Forced Uprooting: Effects of Climate on Mood and Behavior

TALES FROM THE CLINIC

-Series Editor Nidal Moukaddam, MD, PhD

In this installment of Tales From the Clinic: The Art of Psychiatry, we look at the effects of climate on mood and behavior. The impetus for this piece stemmed from a discussion of irritability on hot days, and how individuals may react to increasing extreme weather events. Both heat and extreme events cause life disruption, as well as increases in intimate partner violence, trauma, and mood/suicidal symptoms, but seem to follow socio-economic fault lines. One wonders if climate anxiety, as it is currently understood, is itself a privilege in some ways.

Case Study

“Mr Adams” is a 38-year-old White farmworker with no previously diagnosed psychiatric history and no known medical history who presented for intake to the outpatient psychiatry clinic for approximately a 1-year history of increasingly low mood, worsening worries and ruminations, poor sleep, limited appetite, and ongoing fatigue. He describes a “constant worry about the future” associated with a sense of guilt in the setting of his recent move that required him to leave behind his family’s generational farmland.

Mr Adams describes growing up in a rural town in Texas where his childhood was deeply intertwined with the climate’s agricultural rhythms. He reports his family lineage had harvested cotton, corn, and soybeans for generations. However, over the past few years, this pursuit had become less fruitful for the family in the setting of prolonged heat waves and recurrent drought. He describes that the land “stopped responding to the seasons,” resulting in fewer and fewer viable crops. They also suffered from freezing temperatures, which had rarely been seen in that area. Both the heat and the intermittent yet severe freezes hurt the crops.

Alongside this decreasing crop yield, Mr Adams noticed his neighborhood became increasingly unsafe—it was not uncommon to hear gunfire throughout the night. He worried about his safety, along with the safety of his wife and children. Unable to continue to sustain his livelihood, Mr Adams and his family relocated to a suburb of Montanna, a move he describes as a “forced uprooting” with associated profound homesickness and a sense of betrayal for leaving the land and lifestyle maintained by his family for generations. Despite active job searching, he was unable to find employment in Montana related to agriculture and currently works part-time in construction services.

He worries consistently about rebuilding the financial and emotional stability he found in Texas. He describes ongoing mourning of his sense of community, identity, and purpose, which is impacting his relationship with his wife and children. His symptoms manifest physically as chest tightness, irritability, and dread when stepping outside into the hot Montanna heat. He avoids the news or checking the weather out of fear of seeing the constantly elevated temperatures triggering his existential dread. He has found it difficult to get out of bed in the morning and has had no interest in socializing. He often lays awake at night thinking about his past-life, finding himself not infrequently ruminating until 1 or 2 in the morning.

Upon completing Mr Adams’ intake, “Dr Patterson,” a 32-year-old female psychiatrist, reflected on her countertransference of kinship, sorrow, and anger. She found the assessment brought up her own uncertainty surrounding childbearing in the setting of ongoing global instability, recognizing the environmental impact of ongoing population expansion. Mr Adams’ grief over his loss of purpose and identity in the setting of a changing global climate appeared to mirror Dr Patterson’s anticipatory grief and shifting identity, also tied to changes in the global climate. She found herself reflecting on how climate-related disruptions extended beyond simply environmental events and into profound psychological stressors capable of reshaping one’s identity, livelihood and life trajectory.

Discussion

We are all subject to rising global temperatures, which have increased by an average of 0.11° Fahrenheit, or 0.06° Celsius per decade since 1850, or an approximate 2° F temperature increase overall.¹ However, younger individuals have experienced this change more rapidly, as the temperature rise is nonlinear—the rate of warming since 1982 has been calculated to 0.36° F, or 0.20° C, per decade.¹ Not only was 2024 the warmest year since global temperature records began in 1850, but the warmest 10 years in history have all occurred between 2015-2024.¹

While we are all subject to these changes, research has shown us that certain groups are more heavily impacted by, and vulnerable to, temperature shifts. Individuals in lower socioeconomic status groups, including those with lower income and educational attainment levels, have been shown to face greater exposure, and display lower adaptive capacity to, increasing temperatures.^2,3 Older adults appear to engage in a “vulnerability paradox” in which, while they remain one of the higher-risk groups to be affected by rising global temperatures, they may not perceive themselves as vulnerable and thus underprepare, further increasing their risk.⁴

A recent meta-analysis demonstrated that depression, anxiety, and posttraumatic stress disorder are worsened in individuals from low socioeconomic or marginalized groups, including those from disadvantaged racial and ethnic groups and with housing insecurity, following extreme climate events, including cyclones or wildfires.⁵ A Fundamental Cause Theory has been postulated to explain the link between lower socioeconomic status and the increased impact of climate change, explaining that socioeconomic status shapes access to financial, social, and institutional resources that buffer or exacerbate climate-associated stress.⁶

Another argument posits that climate change asks as a risk amplifier for underlying mental health concerns by disrupting social, economic, and environmental conditions that cultivate all facets of well-being, conditions that are already less stable, if accessible at all, to lower socioeconomic groups.⁷ Poorer housing and less access to health care are thought to compound vulnerability to climate stressors, leading to potential reductions in life expectancy.⁸

In relation to life expectancy, an influential 2013 study found that the 20% most disadvantaged neighborhoods in St. Louis, Missouri absorbed more than half of the climate-change-related increases in violence, further highlighting the interconnection between violence, climate change, and socioeconomic status.⁹ This relationship is supported by more recent work, which hypothesizes that a lack of adaptive capacity to temperature increases, through air conditioning or green infrastructure, plays a role in the more pronounced heat-induced crime in poorer neighborhoods.¹⁰ In New York City, higher air conditioning use during maximum monthly temperatures was associated with lower shooting rates, suggesting that cooling and housing access interventions may mitigate violence risk.¹¹

In further relation to life expectancy, numerous studies have highlighted an inverse relationship between climate-related anxiety and fertility intentions, including a desire to avoid having children or a decision to have a smaller family than originally planned.^12-15 Interestingly, while extensive literature exists investigating the relationship between lower socioeconomic status and the impacts of climate change, most of the literature on climate anxiety has been focused on Western, educated, industrialized, and wealthy individuals.¹⁶ This relationship appears to suggest that individuals of higher socioeconomic status are experiencing climate anxiety in a different way than individuals of lower socioeconomic status, specifically in the realm of child bearing decisions.

Suggested interventions for climate anxiety emphasize a grief-informed, holistic, nature-based approach.^17,18 Advocacy, volunteering, and community engagement are also recommended strategies.¹⁷ Nature-based treatment approach recommendation appear to further highlight the disparity in climate anxiety interventions, as individuals from lower socioeconomic groups have been shown to have more limited access to greenspace.¹⁹ Similarly, advocacy, volunteering and community engagement efforts suggest an individual has disposable time, a sophisticated education level, and access to community resources or leaders, all of which are resources that might be limited in a lower socioeconomic group.

Concluding Thoughts

The landscape of climate-related vulnerabilities is complex and unequal—while rising global temperatures affect everyone, its impact is neither evenly distributed nor uniformly experienced. Individuals with lower socioeconomic status, limited health care and greenspace access, and unstable housing are disproportionally burdened by the direct and indirect consequences of climate change, including detriments to mental health, increased violence exposure, and decreased overall life expectancy. While climate anxiety many manifest as immediate survival threats in this population, individuals of higher socioeconomic status may voice their concerns through altered fertility intentions, highlighting an area ripe for future investigation.

Currently recommended interventions at reducing climate anxiety, including nature-based therapies, community engagement, and advocacy work, seem to rely on resources often inaccessible to the very groups most affected by climate changes. Effective responses to climate anxiety must be rooted in awareness of these structural vulnerabilities. Mitigating the psychosocial, social, and physical harms of climate change requires not only addressing global temperature changes but confronting the longstanding social inequities that magnify its effects.

Dr Beal is a psychiatry resident at Baylor College of Medicine.

Dr Moukaddam is a professor of psychiatry in the Department of Psychiatry at Baylor College of Medicine and the director of outpatient psychiatry at Harris Health System. She also serves on the Psychiatric Times Editorial Board.

References

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