The Country on the Couch
The quiet mental health crisis reshaping red and blue America alike.
As more than half of Americans are navigating a perfect storm of political unrest, economic uncertainty, attacks on basic rights, and the erosion of core democratic structures, the therapeutic relationship between clinicians and their clients has become both a mirror and a buffer for societal change.
Mental health professionals are on the frontlines of a different kind of epidemic—one that’s rooted in fear, instability, and the trauma of witnessing democracy under siege. Pervasive turmoil and instability has led many to seek out therapy not just for personal issues, but to process collective trauma.
Kate Weis knows this first-hand from the data she works with. A trauma-informed leadership coaching client of mine, Kate is Vice President of RevKey, a digital marketing agency for the mental health industry. We recently sat down together to discuss some interesting trends.
“Ninety percent of the companies we serve are mental health practices. We’re seeing two things happening—a significant increase in clients’ anxiety and many clients becoming more cost-conscious, as it relates to private-pay practices versus those that accept insurance”
This isn’t just anecdotal. Many therapists across the country are reporting that their clients are overwhelmed—not only by personal stressors, but by the state of the nation. It’s no longer rare to hear the words “politics,” “election,” or “freedom” come up in a first session. For practitioners, it creates a dual burden: managing their own fears while supporting clients through theirs.
Red State, Blue State, Anxious State
According to RevKey’s ad data and research, blue states use the word “therapy” more often while red states tend to use the word “counseling” in their targeted keywords with greater success. In fact, according to Google Ads Keyword Planner, when extracted from total search numbers for therapy and counseling, the search for “therapy in blue states is 60.49%, compared to 56.76% in red states. It’s important to note that blue cities (i.e. Austin, Houston, etc.) in red states pull up the number that are showing for therapy in those red states. Read: The 4% does not quite encapsulate the difference RevKey sees as this is much more of a county level verses state issue.
Weis has some thoughts: “On a deeper level, the use of the word ‘therapy’ may come with the acceptance of mental health as part of overall well-being. Counseling may be seen as dealing with more surface-level issues or or as something more aligned with religious or community-based guidance, rather than a clinical or medical approach. The language reflects deeper cultural values around vulnerability and help-seeking.”
Since the presidential inauguration, cognitive behavioral therapy (CBT) practices in blue states experienced a severe uptick in clients reporting higher levels of election anxiety, generalized worry, and sociopolitical overwhelm. In red states, however, search remained status quo likely because those who voted for the current administration were expecting many changes to occur.
What’s Changing in Real-Time?
What those same voters weren’t expecting was how these changes would impact them directly. By and large, they simply believed that what they were promised would have a positive impact on them and their families.
Now, many have realized that they’re not immune to DOGE cuts, the loss of funds from Social Security, as well as Medicaid and Medicare benefits and more—not to mention the significant decline they’ve already seen in any market investments. And, depending on age and retirement status, that could drastically impact quality of life.
Between the fundamental shifts in democracy in the US, backsliding of basic human rights, trade tariffs, illegal deportation of US citizens, and the financial situation we’re all facing, it takes a toll on mental health—regardless of where you live or for whom you voted.
The ripple effects of these policies are beginning to break down the traditional lines of political affiliation when it comes to stress and dissatisfaction. Mental health is emerging as one of the few areas where bipartisan pain is palpable—and growing. As a result, therapists are now doing more work that resembles crisis response than traditional long-term development.
And, because people are flocking to practices that take insurance, most private-pay practices find themselves in need of marketing, some for the first time. The reality is that we don’t know how the current administration could impact the mental health care that is available—in the same way that we couldn’t fathom how women’s healthcare and gender-affirming care would be as severely impacted as it has been since Inauguration Day.
The Power in Confronting Discomfort
If there’s a silver lining, it’s that more people are reaching out for help—and that, perhaps, is the first step toward resilience. Seems fitting to talk about as Mental Health Awareness Month comes to an end.
What we’re seeing isn’t just a spike in anxiety—it’s a collective reckoning. For many Americans, the therapy session has become the one place where it's safe to say out loud: I’m scared about where our country is going. Therapists are no longer just addressing childhood wounds or relationship struggles—they’re navigating existential dread, fears about authoritarianism, and the emotional fallout of policies that feel deeply personal.
In the past, political stress might have been a background hum. Today, it’s the loudest noise in the room. The mental health field is being stretched in new ways, forced to evolve alongside the crises shaping the national psyche. Therapists are acting as anchors in a time when many feel unmoored—helping people find agency in the face of powerlessness, and coherence amid the chaos.
If there’s any hope in this moment, it’s this: more people are naming what they feel. They're not bottling it up, or pretending it's all fine. They're asking for support. And perhaps that willingness to confront discomfort—honestly, collectively, and out loud—is the first step not just toward personal healing, but toward rebuilding something stronger.
