Extreme weather post-traumatic stress disorder

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

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 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 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.

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]

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.

One possible treatment for extreme weather PTSD is psychological debriefing, but this has been shown to be an ineffective intervention for flood events.[15] 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.[16]

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.[17]

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.[18]

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.

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.

UK flooding and heat waves

PTSD after extreme weather events leading to flooding in the United Kingdom was recorded at 30.36%.[20]

Wildfire spreads in Fort McMurray.