WASHINGTON — When Cristina, a 50-year-old graphic designer in Minneapolis, wakes up, her muscles are tight, her stomach is upset.
What's the latest in the presidential campaign? She checks her phone, though she knows it will only heighten her distress.
"I want to know if something worse has happened," said Cristina, whose full name is not being used because she is in therapy as a result of the campaign.
The vicious rhetoric, the anger and the slurs of this campaign are unleashing buried fears and anxieties in voters. Relationships are strained. Marriages are at crossroads. Women find bad memories of sexual assault rekindled. Even veterans being treated for post-traumatic stress from combat are talking to therapists about the campaign.
"I don't ever remember politics being like this," said Laura Bryan, a marriage and family therapist near Raleigh, N.C., who's the director of the Marriage and Family Therapy Program at Pfeiffer University. "It was certainly not something that people would mention in the context of therapy."
Wendy Whelihan, a marriage and family therapist in Minneapolis, said she had started asking her clients about the election, "which is traditionally not in our repertoire … because when it comes up it is so visceral. It's clearly impactful for them."
Not all therapists have experienced the phenomenon, or if they have, not to the extent that colleagues elsewhere have. But the concern developed when William J. Doherty, a psychology professor at the University of Minnesota who's the director of its Marriage and Family Therapy Program, noticed that therapists around the country were all talking about a common source of stress among their clients.
"These are ongoing patients who are immigrants, members of minority groups and … middle-class white folks who, when given an opportunity to say how are you feeling about what's going in the world, just are eager to talk about how distressed they are at what Trump is doing and what he stands for," Doherty said.
Led by Doherty, more than 3,000 therapists, counselors and social workers formed "Citizen Therapists Against Trumpism."
"The fear is that this person (Trump) who is so divisive could possibly get elected," said John McDonald, a mental health counselor in Seattle. "I realize in some ways Hillary is that for some people."
Whether it's Trump or Clinton, a majority of American adults find this election very or somewhat stressful, according to a recent survey by the American Psychological Association.
Much of it is driven by Trump's campaign.
He has appealed to aggrieved voters, giving voice to their fears about the changing rules of economics, class and social mores. He channels their resentments about factories shedding jobs and moving overseas, the influx of foreign faces in their communities and public acceptance of a morality in conflict with their own.
"What we're seeing is someone who is a master of selling that fear," said Robert Cox, a mental health counselor in Liberty, Mo.
It's igniting stress and apprehension on various fronts.
Therapists and counselors say Trump's attacks on immigrants have created fears about deportation among those already living in this country. His name-calling has triggered violence at his rallies and created safety concerns among groups he has targeted.
"Crime is happening more and more to people of color, Muslims and to Hispanics," said Cristina, 50, whose father escaped from Cuba during the Castro regime and who also has Native American and African-American ancestry. "It's the level of anxiety because of the violence he's inciting. So even if he doesn't win, I'm still scared. It's palpable. It's out there and you can feel it."
Labeling it the "Trump effect," teachers have reported a rise in bullying and harassment by students, according to a report from the Southern Poverty Law Center. When Clinton cited the findings, PolitiFact, a nonpartisan watchdog that scrutinizes political rhetoric, determined that while the survey was unscientific and based on anecdotal reports, her comments were "mostly true."
Trump's casual talk about the use of nuclear weapons also evokes fears.
"'Oh my gosh! If this person is elected, we're going to end up in WWIII!'" said therapist Lisa Merlo-Booth, of Franklin, Mass., quoting one of her clients.
More recently, a tape of Trump's about the freedom he feels to take liberties with women has awakened troubled memories among those who've experienced lewd and suggestive behavior or have been victims of sexual assault.
First lady Michelle Obama spoke to that concern in a candid airing of grievances against Trump during a campaign stop in New Hampshire last Thursday. She said the GOP nominee's bragging in 2005 about sexually assaulting women, caught on an open mic, had "shaken me to my core."
Several therapists said the meanness of this campaign was baked in even before Trump became the nominee because the country had been so politically polarized. The extreme animosity and distrust that each side feels toward the other's candidate has so super-charged the political tension that notions of acceptable behavior, at least on Trump's part, have long since gone out the window.
"People don't know where to go," said Merlo-Booth. "They don't know what sources to trust … where to go for the truth."
She has clients who are un-following friends on Facebook because the campaign has made them wary as to whether "we have the same values.'"
Barbara Goldberg, a marriage and family therapist in Sacramento, Calif., does pro bono work with veterans who are suffering from post-traumatic stress disorder, the result of their time in combat. The campaign is not helping them get better.
It appears to be "really triggering a lot of anger," she said. "They had been getting control of it."
The bitter political mood has become an additional hurdle to some couples who are already seeking help. Goldberg said a woman told her the other day that she wouldn't watch the news anymore because she found it so upsetting. But her husband has it on all the time on their TV in the bedroom.
"She never goes in there, and it's having an impact on their relationship," the therapist said.
Goldberg is counseling another couple where one spouse is a Republican and the other a Democrat. This campaign has been a strain.
"They have agreed to never, never talk about politics," she said, "or they're splitting up."
Stressed about the election? Here's advice from the American Psychological Association
*Cut back on news consumption. Take a walk, Spend time with family and friends.
*If someone starts discussing politics, run the other way. Quickly.
*Don't just fret about issues that concern you. Do something about it. Volunteer.
*Take a stand.