Carol Wachs, a psychologist in private practice in Manhattan, recently started seeing an old patient again. The client had first sought treatment for anxiety following the terrorist attacks on Sept. 11. Now she was worried about a new menace: Donald Trump and his zealous supporters. The patient, Wachs says, comes from a family of Holocaust survivors, and “it feels to her like all the stories she heard from her grandparents about how things feel normal and then all of the sudden, oh my God, here we are.”

According to Wachs, the election casts a shadow on many of her patients. “If I have seven patients in a day, it comes up in six sessions, maybe five,” she says. “Sometimes I’ll have a session where people will say, ‘Let’s not talk about what’s going on in the election, it’s so upsetting.’ ”

With the presidential race staggering into its final stretch, the once inconceivable prospect of a Trump victory is becoming, if not likely, then definitely possible. (As of this writing, FiveThirtyEight gives Trump a 42.4 percent chance of prevailing, though that might change by the time you read this.) As that reality sets in, a hallucinatory sense of slow-motion doom is descending on many liberals. (Though not only on liberals.) Victims of Trump-induced anxiety describe nightmares, insomnia, digestive problems, and headaches. Therapists find themselves helping their patients through a process that feels less like an election than a national nervous breakdown.

“People are scared,” says Fiachra “Figs” O’Sullivan, a psychotherapist in San Francisco who specializes in relationships. “People are distressed, and it’s affecting their level of presence in their relationships with their significant others.” Dorie Chamberlain, a 54-year-old stay-at-home mom in Los Angeles who says she talks about Trump every time she goes to therapy, says watching the election “is like living in a house where everybody screams.”

There is, of course, no way to quantify the scope of mental anguish caused by Trump’s campaign; these stories are entirely anecdotal. There are, however, a lot of anecdotes, as I discovered when I started speaking to both therapists and panicking voters. I’ve covered four elections as a journalist, but this is the first one to regularly poison my dreams; at least once a week I wake up in the middle of the night in clammy, agitated horror. I was curious if other people were suffering in similar ways, so I reached out to a therapist I know. She queried two email lists of mostly New York–based colleagues, asking them to contact me if they’d seen Trump-related distress in their practices. Responses quickly started pouring in; soon I had almost a dozen.

Some of the therapists told me they are talking their patients through their Trump terror while trying not to succumb to it themselves. “The therapists that I know are pretty overwhelmed by managing their personal feelings, which we have to do and we’re doing, but it’s a lot,” says psychologist Heather Silvestri. She belongs to a meditation group for therapists and says the election comes up in every session.

Of course, not everyone beset by Trumpian maladies is in therapy. About two weeks ago, Liz, a 45-year-old photographer in suburban Minneapolis who asked to be identified only by her first name, started noticing alarming symptoms: headaches, jitteriness, tightness in her chest, sometimes even difficulty breathing. She went to her physician, who said it sounded like she was suffering from anxiety. “I thought, huh, I don’t even have a stressful job. I don’t know what that can be,” she says. Then she went home and turned on the news, “and all the sudden the symptoms came back with a fury.” She realized that thinking about Trump was affecting her health.

Liz hasn’t agreed with past Republican candidates, she says, but she didn’t think they would “ruin my country, or cause civil war, or cause World War III.” But her fear also stems from her incredulous realization that so many of her fellow citizens inhabit a reality that barely intersects with her own. “I can no longer see where they’re coming from,” she says of Trump supporters. “I feel like I’m in The Twilight Zone.” Even if Clinton wins, she’s terrified of Trump’s followers responding with violence. “We’re getting closer and closer and closer to something that seems so insane,” she says, “The thought of him winning, or even the thought of her winning and parts of the country imploding in chaos as a result—it all just seems like a nightmare.”

The anxiety is encroaching on her relationships, Liz says. Sometimes she’ll delay putting her 9-year-old daughter to bed because she’s so caught up in the news. Socially, she can’t always focus. “I’m strained in my conversation because of something I may have just heard” about the campaign, she says. She’s making an effort to cut back on her news consumption and is thinking of taking up meditation. “There’s a true need here to figure out ways to cope, because as the next 50 days count down, I don’t anticipate it’s going to get any better,” she says. “Probably far worse.”

But meditation, for all its benefits, is not a panacea. Sharon Salzberg, the renowned Buddhist meditation instructor, was teaching this past Sept. 11. “During the lunch break I checked my email or Twitter or something, and it just said, ‘Hillary Clinton fainted,’ ” she tells me. “And I almost fainted. Oh my God!” Salzberg certainly finds profound comfort and stability in her meditation training, but she’s on edge like other liberals. “When I see my mind starting to trip out, I remind myself, just come back, deal with what’s now,” she says.

Fear of a Trump presidency is a normal human reaction, of course, not a clinical condition. A vertiginous sense of unreality is a symptom of an anxiety attack, but it is also a symptom of being a thinking person in America in the fall of 2016. People with anxiety disorders tend to imagine that catastrophe is imminent, but in this case they may not be wrong. “You can’t pathologize this anxiety,” says Andrea Gitter, a New York psychotherapist and member of the faculty at the Women’s Therapy Centre Institute. “People who are marginalized to begin with know that they are targets because of the hatred that’s been unearthed.” Gitter says the election comes up daily in her practice.

Still, therapists have to help their clients manage their feelings and live their lives, however astonishing it might seem that normal life is going on while the republic teeters on the edge of kakistocracy. Kimberly Grocher, a psychotherapist in New York, says she talks to patients about their Trump-induced political distress several times a week. “It’s really pervasive, and it’s really come into the treatment room,” she says. “Usually it’s combined with other anxiety triggers that they may be having, and it can cause sleeplessness, restlessness, feeling powerless. It can lead to feelings of depression.”

Grocher is black, and many of her clients are people of color. For several of them, she says, anxiety about the election is linked to worries about the physical safety of their communities. They wonder what the outcome will mean for police violence; Trump has said urban police should be “much tougher” and recently called for the nationwide adoption of stop-and-frisk. “For the minorities who I see, and even the Caucasians who I see, that issue has been very closely tied to the election,” Grocher says. “Usually the two come up in conversation together. It’s about, What’s going to happen in my community if this person is in office?”

Sometimes the election’s psychic fallout takes less obvious forms. Silvestri, for example, has noticed a curious phenomenon among some of the millennial women in her practice: The rise of Trump has made them wonder how much they can reasonably expect from romantic relationships. Trump embodies some of the worst aspects of their ex-boyfriends, men who were “self-aggrandizing, self-important, not amenable to collaboration, cooperation, etc.,” Silvestri says. “When you break up with someone you need space, and they’re feeling like they can’t get space because their ex is sort of incarnate all over the news.”

It’s not just that Trump reminds them of their exes. It’s that Trump’s success seems to validate the men’s behavior. “They had gotten themselves to a place of, This is not what I deserve, I deserve better, I can do better,” Silvestri says. But watching dutiful, responsible Clinton struggle to best Trump, “people are really backtracking and saying, ‘I made this move to be more empowered and be who I am based on my values, but now I see my ex writ large on the national stage, and everyone’s following him,’ ” Silvestri says. They start thinking that, for a woman, maybe being beautiful really is more important than being smart, assertive, and authentic. “What happens in microcosm on a Friday night,” she says, is now playing out on the national stage. “The men have the power, and [the women] are trying to be a better version of themselves, but it doesn’t play well.”

Part of what Silvestri is describing is a sad and fretful confusion over which traits our culture admires in women and which it disdains. For older women who identify with Clinton, there is less confusion and more anguished realization of the degree to which aging women are held in contempt. “For a year, I’ve been hearing in very hushed tones all this sadness,” Wachs says. “Women who thought that women have more stature in the world hear how young men and older men are talking about this female candidate—the misogyny, the focus on her appearance, the focus on the cool factor.”

Instead of feeling excited about the possibility of the first female president, these women feel ground down. “Some people are terrified of Trump because he’s a fascist demagogue, and some people are just incredibly demoralized that Bernie, who we all love, is your cool, funky, uncle, and Hillary is Nurse Ratched,” Wachs says.

This demoralization could help explain why more people are not channeling their anti-Trump anxiety into action to prevent his election. “I think people are paralyzed by it,” Silvestri says. “I see it in myself, too. In Obama’s previous campaigns, I was out there campaigning in Pennsylvania from July or August on. I have not ventured to Pennsylvania yet. I’m too overwhelmed. Nor have any of my friends mentioned anything so far in terms of actually being out there, involved.”

Silvestri can’t quite put her finger on what’s kept her aloof from the campaign. “It’s hard to be passionate about her, and I feel bad saying that, but I don’t feel passionate about her,” she says. “How much of that is endemic sexism? I don’t know.”

Naturally, a Clinton critic would attribute the lack of passion to Clinton’s weaknesses as a candidate. That’s surely some of it. But Wachs sees deeper, more elemental drives at work. She notes that for some people, fear of Trump translates into fury at Clinton. “There’s a lot of blame on Hillary, the way you would blame your mother for something going wrong in the world,” Wachs says. “People blame Hillary for not being a better candidate. How can it be that he’s able to be a good candidate?”

Perhaps it’s inevitable that therapists would trace all this anxiety back to people’s relationships with their parents. But one needn’t be a psychoanalyst to appreciate the way the election can serve as a fun house mirror of old family trauma. “There’s overall a preoccupation with parental failure,” Michael Mance, a clinical psychologist in New York, says of his patients. “One might hypothesize that Trump represents a particular kind of very difficult father—an untrustworthy, persecutory, and frightening father—and Hillary represents a kind of toxic, unloving, and secretive mother.” There’s a sense, he says, that “somebody’s going to fail us. I think that presents people with a lot of discomfort, which is hard to manage.” There’s no authority that can protect us from the calamity on the horizon. It’s like a child’s bad dream. It’s also our reality.