The link between exposure to trauma and substance use disorders has been well established. “Traumatic life experience, such as physical and sexual abuse as well as neglect, occurs at alarmingly high rates and is considered a major public health problem in the United States,” wrote Lamya Khoury et al in a 2010 study on the correlation between substance use, childhood traumatic experience, and Posttraumatic Stress Disorder (PTSD). Many other studies show as well that there is high comorbidity between PTSD with substance abuse disorders. In recent years a new traumatic stressor has appeared on the scene: global climate change!
“Climate change can be considered an additional source of stress to our everyday concerns, which may be tolerable for someone with many sources of support but can be enough to serve as a tipping point for those who have fewer resources or who are already experiencing other stressors,” writes the American Psychological Association (APA) writes its 2017 report on the impact of climate change on mental health, co-authored by Climate for Health and EcoAmerica, both environmental organizations.
“From wildfires and drought in California to severe flooding in Maryland to Alaskan communities threatened by rising seas, we are clearly living through some of the most severe weather events in US history as a result of damage to our climate.” Being directly exposed to these kinds of severe weather events can have physical and mental consequences. Watching their entire community go up in flames may certainly traumatize people witnessing such an event. But even just watching wildfire coverage on the news constantly can be a source of unhealthy stress. And then there is the persistent looming threat of a global climate crisis with possibly devastating consequences in the future and present impact on mental health.
According to the APA, mental health consequences of climate change may include:
- Depression, stress, and anxiety
- Strains on social relationships
- Complicated grief
- Substance use disorder (SUD)
- Post-traumatic stress disorder (PTSD)
- Loss of personal identity
- Helplessness and fatalism
This reads like a standard list of co-occurring mental issues for substance use disorder (although SUD is also included in that list as well). Depression, stress, anxiety, PTSD, and fatalism are widely regarded as drivers of SUDs by addiction professionals.
Equally interesting are the remedies the APA recommended in the report for practitioners,
policymakers, and communicators to help people recover from climate change-related mental trauma. The following list represents the top five recommendations:
- Build belief in one’s own resilience.
- Foster optimism.
- Cultivate active coping and self-regulation skills.
- Maintain practices that help to provide a sense of meaning.
- Promote connectedness to family, place, culture, and community.
These are some of the main pillars of any effective addiction treatment program—a strong indication of the correlation of mental health issues and substance use disorder.
“The APA recommendations are very much aligned with our own therapeutic interventions to rebuild families and clients’ sense of self,” says Muir Wood’s clinical director Carolyn Younger. “Developing and promoting a sense of community within Muir Wood is paramount in our residential treatment program so that Muir Wood becomes a sort of parallel family system. We learn that taking care of our own needs as well as the needs of our families and communities is tantamount to feeling connected which reduces feelings of hopelessness and loneliness.”
“The California wildfires brought the Muir Wood community together as there was a common concern regarding the health of the land we live on and the health of the people in our families and communities,” says Younger. “We were confronted with the big question, ‘Are we really safe?’ This increased our awareness of the fragility of the planet, and whether or not our lives were going to change dramatically because of it. At Muir Wood, activities had to be confined to the inside and we all had to wear masks. In some ways, this actually promoted distress tolerance and coping skills within ourselves and vis-à-vis one another because our space shrank from being largely outside across acres to being confined inside. We couldn’t use the outside to de-escalate or escape, but it meant activating coping skills. In a way that was a blessing.”
While the impact of disasters such as wildfires may include many acute challenges for a person’s psychological well-being, the much more gradual impact of climate change causes long-term chronic psychological consequences. These gradual changes in the climate and even just their anticipation can be the source of troubling emotions, such as fear, anger, feelings of powerlessness, or exhaustion. Some clinicians have termed this condition “ecoanxiety.”
Climate events and ecoanxiety strike young people the hardest. Physically, children are more sensitive to temperature, because their physiological regulatory systems may be less effective. Mentally, children may experience PTSD and depression following traumatic or stressful experiences with more severity and prevalence than adults.
“Children’s fears about climate change revolve around known and mysterious future effects. Direct experience with natural disasters can cause symptoms of post-traumatic stress disorder, including panic symptoms, nightmares, and phobic behavior,” the APA report quotes Elizabeth Haase, MD. “Children also develop symptoms because they fear losing control over an unknown future. Often obsessive-compulsive behaviors result, such as picking up every piece of garbage on the way to school or running relentlessly through ‘what if’ scenarios.” One of Dr. Haase’s young patients “terrified that climate ruin would leave him poisoned by toxins, developed a rigid nightly schedule of self-improvement to prepare and educate himself. Only by checking off every evening ritual could he ward off panic attacks and insomnia.”
Other children—adolescents in particular—are tempted to self-medicate such fears and panic attacks with drugs and alcohol. The Muir Wood team frequently encounters young patients suffering from ecoanxiety who have been trying to mitigate their emotional pain by misusing drugs and alcohol. Anxiety rates among people under 25 are way up and suicide rates have been climbing among US teenagers for almost a decade now.
A number of trends contribute to this mental health crisis: the prevalence of social media and its interpersonal stresses on young people, a decline of face-to-face interaction of the “super-connected” kids, and the rise of emotional reasoning, when uncomfortable facts are dismissed because they cause strong negative feelings, i.e. stress.
A 2018 study released by the Barna Research Group shows that Generation Z (the current emerging generation of people born in the late 1990s or early 2000s) is more emotionally affected by the perils of social media than other generations who are also active online. A full third of Generation Z seems to be emotionally affected negatively by the many posts they view online on a daily basis. That percentage is far lower for boomers and there is plenty of evidence that “feeling down” about what they see online often translates into depression and anxiety for that generation—both conditions are certainly on the rise among teens.
According to the NOLA Group, half of the Gen Z cohort is connecting online 10 hours a day to content most of which may have a negative emotional impact. In the Barna survey, 31 percent of Gen Z participants affirmed that “Looking at other people’s posts often make me feel bad about the way I look.” 33 percent stated that they have experienced bullying on social media. Based on the relentless and continuous smartphone activity of this cohort, psychology professor and author Jean Twenge named this generation “iGen.”
“The complete dominance of the smartphone among teens has had ripple effects across every area of iGen’ers’ lives, from their social interactions to their mental health,” Twenge writes in her 2017 book iGen. “The average teen checks her phone more than eighty times a day.” Twenge fears that “They are at the forefront of the worst mental health crisis in decades, with rates of teen depression and suicide skyrocketing since 2011.”
The increasingly pervasive coverage of the global climate crisis is now piling on other chronic stressors such as income insecurity in a globalized economy, increasing lack of religious affiliation, and general uncertainty about what the future might bring.
Such fears and anxieties need to be countered with healthy coping skills which build resilience instead of numbing unhealthy emotions with addictive substances. If a substance use disorder develops, its treatment needs to address all the biopsychosocial factors involved to result in a successful recovery.