits with media. Because just that constant flow of information is something that just creates more anxiety, and it creates more -- we're already in the state of uncertainty. And so, constantly having that going in the background creates a stimulus that is not helpful.

LAKSHMINThe other thing is I like to say that we need to kind of balance taking action and activating our agency, and then reflecting on the difficult feelings. And so, when we're activating agency, we're doing like what Karen said. You're going out and voting in person, if it's safe enough for you, and getting that sense of community. Or whether that's, you know, sending postcards or, you know, text thanking, or whatever it is, to have you feel connected to a greater mission, that can really help with the stress.

LAKSHMINBut that also needs to be balanced with taking time to reflect on the fears that you're having, the worries that you have. So, whether that's journaling, whether that's seeing a therapist, making sure that you're surrounding yourself with people that are safe and that you trust and that you can speak openly with. I think having a tribe right now -- especially if you're a person of color or if you're in a minority group -- having that safe space where you can have honest conversations about your fears, it is really invaluable.

NNAMDIHere's Jack in Falls Church, Virginia. Jack, you're on the air. Go ahead, please.

JACKThank you, Kojo. You know, I live in Northern Virginia, and I sent away to get an absentee ballot, and I got it. And I read all the instructions and filled it all out and got a witness to sign it, and all the things you do. But it's still sitting on my dining room table, because I do not trust the Post Office to actually deliver it. I'm going to go down to our local polling place, in person, and take the risk, because I think it is incredibly important. I'm 70, okay, and I'm sure this is the most important election in my life.

NNAMDIAnd so, you're going to go and stand in line. Karen Heller, you were born and raised here in the District, grew up close to where WAMU is located in nearby Cleveland Park, but you mentioned you're now living in the critical swing state of Pennsylvania. What are the attitudes there about getting in lines?

HELLEROh, my gosh. (laugh) So, that call is excellent, by the way. That is an observation in reporting this story that I heard over and over again. While these lawsuits have been going on challenging things, and also about the mail, we have drop-off boxes, which a lot of states have. We just posted a story a few minutes ago that in Ohio there is one drop-off box per county, whether the county has like 8,000 people in it or 800,000 people. It's insane.

HELLERSo, I understand that, because that goes to the issue of control. And a lot of people feel -- they don't trust the mail. The drop-off ballot boxes are a good alternative, although in California, Republicans put up fake ballot boxes, and admitted it, to confused voters. So, voters are confused. They're anxious. And I get that desire to be in person.

HELLERThe only issue in somebody -- we've been having debates like this all over Pennsylvania, because it's the first year you can do it by mail if you want. And people have said, what if the weather is bad, what if you're feeling bad on Election Day, what if the person next to you feels sick? Those are some of the risks, which, of course, increases anxiety.

HELLERBut I completely get the idea of control. That if you go that day and you vote by machine and turn in your ballot or however you vote, that you will have voted, and you'll know that. And that sense of certainty is even more important, you know, during these times. I get it. I completely get it, this feeling of loss of control, and particularly when there have been so many questions.

NNAMDIWell, we got a tweet from Helena, who says, I'm actually more anxious of what happens around the country after Election Day. It's likely we will not know the results on Election Day, or even days after, and may result in weeks of legal battles and potential unrest. Dr. Lakshmin, is that something you are hearing from people also as a source of anxiety?

LAKSHMINYes. I'm so glad that this listener brought this up. I think it's really important for us to mentally prepare ourselves not to have an answer on election night, or even the day after the election. Because I think, you know, just from what we've seen so far, you know, we really just cannot predict how things are going to go.

LAKSHMINSo, that's why I think it's really important to make a plan for yourself for how you're going to spend election night, how you're going to spend the evenings after work, you know, the week after the election. Set up, you know, virtual Zooms with friends who are sympathetic or, you know, kind of have similar views so that you have a support system during that time. Because this isn't going to be ending on Tuesday night.

NNAMDIIndeed, it won't necessarily be ending on Tuesday night at all, but for the time being, we have to end this conversation. Dr. Pooja Lakshmin is a professor of psychiatry at the George Washington University School of Medicine, also a women's mental health advocate and a contributor to The New York Times. Thank you so much for joining us.

LAKSHMINThank you. It's been a pleasure to be on, Kojo.

NNAMDIAnd Karen Heller is a national features writer for the Washington Post who recently authored the piece "'I've been crying for a few days': How voting became the latest of 2020's many anxieties." Karen Heller, thank you for joining us.

HELLEROh, thank you so much for having me. It's been a pleasure.

NNAMDIToday's show, the last in our month-long local election series, was produced by Kurt Gardinier. And speaking of final episodes, you can now listen to the sixth and last of the podcast "Fifty First," which is about D.C.'s fight for representation. It features yours truly and Politics Hour analyst Tom Sherwood explaining why D.C. statehood is so personal for local journalists like us.

NNAMDIComing up tomorrow, a federal judge recently struck down the Trump Administration rule that would have cut SNAP benefits for thousands of D.C. residents. This comes as many in the region are already struggling with food insecurity. Plus, chef and restaurateur Marcus Samuelsson joins us to discuss black food culture and his latest book, "The Rise: Black Cooks and the Soul of American Food." That all starts tomorrow, at noon. Until then, thank you for listening and stay safe. I'm Kojo Nnamdi.