First pandemic. Then recession. Now, Russia invades Ukraine. Anything else, world?

Like many Americans, Marsha Delgado has endured two difficult years.

The 50-year-old watched vulnerable patients at her Santa Ana radiology clinic struggle to recover from lung damage caused by COVID-19. She has clashed with patients who would not wear face masks. And she has not attended a family gathering for months because some relatives refused to get tested for the virus while she was being treated for metastatic breast cancer.

As case rates began to fall, her stress finally started to ebb. Then Russia invaded Ukraine.

"I saw the ugly side of humanity in the last few years," Delgado said. "It’s extremely frustrating. We’re tired. The world is tired. We’re tired of fighting each other."

With COVID-19 cases falling and mask rules easing, life seemed like it might soon return to normal. That thread of hope was snapped late Wednesday, when Russian troops attacked Ukraine, sparking fears of a global conflict.

A war in Eastern Europe and a looming humanitarian crisis have triggered fresh waves of anxiety and depression for Americans who have spent two years trying to survive an unprecedented period of instability, including a public health crisis, a recession, political upheaval, supply chain problems and inflation.

Pain, sadness and confusion swept across social media Wednesday and Thursday, with people expressing shock and frustration at the unfolding crisis and mounting casualty count. Many said they felt powerless to help.

Some said they feared for the safety of loved ones stuck in Ukraine. Others wondered whether the conflict, 6,000 miles away from California, could reach the U.S. — then expressed guilt about those worries, as Ukrainians fled the country and took shelter in subway stations to avoid Russian airstrikes.

Others turned to dark humor as a coping mechanism.

"Just making potatoes while dread presses in from every direction," wrote John Green, the bestselling author of "The Fault in Our Stars," in the caption of a cooking video he posted to TikTok at lunchtime Thursday.

Imagine being an anti-depressant pill, said one Tweet. You were designed to adjust chemical imbalances in the brain, but now, you're being asked to "face off against a never ending pandemic, economic recessions, a spiraling political climate, and now World War III."

Lawrence Palinkas, a USC professor who studies mental health, noted that, "as individuals, we may be able to cope with any one of these events. Having to cope with all of them simultaneously is proving to be overwhelming for many people."

Coverage of the onslaught could be particularly difficult for U.S. residents who came to the country after fleeing conflicts in other countries, Palinkas said: "We have refugees from Syria, from east Africa, from Central America, even dating back to the Vietnam War, who are likely to re-experience the kinds of trauma that they endured prior to coming to the United States."

It is "more common than it's ever been" for clients to mention major news events like the pandemic and the conflict between Ukraine and Russia during sessions, said Jeff Guenther, a therapist in Portland, Ore., who runs a national therapist directory called Therapy Den.

"Everything that has happened in the last couple of years is bringing all our powerlessness to the forefront," Guenther said.

Guenther reassured his more than 800,000 followers on TikTok on Thursday that if they feel overwhelmed when "there's so much tragedy, so much despair, so much unfairness ... it's OK to have the very normal and healthy response to just be consistent in your daily routine." That could include exercising, seeking out comforting television shows or checking in with friends, he said.

Other people cope with stressful news events by trying to learn as much about them as possible, he said. Understanding what is happening can bring a sense of relief, he said, but it can also bring a sense of obsession, or a feeling of falling down the rabbit hole. He suggests thinking carefully about "how much you can take in."

"You won't ever get to the end of the internet or the end of Twitter," Guenther said. "We need to be incredibly aware and mindful of that."

Susana Sanchez, 51, of Santa Ana has not been the same since the pandemic began. Her husband lost his job as a restaurant cook, and she nearly died from pneumonia after falling ill with COVID-19. After so much fear and trauma, she said, she was depressed.

She began to feel better as new cases declined. Then she became aware of the situation in Ukraine. The fear of the unknown resurfaced. Her mind started to race. She spent most of Wednesday night on her phone in bed, checking for news updates. She woke up shaking Thursday, terrified of a world war.

During a regularly scheduled session that morning, her therapist told her: "You cannot stress out or fear over something you have no control of."

At Page Against the Machine, a bookstore in Long Beach, the shelves are stocked with titles about Black history, fascism and political history. When new chaos erupts in the world, owner Chris Giaco tries to stock relevant books.

At the window sit a few books on Afghanistan. After last spring's Israeli-Palestinian conflict, he highlighted "Freedom Is a Constant Struggle." On Thursday, as two customers roamed the narrow store, he thought of what he could add on Ukraine.

There was a time during pandemic shutdowns when people were able to take the time to envision how society could be better, including an improved job-life balance and shorter workweeks, Giaco said.

The sense of quiet didn’t last long enough, he said: "It just feels like a constant stew of chaos. We can’t get space to think about things."

For Russian President Vladimir Putin "to act with this aggression seems unwarranted, and an unacceptable reaction in trying to protect his sphere of influence," Giaco said. "It’s the civilian population who has to endure this. It’s not clear to me what the endgame is."

Giaco said he worries about a potential war breaking out. War, after all, has historically happened in times of destabilization. And coming out of a global pandemic, it’s certainly an unstable time.

Kitty Hall, 72, said that, like everyone else, she had been comforted by the idea that the pandemic might be nearing its end. Now she's watching gas and grocery prices rise. And she doesn't trust the Biden administration to deal with the crisis, she said.

"It's depressing," Hall said. "It's hard to find the words."

Will the U.S. send more troops abroad? Will the country be attacked? Will we see nuclear war? It's all upsetting and scary, she said.

"I let my emotions run," she said. "It's something a lot of us have never experienced, ever."

This story originally appeared in Los Angeles Times.