It is no secret that the accelerating climate change increasingly threatens patients' mental health and psychosocial well-being, leading to psychologic distress, anxiety, depression, grief, and suicidal behavior. This relationship is evidenced by the emergence of new terms such as "eco-anxiety."
During the recent Days of Neuroscience, Psychiatry, Neurology, a session brought together Professor Martin Beniston, a climatologist from the University of Geneva, Geneva, Switzerland, and former director of the Swiss Environmental Science Institute, and Professor Philippe Conus, a psychiatrist at the University Hospital of Lausanne in Lausanne, Switzerland. Beniston has significantly contributed to understanding the effects of climate change and developing adaptation strategies. Conus conducts research aimed at the early detection of mental disorders related to climate change to propose appropriate interventions. The latter provided advice on coping with widespread eco-anxiety, especially within the younger generation.
Global Temperatures Rise
"Since the industrial era, there has been a continuous rise in global temperatures, just over 1 °C in the span of a century, with an even more pronounced increase in the European territory," said Beniston. He supported his statements with an illustrative composite animation created by National Aeronautics and Space Administration in 2022 that showed the evolution of Earth's temperature year after year.
"But more than temperatures, it is the climate consequences that will have an impact on mental health," he said. The effects can be direct when heat waves, extreme cold, and natural disasters lead to physical and psychologic vulnerability, as seen with repeated floods in northern France this past winter. The effects also can be indirect, however, as pollution, invasive species, and new contamination pathways are capable of amplifying or generating new infectious and other diseases. "What is worrying," he said, "is that we are already witnessing events today that the Intergovernmental Panel on Climate Change predicted for 2040/2050 and beyond."
Impact Varies Among Populations
"While the effect of climate change on mental health is now evident, the impact is not the same for everyone, with some groups disproportionately affected, based on factors such as socioeconomic status, gender, and age," said Conus.
In this regard, patients with mental illness are particularly vulnerable. For example, the northwest part of North America experienced an unprecedented heat wave in 2021 that was characterized by high temperatures and reduced air quality. The event resulted in approximately 740 excess deaths in the province of British Columbia. During the eight hottest days in the region, 134 patients with schizophrenia died, which was triple the average number of deaths during the same period between 2006 and 2020.
Nevertheless, studies focusing not on vulnerable patients but on the general population also show a link between climate change and mental health. One study coupled meteorologic and climatic data with reported mental health difficulties in two million randomly sampled American residents between 2002 and 2012. It revealed that a shift from average temperatures of 25 °C to 30 °C was associated with a 0.5% increase in the prevalence of mental health problems, equivalent to 2 million additional patients for the United States, "which would still amount to 320,000 individuals in France," said Conus.
Moreover, a 1 °C average warming over 5 years was linked to a 2% increase in the prevalence of mental health problems. This increase translates to an additional eight million patients for the United States and an additional 1.2 million patients for France.
Psychiatric Consequences
From a strictly psychiatric perspective, "the impacts of climate change can be classified into three categories," said Conus. First, there are direct impacts, such as natural disasters that cause significant destruction like fires or floods. "We observe an increased incidence of depressive states, posttraumatic disorders, and even suicides when individuals are directly affected, with a gradual effect over time." Indeed, a study showed that Hurricane Katrina led to 40 times more psychologic disorders than somatic ones.
The second category includes gradual impacts that affect individuals, such as farmers who tend the land for their work. "For them, this slow change resulting in periods of drought or rising waters will lead to income and activity losses, ultimately causing depression and suicides. This progression of disorders has been well demonstrated in the American Midwest with a twofold increase in drought episodes and a rise in the number of suicides."
Finally, there are indirect impacts, which primarily are observed in Western societies. "It is eco-anxiety or solastalgia, this nostalgia for the planet as we once knew it and sadness for a new ecosystem in which we are deprived," said Conus.
A New Condition
Of the two terms, eco-anxiety has been predominantly used to describe the sense of fatalism toward climate change. "It mainly manifests as fear, which can even be paralyzing, along with sadness and anger." One of the main contributors to this anxiety is the inaction or inadequate action by governments in facing the environmental crisis.
A study published in Lancet in 2021 showed that out of 10,000 young people surveyed in 10 countries (ie, Australia, Brazil, Finland, France, India, Nigeria, the Philippines, Portugal, the United Kingdom, and the United States), 60% reported feeling "very worried" or "extremely worried" and associated negative emotions (eg, sadness, fear, anxiety, anger, and helplessness) with climate change.
Reconnecting With Nature
Are there keys to managing eco-anxiety? "First, one must acknowledge the reality of the concern" and "share one's own experience," said Conus. Among the practical advice to give to patients, he suggests not staying alone with one's feelings and sharing them with others. "It is also essential not to spend too much time in front of screens with information but to "give oneself bubbles of disconnection," he said. He also recommended staying connected with nature, which is known for its benefits, and "developing resources to experience positive and negative emotions."
Another solution proposed is to act, thereby regain a measure of control over matters, he said. "Each person can engage at his or her scale, according to his or her means and limits." Patients can choose products from environmentally friendly agriculture, reduce red meat consumption, prefer trains over planes, and embrace simple pleasures. For citizens, acting includes voting, engaging in associations, speaking out in debates, and exerting pressure on political representatives. Healthcare professionals can take actions in medical clinics or hospitals and join an association.
Note: This article originally appeared on Medscape.
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