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Lindsay Saunders has been plotting her escape since the spring.

If President Trump is reelected, she and her wife are packing their bags and moving from North Carolina to Ireland.

Like many women, Saunders, 30, has been riddled with extreme election-induced anxiety, punctuated by sleepless nights, panic attacks and an inability to focus.

“I pretty much exist in this constant state of nausea,” she said. “I feel jittery and on edge all the time. The potential impact this has on our lives is so significant.”

Steven Stosny, a Washington, D.C.,-based therapist, who coined the term “election stress disorder” during the 2016 election cycle, said she’s not alone.

“It’s on steroids this time,” he said.

“Election stress disorder is a continual worry and continual obsession with the election and having it spill over into all areas of your life,” he explained, adding that this year, it’s exacerbated by compounding crises: “It’s not just the election, it’s also the pandemic, social injustice and job insecurity.”

Saunders grew up in a conservative household, with parents who are now avid Trump supporters. The 2020 election has strained — and in some cases, severed — her relationships with family members, she said.

“This is a particularly stressful election cycle for my wife and I,” Saunders continued. “One of the biggest concerns for me personally is my preexisting condition. I have cerebral palsy, and if I had a gap in medical coverage, I’d run the risk of being disqualified from future coverage because of that.”

Along with having tense family ties and serious health-care concerns, Saunders is in a same-sex marriage with an immigrant.

“My wife is a permanent resident, but she is not a citizen,” Saunders said, adding that the couple is actively planning to have children.

She worries about the future of immigration, and how her wife, who is from Bulgaria, might be impacted. Plus, because the Supreme Court recently cemented its conservative majority, Saunders is anxious about what rights she’ll have over her future children, to whom she will not be biologically related.

Given the likelihood of delayed results, the looming Election Day feels like “a mysterious cloud of dread,” Saunders said.

Women across the country — on both sides of the political divide — have echoed similar sentiments. The particularly fraught political landscape, set against the backdrop of a public health crisis and a reckoning on racial justice, has spurred pervasive and extreme election anxiety.

Like Saunders, Amanda McCubbins, 27, a graduate student at the University of Virginia with Type 1 diabetes, is deeply distressed over how the election and the impending Supreme Court decision on the Affordable Care Act could impact her ability to pay for critical medication.

Living in Charlottesville, the epicenter of racial unrest amid the 2017 Unite the Right rally, McCubbins frets over the possibility of clashes on Election Day and the weeks that follow, if the results are delayed.

“The longer the results take, the more opportunity people will have to claim the election is fraudulent, which will just stoke conspiracy theories and incendiary rhetoric, and it could lead to violence,” McCubbins said.

Her election anxiety has manifested in insomnia, weight loss and severe bouts of panic.

On the other end of the political spectrum, April Covet, 41, is experiencing anxiety, too.

“It’s getting to the point where I can physically feel it,” she said. “I feel a little shaky.”

She worries about what will happen to the economy if Democratic nominee Joe Biden is elected president. She expressed unease surrounding the continued protests for racial justice and what she described as a troubling surge in government control if Trump loses.

“Whether Trump or Biden wins, I worry there will be violence no matter what,” said Covet, who lives in central Alabama. “It consumes me. I wake up in the middle of the night and check my phone. I don’t want to miss what’s going on.”

Tracie Hirz, 51, lives in Arizona and is also a Trump supporter. Like Covet, she’s anxious about the fate of the oil industry and a fiscal downturn, particularly given the fragile state of the U.S. economy amid the pandemic.

“I worry that if we shut down, the American people, they will not be able to pay their bills and will be dependent on government welfare,” she said. “I can’t sleep. I am stressed 24 hours a day.”

As a devout Christian, Hirz fears Biden is going to “allow abortion on demand” and that “fundamental rights,” including to bear arms, will be stripped away.

While women across the country vary drastically in political opinion, they do seem to be united on one thing: The 2020 election has prompted unparalleled levels of anxiety among them.

Experts agree.

“It’s been brought up in most of my sessions with people of color specifically, and women,” said Jennifer Young, a D.C.-based psychologist. “People are reporting disturbed sleep and an increase in nightmares, and physical symptoms, like heart palpitations and dizziness.”

For those suffering from extreme election anxiety, Young suggests reflecting on two concepts: boundaries and action.

“Limit your exposure to news or social media,” she said, adding that there is a clear correlation between information intake and anxiety levels. “Read highlights instead of doing a deep dive into each news story or follow one story really closely and let go of the rest.”

As for taking action, “I advise people to consider looking at what they can do about a cause they’re passionate about, including volunteering to phone bank and asking whether people need a voting plan,” she said.

If the candidate for whom you didn’t vote wins the election, “give yourself a moment, pause and breathe. It’s going to be a grieving process,” Young said.

Angela Bosco, 36, a hairdresser in Las Vegas is preparing for that possibility.

“I took November 4 off work, in case I need the day to mourn,” she said, adding that she has suffered from panic attacks related to the election and has been taking medication and seeing a therapist in an effort to quell her nerves.

For her, the election anxiety is debilitating.

“I feel like I’m in a haze. I can’t get anything done. Sometimes I can’t sleep; sometimes I sleep too much. I have no motivation to do anything,” she said.

According to the American Psychological Association, more than 68 percent of American adults claim the 2020 election is a significant source of stress — a marked increase from the 2016 presidential election, when 52 percent said the same. More broadly, 77 percent of Americans say the future of the country is a significant source of stress.

Women are more than twice as likely to be affected by anxiety disorders and panic attacks than men, and the financial fallout from the coronavirus has disproportionately impacted women of color, stimulating more stress and unease among minorities.

“Women are also far more likely to somaticize — the physical manifestation of psychological stress — which can include headaches, muscle aches and digestive problems,” Stosny, the therapist who coined election stress disorder, said.

Still, there are ways women experiencing this can lessen their election anxiety.

For one, “connections are important. Zoom with your friends. If you live with someone, hug that person six times a day. Hug more — that’s the biggest thing you can do,” Stosny said.

Along with increasing human connection, Stosny recommends regular exercise — walking for 30 minutes a day or an hour a week in nature — and diarizing worries.

Stosny also recommends taking action.

“Focus on what you’re for rather than what you’re against. If you focus on what you’re for, you’re motivated by passion and conviction. If you focus on what you’re against, then you’re motivated by anger,” he explained. “It’s not fulfilling to destroy something; it’s fulfilling to build something.”

Even in the wake of wrenching uncertainty, there are pockets of hope, reinforced by record voter turnout.

Many women have been using their anxiety to fuel their activism, including Saunders, who spent the past several weeks ensuring those around her have a voting plan and access to polling locations.

“I want to make sure I’m doing my part,” she said. “I do think there is hope for the future.”

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