July 27, 2022 1:48 PM EDT

Americans’ mental health tanked during the first year of the pandemic. More than 36% of U.S. adults experienced symptoms of anxiety or depression in August 2020, according to the U.S. Centers for Disease Control and Prevention. By January 2021, the number was above 40%.

It’s not hard to see why. A novel and scary virus was spreading without vaccines to slow it. Cities and states were in various degrees of lockdown for much of 2020, with many people forgoing special occasions and visits with friends and family. Isolation and fear were widespread, and people had every reason to feel acutely stressed.

But even as lockdowns lifted, people got vaccinated, and life resumed more of its normal rhythms, many people continued to feel…off. In an American Psychological Association survey published in October 2021, 75% of people said they’d recently experienced consequences of stress, including headaches, sleep issues, fatigue, and feeling overwhelmed.

Now, more than two years into the pandemic, many people still haven’t bounced back. One reason could be “ambient stress”—or “stress that’s running in the background, below the level of consciousness,” says New York-based clinical psychologist Laurie Ferguson, who is director of education development at the Global Healthy Living Foundation, a nonprofit that supports people with chronic illnesses.

“There’s something amiss, but we’re not registering it all the time,” Ferguson says. “We’re always just a little bit off balance. We kind of function at a level like everything’s fine and things are normal, when in fact, they’re not.”

In a 1983 article published in the journal Environment and Behavior, researcher Joan Campbell described ambient stressors as those that are chronic and negative, cannot be substantively changed by an individual, usually do not cause immediate threats to life (but can be damaging over time), and are perceptible but often unnoticed. “Over the long run,” Campbell wrote, these stressors could affect “motivation, emotions, attention, [physical] health, and behavior.”

Campbell cited examples like pollution and traffic noise, but it’s also an apt description of this stage of the pandemic. In March 2020, the pandemic was an in-your-face stressor—one that, at least for many people, felt urgent and all-consuming. Two years later, most people have adapted, to some degree. Most people are vaccinated, the news isn’t broadcasting the latest case counts 24/7, and life looks closer to 2019 than 2020. But, whether we’re conscious of it or not, we’re still bearing the psychic toll of two years of death, disease, upheaval, and uncertainty, as well as smaller disruptions like changes to our social or work lives, Ferguson says.

Even ambient stress can have health consequences, as Campbell pointed out. Humans evolved to deal with short-term stressors, but we’re not as good at coping with chronic stress, explains Laura Grafe, an assistant professor of psychology at Bryn Mawr College. Chronic stress has been linked to conditions including high blood pressure, diabetes, sleep issues, and mental health and cognitive disorders.

Constant stress can also compound the effects of other stressors. “Everything else just seems worse with the chronic stress of the pandemic going on in the background,” Grafe says.

Ambient stress doesn’t have to zap all the joy from your life, though. In a 2021 study, Grafe and her co-authors examined how pandemic stress and coping strategies affected sleep. Her team found that a person’s sleep quality wasn’t necessarily dictated by their overall level of pandemic-related stress, but rather by how well they coped with that stress. That suggests stress, itself, isn’t necessarily the problem—it’s unmanaged stress.

When stress becomes so routine that we stop acknowledging it, we’re less likely to manage it effectively. As Cambell wrote in 1983, “coping is most likely to occur when the stressor is still novel.” Halfway through 2022, many people have abandoned soothing hobbies like bread-baking, yoga, and knitting that they adopted in spring 2020.

That’s why it’s important to develop sustainable coping strategies, says Niccole Nelson, a postdoctoral research associate in the University of Notre Dame’s psychology department who has also studied pandemic stress. “There’s no single coping strategy that is inherently good or bad,” Nelson says, but it’s often helpful to mentally reframe a stressor as less threatening. That’s difficult to do with something as serious as the pandemic, but Nelson suggests trying it on a smaller scale: finding ways to appreciate the positive aspects of working from home, for example. (Grafe suggests mindfulness exercises and cognitive behavioral therapy to cope with stress.)

Giving your brain new stimuli can also help during a prolonged period of stress, Ferguson says. Even small changes, like eating something new for breakfast or taking a different route for your daily walk, can introduce some healthy novelty. Physical activity is also a tried-and-true stress reduction tactic, she adds.

Simply noticing and naming your ambient stress can also go a long way, Ferguson says. “Even people who have gone ‘back to normal’ still have that ambient stress running, and they may not realize they’re a little more short-tempered, or they’re a little less hopeful,” she says. “It’s subtle, in many ways, and harder to notice” than full-blown pandemic stress, but just as important to manage.

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Write to Jamie Ducharme at jamie.ducharme@time.com.

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