Science
Heat Singes the Mind, Not Just the Body
If you find that the blistering, unrelenting heat is making you anxious and irritable, even depressed, it’s not all in your head. Soaring temperatures can damage not just the body but also the mind.
As heat waves become more intense, more frequent and longer, it has become increasingly important to address the impact on mental health, scientists say.
“It’s really only been over the past five years that there’s been a real recognition of the impact,” said Dr. Joshua Wortzel, chair of the American Psychiatric Association’s committee on climate change and mental health, which was set up just two years ago.
“Our understanding of the basic biology of why this association exists is still in its infancy,” he added.
High temperatures are strongly associated with an increase in suicides, researchers have found. Heat has been linked to a rise in violent crime and aggression, emergency room visits and hospitalizations for mental disorders, and deaths — especially among people with schizophrenia, dementia, psychosis and substance use.
For every 1 degree Celsius (or 1.8 degrees Fahrenheit) increase in temperature, scientists have estimated that there is a nearly 5 percent increase in the risk of death among patients with psychosis, dementia or substance use.
Researchers have reported a 0.7 percent increase in suicides linked to rising temperatures, and about a 4 percent to 6 percent increase in interpersonal violence, including homicides.
Heat not only fuels feelings like irritability and anger, but also seems to exacerbate mental illnesses, such as anxiety, schizophrenia and depression. Older adults, adolescents and people with pre-existing mental illnesses are particularly vulnerable, as are people who do not have housing or are of lower socioeconomic status.
A landmark study last year analyzed data on more than two million people with private insurance and found that emergency department visits for mental illnesses were significantly higher during the five or six hottest days of summer, compared with the coolest days of the same season.
The increase was greater in northern parts of the United States, perhaps because these areas are less prepared to cope with heat waves than places like the Southwest, said Amruta Nori-Sarma, an environmental epidemiologist at Boston University School of Public Health, who led the study.
The gap was evident across a range of mental health conditions, including mood and anxiety disorders, stress disorders, schizophrenia, substance use disorders and self-harm. “Extreme heat is an external stressor that seems to be exacerbating people’s mental health symptoms,” Dr. Nori-Sarma said.
The effect is likely to be even more pronounced among people with limited or no insurance coverage or who are experiencing homelessness, she added.
Scientists have proposed various biological explanations for the connection between soaring temperatures and mental health disorders. At least some of these illnesses may have a simple origin: disrupted sleep.
Room temperature needs to dip below 68 degrees for a comfortable rest. On warmer nights, people fall asleep later and wake up earlier, and the quality of their sleep is poorer.
Days or weeks of sleeping in overly warm rooms can not only exacerbate chronic conditions like diabetes and heart disease, but also negatively affect psychiatric disorders, suicide risk, memory, mood and cognitive function.
Older adults and women are more likely to be affected: One study found that sleep loss among older adults is about twice as high as among younger people.
Some mental health problems may be an extension of physical issues. On a recent afternoon, Dr. Asim Shah, a psychiatrist at Baylor College of Medicine in Houston, found that nearly every patient’s pulse or heart rate was higher than it had been three months earlier.
“That increase in your heart rate can increase your anxiety,” Dr. Shah said. “So heat causes a lot of physical changes, which leads to a lot of emotional and mental changes.”
Serotonin, a neurotransmitter linked to mood, anxiety and depression, also regulates the body’s ability to sense temperature. Increased sunlight and heat can raise serotonin levels and may lead to mood swings, aggression and irritability. A range of widely used drugs — including antibiotics, beta blockers, some antidepressants and antihistamines — also affect the body’s ability to sense and regulate body temperature.
Medications prescribed for schizophrenia, depression and bipolar disorder, including widely used lithium, impair the body’s ability to sweat and cool itself. Extreme heat and sweating can concentrate levels of lithium in the body to toxic levels, and can lead to serious physical and mental problems and even death, Dr. Shah said.
“We need to prepare our patients who take these medicines, which interact with sunlight,” he added. “Physicians also need to be more aware.”
Other drugs suppress thirst and can result in dangerous levels of dehydration. Alcohol, caffeine and some medications that increase urine output can also lead to dehydration, mental problems and confusion.
And there are indirect routes through which high temperatures can affect mental health, according to Dr. Wortzel. In hot weather, some crops absorb less zinc, iron and other micronutrients. Deficiencies of those nutrients can have psychiatric consequences, including neurodevelopmental disorders.
Rising temperatures are expanding the reach of disease vectors, like ticks, that carry pathogens that may cause psychiatric and neurological symptoms. Heat also increases allergens and pollutants, and worsens air quality, which alone can trigger anxiety and depression.
Heat is only one aspect of climate change, and its immediate effect on mental health can be difficult to extricate from emotions regarding the larger existential threat.
Last year, the Intergovernmental Panel on Climate Change warned that rising temperatures, displacement, famine and economic and social losses would lead to deep anxiety, grief and stress. Children, adolescents, older adults and those with chronic health problems are particularly vulnerable, the report cautioned.
“The heat has very profound effects,” said Dr. Robert Bright, a psychiatrist at Mayo Clinic. This summer, Phoenix, where Dr. Bright is based, experienced temperatures above 110 degrees Fahrenheit for a record 31 consecutive days.
“People get very overwhelmed and worried about this,” he added.
Scientists have coined the term “climate distress” to describe a multitude of feelings triggered by the environmental changes appearing around us: anxiety, terror, sadness, shame, guilt. Those who already have anxiety or are depressed may have an even more difficult time coping.
“It is unfortunately true that this may be the coolest summer for the rest of our lives, which is unsettling to reckon with,” said Britt Wray, the director of Stanford University’s program on climate change and mental health.
People often turn to cognitive behavioral therapy, medications or other strategies to cope with difficult emotions. But “when it comes to the climate crisis, those interventions fall apart, because the threat is real,” not just a matter of perception, she said.
Local governments can help people feel less vulnerable and more empowered by planning for long stretches of hot days. Officials can provide information about the nearest cooling rooms for people without air-conditioning at home.
Dr. Wray said connecting to others with similar worries and taking action at various levels to forestall the worst outcomes can also help alleviate climate distress.
“People in Phoenix, Ariz., have died just from falling on the pavement and getting third degree burns,” she noted. “That’s the kind of thing that nightmares are made of.”
Science
Cluster of farmworkers diagnosed with rare animal-borne disease in Ventura County
A cluster of workers at Ventura County berry farms have been diagnosed with a rare disease often transmitted through sick animals’ urine, according to a public health advisory distributed to local doctors by county health officials Tuesday.
The bacterial infection, leptospirosis, has resulted in severe symptoms for some workers, including meningitis, an inflammation of the brain lining and spinal cord. Symptoms for mild cases included headaches and fevers.
The disease, which can be fatal, rarely spreads from human to human, according to the U.S. Centers for Disease Control and Prevention.
Ventura County Public Health has not given an official case count but said it had not identified any cases outside of the agriculture sector. The county’s agriculture commissioner was aware of 18 cases, the Ventura County Star reported.
The health department said it was first contacted by a local physician in October, who reported an unusual trend in symptoms among hospital patients.
After launching an investigation, the department identified leptospirosis as a probable cause of the illness and found most patients worked on caneberry farms that utilize hoop houses — greenhouse structures to shelter the crops.
As the investigation to identify any additional cases and the exact sources of exposure continues, Ventura County Public Health has asked healthcare providers to consider a leptospirosis diagnosis for sick agricultural workers, particularly berry harvesters.
Rodents are a common source and transmitter of disease, though other mammals — including livestock, cats and dogs — can transmit it as well.
The disease is spread through bodily fluids, such as urine, and is often contracted through cuts and abrasions that contact contaminated water and soil, where the bacteria can survive for months.
Humans can also contract the illness through contaminated food; however, the county health agency has found no known health risks to the general public, including through the contact or consumption of caneberries such as raspberries and blackberries.
Symptom onset typically occurs between two and 30 days after exposure, and symptoms can last for months if untreated, according to the CDC.
The illness often begins with mild symptoms, with fevers, chills, vomiting and headaches. Some cases can then enter a second, more severe phase that can result in kidney or liver failure.
Ventura County Public Health recommends agriculture and berry harvesters regularly rinse any cuts with soap and water and cover them with bandages. They also recommend wearing waterproof clothing and protection while working outdoors, including gloves and long-sleeve shirts and pants.
While there is no evidence of spread to the larger community, according to the department, residents should wash hands frequently and work to control rodents around their property if possible.
Pet owners can consult a veterinarian about leptospirosis vaccinations and should keep pets away from ponds, lakes and other natural bodies of water.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
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