As the climate crisis worsens, we know of farmers whose crops are dying and people who have lost their homes to the spread of wildfires.
But there is another group for whom the climate crisis poses a potentially deadly threat. That’s people with mental health issues such as schizophrenia, bipolar disorder, and anxiety disorders.
And this threat is already a reality for some people. During British Columbia’s record heat wave in June 2021, 8 per cent of those who died in the heat wave were diagnosed with schizophrenia. According to a survey in March. This made the disease a more dangerous risk factor than all the other diseases the authors studied, including kidney disease and coronary artery disease.
“Until climate change is brought under control, unfortunately things are only going to get worse,” said Robert, a retired New Hampshire-based psychiatrist and director of the American Psychiatric Association’s Medical Society Consortium on Climate and Health.・Dr. Feder says. “As temperatures continue to rise, these effects will become even more widespread. There will be more storms and fires, and there are more things happening, so people will start to worry about what’s going to happen. .”
Rising temperatures are also associated with increased rates of suicide attempts and mental health-related emergency department visits, several studies have found. And long-term exposure to air pollution (which can exacerbate the climate crisis by increasing particles from droughts and wildfires) is associated with increased anxiety and suicide.
What happens in the brains of people with schizophrenia and other illnesses is just one factor that makes them more vulnerable to extreme heat, air pollution and stress, experts say. They need support from their loved ones, their communities and policy makers.
extreme heat and mental health
The susceptibility of some psychiatric patients to the harms of extreme heat, including heat stroke and death, begins in a part of the brain called the anterior hypothalamus. Think of it like your body’s thermostat.
“It’s the part of the brain that works to tell you to start shivering or start sweating when you’re too hot or too cold,” says Dr. Peter Crank, the body’s cooling mechanism. I did. He is an assistant professor in the Department of Geography and Environmental Management at the University of Waterloo, Canada. Crank was the lead author of a March study on the link between temperature in Phoenix, Arizona, and hospitalizations for schizophrenia patients.
“It tells the rest of your brain that you need to take action, like drink water, put on a coat if it’s too cold, or take off your coat if it’s warm,” he added. “Whether these disorders are bipolar disorder, schizophrenia, or manic depression, all three impair the neurotransmission of information to that part of the brain.”
Experts say the ability to regulate body temperature may also be related to brain chemicals such as serotonin and dopamine, which are commonly lowered in the brains of people with these diseases. It is said that they are doing so.
“The hypothalamus is directly dependent on stimulation by serotonin,” says Dr. McConlogue, a psychiatrist at Brown University Bradley Hospital in Rhode Island and chair of the American Psychiatric Association’s Committee on Climate Change and Mental Health. says Dr. Joshua Wortzel. “Serotonin levels in the brain are affected by outside temperature, so you can imagine that if you’re using drugs to play with serotonin levels in the brain, that could change a person’s ability to sweat.”
Some drugs used to treat these conditions can increase risk by affecting your ability to sweat or increasing your core body temperature.
Antipsychotic drugs, commonly used to treat schizophrenia, bipolar disorder, paranoia and delusions, are most effective, Feder said. These include aripiprazole, olanzapine, risperidone, quetiapine, and lurasidone.
Some stimulant medications for attention deficit hyperactivity disorder (ADHD), such as lisdexamfetamine and amphetamine/dextroamphetamine salts, and anti-anxiety medications can also cause this problem.
Lithium, a mood stabilizer, can cause dehydration, Feder added.
Lifestyle habits that are important for managing mental health symptoms can also be affected. Experts say hot temperatures can disrupt sleep, which is an important factor in managing mental health symptoms.
Additionally, “the nature of most mental health conditions is that once diagnosed, there is a risk that the illness will return,” Feder said. “And these episodes are often triggered by some kind of stress. And climate disasters are certainly stressful.”
Homelessness rates are also higher among people with mental health conditions, particularly those with schizophrenia.
“And when you’re homeless during a heat wave, you’re at increased risk of death because you don’t have access to air conditioning,” Feder said.
Behaviors triggered by these symptoms can also increase the risk of heat-related illness and death. For example, the psychosis experienced by people with schizophrenia may mean that they are not interpreting reality correctly, so they may not even be aware that they are overheated, or You may think that the cause of the problem was because, for some strange or irrational reason, you didn’t do the right thing to beat the heat or stay safe. ,” Feder said.
People with mental health problems are also more likely to self-medicate with medications that interfere with their body’s ability to sense and respond to heat.
How to protect yourself and others
If you’re taking any of these drugs and think the solution is to stop taking them anymore, it’s not too soon. “That would be much worse than continuing to take the medication,” Wurtzel said. This plays an important role in treatment.
Ask your doctor if any medications you are currently taking or starting to take may make you more vulnerable to extreme heat. Information leaflets for these drugs may not list the risks as potential side effects.
“These are rather just warnings,” he added. “It’s actually about staying in a cool environment and making sure you stay hydrated. If climate change continues to get worse, this is going to be really troubling.” We will have to worry more and more. ”
That’s not a reason to stop taking antipsychotic medication, Wurtzel said, but it’s a good reason to stay in shape in the heat.
Addressing the root of the problem, the climate crisis, is of course the most important solution, Wurtzel said. Also needed at the policy level is expanding access to cooling centers and other resources and providing more funding for research that helps us better understand the impact of heat on mental health. he added.
There are steps individuals and communities can take to protect vulnerable populations when hot weather arrives.
“Patients need to realize that they are vulnerable to stress,” says Wurtzel. “You have to make sure you have access to air conditioning and cooling centers, make sure you stay hydrated, make sure you know how long you’re outside, make sure you’re not out during the hottest part of the day, things like that.”
Wear sunscreen, a hat, and light-colored, loose-fitting clothing, Krank says. Taking a cold shower can also help lower your core body temperature.
“Another thing people can do is start getting involved in climate action,” Feder said. “The best thing people can do in response to the anxiety that comes with climate change is to actually join climate change (advocacy) organizations and start working to change the climate crisis.”
Mr. Feder also encouraged people to write and speak to their legislators about this issue.
You should also let your loved ones know about your weakness so they can provide support.
If you’re not one of those at greater risk and are wondering how you can help, keep a bottle of water in your car and help those at higher risk of harm from extreme heat. Hand them out and practice empathy and awareness.
“If you see someone in distress, please take the time to call some type of emergency service so they can get you treatment,” Crank said. This will probably only take him a few minutes out of his day.
