FORT LAUDERDALE, Fla. — Nearly five months pregnant, Vanessa is just beginning to show. But a time of excitement and celebration has instead become one of rage, sadness and anxiety for the 39-year-old from Miami, who fears her health care could be affected by the outcome of Florida’s abortion amendment and the presidential election.

“My life is literally in their hands, and that makes me so angry,” she said. “Because never has any other person’s life been in their hands like that, not at this level, when we’re talking about health care.”

Vanessa asked that her last name not be used as she has not announced her pregnancy.

As Election Day approaches, South Floridians are praying for their preferred outcome, struggling to eat and sleep, consumed with dread, and even fearful of violence. Regardless of their political persuasions, many feel more is on the line than ever before, including their health, livelihoods, safety and the future of democracy.

Their anxiety over the presidential election is compounded by the constitutional amendments over major issues such as the legalization of recreational marijuana and, in particular, abortion access.

Bethany Sharp says she prays more often as her stress level rises.

The Jupiter mother of two says she fears a world war could be in the nation’s future, depending on the outcome of the presidential election. On election night, she plans to go without sleep to watch the voting results, hoping for a Trump victory.

“I’m feeling anxious because people are voting a certain way because their feelings are hurt, or they don’t like the way people talk,” she said. “They have lost the idea that we are voting for a national leader who will be discussing foreign matters with other countries.”

Sharp says her anxiety is compounded by the election results being out of her control. “I’m truly trying to pray about it. I have a strong relationship with God, so I find peace at the end of the day.”

A new Stress in America survey by the American Psychological Association shows that Democrats and Republicans are equally stressed about the nation’s future as election day nears. Many Americans report escalating sentiments, including worry, frustration, fear, and skepticism. Although some feel hopeful, a majority believe the election could lead to violence and be the end of democracy.

Melanie, a 47-year-old Harris supporter who asked that her last name not be used out of fear of retaliation over her political beliefs, thinks that the country is on the brink of widespread violence or even a civil war, regardless of the election results.

“I firmly believe that there’s going to be violence after the election no matter who wins,” she said.

She lives in Key Largo, where nearly all of her neighbors are Trump supporters. She stifles her opinions in public, afraid that a Harris bumper sticker or lawn sign could incite someone’s anger. And she doesn’t see an end in sight to her worries.

“I do not feel that a break is coming,” she said. “I do not feel that I’m going to get to relax on November 6th. Certainly not November 6th. I’m not going to be able to relax until at least next year, on January 21st. And that’s only if the person I support wins.”

Divisiveness had been deepening before the election, and many fear the election itself will only serve to make it worse. Multiple people who spoke to the South Florida Sun Sentinel described alienation from neighbors, friends, and family members that began after 2016.

Michelle, a Broward County fitness instructor, said she has grown distant from Trump-supporting clients and feels her entire body tensing up with the election just days away.

“My anxiety level is elevated as I think about all the chaos, the firings that went on when Trump was president. I don’t think he is fit to run the country. But I can’t talk about it at work because some people support him and won’t talk to me.”

Many are scrolling social media feeds where divisive rhetoric is rampant. Melanie said that she has seen posts from Facebook friends about arming themselves or echoing Trump’s comments about the “enemy from within.”

The election anxiety has triggered her existing diagnosis of PTSD. Often nauseous, she struggles to eat, and has nightmares. She is currently reading “It Can’t Happen Here” by Sinclair Lewis, a 1935 dystopian novel about the rise of America’s first dictator, and dwelling on the prospect of fascism. To take breaks, she watches Netflix or takes her dog to the park.

“The thoughts, the thoughts in your head, they kind of go off on their own tangent and they bring about the anxiety,” Melanie said. “They cause the physical symptoms. But the thoughts can get overwhelming.”

Some voters feel disillusioned by both candidates, yet the anxiety persists.

Robert Gross, 31, of Lake Worth Beach says he has suffered from insomnia since he found out Trump was running again.

“My generation is concerned with the job market and housing costs,” he said. “We want to see leaders who address these issues. We can’t afford to rent, let alone buy a home.”

Gross said he doesn’t feel confident either candidate will help, but he’s apprehensive about Donald Trump. “I don’t think he is going to address those issues.”

JP Errico, a South Florida-based stress expert and inventor of stress-relief devices, said the emotions people struggle with can manifest physically and psychologically.

“Some people have a genuine feeling of lack of control over something they feel is going to have a major impact on their lives,” Errico says. “Anytime you lose control it is stressful.”

One Fort Lauderdale women’s book club member said at a recent meeting that the entire group described itself as having a collective nervous breakdown due to election stress.

Errico said anyone prone to anxiety or panic may see their condition exacerbated by the collective angst about the upcoming election. He recommends taking breaks to move and walk around.

“Don’t just sit there obsessing or arguing about the election,” he said.

For some, the angst stems from the fact that the election outcome could affect their livelihood.

“The real estate market is at a standstill,” said Ian VanSack, a West Palm Beach real estate agent. “There’s just a lot of trepidation about the future.”

VanSack said although he is a member of the LGBTQ community, his overarching concern is the nation’s security, which is why he supports Trump and fears what will happen if he doesn’t win.

“If we don’t secure our country, we won’t have a country to have equal rights,” he said. “So, to me, that is paramount. I feel that this is the first election of my life where I feel like it is impacting my basic sense of safety and security.”

On election night, VanSack said he’s going to say a prayer before he goes to bed.

Amendment 4

For some Florida residents, election stress is exacerbated by the fact that an abortion access amendment is on the statewide ballot. The amendment will need 60% approval from voters to pass, and polling shows the outcome could be a close call.

“Ever since I’ve been able to vote, I’ve voted in every single general election,” said Daniel Montenegro of Pembroke Pines. “Primaries as well. But I think this is the first election where it became extremely personal.”

Montenegro, whose wife’s pregnancy ended suddenly in a fatal fetal abnormality, has personally felt the effects of the overturning of Roe v. Wade, which opened the door to Florida’s abortion restrictions.

At a 20-week checkup in March, a doctor had told the couple that the baby had multicystic kidney disease, meaning its vital organs were not forming. Its chances of survival at birth were a fraction of a percent — practically zero. But instead of figuring out a plan to safely end the pregnancy, the doctor told them they would probably have to go out of state because of Florida’s laws.

“Imagine you’re dealing with easily the worst moment of everyone’s life,” Montenegro said. “Now you’ve got to figure out what, legally, are your avenues here.”

They started looking at flights when a family member who happens to be an OB-GYN connected them with someone willing to do the procedure in northern Florida. They packed everything and drove five-and-a-half hours north.

Now, Montenegro fears Amendment 4 might not meet the 60% vote threshold. He struggles when talking to family members who support what he and his wife had to do, but do not plan to vote yes on the amendment.

“It’s kind of like, at this point, having a wound,” Montenegro said. “Whenever that wound is pressed on, the hurt goes deep. Having conversations with family members not fully on board on Amendment 4 pushes down on the wound a bit more.”

Sharp, the mother of two daughters, feels anxious about the proposed amendment because she wants to see it defeated.

“It would give minors the right to medical procedures without parental consent, and that causes me a lot of angst,” she said. “I am truly trying to pray about it.”

Meanwhile, Vanessa is plagued by thoughts about abortion access and what she perceives, more broadly, as a new wave of sexism — a sense that the election is not just about right versus left, but about “misogynists versus non-misogynists.”

Vanessa, who is Cuban America, has distanced herself from her conservative Republican family members in Miami and doesn’t engage in political arguments in real life.

But scrolling the internet “has gotten progressively harder,” she said. She often finds herself reading articles and posts about women suffering under abortion bans. Her pregnancy hormones have made her emotions even stronger.

“There have been some times I’ve seen some rhetoric regarding this,” Vanessa said, “and I’ve just straight up cried.”

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