Mental Health: Climate Distress in Youth: How Physicians Can Make a Difference

Column Author: Sara Jane Anderson, MD, MPH | Clinical Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine

Column Editor: Teddy Brisimitzakis, DO | Clinical Assistant Professor of Pediatrics, University of Missouri-Kansas City School of Medicine

Children and adolescents are especially vulnerable to the mental health consequences of climate change, facing both immediate physiological stress and long-term psychological challenges. Recognizing and addressing these risks is essential for supporting healthy development and resilience in the next generation.

The mental health effects of climate change intersect with, and compound, other challenges, such as poverty, racism, housing insecurity and limited access to care. Physicians have a professional and ethical responsibility to recognize these risks, provide compassionate care, and help young patients process their fears and emotions in a safe space. By doing so, they can foster resilience, offer hope, and connect families with the resources and support they need.

What Is Climate Distress?

Climate change is rapidly becoming a major mental health concern for young people. Climate distress describes the fear, sadness, anger and helplessness expressed by many youth about the effects of climate change. While these emotions are understandable, when overwhelming or persistent, they can contribute to anxiety, depression and hopelessness.

The Scope of the Problem

According to a recent U.S. survey by Hickman et al., 85% of youth report being at least moderately worried about climate change, with 43% saying it directly affects their mental health. In the wake of climate-related disasters, adolescent mental distress may surge by up to 25%, and this heightened distress can persist for as long as two years.¹ Furthermore, 38% of young people say their feelings about climate change have a noticeable, negative impact on their day-to-day lives.²

Effects of Climate Change on the Body and Mind

Heat stress from rising temperatures and heatwaves increases hospital admissions for mood disorders and suicide risk.³ Children and adolescents are especially vulnerable due to less efficient temperature regulation, making them more susceptible to heat stress, sleep disruption and cognitive impairment.⁴ Poor air quality from wildfires and pollution increases irritability, anxiety, neuroinflammation and mood disorders.⁴

Chronic stressors like drought and displacement create persistent anxiety, while extreme weather can trigger trauma and post-traumatic stress disorder.⁴ Loss of essentials, like food, water, or shelter, disrupts stability and coping mechanisms. Many youths feel powerless or betrayed by inaction on climate change, leading to existential distress and a sense of doom.⁵

Clinical Concerns

Youth exposed to climate-related stressors commonly experience symptoms such as anxiety, depression, sleep disturbances, post-traumatic stress and substance use disorders.⁴ Key risk factors include a history of prior trauma, socioeconomic disadvantage, pre-existing mental health conditions and repeated exposure to disasters. Special consideration is warranted for youth from marginalized communities, who may face compounded risks due to systemic inequities and higher environmental exposures.⁶

Barriers to Support and Communication

A striking 57% of youth fear their concerns about climate distress will be dismissed or ignored. Despite a strong desire for open dialogue, with 70% wanting to talk about their concerns, opportunities for such discussions are often lacking.⁵

How Physicians Can Make a Difference

Physicians are uniquely positioned to guide, support and empower youth experiencing climate distress. Screening should include climate-related stressors and disaster exposure, and trauma-informed care is crucial for high-risk populations. Key steps include recognizing and validating concerns, fostering open dialogue, connecting patients with resources, and advocating for systemic solutions. Finally, encouraging school and community engagement can promote resilience and peer support.

References:

1. Auchincloss AH, Ruggiero DA, Donnelly MT, Chernak ED, Kephart JL. Adolescent mental distress in the wake of climate disasters. Prev Med Rep. 2024;39:102651.
2. Hickman C, Marks E, Pihkala P, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5(12):e863-e873. doi:10.1016/S2542-5196(21)00278-3
3. Liu J, Varghese BM, Hansen A, et al. Is there an association between hot weather and poor mental health outcomes? A systematic review and meta-analysis. Environ Int. 2021;153:106533.
4. Clayton S, Manning CM, Hill AN, Speiser M. Mental Health and Our Changing Climate: Children and Youth Report 2023. American Psychological Association and ecoAmerica; 2023.
5. Lewandowski RE, Clayton SD, Olbrich L, et al. Climate emotions, thoughts, and plans among US adolescents and young adults: a cross-sectional descriptive survey and analysis by political party identification and self-reported exposure to severe weather events. Lancet Planet Health. 2024;8(11):e879-e893.
6. Cianconi P, Betrò S, Janiri L. The impact of climate change on mental health: a systematic descriptive review. Front Psychiatry. 2020;11:74.