The world’s climate is changing in every region and across the whole climate system, the Intergovernmental Panel on Climate Change Working Group confirmed in its report Climate Change 2021: the Physical Science Basis in August 2021.  Described by the United Nations secretary general António Guterres as a “code red for humanity,” the report’s alarm bells were “deafeningly loud,” spelling out the irrefutable facts that “greenhouse gas emissions from fossil-fuel burning and deforestation are choking our planet and putting billions of people at immediate risk, and many of the changes are becoming irreversible.” 
For the eco-anxious, more concerning than even this apocalyptic news is the extraordinary level of indifference and banality with which the climate crisis is treated by many others, including those in positions of influence. Eco-anxiety is growing, and refers to the chronic fear of environmental doom probably first described in 2017 by the American Psychiatric Association.  Although not yet formally considered a diagnosable condition, recognition of eco-anxiety and its complex psychological responses is increasing, as is its disproportionate impacts on children, young people, and the communities with the least resources to overcome the adverse consequences of the climate crisis. 
Does eco-anxiety matter when compared with the more familiar climate change impacts on physical health, such as heat-related stress, asthma and allergies, vector borne illness, and the health consequences of floods and droughts? The true burden of its costs and consequences has yet to be estimated but is likely to be significant and potentially damaging to individuals and society. Evidence points to a clear relation between experiencing climate change effects and the increased risks of depression, low mood, extreme mental distress, post-traumatic stress disorder, suicide, and further deterioration in those with a history of mental illness.  One study carried out in the US showed high levels of fear among respondents aged 27 to 45 about their offspring struggling through a climate apocalypse and the factoring in of climate change into their reproductive choices. [5,6] While the scale of this anxiety is unknown, it is likely to grow worldwide.
Anxiety in young people
A 2020 survey of child psychiatrists in England highlighted that more than half (57%) are seeing children and young people distressed about the climate crisis and the state of the environment. [7,8] That climate anxiety is not confined to the UK was confirmed very recently by the “largest and most international” survey of climate anxiety in young people aged 16 to 25 to date, which showed that the psychological (emotional, cognitive, social, and functional) burdens of climate change are “profoundly affecting huge numbers of these young people round the world.”  Not surprisingly, respondents from countries in the “global south,” who may have experienced or observed climate change, expressed more worry and greater impact on functioning, but significant numbers from all countries reported feeling “very or extremely worried and that their feelings about climate change had affected their daily lives.” Furthermore, it is the first study to offer insights into how young people’s emotions are linked with their feelings of betrayal and abandonment by governments and adults. Governments are seen as failing to respond adequately, leaving young people with “no future” and “humanity doomed.”
The mental health impacts of the climate crisis have profound implications. Psychological responses, such as conflict avoidance, fear, helplessness, and resignation, are serious barriers to collective action to mitigate further global warming and to build resilience and adaptation strategies. Neglecting the effects of increasing eco-anxiety risks exacerbating health and social inequalities between those more or less vulnerable to these psychological impacts. The socioeconomic effects—as yet hidden and unquantified—will add considerably to the national costs of addressing the climate crisis.
What is to be done to alleviate the rising levels of climate anxiety? The best chance of increasing optimism and hope in the eco-anxious young and old is to ensure they have access to the best and most reliable information on climate mitigation and adaptation. Especially important is information on how they could connect more strongly with nature, contribute to greener choices at an individual level, and join forces with like-minded communities and groups. Spending time in nature as a family is one of many actions suggested by the Royal College of Psychiatrists to manage eco-distress in children and young people.  Helping individuals to build their emotional resilience and optimism is also of benefit.
The climate crisis is an existential threat, and fearfulness about the future cannot be fully tackled until a common united global strategy is put in place to address the root cause, global warming, and to give everyone—especially the young and the most vulnerable communities—the hope of a better future. John Kenneth Galbraith, the distinguished American economist, said, “All of the great leaders have had one characteristic in common: it was the willingness to confront unequivocally the major anxiety of their people in their time. This, and not much else, is the essence of leadership.” We must hope that our leaders recognise the challenges ahead, the need to act now, and the commitment necessary to create a path to a happier and healthier future, leaving no one behind.
Mala Rao, Ethnicity and Health Unit, Department of Primary Care and Public Health, Imperial College London, London, UK and NIHR Applied Research Collaboration North West London, London, UK
Richard A. Powell, Ethnicity and Health Unit, Department of Primary Care and Public Health, Imperial College London, London, UK and NIHR Applied Research Collaboration North West London, London, UK
1. InterGovernmental Panel on Climate Change. 2021. https://www.ipcc.ch/site/assets/uploads/2021/08/IPCC_WGI-AR6-Press-Release_en.pdf.
2. United Nations. UN secretary-general calls latest IPCC climate report ‘code red for Humanity’, stressing ‘irrefutable’ evidence of human influence. 2021. https://www.un.org/press/en/2021/sgsm20847.doc.htm
3. Clayton S, Manning CM, Krygsman K, Speiser M. Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association, and ecoAmerica, 2017. https://www.apa.org/news/press/releases/2017/03/mental-health-climate.pdf.
4. Lawrence E, Thompson R, Fontana G, Jennings N. The impact of climate change on mental health and emotional wellbeing: current evidence and implications for policy and practice. Grantham Institute Imperial College London Briefing paper, 2021. 10.25561/88568
5. Schneider-Mayerson M, Leong KL. Eco-reproductive concerns in the age of climate change. Clim Change 2020;163:1007-23. doi:10.1007/s10584-020-02923-y.
6. Carrington D. Climate ‘apocalypse’ fears stopping people having children—study. Guardian 2020. https://www.theguardian.com/environment/2020/nov/27/climate-apocalypse-fears-stopping-people-having-children-study.
7. Watts J, Campbell D. Half of child psychiatrists surveyed say patients have environment anxiety. Guardian 2020. https://www.theguardian.com/society/2020/nov/20/half-of-child-psychiatrists-surveyed-say-patients-have-environment-anxiety
8. Royal College of Psychiatrists. The climate crisis is taking a toll on the mental health of children and young people. 2020. https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2020/11/20/the-climate-crisis-is-taking-a-toll-on-the-mental-health-of-children-and-young-people?searchTerms=child%20psychiatrists%20survey
9. Marks E, Hickman C, Pihkala P, et al. Young people’s voices on climate anxiety, government betrayal and moral injury: a global phenomenon. https://ssrn.com/abstract=3918955 or 10.2139/ssrn.3918955
10. Royal College of Psychiatrists. Eco-distress: For parents and carers. https://www.rcpsych.ac.uk/mental-health/parents-and-young-people/information-for-parents-and-carers/eco-distress-for-parents-and-carers