Roshan Rahnama remembers a client call several years ago, during which the early morning sky over her San Francisco home turned a discomforting hue.

“We started really early, so it was dark outside. But hours later, around 9 or 10 a.m., it was still dark outside,” she recalls. “When we looked out the window, the sky was orange and it was because of the wildfires.”

The words she uses now to describe the situation and the unease it created in her: “so apocalyptic.”

As she spoke, Rahnama, SVP of commercial and public health strategy at McCann Global Health, was enduring an equally terrifying series of weather events: the bomb cyclones, torrential downpours and flooding that assaulted California in January. She now begins her day by posing a series of questions she never thought she’d have to ask: Will she be able to take a walk outside? Is her home at risk of imminent disaster?

While the physical evidence of natural disasters, such as the recent torrential rain and flooding in California, are entirely apparent, the mental toll can sometimes be just as worse — and linger for years. Source: Getty Images.

“In California, it used to be about earthquakes and now it’s become fires and floods,” she laments, referencing the weather-related anxiety she and many of her neighbors have learned to live with. “It’s a part of our everyday lives now — and it’s terrible in terms of its effect on mental health.”

Climate anxiety, a phrase coined to encapsulate the mental health issues stemming from climate change, is becoming increasingly visible in the U.S. and around the globe. The only surprise, frankly, is that it took so long for psychiatrists and other clinicians to put a name to it.

“When people face a disaster, they can experience a sense of powerlessness,” notes Dr. Gagandeep Singh, a psychiatrist and the chief medical officer at Phoenix-based Mercy Care. “It can disrupt their social networks and increase the chances of post-traumatic stress disorder, depression or anxiety.”

By way of example, Singh pointed to significant wildfires that tore across Arizona in 2022, particularly near Flagstaff, that forced hundreds of people to evacuate: “It’s the suddenness of it that affects people,” he continues. “It leaves them feeling unprepared, isolated and overwhelmed.”

The obvious problem is that wildfires and other incidences of extreme weather are occurring more frequently — and often with more intensity. And it’s becoming harder and harder to find refuge: More than 40% of Americans now live in a county recently affected by severe weather, in the form of fire, flood, hurricane, landslide or other natural disaster, according to a 2022 Washington Post analysis.

Flooding is nearly a daily occurrence in the U.S., according to The Pew Charitable Trusts. To the surprise of exactly no one, the last eight years were the hottest on record, according to new data from the European Union’s Copernicus Climate Change Service.

“The difficulty with these natural disasters happening a lot more is that people are getting re-exposed to them,” Singh says. “From a mental-health perspective, that re-exposure can be harmful for people.”

While a definitive connection between climate change and mental health may have been harder to make 10 years ago, more and more research has affirmed the link. In a paper published last year, Brenda Hoppe, a climate resilience researcher at the University of Minnesota Climate Adaptation Partnership, sought to track the evidence that climate change was on people’s minds during their therapy sessions.

Her study asked Minnesota mental health professionals whether they had regularly encountered mental health issues related to climate change, and 81% said they believed climate change was already a significant problem in mental health, while 61% said they were beginning to see the impact in their patients. More than half said their clients were open to discussing climate change as part of their treatment.

“Our desire was to bring that testimony forward not only to help mental health professionals develop resources and training on how to deal with climate change, but also to say to the public, ‘Hey, here’s what mental health professionals are seeing. This is what they’re saying,’” Hoppe explains.

She divides the mental health impact of client change into three basic categories. The first is a direct, more acute impact triggered by the trauma of sudden weather events or natural disasters: heat waves, floods, wildfires and the like. The second is a more indirect effect on social determinants of health, such as how a changing climate makes it harder for farmers to maintain their livelihood and contributes to an uptick in suicides.

Family watching burning globe
Source: Getty Images.

The third only recently came to light, but has emerged most acutely in young people: a rising sense of existential doom and hopelessness about the future that is driving up rates of depression and anxiety. Such dread has become apparent even among people who don’t live in areas prone to severe weather events.

“It’s mediated through a rising awareness of climate change and what it means for our society, as well as an awareness of how we’ve dropped the ball in addressing it in the past,” Hoppe explains. “We certainly see that manifesting in youth.”

Any number of phrases designed to capture that sense of existential despair, including eco-anxiety and solastalgia (officially defined by the journal Australasian Psychiatry as “the distress that is produced by environmental change impacting on people while they are directly connected to their home environment”), have emerged. The phenomenon has been observed all over the globe, from indigenous communities in the U.S. to ranchers in Australia, Hoppe says.

A study published in 2021 by The Lancet attempted to quantify the rising levels of climate-related anxiety. It found that 59% of the young people surveyed were “extremely worried” and 84% were “moderately worried” about climate change. More than half of the respondents said they experienced sad, anxious, angry, guilty and powerless emotions in relation to climate change and 45% said climate anxiety negatively impacted their daily lives.

However, for healthcare marketers the conversation is still in its infancy.

“I haven’t heard much talk about climate change, let alone the mental health impact of climate change,” Rahnama says. “There’s a big gap, and thus a huge opportunity for us to lean further into this.”

Flower brain
Source: Getty Images.

Fingerpaint chief strategy officer Nick Megjugorac agrees. “I don’t think climate anxiety is anywhere near as top-of-mind as some of the other things we’ve heard about,” he says. “[Healthcare marketers] need to introduce it into the world in a way that people can digest it, and present a clear call to action.”

That heightened awareness also needs to find its way into personalized treatment plans.

“If we think about solutions we’re devising for diabetes, for example, how can we also incorporate mental health from the angle of climate change?” Rahnama says. “If a doctor is coming up with a plan for someone who might be living in a place that’s ravaged by severe weather and they don’t have the ability to go out and take a walk every day, that’s not going to be the right plan.”

There is a silver lining. Amid the eco-anxiety and existential despair, mental health professionals have identified an emerging “climate resilience” in the people they treat.

In some communities, that means programs that proactively reach out to vulnerable people in the wake of severe weather events. Mercy Care tracks wildfires in its areas of coverage and reaches out to members, many of whom are low-income people in marginalized communities, to make sure their basic physical and mental health needs are met in the aftermath of a severe weather event.

“We figure out which of our members live in that geographic area and we try to reach out to them by phone or text to say, ‘Hey, how are you doing?’” Singh notes. “We’ve got care managers who check in and ask, ‘Are you safe and do you have any significant healthcare needs?’”

But climate resilience goes much deeper than putting basic health services and mental health infrastructure in place. It also means using the newfound hyper-awareness of climate change and channeling some of the existential dread into action.

“While we’re having the conversation of all the negative mental health impacts from climate change, we’re also pushing forward this idea of active hope and asking, ‘How can we counter these impacts?’” Hoppe explains. “We need to engage people so they don’t just turn off and veer into a sense of hopelessness.”

Hoppe is encouraged by the increasing number of people using climate awareness as a rallying cry to spur innovation and behavioral change.

“For a long time, the messaging in the climate adaptation space was doom and gloom,” she notes. “But now we’re realizing we have more of an ability to celebrate and promote all these solutions, and to rally people around them.”