Climate anxiety & lifestyle medicine
2nd Dec, 2021


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Welcome to Common Ground, a podcast series discussing new research and interesting projects in the field of complementary medicine. Hello, my name is Wendy McLean, educator at vital.ly.

vital.ly is a digital platform, a professional health resource, and a distribution service all in one.

Firstly, I’d like to begin by acknowledging the Gadigal people of the Eora Nation as the traditional custodians on the land on which we gather here. I would also like to pay my respect to their elders, both past and present.

Today I'm discussing one of the often-overlooked aspects of climate change, which is the effect on mental health. And specifically, I'm going to delve into this emerging concept of climate anxiety and look at lifestyle interventions that can help individuals mitigate and adapt to the risks of climate change while also strengthening their mental health and the health of the planet.

Climate change is no longer a distant, unimaginable threat. It is a growing reality, and the UN secretary general called the recent IPCC report on the climate crisis “a code red for humanity”.

The projections from this report suggest an increase of two degrees or more in the global average temperature could be realised by the end of the decade. And scientists agree that to stave off the irreversible consequences from climate change, global greenhouse gas emissions must be cut in half within the next 10 years and bought to net zero by 2050.

Climate change poses, a fundamental threat to both planetary and human health. And these health effects can be direct, such as due to injury or death from extreme weather events, or they can be indirect and arise from things like air pollution, heat waves, changing vector patterns and food and water insecurity.

The World Health Organisation estimates 12.6 million deaths can be attributed to environmental factors which are exacerbated by climate change.

Furthermore, climate changes are expected to cause an additional quarter of a million deaths worldwide per year, between 2030 and 2050.

And with a growing awareness of climate change and an increased sense of urgency to reverse the impact of global warming, is it any wonder that we're seeing a rise of climate anxiety?

So what exactly is climate anxiety?

 Well, the term first started appearing in the literature as early as 2007. However, it didn't become a mainstream concept untll later, probably around 2017, when the American Psychological Society released a report providing a working definition for eco-anxiety. And there's been a particular focus on it since 2018, where there’s been this increasing media coverage about climate anxiety. And a point for this discussion has been on the young climate activist, Greta Thunberg, who has spoken of her climate change anxiety.

Climate anxiety is a heightened, emotional, mental, or somatic distress in response to dangerous changes in the climate system.

There are several definitions for eco-anxiety and these include chronic fear of environmental doom or anxiety experienced in response to the ecological crisis. And eco-anxiety and climate anxiety are often used interchangeably.

And then there are several other terms which can be used to describe climate change related stress. These include solastalgia, and this is the distress that is produced by environmental change impacting on people while they are directly connected to their home environment. And this has been studied in indigenous communities, such as the Inuit.

Then there's ecological grief, which explains grief felt in response to experienced or anticipated losses in the natural world. And then there's eco-angst, which is a feeling of despair at the fragile condition of the planet. And regardless of the definition, common elements to all of these include a description of the challenging emotions due to an awareness of climate change and environmental threats, and collectively they're referred to as psychoterratic or earth-related syndromes.

So how common is climate anxiety?

Well, there's been several national surveys done over the last few years in different countries around the world to assess this. In 2018, the American Psychological Association conducted the “Stress in America” survey and found that nearly 70% of adults in the US reported being worried about climate change and 51% of respondents listed climate change as a somewhat or significant source of stress.

Last year, there was a study done in Australia of nearly five and a half thousand adults, and it found that while Australians are concerned about COVID-19, they were almost three times more concerned about climate change.

And just recently there was a landmark survey conducted and published. This study included 10,000 youth from 10 countries around the world. And they found that nearly 60% of respondents said they felt very worried or extremely worried, many associated negative emotions with climate change. So things like feeling sad, anxious, and afraid.  And 45% of respondents said their feelings about climate change affected their daily lives.

And there are certain populations that are more at risk of developing climate anxiety, and you don't have to have necessarily experienced a natural disaster or an extreme weather event to be at risk. Indigenous populations are potentially at risk because they rely on the natural environment and they're at risk of losing their livelihood and their heritage and their sense of identity. Then we have displaced communities; people who are exposed to physical, environmental changes like rising sea levels. We have first responders to environmental disasters and environmental and climate scientists. People with pre-existing health conditions and mental health disorders are more at risk, as are people of lower socioeconomic status and females.

Young children and adolescents are particularly vulnerable. They are at a crucial point in their physical and their psychological development, when enhanced vulnerability to the effects of stress and everyday anxiety elevate their risk of developing mental health disorders, such as depression and anxiety.

And this vulnerability can occur in utero, so before they're even born. There are numerous studies demonstrating that stress during pregnancy is linked to preterm birth and obstetric complications, and these are risk factors for neurodevelopmental and psychiatric disorders. Exposure to transient environmental stresses in utero has been shown to be associated with epigenetic changes. And these can potentially increase metabolic, immune, and neuro-psychological conditions that may persist throughout life.

So looking now at the symptoms of climate anxiety.

We know that anxiety is a fundamental process that serves as an adaptive response in humans. It does involve negative emotions and is characterised by physical symptoms and future-oriented apprehension. As it is future-oriented, it can lead to appropriate and adaptive responses. However, in more extreme forms, it is maladaptive and leads to dysregulation of emotions and a chronic state of worry.

Several studies have reported on the symptoms specifically related to climate anxiety, and they've included things like adverse emotional reactions, such as irritability, weakness, a sense of helplessness or hopelessness, frustration, and anger, and feeling scared.

Other symptoms include depression, sleep disturbance, a state of apathy and physical symptoms such as digestive issues, headaches, unexplained muscle pains, and excessive sweating.

Now people also report positive symptoms. As I said, anxiety can lead to an adaptive response. And there was an American survey that was published in 2020 that found that people who reported eco-anxiety were more than twice as likely as those who did not to say that they're motivated to change their behavior in order to reduce their contribution to climate change.

So how do we assess or measure climate anxiety?

Because it's not considered a diagnosable mental disorder under the DSM-V, the condition lacks clear diagnostic criteria. However, several researchers have developed scales over the last few years to assess the prevalence of climate anxiety; so looking at its occurrence across populations and across time. So not necessarily a clinical diagnosis, but they may be useful tools.

And for example, there was a 13-item scale for assessing climate change anxiety and personal wellbeing that was published last year. Eight of the items on the scale looked at cognitive and emotional impairments. So how thoughts about climate change impacted things like concentration and sleep. And then five items measured functional impairment - so how it impacted relationships and the ability to work or attend school.

So how can we support the individual to build mental resilience, to face the challenging impacts of climate change?

This is where lifestyle medicine can really play a role. Lifestyle medicine includes nutritional and lifestyle factors that have positive effects on physical and mental health. But these interventions can also have a positive effect on the environment.

The first one I'm going to look at is nutrition. There's a lot of literature demonstrating the health benefits of particular eating patterns, such as whole foods, flexitarian or Mediterranean, and numerous population studies and randomised control trials demonstrate positive effects for mental health and also metabolic health, immune function and gut microbiome.

Now, many of these eating patterns are also beneficial for the environment. In fact, in 2019 EAT-Lancet Commission on Food, Planet and Health developed the “Planetary Health Diet”, and this provides guidelines for optimal diet for human health and environmental sustainability. It emphasises a plant-based diet where whole grains, fruits, vegetables, nuts, and legumes comprise a greater proportion of foods consumed and meat and dairy constitute important parts of the diet, but in significantly smaller proportions. And the study found that a global shift towards this flexitarian diet, with significant reductions in red meat consumption, could potentially reduce diet-related disease mortality by 11 million people per year, and significantly reduce greenhouse gas emissions.

Now it's not just what we eat. It's what we do with our food as well. One third of all food produced is wasted or lost. Australia creates greater than two and a half million tonnes of food waste per year. So this equates to one in five shopping bags worth. Now food waste is responsible for 8 to 10% of our global greenhouse gases. And if food waste was a country, it would be the third biggest emitter. So at an individual level by reducing our food waste, we can have a positive effect on greenhouse gas emissions, and we have a positive effect on our mental health by this proactive action.

Now, physical inactivity has been linked to 3.2 million deaths a year and multiple chronic diseases, including obesity, diabetes, cardiovascular disease, and also mental health disorders as well. So numerous evidence shows that exercise plays a role in alleviating symptoms of mental health conditions. So it can prove improve stress, anxiety, and depressive symptoms. And when this exercise or physical activity is done outdoors, there may be a synergistic effect on mood, social connectedness, and stress management.

Exercise can be incorporated into daily life by active transport. So things like walking or cycling to work or school rather than driving or taking public transport, and active transport can reduce greenhouse gas emissions and also reduce morbidity from some of these chronic diseases. In fact, a study found if there was a global increase in levels of active transport, more than 1 million deaths could be avoided.

And as I mentioned nature, so connecting with nature has benefit. Now there's this concept of Shinrin-yoku or forest bathing, and it was developed in Japan in the 1980s, specifically to combat stress and death from overwork. And it's now accepted around the world. And it's supported by governments and there's been a lot of research looking at the health benefits of forest bathing. It's been found to have positive effect on things like cardiovascular disease, blood pressure, stress levels, and pulmonary benefits as well. And there was a meta-analysis of 20 studies that was published last year and found that different bathing techniques, things like breathing, walking, or doing yoga in nature, were particularly beneficial for reducing acute mental health symptoms and specifically anxiety.

Now, there was another meta-analysis that was just published, looking at 50 studies, and it found that nature-based interventions were effective for improving depressive mood and reducing anxiety in different populations, including those with pre-existing mental health problems. And it found that the most effective interventions were offered for between eight to 12 weeks and the optimal dose ranged from 20 to 90 minutes. Beneficial activities included gardening, green exercise, and nature-based therapy.

Now another intervention is mind-body therapies, such as meditation and mindfulness, and they may be helpful to proactively help people address the climate change-related stresses and anxiety. Again, there's numerous evidence looking at the benefits of meditation and mindfulness to reduce stress, inflammation and improve immunity. And there's been a few studies looking particularly at the role of mindfulness to build psychological resilience in the face of the changing climate. For example, there was a Swedish study of 600 households, which were at risk of severe climate change, and they showed that individual mindfulness coincided with higher motivation to take climate adaptation actions or to support them.

And so that leads me to my final point, which is pro-social behaviour.

So pro-social behavior is this act of volunteering or helping, sharing, or working with an individual or a group, cooperating.  Studies show that pro-social behavior has mental and physical health benefits. It can improve self-resilience and the ability to withstand trauma and help adapt to climate change and environmental stresses.

Specifically, several studies have looked at environmental volunteering and they found that it provides new skills, improved social connection, improves mental health, and also this connection to place and nature. And there's been studies of youth activists involved in the global climate strikes and other climate change initiatives, and they report feeling a sense of social connection, improved mood and a sense of purpose as well. So social activism can support this connectedness while facilitating initiatives that have benefits for mental health and environmental benefits.

So the take home points today are:

  • Climate change's current and future impact may elevate people's experiences of fear, distress, and climate anxiety which can manifest in many ways.
  • And although climate anxiety is not a recognised psychological condition in the DSM-V, it can profoundly impact lives of vulnerable populations. In fact, in youth, more than 45% report climate anxiety affecting their daily lives. And recent surveys indicate that Australians are three times more worried about climate change than COVID-19.
  • Lifestyle medicine interventions have the potential to not only improve mental resilience and adaptation to climate change but improve planetary health as well.

So thank you very much for listening today. And if you would like to, we would love it if you would subscribe to Common Ground. We do appreciate your support and feel free to leave us a review, we'd love to hear from you. Thank you.