Rolling Stone, May 16, 2019
By Andrea Marks
When San Francisco broke heat records in 2017, with 106-degree temperatures in September, psychiatrist Robin Cooper didn’t hear until after the fact that one of her patients had been feeling dizzy and feverish. One day, he’d fainted in his poorly ventilated workspace. Emergency room doctors had surmised he’d had a virus. But Cooper warned him it could actually be a drug she’d prescribed him interacting with the extreme heat. Certain antipsychotic medications, often used in treating schizophrenia and bipolar disorder, can impair the body’s ability to cool itself. This is one reason hospitalization rates among schizophrenic patients can spike with the temperature. “I told him, you need to know these medications put you at risk during heat waves,” Cooper says. “He now is armed with that knowledge the next time around.”
With temperatures rising globally, there will be increasingly frequent “next times.” The potential danger of heat-drug interactions is just one reason concern is growing about the impact of climate change on mental health. The fourth federally mandated National Climate Assessment, released in late 2018, lists mental health consequences and stress among the outcomes driven by increased temperatures, extreme weather and sea-level rise. “The last two years, the conversation has shifted toward climate change,” says Reggie Ferreira, editor of the journal Traumatology and director of Tulane University’s Disaster Resilience Leadership Academy. “We see disaster causing trauma, but climate change is intensifying the disaster. We need to focus on what’s intensifying these disasters and get people prepared.”
Mental health professionals have begun to mobilize against the threat. The American Psychiatric Association (APA) has a half-dozen climate change–related sessions planned for its 2019 annual meeting. The programming is thanks to the efforts of experts like Cooper, an assistant psychiatry professor at University of California, San Francisco, and her colleagues, who organized the Climate Psychiatry Alliance (CPA) in 2017. “We’re all from different areas of psychiatry, but we’re all focused on what can we do to address this,” says community psychiatrist David Pollack, a CPA founding member and professor emeritus for public policy at Oregon Health and Science University. “As we’re talking about planning for the future in mental health issues, we have to be thinking about climate change.”
The mental health impact of climate change is a one-two punch: There will be increasing anxiety about the future, as well as an increasing number of people undergoing the trauma of climate catastrophes like flooding and hurricanes. As predictions become more dire — in October, the UN’s Intergovernmental Panel on Climate Change set a 12-year deadline for us to avoid warming the planet a disastrous 1.5 degrees Celsius above pre-industrial levels, and just last week the UN reported a million species are now at risk of extinction — more and more people are facing existential distress. In his new book The Uninhabitable Earth, David Wallace-Wells notes that climate anxiety has also been called “climate grief” and “climate depression.” “While it may seem intuitive that those contemplating the end of the world find themselves despairing, especially when their calls of alarm have gone almost entirely unheeded, it is also a harrowing forecast of what is in store for the rest of the world, as the devastation of climate change slowly reveals itself,” he writes.
Climate anxiety is a relatively recent phenomenon, but the concern is spreading. A Yale survey in December found nearly 70 percent of Americans are “worried” about climate change, 29 percent are “very worried” — up eight percentage points from just six months earlier — and 51 percent said they felt “helpless.” “Historians will say that groups of people have faced very difficult, tumultuous times,” says CPA’s Janet Lewis, who has a private practice near Ithaca, New York. “But human beings have never faced this before.”
The Good Grief Network, a nonprofit for collective mourning, in 2016 launched a 10-step program focused on eco-anxiety and climate grief. In March, a group of “birthstrikers” in the UK announced they wouldn’t have children out of concern for the livability of the planet where they’d be raising them. Cooper’s patients are fearing for the safety of children they’ve already had. “One person wanted to flee and go somewhere, but the reality is, there really is no place that’s a respite from what is happening,” she says.
Perhaps the most striking challenge about mitigating people’s climate anxiety is that the fear is real. “Most of the time when we’re treating anxiety, we’re treating people who have unrealistic levels of anxiety,” Lewis says. “We’re all in the same boat with this.” She and Cooper say it’s particularly important to validate their patients’ feelings in these cases, and, as psychotherapists, to come to terms with the reality of climate change themselves. “There’s a shared sense of ‘We’re in this together,’” Cooper says. “There’s a deep sadness.”
According to Lewis, helping people cope with climate anxiety will mean encouraging them to grieve for losses — of ecosystems, of missed chances for society to change course — and acknowledging with them that we’re entering a turbulent time. “We’re headed into something new, so we have to kind of parent ourselves in the process and be a bit generous with ourselves,” she says. “We don’t come to terms with difficult info all at once.”
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