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Over the last two months, the focal point of the emotional pain has shifted, she says. Initially, the spike in traffic was over anxiety about the virus itself. That shifted to complaints of isolation.

Knox’s home flooded years ago, and he says that flood anxiety never goes away. ”That’s why we ever since then, we’ve been cautious,” added Knox.

People are calling crisis hotlines in greater numbers, complaining of more complex struggles. What these lines are seeing offers a window into the emotional struggles Americans face.