by Subscribe to CNN’s Life, But Greener newsletter. Our limited series of newsletters guides you on how to minimize your personal role in the climate crisis and reduce your ecological anxiety..
As the climate crisis worsens, we hear of farmers whose crops are drying up and people losing their homes to rampant wildfires.
But there is another group for whom the climate crisis is a potentially lethal threat: people with mental health problems such as schizophrenia, bipolar disorder or anxiety.
And this threat has already become a reality for some people. During a record heat wave in British Columbia in June 2021, 8% of people who died from extreme heat had been diagnosed with schizophrenia, according to a March study. That made the disorder a more dangerous risk factor than all the other conditions the authors studied, including kidney disease and coronary artery disease.
“Until climate change is under control, things will unfortunately only get worse,” said Dr. Robert Feder, a retired psychiatrist based in New Hampshire and American Psychiatric Association representative to the Medical Society Consortium on Climate and Health. “As temperatures continue to rise, these effects will be magnified. There will be more storms, more fires and people will be more worried about what could happen because there is so much more going on.”
Several studies have found that rising temperatures have also been associated with suicide attempts and higher rates of mental health-related emergency department visits. And prolonged exposure to air pollution, which the climate crisis can make worse by adding more particles from droughts or wildfires, has been linked to greater anxiety and an increase in suicides.
What happens in the brains of people with schizophrenia or other conditions is just one factor that makes them more vulnerable to extreme heat, air pollution and stress, experts said, and they need support from loved ones, communities surrounding communities and policymakers.
Extreme heat and mental health
What makes some psychiatric patients more susceptible to extreme heat damage (such as heatstroke or death) begins in a part of the brain called the anterior hypothalamus. Think of it as the body’s thermostat.
“That’s the part of the brain that works to tell you, when you’re too hot or too cold, to start shivering, to start sweating,” which is the body’s cooling mechanism, said Dr. Peter Crank, an assistant professor. in the department of geography and environmental management at the University of Waterloo in Canada. Crank was the lead author of a March study on associations between temperatures in Phoenix, Arizona, and hospital admissions for people with schizophrenia.
“It tells the rest of the brain that it needs to take behavioral actions, like drinking water or putting on a coat when it’s too cold or taking off a coat when it’s hot,” he added. “These disorders, whether bipolar, schizophrenia or manic depression, all three impair the neurotransmission of information to that part of the brain.”
The ability to regulate body temperature may also have to do with brain chemicals such as serotonin and dopamine, which are generally lower in the brains of people with these disorders, experts said.
“The hypothalamus is directly dependent on serotonin stimulation,” said Dr. Joshua Wortzel, a psychiatrist at Brown University Bradley Hospital in Rhode Island and chair of the American Psychiatric Association’s mental health and climate change committee. “Serotonin levels in the brain are affected by the outside temperature, so you can imagine that when we play with serotonin levels in the brain with our medications, that can change a person’s ability to sweat.”
Some medications used to treat these disorders may increase the risk by affecting the ability to sweat or raising the body’s core temperature.
Antipsychotic medications (often used to treat schizophrenia, bipolar disorder, paranoia and delusions) have the greatest effect, Feder said. These include aripiprazole, olanzapine, risperidone, quetiapine, and lurasidone.
Some stimulant medications for attention deficit hyperactivity disorder, or ADHD, such as lisdexamfetamine and amphetamine/dextroamphetamine salts, and anti-anxiety medications can also cause this problem.
Lithium, a mood-stabilizing medication, can cause dehydration, Feder added.
Lifestyle habits important for managing mental health symptoms may also be affected. Warm temperatures can also interfere with sleep, an important factor in managing mental health symptoms, experts said.
Additionally, “the nature of most mental health conditions is that once you’re diagnosed, you’re at risk for recurring episodes of that illness,” Feder said. “And these episodes are usually caused by some type of stress. And climate disasters are certainly a stress.”
Homelessness is also high among people with mental health problems, especially in the schizophrenic population.
“And if you become homeless during a heat wave, that puts you at greater risk of death, because you don’t have access to air conditioning,” Feder said.
Behaviors caused by these conditions may also contribute to an increased risk of heat-related illness or death. The psychosis that people with schizophrenia may experience, for example, may mean that they are not interpreting reality correctly, so “they may not even be aware that they are overheated, or they may think that the source of their overheating is due to some strange or irrational reason and not doing something appropriate to get out of the heat or to be (safer),” Feder said.
People with mental health problems are also more likely to self-medicate with medications that interfere with their body’s ability to feel and respond to heat.
How to protect yourself and others
If you are taking any of these medications and think stopping them is the solution, don’t do it too quickly. “That would be much worse than continuing to take the medication,” which plays a crucial role in treatment, Wortzel said.
Talk to your doctor about whether a medication you are taking or starting makes you more vulnerable to extreme heat, as some information leaflets about these medications may not mention that risk as a possible side effect.
“These are rather simple precautions,” he added, “to make sure you stay in cooler environments and stay hydrated; if climate change continues to get worse, this will really be a side effect.” effect that we are going to have to worry about more and more.”
It’s not a reason to stop taking antipsychotics, Wortzel said, but it’s a good reason to take care of yourself in the heat.
Addressing the climate crisis, the root of the problem, is, of course, the most important solution, Wortzel said. What’s also needed at the policy level, he added, is expanding access to cooling centers and other resources, and providing more funding for research that would help us better understand the impact of heat on mental health.
There are steps that individuals and communities can take to protect vulnerable people when warm weather hits.
“Patients need to be aware that they are vulnerable to stress,” Wortzel said. “You want to make sure you have access to air conditioning, to a cooling center, to stay hydrated and make sure you monitor how long you’re outside, (that) you’re not outside in the hottest times of the year. the day, things like that.”
Wear sunscreen, hats and loose, light-colored clothing, Crank recommended. Taking cold showers can also help keep your core temperature down.
“The other thing people can do is start getting involved in climate activities,” Feder said. “For anxiety associated with climate change, the best thing people can do is get involved in climate (advocacy) groups and start working to make changes to the climate crisis.”
Feder also suggested that people write or talk to their legislators about the issue.
You should also inform your loved ones about your vulnerabilities so they can offer you support.
If you are not someone who is at higher risk and are wondering how you can help, practice empathy and awareness by keeping water bottles in your car to give to those who are most at risk of harm from extreme heat.
“If you see someone in danger, take the time to call some type of emergency service so they can receive medical attention,” Crank said. Doing so will probably take only a few minutes of your day.
Correction: An earlier version of this story incorrectly stated which study Dr. Peter Crank authored.
For more CNN news and newsletters, create an account at CNN.com
