During the springtime of 2017, I told a good friend that I was worried about almost everyone we knew. Anyone politically left of center seemed to be anxious, depressed, addicted to everything bad, and looking forward to nothing.

“It’s Trump,” my friend said, downing his third Bloody Mary before lunchtime. “We’re all falling apart.”

We weren’t alone. The first Trump administration caused deep mental distress among liberals, leftists, and many apolitical people with a strong sense of human decency. The problem was sometimes derisively called “Trump derangement syndrome,” but it was real. The American Psychological Association found that the outcome of the 2016 election caused a dramatic spike in American stress levels. Shrinks reported an increase in patients severely distressed over politics; at the time, I remember one therapist telling me that some days, his patients talked about nothing else. That psychic stress took a physical toll, with an increase in stress-related ailments from headaches to cardiac arrhythmias. Calls to suicide hotlines went up.

This time around, there’s plenty to worry about as we gear up for Trump 2.0: mass deportations, increased political violence, policies that will exacerbate disasters worsened by climate change like the fires now consuming Los Angeles. Nightmares will turn real. Then there are the dangers that have never kept us up at night because we didn’t have enough imagination to fear them, like a war over Greenland. And then as now, many will worry about their own safety and financial future; economic inequality is already catastrophic and will only worsen under Trump.

Then as now, Trump’s presidency is a danger to our mental health because he is alienating and divisive, his far-right policies cause us anxiety, and he is a master of staying in the news. For anyone who has ever been victimized by a bully or a narcissistic man, Trump is almost unbearably evocative.

As he returns to the Oval Office, we must find some way to keep from going mad.

Much said about “self-care” is eye-rolly, but some of it is true. Now more than usual, it is a good idea to get exercise, cut down on alcohol, get outdoors every day, limit time on the internet, and get a good night’s sleep. Personally, I try to avoid consuming the news after dinner, read novels before bedtime instead of consuming more content blaring political doom (a habit I began in mid-2017 as a direct response to feelings of Trump overwhelm), and walk in the sunshine every possible day. Some of us should probably go to therapy, do fewer drugs or more (depending), make changes in our diet, acquire a pet, and spend more or less time with our families (again, depending).

But it’s not enough to manage ourselves. The worst thing we can do right now is to retreat into private life.

Social isolation is reaching alarming levels these days. Extensive data shows Americans spending far more time alone and far less time with friends and communities. “The Anti-Social Century,” a powerful and lengthy article in this month’s Atlantic, showed the depth of the problem through sobering statistics. Men who watch television spend seven hours in front of the TV for every hour they spend hanging out with somebody outside their home, while a female pet owner spends more time actively engaged with her pet than in face-to-face contact with human friends.

This isolation is harming our mental health, even when it feels like a choice. What’s equally bad is that it’s harming our society, making us more inwardly focused, eroding our empathy and solidarity, and making us more likely to vote for someone like Donald Trump.

We need to break out of this. The solutions are basic but essential: Have people over. Start a pickup basketball game. And we can take it up a notch: build more resilient and nurturing communities and start or participate in neighborhood food co-ops, community fridges, block associations, churches, Little League teams, and beach cleanups. This may sound silly as political advice, but this is the stuff communities are made of.

Community is vital to our psychic survival, but we also need to organize and fight the political horrors coming our way. The best way to address political distress is to find effective and collective ways to fight our enemies and make things better. Comradeship and feeling as if one is helping to repair the world are among the best forms of solace, the only real antidotes to despair. I’m active in my union and in Democratic Socialists of America. I will likely dial up these commitments in the Trump administration. I recommend that we all do so. That recommendation is shared by most psychologists: we must counter these feelings of powerlessness, and for that, solidarity and action are the best medicine.

We also need to stay focused on the wins, which can come unexpectedly. In the weeks leading up to the inauguration, amid devastating reminders of our failures and losses, we still had some victories, partial though they were. Joe Biden, in response to an organized campaign, removed Cuba’s designation as a terrorist state. There is a cease-fire in Gaza. New York City has congestion pricing. All of these advances have huge caveats attached, of course. But being open to the unanticipated ways we might win is politically smart — and essential to our sanity.

America needs help — and so do we. We’ll get through this, but only together.