Psychiatry Needs to Care About Climate Change: Reflections From the 2025 APA Annual Meeting

"It is important for psychiatrists to start realizing and addressing how much climate change is affecting their patients," said Badr Ratnakaran, MBBS, the Climate Change Section Editor of Psychiatric Times at the 2025 American Psychiatric Association (APA) Annual Meeting.

Climate change has been named the greatest threat to human health in the 21st century.¹ Patients with psychiatric disorders are at increased risk of climate adverse effects, particularly from heat exposure, due to physiological vulnerability; the neurotransmitters that are involved in thermoregulation are also involved in the disease processes of schizophrenia and depression.² Neuroleptics have varying degrees of anticholinergic and anti-alpha-adrenergic effects, both of which impair heat dissipation; anticholinergic properties decrease sweating and alpha-adrenergic blockade causes vasodilation, which may enhance heat absorption from the environment.³

Patients may also be deeply affected by climate anxiety, experiencing solastalgia, eco-anxiety, eco-grief, eco-trauma, climate anxiety, and ecological posttraumatic stress disorder (PTSD), as well as denial and apathy.⁴

"They may read about climate-related disasters, or worry about what will happen to their children. We have to help our patients become more resilient to climate change," said Ratnakaran.

To learn more about Ratnakaran, check out our welcome interview here: New Psychiatric Times Climate Change Section Editor.

Dr Ratnakaran is an assistant professor and geriatric psychiatrist at Carilion Clinic-Virginia Tech Carilion School of Medicine. He also serves as the medical director of CONNECT, 24-hour emergency evaluation and referral service of Carilion Clinic.

References

1. Costello A, Abbas M, Allen A, et al. Managing the health effects of climate change: Lancet and University College London Institute for Global Health Commission. Lancet.2009;373(9676):1693-733.

2. Bark N. Deaths of psychiatric patients during heat waves. Psychiatr Serv. 1998;49(8):1088-1090.

3. Lefkowitz D, Ford CS, Rich C, et al. Cerebellar syndrome following neuroleptic induced heat stroke. J Neurol Neurosurg Psychiatry. 1983;46(2):183-185.

4. Cianconi P, Hanife B, Grillo F, et al. Eco-emotions and psychoterratic syndromes: reshaping mental health assessment under climate change. Yale J Biol Med. 2023;96(2):211-226.