Extreme weather post-traumatic stress disorder

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Extreme weather events can have a significant impact on mental health, particularly in the form of post-traumatic stress disorder (PTSD). With the increasing frequency and severity of these events due to climate change, it is important to understand how they can lead to long-lasting psychological trauma and learn to provide support for those affected.

Contents

Background

Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a condition caused by past, life altering events in which people have experienced or witnessed. Events could include a serious accident, physical or sexual violence, combat, or natural disasters. Recently, studies have found that extreme weather also leads to PTSD. Symptoms of PTSD related to extreme weather events can include replaying flashbacks of an event, having greater anxiety, and/or detachment when thinking about an event. Symptoms can also arise months or years after the extreme weather event occurs. [1]

Extreme weather events

Examples of extreme weather events include tropical storms, hurricanes, heat waves, droughts, and floods. These events have been growing in frequency in the past few decades due to climate change. With this growing frequency, it will increase the effects of these events onto humans and society in the future. [2] People who are exposed to life threatening situations, including extreme weather events, are at a greater risk of experiencing PTSD symptoms or developing the disease. [1] Experiencing or knowing someone who experienced an injury from a natural disaster increased the likelihood and frequency of PTSD symptoms. Also, experiencing a close death of a family member in relation to the natural disaster or weather event often led to a higher likelihood of PTSD. [3]

Symptoms

Eco-anxiety

Eco-anxiety is a term that describes one's reaction to the ever changing and worsening environmental conditions. One is constantly worried or scared of the eventual doom of the Earth and our society. There are sustained effects on the effects of individuals, as well as the increase in eco-anxiety as a health condition. This has led to increased mental health issues in response to climate change, thus allowing for more research to be developed on the topic (Arcanjo, 2019). [4]

Suicide

Among other issues, the effects of climate change and extreme weather can lead to an increase in suicide rates. [5] This can be experienced both when one experiences an extreme weather event, but also due to the uncertainty of the future, in relation to climate change.

Violence

It has been shown that there is a relationship between heat and violence, especially after heat waves. Therefore, it can be assumed that an increase in global temperature can lead to an increase in cases of violence. People experience an increase in aggressive behavior due to an increase in temperature, which can lead to violence or other mental health problems. [5]

Post-traumatic growth

Post-traumatic growth is a term used to describe the change that can occur after a traumatic event, in which the person experiences adaptation, growth, and a new sense of living. It is a positive reaction to one’s experience of a negative event, in which one would want to change their life, or others lives for the better. Post-traumatic growth can occur after a traumatic event, including extreme weather events. When someone is given social support after an event, they are more likely to experience post-traumatic growth. [6]

Prevalence

PTSD surpasses depression and anxiety as the most common mental health outcome from extreme weather events.This phenomenon has been studied on global, regional, and local scales.[ citation needed ]

Climate-related disasters and exposures including drought, extreme temperature, floods, landslides, storms, and precipitation have various mental health outcomes, but PTSD is consistently the most commonly reported among low and middle-income countries. Across weather events, PTSD ranks highest among victims before depression and anxiety. PTSD in a flooded setting and PTSD in a storm setting are among the top three most common combinations of mental health outcomes and extreme weather events. [7] This trend can be seen throughout many countries in South America and Asia where there are significant increases in PTSD for individuals exposed to floods and storms compared to unexposed groups. [8]

Populations in the UK that have been exposed to flood events have higher rates of diagnoses than the general population. The most common problem associated with flooding is PTSD (30.4%), surpassing depression (21.3%) and anxiety (19.8%). [9]

Current[ when? ] research focuses on PTSD associated with floods and storms. Knowledge about other events such as droughts, heatwaves, landslides, and precipitation is more limited. Further investigation is needed[ according to whom? ] to determine the prevalence of PTSD in the instance of these various events and to identify which symptoms of PTSD correspond to which extreme weather incidents.[ citation needed ]

Risk factors

The Intergovernmental Panel on Climate Change has connected climate change to extreme weather events as a reason for concern, which has been transitioned from a high to very high risk at near term warming with medium confidence. Negative mental health effects due to climate change are predicted with very high confidence globally, and the association with trauma from extreme weather events is also evaluated with very high confidence. [10] As different events of extreme weather can cause extreme weather PTSD, and extreme weather is expected to increase globally, there is an enormous scale of people who may be affected by extreme weather PTSD. In an analysis of extreme weather events and mental health reviewing floods, droughts, storms, and heatwaves, PTSD rates as a result of these events ranged from 2.6% to 90% and results vary due to populations, disaster type, and study characteristics, and cross-cultural applications of PTSD diagnoses. [8]

Vulnerable populations

There are many factors that increase vulnerability as well. Low and middle-income countries are more vulnerable due to the interaction of inadequate mental healthcare and increased vulnerability to the effects of climate related disasters. Specifically, flood and storm related PTSD are observed frequently for people residing in low and middle income areas impacted by climate disasters. [11] Other vulnerable groups to extreme weather mental health effects include the economically disadvantaged, elderly, disabled, prisoners, substance abusers, and children. [12] Children are particularly vulnerable because the mental health impacts of extreme weather can contribute not only to PTSD, but to infectious and chronic disease susceptibility as well as cognitive deficits, lower IQ and dementia later in life. [13] Extreme weather events also force migration in many situations and PTSD is found in higher rates among refugees and forced migrant populations and there are more barriers to receiving treatment such as affordability, information on available services, and cultural or language barriers. [14]

Treatments and solutions

There are many treatment and prevention tactics available for extreme weather-related PTSD. Individual conditions and psychological behavior, government action, secondary stressors, and weather events make the assessment of interventions difficult. Some interventions have proven relatively ineffective while others have produced more successful outcomes.[ citation needed ]

One possible treatment for extreme weather PTSD is psychological debriefing, but this has been shown to be an ineffective intervention for flood events. [9] Prolonged exposure (PE), cognitive processing therapy (CPT), and cognitive therapy for PTSD (CT-PTSD) all significantly reduce PTSD symptoms in research and clinical settings. Emotional processing theory is the basis for PE. PE employs emotional processing techniques to activate trauma memory and modify the patient’s pathological fear structure. CPT utilizes social cognitive theory (SCT) to consider the patient’s cognitions, emotions, and behavior in the context of the trauma. CPT reduces symptoms of PTSD through cognitive restructuring. CT-PTSD is based on the theory that individuals afflicted with PTSD maintain a sense of a serious and current threat. Patients work to modify assessments of current threats, reduce dysfunctional cognitive strategies, and elaborate their trauma memory through a wide range of behavioral activation assignments. [15]

Prevention and preparedness

Prevention and preparedness tactics include enhanced risk communication, mental health literacy and first aid, and government planning. Incorporating flood risk and management infrastructure in urban design is an effective mode of prevention for PTSD. Establishing resilience by allocating resources and encouraging community growth is also an effective tactic for reducing associated flood risks, especially among more vulnerable populations. [9]

Policy-based solutions such as enhanced monitoring of mental health and greater access to mental health resources have been shown to help effectively prepare for PTSD due to extreme weather events. Prevention planning for PTSD within the healthcare system can include increasing funding and encouraging mental health training for professionals in the field, both of which have produced beneficial outcomes. Establishing a robust and well-trained mental health force is a productive step in resilience planning and adaptation. [7]

Traditionally, mental health research has focused on high-income countries, excluding vulnerable populations. Low and middle-income countries are more burdened by exposure and vulnerabilities to extreme weather events, therefore a useful step in PTSD preparation and planning is expanding research among these populations. [8]

The Intergovernmental Panel on Climate Change has suggested increased mental health services as well as surveillance and monitoring of mental health impacts of extreme weather and other climate change related mental health effects as a potential solution (Intergovernmental Panel on Climate Change, p. 25).  As extreme weather events grow stronger and more prevalent, the incorporation of treatments, solutions, prevention, and preparedness will be an important step for mitigating extreme weather PTSD. [ citation needed ]

Examples of extreme weather events

Many extreme weather events from the recent past have led to many new cases of Extreme Weather PTSD. Presented below are a list of extreme weather events and the prevalence of PTSD in the aftermath.

New York and New Jersey, US flood

Hurricane Sandy was a post-tropical cyclone and flooding event in the NYC area causing $19 billion in damages and 43 deaths. Prevalence of PTSD following Hurricane Sandy was 2.0%. [16]

UK flooding and heat waves

PTSD after extreme weather events leading to flooding in the United Kingdom was recorded at 30.36%. [17]

Wildfire spreads in Fort McMurray. Wildfire spreads in Fort McMurray.jpg
Wildfire spreads in Fort McMurray.

Fort McMurray, Canada wildfires

After wildfires caused the evacuation of 90,000 residents of Fort McMurray, Canada, and the destruction of 10% of housing, PTSD afflicted 39.6% of those affected. [18]

Krymsk, Russia flooding and droughts

PTSD was expected to be a long term effect of the Krymsk area after flooding in 2012 after warning signs were found in residents during the following weeks. [19]

Tamil Nadu, India flooding

After particularly high intensity rainfall and the overflowing of neighboring rivers in Tamil Nadu, 26.9% of the studied population were diagnosed with PTSD. [20]

Related Research Articles

<span class="mw-page-title-main">Anxiety disorder</span> Cognitive disorder with an excessive, irrational dread of everyday situations

Anxiety disorders are a cluster of mental disorders characterized by significant and uncontrollable feelings of anxiety and fear such that a person's social, occupational, and personal functions are significantly impaired. Anxiety may cause physical and cognitive symptoms, such as restlessness, irritability, easy fatigue, difficulty concentrating, increased heart rate, chest pain, abdominal pain, and a variety of other symptoms that may vary based on the individual.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, such as experiencing violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se.

Acute stress disorder is a psychological response to a terrifying, traumatic or surprising experience. It may bring about delayed stress reactions if not correctly addressed. Acute stress may present in reactions which include but are not limited to: intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. Reactions may be exhibited for days or weeks after the traumatic event.

Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e. commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.

The management of traumatic memories is important when treating mental health disorders such as post traumatic stress disorder. Traumatic memories can cause life problems even to individuals who do not meet the diagnostic criteria for a mental health disorder. They result from traumatic experiences, including natural disasters such as earthquakes and tsunamis; violent events such as kidnapping, terrorist attacks, war, domestic abuse and rape. Traumatic memories are naturally stressful in nature and emotionally overwhelm people's existing coping mechanisms.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

<span class="mw-page-title-main">Transgenerational trauma</span> Psychological trauma

Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary modes of transmission are the uterine environment during pregnancy causing epigenetic changes in the developing embryo, and the shared family environment of the infant causing psychological, behavioral and social changes in the individual. The term intergenerational transmission refers to instances whereby the traumatic effects are passed down from the directly traumatized generation [F0] to their offspring [F1], and transgenerational transmission is when the offspring [F1] then pass the effects down to descendants who have not been exposed to the initial traumatic event - at least the grandchildren [F2] of the original sufferer for males, and their great-grandchildren [F3] for females.

<span class="mw-page-title-main">Effects of climate change on mental health</span> Effects of climate change on mental health

The effects of climate change on mental health and wellbeing are documented. This is especially the case for vulnerable populations and those with pre-existing serious mental illness. There are three broad pathways by which these effects can take place: directly, indirectly or via awareness. The direct pathway includes stress-related conditions caused by exposure to extreme weather events. These include post-traumatic stress disorder (PTSD). Scientific studies have linked mental health to several climate-related exposures. These include heat, humidity, rainfall, drought, wildfires and floods. The indirect pathway can be disruption to economic and social activities. An example is when an area of farmland is less able to produce food. The third pathway can be of mere awareness of the climate change threat, even by individuals who are not otherwise affected by it.

Disaster psychiatry is a field of psychiatry which focuses on responding to natural disasters, climate change, school shootings, large accidents, public health emergencies, and their associated community-wide disruptions and mental health implications. All disasters, regardless of exact type, are characterized by disruption: disruption of family and community support structures, threats to personal safety, and an overwhelming of available support resources. Disaster psychiatry is a crucial component of disaster preparedness, aiming to mitigate both immediate and prolonged psychiatric challenges. Its primary objective is to diminish acute symptoms and long-term psychiatric morbidity by minimizing exposure to stressors, offering education to normalize responses to trauma, and identifying individuals vulnerable to future psychiatric illness.

<span class="mw-page-title-main">Dual representation theory</span>

Dual representation theory (DRT) is a psychological theory of post-traumatic stress disorder (PTSD) developed by Chris Brewin, Tim Dalgleish, and Stephen Joseph in 1996. This theory proposes that certain symptoms of PTSD - such as nightmares, flashbacks, and emotional disturbance - may be attributed to memory processes that occur after exposure to a traumatic event. DRT proposes the existence of two separate memory systems that run in parallel during memory formation: the verbally accessible memory system (VAM) and situationally accessible memory system (SAM). The VAM system contains information that was consciously processed and thus can be voluntarily recalled or described. In contrast, the SAM system contains unconsciously processed sensory information that cannot be voluntarily recalled. This theory suggests that the VAM system is impaired during a traumatic event because conscious attention is narrowly drawn to threat-related information. Therefore, memory of the trauma is heavily focused on fear, which affects information processing. This gives rise to PTSD symptoms such as trauma-related cognitions, appraisals, and emotions. The SAM system captures vivid sensory information during the traumatic event, which is automatically recalled through exposure to trauma-related triggers. This system is thought to be responsible for the presence of flashbacks and nightmares in PTSD symptomatology.

<span class="mw-page-title-main">Psychological impact of climate change</span> Aspect of climate change and society

The psychological impacts of climate change concerns effects climate change can have on individuals' mental and emotional well-being. They may also relate to more generalised effects on groups and their behaviours, such as the urge to migrate from affected areas of the globe to areas perceived as less affected. These impacts can manifest in various ways and affect people of all ages and backgrounds. Some of the key psychological impacts of climate change include: emotional states such as eco-anxiety, ecological grief, eco-anger or solastalgia. While troublesome, such emotions may not appear immediately harmful and can lead to a rational response to the degradation of the natural world motivating adaptive action. However, there can be other effects on health, such as post-traumatic stress disorder (PTSD), for instance, as a result of witnessing or seeing reports of massive wildfires, which may be more dangerous.

<span class="mw-page-title-main">Internet-based treatments for trauma survivors</span>

Internet-based treatments for trauma survivors is a growing class of online treatments that allow for an individual who has experienced trauma to seek and receive treatment without needing to attend psychotherapy in person. The progressive movement to online resources and the need for more accessible mental health services has given rise to the creation of online-based interventions aimed to help those who have experienced traumatic events. Cognitive behavioral therapy (CBT) has shown to be particularly effective in the treatment of trauma-related disorders and adapting CBT to an online format has been shown to be as effective as in-person CBT in the treatment of trauma. Due to its positive outcomes, CBT-based internet treatment options for trauma survivors has been an expanding field in both research and clinical settings.

Being exposed to traumatic events such as war, violence, disasters, loss, injury or illness can cause trauma. Additionally, the most common diagnostic instruments such as the ICD-11 and the DSM-5 expand on this definition of trauma to include perceived threat to death, injury, or sexual violence to self or a loved one. Even after the situation has passed, the experience can bring up a sense of vulnerability, hopelessness, anger and fear.

Trauma and post-traumatic stress disorder (PTSD) in Asian Americans is a growing topic related to trauma and racial psychology that requires more attention and research.

Scuba diving therapy is a type of treatment that consists of different scuba diving techniques and exercises. Essential elements are increased body awareness, social bonding, and breathing techniques. The goal is to improve physical and psychological well-being.

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