As I finish writing this article, the UK has recorded its hottest ever temperature at 40.3°C. It is ridiculously hot, and I’m thankful that I own an air conditioner as I’m prone to dehydration, and at a higher risk of heat stroke. With such hot summers, you really need to be prepared.
For this reason, my partner bought me an air conditioner back in the mid-2010s. There was one summer where I was experiencing symptoms of heat stroke dearly every day for the entire summer. The room in which I lived would turn into an oven and become unbearable, even on days where it was only 28°C. But on the really hot days, my room would jump to over 40°C. My GP ordered a bunch of tests because this was something they’d never come across before. As you can imagine, this really did a number on my health and mental wellbeing, which is why I wanted to write this article.
Hot Weather And Mental Health
As new temperature records seem to be broken almost every year as we endure more hot summers, we often talk about the elderly. I’m not saying that’s wrong, because you should check on your elderly neighbours, family, and friends during such unrelenting heat. However, I’m here to make the case for doing the same with people you know who have mental health issues as well.
My reasons for this? Well, an article by The Guardian reported on the most comprehensive study to date on how summer heat is affecting us. According to this article and study, our hot summers are causing an increase in mental health emergencies.
This is echoed by the APA (2021, June 30), who warn that across the USA, their extremely hot summers are having a significant impact on mental health and physical health. Adding, that people with pre-existing mental illnesses are especially vulnerable.
A study by Hansen, Bi, Nitschke, Ryan, Pisaniello, and Tucker (2008) found that above 26.7°C, they observed a positive relationship between our hot summer temperatures and hospital admissions for mental and behavioral disorders. Thus, the results highlight how our hot summers pose a genuine risk to those of us with mental health issues.
This is supported by Mullins and White (2019) study, who estimates that a 0.56°C (or 1°F as stated in the study, but Fahrenheit makes no sense to me) average monthly temperature increase was associated with a 0.48% increase in mental health A&E (emergency department) visits and a 0.35% increase in suicides. They also found through mental health self-reports that a 0.56°C (1°F) increase in temperature causes a 0.06% increase in the number of days of reported poor mental wellbeing.
Just to emphasise just how real a problem our hot summers are, Liu et al. (2021) conducted a meta-analysis study of peer-reviewed epidemiological studies on heat exposure and mental health outcomes (1990-2020). The team found that for every 1°C increase in temperature during our hot summers, there is an associated 2.2% increase in mental health-related mortality.
The Risks Of Hot Summers
There are countless studies that show the connection between the extreme heat of our hot summers and its negative impact on mental health. These studies have shown us that hot weather can increase irritability and symptoms of depression (APA, 2021, June 30) and can cause an increase in suicides (APA, 2021, June 30; and Mullins and White, 2019).
Those of us who take medications, especially psychiatric medications, are also at an increased risk during our hot summers. As reported by CNBC News, people with fibromyalgia are also potentially at risk because they can be prescribed antidepressant like Cymbalta. Cymbalta helps treat the symptoms of fibromyalgia. However, it can have side effects like profusive sweating, ankle swelling, shortness of breath, and causing the person to feel faint when it gets too hot.
Don’t worry, this is supported by a proper study, one conducted by Christenson, Geiger, and Anderson (2013). They conducted a case series on 27 heat related fatalities during the summer of 2012 in Wisconsin, (USA). They found that 52% of those heat related fatalities had a mental health condition. Of those 14 cases with a mental illness, half were taking a psychiatric medication.
I was diagnosed with persistent postural-perceptual dizziness (PPPD), and one of the treatment options for managing PPPD is taking antidepressants. After experiencing vertigo episodes, I decided to try taking antidepressants to better manage my conditions. Thus, anyone like me, who is taking psychiatric medications for reasons other than mental health, is also at greater risk during our hot summers.
This is significant because 1 in 6 Americans are taking psychiatric medications, which might affect the hypothalamus (CNBC News). The hypothalamus is the part of the brain that helps regulate our temperature and thirst. According to the British government, 26% (or 1 in 4) of the adult population in England are taking psychiatric medications. This is important because people taking psychiatric medications are at risk of losing some of their thirst, even as their body is more prone to dehydration (CNBC News). This clearly isn’t ideal as our hot summers get hotter.
It doesn’t stop with psychiatric medications. Other medications can also increase our risks to the heat by interfering with how our body’s temperature regulates. Some of these medications include beta blockers (which I take for my inappropriate sinus tachycardia) and amphetamines (CNBC News). Amphetamines are used to treat conditions like attention deficit hyperactivity disorder (ADHD) and narcolepsy (Medical News Today).
With hot summers becoming hotter, sleeping in that heat becomes more difficult. The consequences of this lack of sleep have a knock on effect on our mental health. With or without a mental illness, the lack of sleep will affect your mental wellbeing. Sleep is important to help our bodies recharge and repair. With little sleep, we start to feel worse for wear. Which, if it happens night after night, will wear you down. Simply put, we have summer insomnia.
Drugs and alcohol
Another draw back about having hot summers is that people tend to adopt less appropriate coping strategies. According to the APA (2021, June 30), there is an increase in alcohol and substance use to help cope with stress. However, this will increase your risks of harm because of the hot weather. Thus, why not try other healthy stress management methods instead, such as the ones listed in my stress article, which you can find here.
One of the worse downsides to our hot summers is the increase in violence that comes with it. I’m not saying that people with mental health conditions will become more violent, but people in general are more likely to. Hot summers can affect behaviour and contributes to increased aggression and incidences of domestic violence (APA, 2021, June 30).
An unlikely source of support for hot summers and aggression comes from Burke, Hsiang, and Miguel (2015). Their study was based on analysing the expanding economic literature on the links between these two variables. Using these sources of information, they found that hot summers and adverse climatic events increase the risk of violence and conflicts at the interpersonal and the intergroup level in societies around the world and throughout history. Basically, we get more irritable the hotter it gets, which can lead to violence.
Why am I bringing this up then? I hear you ask. Well, one of the sad things about mental health and disabilities is that these groups of people are at a higher risk of being on the receiving end of abuse.
Hot Summers Caused By Climate Change
The Atlantic published an article that talked about an Italian physician named Enrico Morselli. All the way back in 1981, Enrico Morselli saw that suicide rates peaked in the summer. Two decades later, according to the article, a French sociologist named Emile Durkheim noticed the same effect. This supports what I’ve already stated in this article, but The Atlantic lays out a harsh truth as well, one I echo, that suicide rates will get worse because of climate change.
Burke et al. (2018), using their calculations on projected suicide rates because of hot summers caused by climate change, state that this is an important area to plan for. Stating plainly, that suicides increase with hotter temperatures and decrease with cold temperatures. A statement which Mullins and White (2019) also made.
With the positive association between hot summers and poor mental health outcomes, it’s undeniable that this issue will probably increase with climate change (Liu et al., 2021). A hot world will lead to a more unstable climate, so boiling hot summers is much more likely and our mental health will pay the price for it.
Preventive Measures For Hot Summers
As Christenson, Geiger, and Anderson (2013) stated, heat-related fatalities are almost always preventable. We should identify effective interventions targeting vulnerable populations, such as those with mental health conditions. The reason they stated this was because people with a mental illness are more susceptible to the heat because of deficits in self-care and the characteristics of depression and schizophrenia.
Christenson, Geiger, and Anderson (2013) go on to say that people with schizophrenia can be disproportionately affected by heat-related fatalities. 22% of the fatalities reported in their study were schizophreniac, even though the worldwide prevalence of schizophrenia is around 0.5%. Although SANE Australia puts it at 1% globally.
One thing I learnt when I kept having heat stroke because I used to live in a room that turned into an oven pre-air conditioning is that spraying yourself with water can help. Water needs energy to evaporate. This process takes heat from your body, helping you to feel cooler, for a while at least.
Until I met my partner, I hadn’t seen anyone use a parasol to protect themself from direct sunlight. If you don’t have a sun parasol, then you can just use an umbrella. Who doesn’t have an umbrella in the UK? Well, me because I’m plagued by body image issues. It’s a whole thing. Maybe I’ll talk about it another time.
If you don’t want to use a parasol, then you could try wearing a summer hat or any kind of hat to help reduce some of the risks of the heat. Even a durag can help protect your head and neck.
It goes without saying, but I’ll say it, anyway. Always carry a water bottle to keep yourself hydrated (CDC, 2003, July 4).
Mullins and White (2019) found that one method that can help people cope with hot summers and its effect on their mental health is to tackle summer insomnia. They recommend that there should be policies in place to help people with mental health issues to get enough sleep when sleep is impeded by the heat.
Now, I can’t tell you how you can turn that into a personal way to care for yourself during these hot summer months. But, if you work within mental health and the healthcare system, maybe it’s time to discuss creating such policies.
One thing Christenson, Geiger, and Anderson (2013) identified while conducting their study was that there was a complete lack of air conditioning across their sample. They also highlighted that many other studies found that air conditioning was a strong protective factor against heat-related deaths.
However, Burke et al. (2018) begs to differ. They claim that the effect of hot summers on suicide didn’t decrease with the adoption of air conditioning. But they seem to be the exception to the rule. Researchers like Barreca, Clay, Deschenes, Greenstone, and Shapiro (2016) support the use of air conditioning. They believe it’s responsible for the dramatic decrease in the effect of hot weather on all mortality variables observed across the last century. Honestly, I don’t know how it couldn’t be beneficial. Although, given our reliance on fossil fuels, using an air conditioner will increase climate change. Thus, give us more boiling hot summers.
As I said, Barreca, Clay, Deschenes, Greenstone, and Shapiro (2016) study looked at all mortality observed across the 20th century. Thus, we don’t know how it affected suicide rates. However, Mullins and White (2019) conducted a study that replicated the findings of Barreca, Clay, Deschenes, Greenstone, and Shapiro (2016) which also looked specifically at suicide. In doing so, they weren’t able to find anything significant between air conditioning use and reducing suicide mortality.
But riding to air conditionings rescue is Kaiser et al. (2001). They state that air conditioning is the strongest protective factor we currently have. The CDC (2003, July 4) also goes on record of saying the same thing. As does Christenson, Geiger, and Anderson (2013), who also say that fans haven’t been shown to be significant as being a protective factor against the heat.
Let’s be honest, the countries that are used to hot weather like America and Australia, all have air conditioners. So it might be time for the UK and the rest of Europe to adapt to our new reality of overwhelming hot summers and invest in air conditioners too.
There is a whole list of studies that have found a positive relationship between higher summer temperatures and poor mental health across the spectrum. Ranging from an increase in A&E (emergency department) visits and suicide attempts (Mullins and White, 2019).
The steps mentioned here (and others) can help mitigate the risks of hot weather, with the first one being awareness of these risks. Risks that will get worth with climate change. So, check in on the people you know who have mental health issues. And for any mental health and health professionals reading this article, make sure you warn patients on psychiatric medications that their medication might increase their risk of heat-related illness or death (Christenson, Geiger, and Anderson, 2013).
As always, leave your feedback in the comments section below. Also, please share your experiences with managing your mental health during hot summers in the comments section below as well. Don’t forget, if you want to stay up-to-date with my blog, then sign up for my newsletter below. Alternatively, get push notifications for new articles by clicking the red bell icon in the bottom right corner.
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Unwanted Life readers.
APA. (2021, June 30). Psychiatry.org – Extreme Heat Contributes to Worsening Mental Health, Especially Among Vulnerable Populations. American Psychiatric Association. Retrieved July 18, 2022, from https://psychiatry.org/news-room/news-releases/extreme-heat-contributes-to-worsening-mental-healt.
Burke, M., Hsiang, S. M., & Miguel, E. (2015). Climate and Conflict. Annual Review of Economics, 7(1), 577–617. Retrieved from https://www.annualreviews.org/doi/10.1146/annurev-economics-080614-115430 and https://web.stanford.edu/~mburke/papers/Burke%20Hsiang%20Miguel%202015.pdf.
Burke, M., González, F., Baylis, P., Heft-Neal, S., Baysan, C., Basu, S., & Hsiang, S. (2018). Higher temperatures increase suicide rates in the United States and Mexico. Nature climate change, 8(8), 723-729. Retrieved from https://www.nature.com/articles/s41558-018-0222-x and repository.essex.ac.uk/25387/10/suicides-ncc-accepted.pdf.
Barreca, A., Clay, K., Deschenes, O., Greenstone, M., & Shapiro, J. S. (2016). Adapting to climate change: The remarkable decline in the US temperature-mortality relationship over the twentieth century. Journal of Political Economy, 124(1), 105-159. Retrieved from https://eml.berkeley.edu/~saez/course131/barrecaetalJPE16.pdf, https://www.nber.org/system/files/working_papers/w18692/w18692.pdf, https://escholarship.org/content/qt08c6t2hs/qt08c6t2hs.pdf, and https://www.journals.uchicago.edu/doi/abs/10.1086/684582.
CDC. (2003, July 4). Heat-Related Deaths — Chicago, Illinois, 1996–2001, and United States, 1979–1999. Retrieved July 18, 2022, from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5226a2.htm.
Christenson, M. L., Geiger, S. D., & Anderson, H. A. (2013). Heat-related fatalities in Wisconsin during the summer of 2012. WMJ: official publication of the State Medical Society of Wisconsin, 112(5), 219–223. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24734418 and https://wmjonline.org/wp-content/uploads/2013/112/5/219.pdf.
Hansen, A., Bi, P., Nitschke, M., Ryan, P., Pisaniello, D., & Tucker, G. (2008). The effect of heat waves on mental health in a temperate Australian city. Environmental health perspectives, 116(10), 1369–1375. Retrieved from https://doi.org/10.1289/ehp.11339 and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569097.
Kaiser, R., Rubin, C. H., Henderson, A. K., Wolfe, M. I., Kieszak, S., Parrott, C. L., & Adcock, M. (2001). Heat-related death and mental illness during the 1999 Cincinnati heat wave. The American journal of forensic medicine and pathology, 22(3), 303–307. Retrieved from https://doi.org/10.1097/00000433-200109000-00022, https://pubmed.ncbi.nlm.nih.gov/11563746, and https://www.researchgate.net/publication/11783799_Heat-Related_Death_and_Mental_Illness_During_the_1999_Cincinnati_Heat_Wave.
Liu, J., Varghese, B. M., Hansen, A., Xiang, J., Zhang, Y., Dear, K., Gourley, M., Driscoll, T., Morgan, G., Capon, A., & Bi, P. (2021). Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. Environment international, 153, 106533. Retrieved from https://doi.org/10.1016/j.envint.2021.106533, https://pubmed.ncbi.nlm.nih.gov/33799230, and https://www.sciencedirect.com/science/article/pii/S0160412021001586?via%3Dihub.
Mullins, J. T., & White, C. (2019). Temperature and mental health: Evidence from the spectrum of mental health outcomes. Journal of health economics, 68, 102240. Retrieved from https://www.econstor.eu/bitstream/10419/207428/1/dp12603.pdf, https://docs.iza.org/dp12603.pdf, and https://doi.org/10.1016/j.jhealeco.2019.102240.