This is your brain on Trump: Four years of chaos has changed us. What would four more do?

On an October afternoon nearly a month ahead of the presidential election, Mohamed Kabba hustled into the mail-in voting center at Tilden Middle School in Southwest Philadelphia with an air of urgency.

“As an immigrant, there’s a lot at stake for me,” said Kabba, 64. He left Sierra Leone 30 years ago — but the past four divisive, unpredictable, and chaotic years have been like nothing he’s experienced in America.

Head-spinning highlights include: President Trump’s impeachment, the longest government shutdown in U.S. history, divisive battles over Supreme Court appointments, countless policy-shaping Tweetstorms, the arrests of numerous presidential advisers, the failure to condemn fringe conspiracy theories and white supremacy groups, an out-of-control pandemic that infected even the White House, and now repeated efforts to undermine the election.

The thought of four more years of that? “I cannot contemplate it at all,” Kabba said. “I’ll go back to Africa.”

Across party lines, a majority of Americans have experienced significant stress as a result of the current political climate. According to the American Psychological Association’s annual Stress in America survey, about 83% of us are stressed about the future of the country. So-called “Trump Anxiety Disorder” (or, as the president has derided it, “Trump Derangement Syndrome”) has elevated blood pressure, caused bouts of irritable bowel syndrome, and generated ambient, chronic anxiety.

» READ MORE: Trending topic in therapy sessions: Trump anxiety

The trigger of all that stress is not just the death spiral that now passes for a news cycle. It’s also the yawning divisions that have only grown more impassible in the past four years, said Michael Baime, founder of the Penn Program for Mindfulness. One measure of that chasm: A Pew Research Center survey found around 75% of voters have few or no friends who support a different presidential candidate.

“It doesn’t matter which side of the political spectrum you’re on: The other side is not just in disagreement with you, but evil and hateful," Baime said. "That’s really not a foundation for a sane culture. That’s not a foundation for a peaceful life. It creates a lot of insecurity and distrust and anxiety.”

In Philadelphia, voters who went for Hillary Clinton by a 5-1 ratio in 2016 have plodded through the last four years by doomscrolling and social-media fasting, knitting pussy hats, and marching for racial justice, wearing safety pins, and posting “Hate has no home here” signs. Now, they’re shouldering the knee-buckling emotional weight of this election with plans to vote, to protest if needed, and to find their own ways of coping, alone and in community, with whatever the outcome may be.

That takes a toll, said Keren Sofer, a psychologist practicing in Center City, who has noted the rise of chronic, “toxic” stress among clients.

“Our limbic system, which appraises threat in the environment and helps regulate emotion, does not distinguish between pandemic stress, political stress, relationship stress, or work stress,” she said. Whatever the threat, she said, the reptilian brain goes ahead and triggers the release of hormones like adrenaline and cortisol.

The problem is when that threat never recedes.

“All your base functions are disrupted. People aren’t sleeping, they aren’t relaxing. People are vigilant all the time. And when we’re more vigilant, we’re less trusting of others. That undermines our ability to reach out. It’s a vicious cycle.”

That sense of a looming, existential threat hung over Independence Mall on Oct. 8, during the sixth night in a row of protests by the group Refuse Fascism (unofficial slogan: “This nightmare must end”).

“It’s a pretty tumultuous atmosphere out there,” said Xavier, 34, who declined to give his last name for fear of being doxxed. “Life has turned upside down. I’ve already seen a dude walking down my street with a gun, looking to, quote, unquote, ‘protect’ my neighborhood.”

And Jo Lester, a graduate student in social work at Temple University who wore a bright orange “Trump/Pence Out Now!” sticker, said the average person is not stressed enough.

“Trump is already saying there is not going to be a peaceful transfer of power. He is telling right-wing militias to stand by and basically inciting civil war,” Lester said. “People need to be outraged.”

Minutes later, after one of the activists began a scheduled teach-in about the Proud Boys — the white supremacist group that Trump told to “stand by” during the presidential debate — a dozen Proud Boys appeared, at least one armed, to shout down the lecture. (National Park Service rangers intervened, the Proud Boys dispersed, and the lecture resumed.)

» READ MORE: What should we do with our anger right now?

Trump supporters feel under threat, too. Outside the Trump Store in a Bensalem strip mall — where shoppers have been flocking to purchase “Trump Train” banners and “Make Liberals Cry Again” T-shirts — many expressed optimism for his reelection. “Four more years! Buckle up,” one man said before getting into a pickup truck.

But they, too, see the election as a critical inflection point for the nation. “I think the Democrats are a bunch of idiots and I think if they get in it’s going to be socialized. It’s going to be communism, and I think it’s going to ruin this country," said a 64-year-old Montgomery County resident who would give his name only as Joe K.

Camille Heppard, 73, a retired sales clerk from Norristown who had picked up a tie-dyed Trump T-shirt, shared his anxiety. “My grandkids, I don’t want them growing up in a socialist country, and that’s what’s going to happen if Biden wins. These people are hateful — hateful of America.”

Impossible as it can seem in this moment, finding ways to work through it is crucial to our collective well-being.

Sofer’s recommendation: Reach out.

“The antidote to threat is social support,” she said. “It’s connection.”

» READ MORE: ‘I feel like I need to be there’: How Philly therapists are coping with longer hours and same stressors as their clients

Back at the Tilden Middle School ballot drop site, voters said they’re trying to do just that.

Charles Simmons, 43, of Colwyn, who was boisterously greeting voters at a table for the Working Families Party, said he’ll get through it by focusing on his three kids. “Me and my wife, we have just chosen to do the right thing by our kids and teach them what’s right and wrong, even though it seems like the whole world is going to pot.”

And Abby Vogel, 30, a teacher from South Philadelphia, pours her energy into engaging her students.

“It’s hard for them to feel optimistic, or feel like the country is theirs,” she said. “I talk to them about what they can do, and the power they do have.”

And four University of Pennsylvania students, all 21 years old, who arrived to cast their first presidential ballots in a rush of enthusiastic selfies, said they were texting their peers, encouraging them to make plans to vote. Among their top concerns is the crisis of climate change. The stakes are immeasurable, Shoshi Wintman said. “If Trump wins, there’s no turning back.”

Whatever the outcome of the election, people will have to move forward.

Baime, the mindfulness expert, suggested long walks in nature or close listening to music — focusing on observing your surroundings in the present without dwelling on what’s to come.

Even more important, he said, is to get out of your own head and listen to others.

“When people feel that they’re really heard, it creates connection, even when beliefs and politics are different,” Baime said. “I know that Donald Trump isn’t going to get up there and create bridges for our divides, and I don’t think Joe Biden is capable of doing it, either. I’m not sure it’s possible for it to happen from the top down. I think it has to happen starting from us.”