Climate change affects mental health through multiple pathways, producing a spectrum of psychological responses ranging from acute trauma to chronic existential distress.
Acute mental health impacts: Trauma and stress disorders
Extreme weather events—hurricanes, floods, wildfires, and heat waves—can produce immediate and severe psychological trauma.
Research Evidence
Systematic reviews of disaster mental health literature consistently document elevated rates of PTSD, depression, and anxiety in disaster-affected populations. A recent meta-analysis of 48,170 disaster survivors found PTSD prevalence ranging from 2.6% to 52% depending on disaster type and population studied. PTSD prevalence varies widely based on disaster severity, population vulnerability, and proximity to the event, but studies consistently show substantially elevated rates compared to the general population.
Disasters create the conditions for PTSD development—exposure to actual or threatened death, serious injury, or violence. Survivors may experience intrusive memories, nightmares, hypervigilance, and avoidance of trauma reminders.
Climate disasters involve profound losses—homes, possessions, pets, livelihoods, community connections, and sometimes loved ones.
Clinical pearl
Weather-related triggers are particularly challenging for climate disaster survivors. Forecasts of storms, sounds of rain, or even weather reports can trigger PTSD symptoms, creating ongoing distress that extends far beyond the initial event.
Hurricane Katrina: Long-term mental health
Studies following Hurricane Katrina survivors provide compelling evidence of persistent mental health impacts. Five years after the hurricane, nearly half (47.7%) of low-income survivors had probable PTSD and over half (53.2%) had probable serious mental illness. Research documenting impacts 12 years post-disaster found that rates of PTSD and depression remained elevated, particularly among those who experienced greater displacement, financial loss, and lack of social support. Similar patterns emerged after Hurricane Maria (2017), with PTSD rates of 43.6% among Puerto Rico residents and 65.7% among displaced evacuees to Florida six months post-hurricane; displacement more than doubled PTSD risk.
[VISUAL: Insert bar graph comparing PTSD rates:] General Population PTSD: ~5% Hurricane Katrina Survivors (5 years post): ~48%
Chronic stress and heat exposure
Heat and mental health
Research demonstrates clear associations between ambient temperature increases and mental health outcomes. Systematic reviews document that heat waves are associated with increased emergency department visits for mental health crises, higher rates of psychiatric hospitalization, and elevated suicide rates. People with pre-existing mental illness were three times more likely to die during heat waves than those without mental illness.
Studies using large-scale datasets show associations between higher ambient temperatures and increased suicide rates in multiple countries. The effects are strongest for substance use disorders and anxiety.
Emerging phenomena: Eco-anxiety and solastalgia
Eco-anxiety is the chronic fear and worry about environmental doom and the future of the planet.
Here’s the key: While not a clinical diagnosis, eco-anxiety can be distressing and impairing, particularly for young people. However, it’s important to recognize that eco-anxiety is often a rational response to understanding climate change. It’s appropriate worry about a real threat, not a pathology.
Think of it this way: When you see a threat coming, fear is the natural response. Eco-anxiety is that fear applied to our planetary future. The question isn’t whether the anxiety is justified (it often is), but whether we can channel it into constructive action or whether it becomes paralyzing.
Solastalgia was coined by philosopher Glenn Albrecht, solastalgia describes the distress experienced when one’s home environment is undergoing negative transformation.
Think of it this way: Solastalgia is like nostalgia, except you’re still at home, but your home environment is changing around you. Unlike nostalgia (longing for a past place or time), solastalgia is the pain of environmental change happening to your current home.
Example: A farmer who has worked the same land for 40 years watches as repeated droughts slowly destroy the landscape he knows intimately. He’s still on his land, but it’s becoming unrecognizable. The grief and powerlessness he feels—that’s solastalgia.
Prevalence of eco-anxiety
A landmark 2021 survey published in The Lancet Planetary Health assessed climate anxiety in 10,000 young people (ages 16–25) across 10 countries. The findings were striking:
- 59% were very or extremely worried about climate change.
- 45% said their feelings about climate change negatively affected their daily life.
- 75% said “the future is frightening.”
- 56% agreed that “humanity is doomed.”
These numbers reveal that climate distress among young people is not rare—it’s the norm. As future physicians, you’ll likely encounter these feelings in your patients and possibly in yourselves.
Think about this
Have you experienced eco-anxiety? How does understanding that it's a rational response change how you think about it?
Vulnerable populations
| Population | Heightened vulnerabilities |
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Children and adolescents |
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Pre-existing mental illness |
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Low-income communities |
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Indigenous peoples |
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Older adults |
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Knowledge check
Question 1
A 35-year-old farmer presents 8 months after severe flooding destroyed his crops. He reports persistent sadness, sleep problems, and says "I look out at my fields, and they don't feel like home anymore—everything's changed."
Which concept best describes the farmer's experience?
Solastalgia is the distress experienced when one’s home environment undergoes negative transformation, while you’re still there. The key clues are:
- He’s still on his land.
- The environment has changed around him.
- He describes a sense that it no longer “feels like home.”
This is distinct from:
- Eco-anxiety: The worry about future climate impacts.
- Generalized anxiety disorder: Requires worry about multiple domains.
- Acute stress disorder: Occurs in the first month post-trauma, not eight months later.
Question 2
Research on Hurricane Katrina survivors found that what percentage of low-income survivors had probable PTSD five years after the disaster?
This striking statistic demonstrates the long-term persistence of mental health impacts after climate disasters, especially among vulnerable populations. The “second storm” of mental health impacts can equal or exceed physical health impacts, and effects can last for years, particularly when compounded by ongoing stressors like displacement, economic loss, and lack of support.
Question 3
True or False: Eco-anxiety should always be treated as a mental disorder requiring clinical intervention.
Eco-anxiety is often a rational, adaptive response to understanding climate change, not a pathology. The key clinical question is whether the distress is proportional and whether it empowers action or becomes paralyzing. Treatment focuses on validation, distinguishing adaptive from maladaptive responses, and connecting patients to collective action. Only when eco-anxiety significantly impairs functioning would it warrant treatment as a clinical disorder.
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Introduction to Climate Change
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Inequitable Burden of Climate-Related Mental Health Impacts