- Associated Press - Monday, March 6, 2017

NEW HAVEN, Conn. (AP) - We have become a stressed and anxious nation, increasingly so since the election of Donald Trump as president.

Concerns about immigration restrictions, health care, past sexual trauma and world peace rose even before Trump was elected and have continued since his inauguration, say mental health caregivers in Connecticut.

The strain is not being felt only by undocumented immigrants or liberal Democrats. According to a nationwide survey by the American Psychological Association, a majority of both Democrats and Republicans are concerned about the future of the country.

In this year’s Stress in America poll, conducted annually since 2007, 57 percent of those surveyed said “the current political climate” is a very or somewhat significant source of stress. Just under half (49 percent) said that about Trump’s election. The survey was taken between Jan. 5 and 19, the day before Trump was inaugurated president.

Nationwide, Democrats were far more likely than Republicans (72 percent to 26 percent) to say Trump’s election caused them stress, 59 percent of Republicans said they were concerned about the nation’s future, compared with 76 percent of Democrats.

Mark Gaynor, a psychotherapist in New Haven, said that in this part of the country, “one has to take the perspective that we’re in a very blue state, a very blue bubble.” But in 40 years of practice, he said, “I’ve never heard so much talk . about the nation and the politics.”

Knowing that “this person has his finger on the button” that could start nuclear war, Gaynor said some of his clients have “acute anxiety about their future survival; others are concerned about their future employment.”

While some amount of fear is normal and necessary, Gaynor said, “Too much of it sends us into a rolling kind of an anxiousness that never gets comforted or diminished or ameliorated. . Anxiety and trauma affects our very genetic material and it may indeed shorten your life.

“When people are anxious, they don’t think clearly and they lose focus on other things,” which could lead to accidents. Others resort to coping mechanisms such as overeating, drinking or excessive gambling.

Dr. Marshal Mandelkern, chief of outpatient psychiatry at Yale New Haven Hospital, said he’s seen “the level of concern about where the nation is headed” rising a great deal in the past six months. “I can’t remember seeing this level of intensity and anxiety in any previous (election) cycle,” he said.

While mental health professionals do not view their clients through a political lens, Mandelkern said, “I would say that there is increased anxiety about the political situation and we see that across the range of people.”

When treating patients, “We don’t get involved in rights or wrongs of any particular issue,” he said. “We help them cope better with their anxiety. There’s a variety of things that we work on with patients, including relaxation techniques . as well as cognitive techniques, all of which have been quite helpful.” In some cases, medication may be needed to reduce anxiety, Mandelkern said.

Immigration is an example of an issue that raises concerns among many people, if for different reasons, he said. Some fear that they or people they know will be deported, while others are concerned about their safety if the borders are too porous. “We hear concerns about both sides of that,” Mandelkern said.

Stephen Karp, executive director of the Connecticut chapter of the National Association of Social Workers, said, “What we’re hearing from some of our members is that their clients are afraid,” especially those who work with immigrants and religious groups such as Muslims and Jews. “They’re afraid their families are going to be broken up, that (Immigration and Customs Enforcement) is going to show up and take their parents away.”

Karp said members also report clients’ anxiety based on an increase in anti-Semitic incidents. “It sounds almost like an overreaction, but I don’t think it is,” he said. “They’re working with clients that are very vulnerable; they’re afraid of being attacked. . It’s a very ugly environment.”

Because Trump has made broad statements about Muslims being dangerous and is limiting immigration from majority-Muslim countries, hate groups have felt emboldened to express their views, Karp said. “I think Muslims have clearly felt that increased discrimination, increased fear based on the comments this president has made. . Even people with green cards feel very insecure at this point,” he said.

Green card holders are immigrants who have earned permanent residency status in the United States.

Holly Starkman, a Guilford-based social worker who also teaches at Quinnipiac University, said “The day after the election it was probably one of the hardest days of my career. I don’t say that lightly. Every person that came in was in shock . really feeling very lost, out of control, unraveling a little bit.”

Starkman said she personally coped with the news of Trump’s election by doing “a longer session of yoga and a longer session of my meditation practice.”

She said a number of her clients are women with eating disorders or body image issues who have felt more anxious because of Trump’s “comments and his treatment about women,” including remarks made public during the campaign about grabbing women’s genitals and about the weight gain by Alicia Machado, the 1996 Miss Universe from Venezuela. (Trump had owned the Miss Universe pageant at the time.)

Starkman said she leads three groups of women “who have emotional eating problems and it was a primary focus . just an overall sense of fear and alienation.”

She said one in five Americans suffer from mental illness at some time in their lives, including post-traumatic stress, depression and anxiety. Now, she said, “something’s being triggered, symptoms are being triggered on some level.”

“Pre-existing issues around mental illness or mental health can be exacerbated” by what’s happening in government or in the world generally, Starkman said. She said one client whose grandparent survived the Holocaust was concerned about “some of the hate crimes against Jews that have increased,” although Trump has denounced anti-Semitism.

“On a positive note, it’s really pushed people to really focus on their self-care,” Starkman said. Clients have “felt empowered by participating in political action groups like Indivisible, which published a guide for “resisting the Trump agenda.”

She and other therapists said counseling for clients who are anxious about living under a Trump administration is no different than it would be for other complaints. Starkman asks, “How is it affecting them? How does it make them feel on a day-to-day basis?” She recommended “being mindful, being tuned in to your body and your anxiety and how is that affecting you. . There’s been more of a need for that.”

The group that may be most fearful about living under a Trump administration may be immigrants and their families, whether they are in this country legally or not. The administration’s threats to tighten rules on immigration and to deport those who are undocumented has sent waves of anxiety through Spanish speakers and Muslims, say those who work with those groups.

“A number of our clients could be directly affected and we’ll continue to offer our usual services to anyone who comes in,” said Dr. Evelyn Cumberbatch, director of behavioral health at the Fair Haven Community Health Center. Junta for Progressive Action, a support and advocacy organization for Latinos, has requested counselors from that agency to meet with concerned residents.

“We reached out to them,” said Sandra Trevino, executive director of Junta. “We also reached out to a local psychologist and the (Yale) Child Study Center came out right after the election. It was just really to talk about the emotions people were feeling at the time, a lot of fear and anxiety that was creating insomnia.”

Trevino said people remember ICE raids in the city in 2007 and “I know there are some days that families don’t send their kids to school. The fear is real of not knowing whether they’ll be able to return back from work.”

There is also worry about the Deferred Action for Childhood Arrivals program, launched in 2012 to give undocumented minors, known as Dreamers, a two-year extension before they must leave the country. “One of the things Trump kept saying was he was going to eliminate that his first day in office,” Trevino said. However, that has not occurred as yet.

Martha Plazas, program manager at the Clifford Beers Clinic, works out of the Fair Haven Community Health Center, seeing mostly Latino children and adolescents from families that only speak Spanish in the home.

“Those kids have reported some distress,” she said. “Mainly what they hear (is) that their parents are going to be deported and their families are going to be separated.” While there have been no raids by ICE in New Haven, there’s “just a lot of uncertainty about what is going to happen,” Plazas said. “They are dealing with some rumors of what is happening somewhere else and what might happen here. . They are just hypervigilant, a lot of uncertainty and fears.”

Plazas said children have told her “that their families are telling them not to be afraid, that they won’t be separated, that they won’t allow that to happen.”

The increased anxiety filters down to non-Hispanic children as well. Rose-Ann Wanczyk is a school-based social worker in Meriden who has done “a research study about helping children with their anxiety” and said anxiety disorders may be diagnosed as young as 11.

“Children have a lot of stress that they don’t talk about because nobody asks them,” she said. However, “What goes on in the home, the kids pick up on.” This includes parents’ comments but also what they see and hear in the news media. “They hear their parents talk about what’s going to happen with their health insurance, immigration, nuclear war,” Wanczyk said.

“It affects their academics, it affects their ability to pay attention in class . It affects their behavioral issues in school, it affects their relationships with peers,” she said. “It’s really difficult for kids to come into school, to leave everything behind and pay attention.”

Another source of worry is threats to programs such as Social Security and Medicare. Elizabeth Prete, a social worker in private practice in Branford, said she’s seen stress among patients who are “worried about privatizing Medicare” and losing health insurance, among other issues.

Prete said others who have had anxieties triggered include sexual assault victims. “That started before the election, when someone who’s running for the highest office in the United States talks about grabbing (genitals),” she said.

Others who feel threatened include LGBTQ people, who fear their rights being taken away, and “schoolteachers who are worried about what’s going to happen with money for public schools,” Prete said.

“People have felt more anxious about what’s going to happen in the world,” she said. “I think they’re worried that his insane behavior, he’s going to be trigger-happy.”

Prete said that, in addition to traditional therapy, she helps her clients cope by suggesting they become involved in trying to influence public policy. “For some people, it might make them feel better if they get involved . find a political group they can get involved in, go to protests, go to town hall meetings.”

Social workers have a history of activism on behalf of the most vulnerable populations they serve, and a group of therapists on the shoreline have been meeting to form a political action group. Prete said becoming involved in signing petitions and writing letters to government officials has helped her to deal with her own stress. She attended the Women’s March on Washington the day after Trump’s inauguration.

Kathleen Capen, also a Branford psychotherapist, said social work’s “code of ethics is all about outlining who and what we spend our time caring about,” which includes “people who are most marginalized in society,” whether because of race, religion, gender or sexuality.

Capen said many of her clients are concerned about threats to social programs, “everything from food stamps to Social Security. Medicaid clients are bringing these things up for sure. It affects every area of their health, their overall functioning . potential for long-term illness.

“Social service funding is always a concern that’s always at the forefront of social service lobbying,” Capen said.

Karp of the NASW said, “As social workers, we have a responsibility to speak up, we have a responsibility to be out in the streets . to show solidarity with our clients. We need to help our clients to take action,” such as contacting members of Congress. “I think it’s a whole range of working with individual clients . to help them be a voice.

“I’ve been around a lot of movements for a lot of years,” Karp said. “I’ve never seen so much activity so quickly and so broadly as I’ve seen in the last four weeks.”

Although some people interviewed in New Haven recently were clearly distressed about Trump’s policies, not everyone agreed that the president’s actions, words and policies were a source of anxiety.

“He’s not taking me nowhere, because I’m from here; I’m American,” said Shantae Wales of New Haven, referring to potential deportations. “I’m not stressing myself out with no Trump.”

Frank Crespo of New Haven said he wasn’t concerned for himself, but was for his half-siblings, who have a Mexican father. “The lifeline of this country is immigrants,” he said. “I have a brother and a sister who’s Mexican. It kind of hurts me for them because their father might get deported.”

“I’m not afraid,” said Angelica Martinez of New Haven. “I’m a little nervous with the immigration that they will send my dad back, but you have to go with the wind and see what happens.” His father immigrated from the Dominican Republic 50 years ago “and he still doesn’t have a green card. They could just knock on his door and send him away,” Martinez said.

Treneé McGee of West Haven said, “As a young woman, when Trump was elected I think I cried, I hysterically cried.” However, she said, “I’m still going to do what I do, implement change and learn so I can educate citizens on being productive and supportive of one another.”

Eileen O’Neill of North Haven said she’s concerned about renewed approval of the Dakota Access Pipeline and feeling “very anxious, very scared, very sad - what’s going to happen with our environment? . My daughter has a lot of health issues and . we could lose everything. . The environment and health care are two things that scare me the most.”

Olivia Joy of New Haven said she’s worried about “everything imaginable: war, women’s rights, race, religion, general terror, violence . I think all are equally horrifying. I think in recent years we’ve made a lot of progress and more can be taken away.”

John Johnson of New Haven was keeping an open mind. “Like I say to everybody, you gotta give the guy a chance to see what he does. He just took office and I’ve got nothing against him.”

“It makes me feel anxious for him to get out of there,” said Ruth Twitty of New Haven. “I don’t like him; he talks too much. All this he says he can do himself - what does he think he is, God?”

Cheryll Scott of New Haven also said she wouldn’t allow Trump to bother her. “He ain’t that great to make me anxious, because it’s the almighty God that I serve that takes care of me,” she said.

The American Psychological Association survey, conducted by the Harris Poll, found 66 percent of Americans reported stress about the future of the country, 57 percent about the current political climate and 49 percent about the election outcome. Minority groups, millennials, those living in urban areas, and those with a college education had higher levels of stress about the election. Those are demographics that tend to lean left politically.

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Information from: Hartford Courant, https://www.courant.com

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