Last week, after days of going back and forth over whether to watch the first presidential campaign debate, I sat before the TV at the appointed time and turned to a favorite channel.

And found myself shaking.

So much hinges on this election -- how our nation will handle the war in Iraq, how we'll confront pressing domestic issues, how we'll be regarded, and dealt with, by a complex world -- that my decades-old symptom of tension had kicked in.

I'm not the only one shaking. In recent weeks, I've spoken with numerous people who can't bear to watch the debates or sleep on the nights preceding them. Some are boycotting all TV news and political ads; others signed up as poll monitors in distant cities to avoid the mental torture of watching Election Day coverage.

Few of us can recall a political contest so vital -- or one about which we have felt so anxious. "I'm stressed about it," admits Jayne Lytel, a writer whose husband, David, created the "ReDefeat Bush" campaign bumper stickers that can be seen throughout the area.

Unlike her husband, Lytel is no activist. Before meeting him in 1993, she wasn't even a registered voter. Yet the busy mom of two kids, ages 5 and 7, admits that she worries that "something bad's going to happen -- before the election or after." What if votes don't get counted? It will be like deja vu."

My friend Katy Menges is a homemaker, volunteer and staunch Republican in Dallas who feels "anxiety" over the election. Recently, Menges was reading the newspaper outside her daughter's ballet class when she overheard a pair of moms tearing into the candidates.

"These women weren't angry -- they were vicious," Menges, 46, recalls. "We've become so political that it's as if no one respects the office of the presidency." Burying herself in her newspaper, Menges fumed. Whoever wins, "I worry that we won't get that respect back for a long time."

Citizens behaving like near-neurotics over an election could use a good therapist. Mary Pipher, a clinical psychologist and the best-selling author of "Reviving Ophelia," would seem to qualify.

But when it comes to election anxiety, Pipher's situation might be one of "Physician, heal thyself."

Pipher, of Lincoln, Neb., keeps finding herself in e-mail conversations with people who've considered avoiding the debates because "our stomachs hurt when we're watching," she says.

This week, Pipher's husband, Jim -- whose mother and a close friend are facing serious medical problems -- asked whether it was "weird" that he woke up feeling less worried about them than about Democrat John Edwards's debate performance the night before.

Hardly, she told him. "He was thinking about the world our grandchildren and everyone we know will live in," she says.

I learned about Pipher through a funny, biting and, in some ways, deadly serious piece in the September issue of Psychotherapy Networker magazine, titled "An Assessment Report on Mr. USA."

In it, she discusses the nation as if it were a therapy patient.

Born on July 4, 1776, Mr. USA, the article begins, is seeking help because of "an assault on September 11, 2001, that caused him great physical harm and mental anguish . . . [and] re-opened scars from earlier traumas in his life, such as Pearl Harbor [and] Vietnam."

Although 9/11 had forced him to confront his mental health issues, the piece continues, it was clear before the tragedy that Mr. USA had become "increasingly overwhelmed and lonely," and suffered from "multiple addictions -- caffeine, sugar, alcohol, drugs, nicotine, shopping, gambling" and TV. His finances? "A mess."

No wonder the election seems troublesome. Republicans and Democrats worry about its high stakes and their candidate being misperceived, Pipher says. It concerns her that half the electorate feels a "very mutual" contempt for the other half, and that healthy discourse has been replaced by partisan talk radio, politicians' "demeaning" personal attacks and scare tactics.

Pipher knows discourse. The woman who says, "I really don't believe that Bush's positions are equally tenable to Kerry's, and I can argue why," is the mother of a Republican, evangelical Christian minister who she says sees Bush as "the best possible person to lead the world." For years, she and her son rarely discussed politics.

But recently, Pipher decided that families "respect each other enough to talk about these things." Hers learned that its members agree on the kind of world they want -- just not on how to get it. She had to smile when her daughter-in-law told her, "If I read everything you read for a year, and you read everything I read, we'd probably both have very different opinions."

Of course, Pipher's diagnosis for Mr. USA could apply to many of us. The therapist writes that the client should "accept his mistakes, blind spots and dark side," reconnect with his history, detoxify from too much TV and focus more on hope, reconciliation and cooperation.

"I'm a fairly ordinary person," Pipher says. Like everyone, "I [sometimes] alternate between anxiety and despair, and search for energy to deal with both."

The best antidote to such feelings? Get busy.

Although Pipher writes her way out of worry, election-anxious non-writers can put up a yard sign, work for a candidate or train to be a poll monitor. Cynics who opt out -- saying, "All politicians lie" -- take the easy way out, she says.

It's much harder to be an idealist, "truly caring about the world -- and doing something," Pipher says. "Idealists," whether they're Democrats or Republicans, she says, "are the ones anxious about this election.

"Because it does matter. And we know it."