Extreme Weather Events
The global rise in temperature is driving local spikes of searing heat waves and increasing the frequency and intensity of storms, wildfires, and floods. In the last two decades, extreme weather
has wounded, displaced or required emergency assistance for four billion people; half a million have died (United Nations Office for Disaster Risk Reduction,
2015).
Extreme weather events drive emotional turmoil in every phase. Anticipatory fear is experienced in the early stages, followed by the trauma of the event itself, then sorrow and grief at the losses. Feelings of outrage may emerge—slowing down the working through—when it is believed that government and institutions are not providing enough help or didn’t undertake preventive measures. Despair and feelings of helplessness deepen as reports surface that conditions will get worse.
Those in disaster
-prone areas are the most affected. Anticipatory anxiety
sometimes rises to the level of “pre-traumatic stress disorder” among those who fear that another disaster may be just around the corner. In anecdotal reports, residents of New Orleans report, for example, that sometimes just seeing a storm cloud triggers deep anxiety (Hauser,
2015; Reckdahl,
2017). Communities under stress can fray and decompensate—increasing violence and other psychosocial ills. Mental health professionals
are seeing a full range of psychiatric disorders and conditions emerge as a result of these stressors: major depression
, anxiety
, PTSD, adjustment disorders, a rise in drug and alcohol abuse as people attempt to cope, and domestic violence—including child abuse (American Psychiatric Association [APA],
2017; World Health Organization,
2005). In addition, the more destructive the event, the higher the incidence of PTSD and the greater the risk of suicide (Edwards & Wiseman,
2011).
How we “carry on” is influenced by our background, current mental state, personality, and life experiences. The nature of the event plays a role: the intensity of the feeling of powerlessness, the “merciless” character of incidents, the pace, suddenness, degree of damage, loss of life and injury and the extent to which people personalize these incidents will be factors influencing the extent of emotional injury. Though studies quantifying it are limited, human empathy tells us of the emotional toll: When the place you call home is burned down by wildfires, blown away by tornados, flooded or overrun by hurricanes, when you lose your possessions, maybe your pets, your livelihood, the comfort of a familiar community, and witness the injuries, illnesses, and deaths, the resulting mix of fear, anger, sorrow, and trauma
can easily send a person to a breaking point. Stress drives up the secretion of cortisol; high levels of this hormone are not damaging when they are short-lived, but
persistently elevated levels can be exceedingly damaging. Immune function can be compromised, sleep patterns disturbed, digestion disrupted, memory impaired, and the cardiovascular system harmed—all with an attendant emotional toll (Shaw et al.,
2019). Everyday life is full of burdens and anxieties; confronted by the additional stress of the climate crisis, some individuals will decompensate.
Exposed to repeated or ongoing disasters, victims may not have a chance to recover emotionally before the next disaster hits, compounding the harm because each incident deepens emotional vulnerability. Victims also contend often with the realization that “no lessons have been learned”. The healing process is helped along when we can look back, identify where we went wrong and take action to legitimately say we are doing all that we can to prevent further injury. But on the contrary, even as the dangers continue to unspool at an ever-higher rate, the extraction and use of fossil fuels continues, with recent US government policies promoting their use—exacerbating the mounting psychological toll.
Various phases of disasters
have been studied, along with many common emotional responses to them (SAMHSA Phases of Disaster,
2018). Based on the clinical experience of the first author with victims of trauma, including of natural disasters, many emotional stressors have not yet been measured but warrant being pointed out. In an initial phase, vows to rebuild and faith in outside support do help in the first steps towards emotional recovery, but fears of “next time” often plague survivors. Wrenching, conflicting feelings about remaining in the vulnerable area, financial strain, and friction from different coping styles may erode family stability. Lingering feelings of helplessness, despair, and foreboding make restoring a sense of security more challenging. Emotionally charged triggers can reawaken traumatic memories—in the case of wildfires
, by the simple smell of smoke, the sound of sirens, the once-pleasant crackling of an ordinary fire. Acute displacement may become permanent—rupturing the comfort and stabilizing effect of familiar relationships, places, and daily routines. Some scars may be buried or disguised—expressed in ways that make them not only hard to “count” but worse, harder to confront and work through. The stress on individuals and communities is compounded by mental health systems that are underprepared to deal with the trauma
.
The far-reaching psychological impacts of violent storms saw their prototype in Hurricane Katrina in 2005, now “updated” by other storms, in particular the devastating Hurricane Maria that leveled Puerto Rico in 2018. Grief
, anxiety
, violence, outbursts of outrage, and blame at the government’s slow response are among the acute emotional stressors of many victims. Many report feeling that the government “doesn’t care” about them (Morin & Rein,
2005).
A flood-ravaged home brings a particular type of anguish. Based on experience, violently being run out of one’s refuge from the outside world underscores the fear that no place is safe. Seeing belongings a soggy ruin, often turning black and moldy as they undergo the slow but inexorable process of rotting, brings unconscious associations to dying and death. The sense of powerlessness over “nature unleashed” can weigh heavily on victims.
The widespread presence of mold in homes and other buildings is common in the aftermath of floods; the physical symptoms associated with exposure to mold are well documented (Potera,
2007). Exposure to mold is also linked to psychiatric disorders, especially depression
, and reduced cognitive functioning (Shenassa, Daskalakis, Liebhaber, Braubach, & Brown,
2007). Other impacts include anxiety
, irritability, and fatigue (Hope,
2013). Toxic mold-induced mental illness
and cognitive decline are rarely correctly diagnosed or treated.
Research confirms the association between the chronic stress of climate disaster emotional trauma
and cardiovascular health (Peters et al.,
2014). Residents of New Orleans suffered heart attacks at a rate three times higher than the rate reported before the storm (Peters et al.,
2014). The absence of social support when communities are torn apart is one of the strongest predictors of posttraumatic stress (Brewin, Andrews, & Valentine,
2000; Ozer, Best, Lipsey, & Weiss,
2003).
Summer Heat Waves
As global temperatures rise, the incidence of extreme heat waves
is increasing. Nearly one-third of the world’s population is now exposed to deadly heat waves (Mora, Counsell, Bielecki, & Louis,
2017). In the last decade, with less than 1% increase in warming, the loss of human life has risen 2300% (Mora, Counsell, Bielecki, & Louis,
2017). Significant psychological stress is also associated with heat waves. With rising temperatures comes rising rates of aggression (Bulbena, Sperry, & Cunillera,
2006; Raj,
2014). It is linked to increased catecholamine release in response to the stress of the heat (Al-Hadramy & Ali,
1989). For each standard deviation of increased temperature or more extreme rainfall, studies show a 4% increase in conflict between individuals, and a 14% increase in conflict between groups (Hsiang et al.,
2013). These findings are valid across all regions and among all ethnic groups. Increased acts of aggression include assaults, murders, and suicides, especially violent suicides. As temperatures continue to rise, a global increase in unrest should be anticipated.
Temperatures
modestly above the human comfort zone are associated with a decline in cognitive functioning: slowed response time, diminished accuracy, and less sophisticated patterns of decision-making. Declining cognitive function could become increasingly problematic for those unable to escape the heat (Goodman, Hurwitz, Park, & Smith,
2018). The mental health
toll from heat waves is hard to measure. Like blizzards and storms, the disruptions of heat waves range from irritating inconveniences to profoundly stressful losses. Declining business and productivity—which drops at high temperatures—are consequences of extreme heat (Somanathan, Somanathan, Sudarshan, & Tewari,
2018). Those who must work outdoors or where AC is not available may not be able to work at all. With little financial cushion, it may not be possible to pay bills or even buy food. The emotional toll on families and the communities they live in can be horrendous. With the persistent high temperatures and the ever-expanding desert that they create, scientists predict that the Middle East may well become uninhabitable by the end of the century (Funkhouser,
2016).
Particularly vulnerable are the poor, the elderly, the sick, and the very young. Individuals with preexisting mental disorders are also especially susceptible. During hotter-than-average periods, they appear to get sicker than expected, show greater aggressiveness towards others, and require more frequent use of restraints (Bulbena et al.,
2006). The good judgment to stay cool and hydrated may be compromised; some individuals in this population live outdoors and lack access to air conditioning. Many take medication (psychotropics) that impede the ability to perspire—the body’s chief means of reducing internal temperature.
Summary of Psychosocial Impacts
“Not everything that counts can be counted…” (William Bruce Cameron).Personal anecdotal clinical expertise suggests that it is the inchoate, insidious, complex, and unconscious psychological states driven by climate trauma—not lending themselves to studies and precise numbers—that can be the most profoundly damaging and drive systemic emotional conditions that society will find difficult to treat and surmount. Just as the functioning of families breaks down in the face of a chaotic home environment, in the face of the turbulence from declining national security, without trust that our institutions can protect us, the fabric of society can break down. The waves of injury from climate trauma and frustration from inaction are reverberating across our communities, the workplace, and our families, cumulatively taking a toll on the national mood. Repercussions from a stressed-out national mood drive our economy, our politics, and our relations with other countries. It shapes our culture and increasingly affects how we treat each other. How will we deal with a growing state of fear from diminished productivity, conflict between haves and have-nots, callousness, and numbness in our response to suffering—“compassion fatigue”—an alienated citizenry, distrust of each other?
We can be anxious and not know why, and we can be anxious and not know it. Sometimes anxiety is manifested as anger or another emotion or state that doesn’t even suggest the root cause. We can be anxious and give it the wrong name—often if the real source is especially unsettling. We don’t always recognize the psychological toll anxiety is having on us. Much of the violence in the world can be explained by unaddressed anxiety emanating from fears of impotence and vulnerability. Climate change evokes a profound sense of both. Whether we know it or not, whether we like it or not, whether we accept it or not, we believe the climate crisis is causing varying degrees of anxiety among most of the population.
Special Message to Mental Health Professionals: Recommendations and a Call to Action
Trying to avoid thinking about climate-related issues, or other conditions that cause anxiety, is an attempt to try to control our fears, but fear and avoidance are at the root of denial and inaction.
Years of experience have shown mental health professionals how to move people beyond this state, replacing resistance with the empowering realization that the solution is to take action. As mental health professionals we know the power of words—we know how to break down defenses, put together messages that help people finally begin to understand. We get science, we get suffering, we get urgency, we get lifelong consequences. We see the value of hope, we know how to engender it even in dark times. We are good at encouraging people to grow, to be conscious of the needs of others.
As we consider where the public needs to be on climate change and what we have to offer, we can see that we have largely failed to realize the power of our expertise.
It no longer makes sense, because of the challenges presented by the climate crisis and the unique skills we have, to confine our professional lives only to traditional roles and services in our offices, academic settings and clinics. We need activism now to initiate services in this time of urgency—helping people out of their denial, tending to their wounds, working to create resilience. Just as we have qualifications in other specialties—we need “Climate Mental Health Specialists” (CMHSs), who are specifically trained to offer “trauma informed care” for the many levels and kinds of distress generated by climate instability— both direct and indirect, addressing the plight of refugees and the needs of newly blended populations, helping to organize communities and collaborating with primary care and public health experts, fanning out into settings to educate and advocate.
More research is needed to identify best practices, determining societal and infrastructural resources that are truly helpful, and building upon this evidence base to train the next generation of CMHSs.
Our efforts in every sector send the message—that the fight for sane climate policy is not the exception, but the legitimate expected behavior in this time of crisis. With our understanding of the social sciences, we know that people can be persuaded to take action just because other people are, and promote and harness the power of social norms to accelerate the pace of change.
Our canons of ethics tell us it is our duty to protect the health of the public and to participate in activities that contribute to it.
Committed professionals are joining others to call upon our elected officials, policy makers, and other leaders to show why the public’s health is in jeopardy, what steps must be taken, and how we can use our expertise to speed up the process. Many professional organizations and academic institutions are setting up curricula for training and making collaborative declarations describing the dangers of climate change and the urgent need for action.
But at this epic moment, our unique contributions and the urgent need for global commitment have gone missing. But it does not have to stay this way—because we can change that, too.