For so many, this year’s presidential election is the culmination of one of the most anxiety-inducing years in recent memory. A record number of Americans took to the polls, with the hopes of a clear resolution and direction for the coming weeks and months, instead voters received another dose of uncertainty. It may take some time before the final votes are tallied, so we sought advice from Columbia University Medical Center Psychologist Dr. Jeffrey Cohen, on how to stay calm and carry on.

The following is a lightly edited conversation with Dr. Cohen:

Q: What do you think is the mental health status of Americans right now?

A: People are stressed out. Uncertainty is the core feature of anxiety. And I can't really think of anything that's more uncertain right now than our election. So I personally am stressed out and I'm guessing that most folks are as well.

Q: Many of us may be tempted to brush aside our feelings of anxiety during this election season. What is your advice to folks trying to ignore that growing lump of stress in their chests?

A: The more that we talk about it, the more we create space for it. People are more able to notice their own mental health concerns and sort of reach out if they do need help. All of us are feeling uncertain. So even if we don't have, let's say, a clinical level of symptoms, we're probably all feeling anxious or stressed to some degree. So what can we do to cope? Well, I say first things first; know that it makes sense to feel this way. It makes sense to feel anxious. It makes sense to feel stressed. People from across political divides view this election as a threat to their way of life and the well-being of the country as a whole. So no matter who wins or who loses, all of our reactions make sense.

Q. Why is that important? How does naming your feelings help your mental health?

A. When we deny an emotion, we're unable to identify it or be aware that it's there. It actually gets bigger and it gets worse. So just naming, "hey, I feel anxious" is a way to regulate.

Q. Are there things people should avoid if they are feeling anxious and worried? What are some healthy ways to cope?

A. Do what works for you, like what in the past has gotten you through tough times. It's not a one-size-fits-all with mental health or people. So maybe for you, reaching out to certain folks in your life is going to be a source of support. Make a cope-ahead plan for reaching out to those folks.

Conversely, maybe it's not reaching out to certain folks. We all have that person in our life that is prone to catastrophizing, that might mean putting down the phone. It could mean turning off the TV. Be very strategic about your news consumption, doom scrolling social media, which tends to contain inaccurate information, can really set off our alarm response and add to the anxiety.

Q: And self-care?

A: Self-care is so important. We used to just talk about getting exercise and getting adequate number of hours of sleep, getting healthy food in your body, eating well. But I think in 2020, self-care is so much more than just that. It's also about knowing our boundaries and setting our limits.

Q. What about drinking? The number of Americans struggling with alcoholism is on the rise during the pandemic. What would be your best advice for that? Some might say a glass of wine at the end of the night is my self- care.

A: Drinking, is certainly up. What I usually tell my clients in therapy when they ask this type of question is how does it work for them? For some people that glass of wine, when it is just a glass of wine, can be an effective coping strategy. For other people, one glass of wine, turns into how many glasses of wine? They're usually the first to say that it leads to hangovers and they don't feel so good the next day. So, I would just ask yourself, how is that going to work for you? Is that going to be effective in terms of your coping?

Q: What should parents do who are feeling the stress. What's the best way to buffer kids from the stress but also turn the current political moment into a healthy learning experience?

A. I think it's striking a balance of first validating their concerns. If we talk kids like, “oh, don't feel anxious or you shouldn't feel that way,” that actually communicates to them that what they're feeling doesn't make sense. That's invalidating and that actually makes emotions grow bigger, they can feel shame because we're telling them not to feel a certain way. With kids, just as we would do with adults, step one is to validate. Then offering some reassurance; “things are going to be OK. I'm going to be here for you.” Keeping your typical bedtime routine is important as well and even engaging with your child in a family game.

Q. What if your typical coping mechanisms aren’t working?

A.  There is a crisis survival skill that I teach all the time in therapy. What do you do if the outcome is not what you want, you feel like you're in a state of crisis? You can fill a bowl of ice water and dip your head in the bowl. This actually triggers the dive response in humans and all mammals, and it tricks your body into thinking that you're under water. It slows down the nervous system. So if you're feeling super stressed out, get that bowl, fill it with ice water and dunk your head in for about 20 seconds. And if you can't do that, just go to the sink and splash cold water on your face.

Q. Or take a cold shower?

A. Yeah, why not? The reason we're saying the bowl is because you're actually tilting forward to trigger the dive response. It’s a way to change your physiology and that can change your emotional response in that moment and reduce the intensity of your feelings and help calm you down. It's a tool called TIP. T- change the temperature. The “I” is, do intense exercise, 20 to 30 minutes of intense exercise reduces anxiety and can boost mood. And then the “P” means paced breathing. So slow down, take a breath. Breathe in. Breathe out.

Q: When should someone seek professional help?

A: You can start by checking in with yourself, noticing if you're feeling anxious, if you're feeling stressed, if you're feeling depressed. Some of the signs to look for; Are you worrying so much that you just can't stop and it's interfering with work or school or are your home life? Are you having trouble getting out of bed? Are you having difficulty sleeping? If you're having these types of symptoms pop up in your life, then I'd say maybe it's time to reach out for professional help.

Q. Many of the barriers to video therapy sessions were removed or relaxed during the pandemic. Is it easier now to connect patients than in the past?

A. Absolutely. So now myself and most providers that I know are providing telehealth, using video formats so you can really get care from the comfort of your own home.

Q. You also wanted to talk about being mindful of how the political climate and pandemic may impact others?

A: Yeah. Be sensitive. For marginalized people, people of color, LGBTQ people, immigrants, people with disabilities, this can be particularly stressful. So, just be aware of how this all might influence particular communities and how you have conversations with each other.