There were times, during the first two years of the Biden presidency, when I came close to forgetting about it all: the taunts and the provocations; the incitements and the resentments; the disorchestrated reasoning; the verbal incontinence; the press conferences fueled by megalomania, vengeance, and a soupçon of hydroxychloroquine. I forgot, almost, that we’d had a man in the White House who governed by tweet. I forgot that the news cycle had shrunk down to microseconds. I forgot, even, that we’d had a president with a personality so disordered and a mind so dysregulated (this being a central irony, that our nation’s top executive had zero executive function) that the generals around him had to choose between carrying out presidential orders and upholding the Constitution.
I forgot, in short, that I’d spent nearly five years scanning the veldt for threats, indulging in the most neurotic form of magical thinking, convinced that my monitoring of Twitter alone was what stood between Trump and national ruin, just as Erica Jong believed that her concentration and vigilance were what kept her flight from plunging into the sea.
Say what you want about Joe Biden: He’s allowed us to go days at a time without remembering he’s there.
But now here we are, faced with the prospect of a Trump restoration. We’ve already seen the cruelty and chaos that having a malignant narcissist in the Oval Office entails. What will happen to the American psyche if he wins again? What will happen if we have to live in fight-or-flight mode for four more years, and possibly far beyond?
Our bodies are not designed to handle chronic stress. Neuroscientists have a term for the tipping-point moment when we capitulate to it—allostatic overload—and the result is almost always sickness in one form or another, whether it’s a mood disorder, substance abuse, heart disease, type 2 diabetes, or ulcers. “Increase your blood pressure for a few minutes to evade a lion—a good thing,” Robert Sapolsky, one of the country’s most esteemed researchers of stress, emailed me when I asked him about Trump’s effect on our bodies. But “increase your blood pressure every time you’re in the vicinity of the alpha male—you begin to get cardiovascular disease.” Excess levels of the stress hormone cortisol for extended periods is terrible for the human body; it hurts the immune system in ways that, among other things, can lead to worse outcomes for COVID and other diseases. (One 2019 study, published in JAMA Network Open, reported that Trump’s election to the White House correlated with a spike in premature births among Latina women.)
Another major component of our allostatic overload, notes Gloria Mark, the author of Attention Span, would be “technostress,” in this case brought on by the obsessive checking of—and interruptions from, and passing around of—news, which Trump made with destructive rapidity. Human brains are not designed to handle such a helter-skelter onslaught; effective multitasking, according to Mark, is in fact a complete myth (there’s always a cost to our productivity). Yet we are once again facing a news cycle that will shove our attention—as well as our output, our nerves, our sanity—through a Cuisinart.
One might reasonably ask how many Americans will truly care about the constant churn of chaos, given how many of us still walk around in a fug of political apathy. Quite a few, apparently. The American Psychological Association’s annual stress survey, conducted by the Harris Poll, found that 68 percent of Americans reported that the 2020 election was a significant source of strain. Kevin B. Smith, a political-science professor at the University of Nebraska at Lincoln, found that about 40 percent of American adults identified politics as “a significant source of stress in their lives,” based on YouGov surveys he commissioned in 2017 and 2020. Even more remarkably, Smith found that about 5 percent reported having had suicidal thoughts because of our politics.
Richard A. Friedman, a clinical psychiatry professor at Weill Cornell Medical College, wonders if a second Trump term would be like a second, paralyzing blow in boxing, translating into “learned helplessness on a population-level scale,” in which a substantial proportion of us curdle into listlessness and despair. Such an epidemic would be terrible, especially for the young; we’d have a generation of nihilists on our hands, with all future efforts to #Resist potentially melting under the waffle iron of its own hashtag.
Which is what a would-be totalitarian wants—a republic of the indifferent.
Ironically, were Trump to win, an important group of his supporters would bear a particular psychological burden of their own, and that’s our elected GOP officials. I’ve written before that Trump’s presidency sometimes seemed like an extended Milgram experiment, with Republican politicians subjected to more and more horrifying requests. During round two, they’d be asked to do far worse, and live in even greater terror of his base—and even greater terror of him, as he tells them, in the manner of all malignant narcissists, that they’d be nothing without him. And he wouldn’t be wholly wrong.
The Trump base, however, will be intoxicated. We should brace ourselves for a second uncorking of what Philip Roth called “the indigenous American berserk”: The Proud Boys will be prouder; the Alex Jones conspiracists will let their false-flag freakishness fly; the “Great Replacement” theorists will become more savage in their rhetoric about Black, Hispanic, and Jewish people. (The Trump administration coincided with a measurable increase in hate crimes, incited in no small part by the man himself.)
But at this point, even an electoral defeat for Trump might not significantly diminish the toll that politics is taking on the collective American psyche. “In such a polarized society, everyone is always living with a lot of hate and fear and suspicion,” Rebecca Saxe, a neuroscientist at MIT who thinks a good deal about tribalism, told me. The winner of the presidential election “may change who bears the burden every four or eight years, but not the burden itself.”
Of course, fractured attention, heightened anxiety, and moral cynicism may come to seem like picayune problems if Trump wins and some 250 years of constitutional norms and rules unravel before our eyes, or we’re in a nuclear war with China, or the former chairman of the Joint Chiefs of Staff is frog-marched off to court for treason.
“You get Trump once, it’s a misfortune,” Masha Gessen, the author of Surviving Autocracy, told me. “You get him twice, it’s normal. It’s what this country is.”
This article appears in the January/February 2024 print edition with the headline “The Psychic Toll.” When you buy a book using a link on this page, we receive a commission. Thank you for supporting The Atlantic.