“People are not okay”: The mental health impact of the Trump era

His presidency is over, but the trauma isn’t.

Four years ago, Americans were gathering at airports to protest then President Donald Trump’s newly-enacted Muslim ban. A year ago, they were watching his trial in the Senate after he was impeached on charges of obstruction and abuse of power. Three months ago, some were gathering emergency kits and making safety plans with their neighbors to prepare for potential election violence by his supporters.

And three weeks ago, they were watching those supporters storm the US Capitol in an attempt to overturn the results of a democratic election and keep Trump in power.

Now, Trump has finally left office, despite his constant threats that he wouldn’t. But the impact on the American psyche of four years of racist rhetoric, incitements of violence, and out-and-out chaos remains.

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For many, the past year has been especially difficult, bringing with it a pandemic, the police killings of George Floyd and Breonna Taylor, and the Trump administration’s violent response to the racial justice protests that ensued. “It created an environment where you are constantly in a state of fight or flight,” Lauren Carson, founder and executive director of the mental health nonprofit Black Girls Smile, told Vox.

Among the Black girls and women it serves, as well as among its own staff, the group saw a lot of stress, anxiety, and feelings of being overwhelmed, Carson said. “You are working on two percent every day, day in, day out — or negative percent.”

Some of those feelings have also been reflected in nationwide surveys, with a significant increase in stress about the country’s future and political climate after the 2016 election. And in 2020, 68 percent of Americans said the election was a significant source of stress in their lives, up from 52 percent in 2016.

Like the impact of Trump’s policies, that stress doesn’t go away overnight, especially when the conditions that led to his election — systemic racism, anti-immigrant paranoia, and the rampant spread of misinformation — are still very much a reality.

But Carson and others are working to help people care for themselves and address the trauma of the last four years, even as some of their biggest stressors — if not Trump’s presidency itself — continue. These days “a lot is coming to light that I think is forcing us as a society to work on making some real changes,” she said. There’s “a lot of real pain and real hurt there, but hopefully it creates an opportunity for healing.”

Trump’s presidency was traumatic for a lot of Americans

The problems Trump brought to light — racism, xenophobia, and transphobia, to name just a few — certainly didn’t start with him. But from the moment he announced his campaign in a speech maligning Mexican people as rapists, he made such attitudes more explicit than ever before within the bounds of traditional party politics.

His rhetoric helped embolden a wave of hate crimes across the country targeting Muslim Americans, immigrants, and a number of other groups the president had demonized. Meanwhile, his constant all-caps tweeting, his preference for staff who enabled rather than checked his worst impulses, and his return to campaign-style rallies shortly after his election all led to a relentless news environment that subjected Americans to the president’s disjointed and frequently abusive thoughts multiple times per day. In the first three years of his presidency, Trump tweeted more than 11,000 times — 5,889 of those tweets, according to the New York Times, “attacked someone or something.”

While Trump was able to energize a core of supporters with his mix of bravado, defiance, and racism, for many others, his presidency was quite simply, scary. In the American Psychological Association’s 2016 “Stress in America” survey, 63 percent of Americans said the future of the country was a “significant source of stress,” and 56 percent said they were stressed out by the current political climate. In the 2018 version of the survey, those numbers went up to 69 percent and 62 percent, respectively.

Clinical psychologist Jennifer Panning even coined the term “Trump anxiety disorder” to describe the stress many people were feeling in the weeks and months following the 2016 election. “People tended to experience things like ruminations, like worries of what’s going to be next” as they awaited each new tweet or action by the president, Panning told Vox.

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Meanwhile, Trump also subjected people in America and around the world to language and tactics used by abusers, Farrah Khan, a gender justice advocate and manager of the Office of Sexual Violence Support and Education at Ryerson University in Canada, told Vox. That includes gaslighting (like when he claimed that the official Covid-19 death tolls were fraudulent, or that the virus would “go away on its own”), lashing out in anger (his perennial rage-tweets about “PRESIDENTIAL HARASSMENT”), and seeking revenge on people for perceived wrongs (his attacks on Michigan Gov. Gretchen Whitmer after she criticized his administration’s Covid-19 response). In a relationship with an abuser, “you’re constantly hypervigilant to what he’s going to do next,” Khan said. Under Trump’s presidency, that hypervigilance extended to the millions of Americans affected by him and his policies.

Of course, those effects were not evenly distributed. While all of America had to put up with Trump’s tweets, many immigrants, LGBTQ people, and Black, Indigenous, and other people of color experienced real threats to their families, their well-being, and their lives. Thousands of children were separated from their parents at the US-Mexico border, with attorneys still unable to locate the families of more than 600 children. Trans people faced an onslaught of regulations stripping away their protections from discrimination in health care, housing, education, and more. In at least 41 criminal cases — including an assault on a Latinx man in Florida and threats against a Syrian-born man in Washington state — Trump’s name was invoked in connection with violence or threats, according to an ABC News analysis. The network found no criminal cases with such direct connections to presidents Barack Obama or George W. Bush.

And over the last year, with the country facing a pandemic (that Trump called by a racist name) and a long overdue reckoning with racism and police violence (to which the Trump administration responded by gassing protesters), the administration’s impact on Americans’ mental health and physical well-being has only grown more acute. That’s especially true for Black Americans, who have had to contend with the deaths of Floyd and others, and what ongoing police violence — as well as the pandemic and economic crisis — means for them and their families, Carson said. “During this time we were definitely seeing just a lot of overwhelm, a lot of stress, a lot of anxiety,” Carson said.

Those feelings came to a head, for some, with the Capitol riot on January 6. That day, Trump urged his supporters to “walk down to the Capitol” and “show strength” against “bad people.” He then praised rioters as they occupied the Capitol, some holding Confederate flags and other racist symbols, calling them “very special.” The riot and the way it was covered just added to the trauma Black Americans were feeling, according to Carson. “Even the way that we’ve seen ‘protests’ versus ‘insurrection,’” she said — “those depictions really weigh on the mental health and well-being especially of Black women and girls, because it’s a clear sign that we don’t matter.”

President Joe Biden has begun reversing some of the administration’s policies targeting marginalized groups, like the Muslim ban and the ban on trans people serving in the military. But just as undoing the impact of Trump’s presidency will take longer than a few weeks, healing from the trauma of the last four years will take time.

For some, it hasn’t even sunk in that Trump isn’t president. “People still talk about, ‘I can’t believe we actually did it, we actually got him out,’” Panning said. And for many people, especially in communities Trump targeted, his presidency “had a direct impact on the ways we felt safe,” Khan said. Rebuilding a feeling of safety will take time, and right now, “people are not okay.”

Rest, treatment, and action can help people recover from trauma

For some, the first step toward rebuilding that feeling will be simply acknowledging that the last four years — and especially the last year — have been traumatic. “We need to expect that there’s going to be a lot of emotional upheaval,” Panning said, and those emotions will “take some time to work through.” People are experiencing trauma symptoms from muscle tension to panic attacks to intrusive thoughts to simply deep sadness, Khan said.

For Black girls and women in particular, depression and anxiety have been “running rampant during this time,” Carson said. They’ve been experiencing fear not just for their own health and safety, but also for “our brothers, our fathers, our children.” Amid that, “it is very difficult to see the sunshine, it’s very difficult to see joy, it’s very difficult to be happy,” Carson said.

To combat that, Carson and others are stressing the importance of self-care, which can take many forms. Black Girls Smile, for example, offers online storytelling, journaling, and crafting workshops aimed at helping Black girls and young women “recharge, refresh, and renew,” Carson said. The group has also begun offering therapy scholarships to help Black girls and women afford professional mental health care. Groups like the Audre Lorde Project, Trans Lifeline, the Okra Project, and the Anti-Violence Project also offer support and resources specifically for trans and queer people and communities.

Anyone concerned about their mental health can also take an online assessment like those at Mental Health America to see if they have symptoms of depression, anxiety, or another condition that might benefit from treatment, Carson said. People should also keep in mind that for communities of color, “a lot of symptoms look a lot different in our communities compared to the white cis male community,” she added. For example, Black women can experience social anxiety as a result of experiences in predominantly white schools or workplaces, as well as PTSD and other effects of the trauma of racism. “We have to take a real hard look at the things we may be experiencing,” Carson said.

As individuals take steps toward healing, it’s also a time when we can look at bigger changes to the country’s mental health system. That includes providing child care, flexible hours, and other supports to make therapy more accessible to all Americans, Carson said. It also includes a greater focus on community mental health: “Too often we focus on just an individual, and in many instances, their whole family is impacted, or the whole community.”

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And part of recovery, as a society, is addressing the forces that led to Trump’s election in the first place. “The issues that were uncovered during Trump’s presidency have not magically gone away now that Biden is president,” Panning said. “What Trump did do is energize a lot of people politically to pay attention and to understand how our government works and who it tends to benefit.”

Today “there’s a lot of anger and frustration and resentment that is still lingering,” she added. And one healthy way to deal with it is to “channel that into action.”

Activism can be one way to heal, Khan said. For example, artists around the country have created street art to memorialize George Floyd and protest against police violence and racism, and activists Kenda Zellner-Smith and Leesa Kelly have collected some of the art from around Minneapolis and St. Paul to preserve and hopefully display it. “There has to be a space for Black people, by Black people, where this art can be available for healing and reflection, a reminder of what happened in a way to continue the movement,” Kelly told ABC.

But in addition to action, Khan cautioned, people need to make time for rest. “As activists, sometimes we’re taught to kind of just push through,” she said. “What I’m asking people is to slow down and take care of ourselves and our communities.”