Impact of extreme heatwaves on mental health in India: Experts weigh in

Despite the southwest monsoon bringing relief from the heat the memory of summer 2024 still haunts many in India The country in 2024 witnessed one of the longest and most intense heatwaves in its history Temperatures exceeding 45 degrees Celsius have had a serious impact on the populaceThe heatwave in India was botha physical and emotional health disaster The severe temperatures exacerbate anxiety sadness and violence putting vulnerable people at riskAs India continued to face the challenges of extreme weather it became critical to address the mental health implications to ensure the wellbeing of its citizensThe heatwave has caused tremendous suffering and worry Prolonged exposure to high temperatures experts say can cause a variety of psychological issues including anxiety depression and anger For many Indians the stifling heat has become a major source of mental stressConcerns over mental health as the mercury soaredSpeaking to middaycom Dr Sonal Anand a psychiatrist with Wockhardt Hospitals in Mumbais Mira Road said that not just in India but across the globe people are concerned about the impact of rising temperature on a persons healthincluding mental healthBecause of this global temperature rise people across the globe are concerned about how this increase in temperature is affecting the healthnot just physical mental also of all especially children and elderly Dr Anand added that despite ongoing research we havent been able to prove it on the molecular level per seShe added that some scientists do accept there is Summer Affective Disorder also called SAD like winter affective disorders and said that symptoms of it could be like that of depressionThere could be an exacerbation of those past psychological problems especially depression anxiety sleeping problems and appetite problems These are all psychologically related to heat said Dr SonalMeanwhile Dr Shaunak Ajinkya Consultant psychiatrist at Kokilaben Dhirubhai Ambani hospital said that extreme heat impairs cognitive function leading to difficulties in concentration decisionmaking and problemsolvingThe physical discomfort from prolonged exposure to high temperatures can lead to heightened stress levels Concerns about the increasing frequency of heatwaves can contribute to ecoanxiety and fears about environmental doom A study done in the UK showed that nearly 60 per cent of the young people surveyed were ldquovery worriedrdquo or ldquoextremely worriedrdquo about climate change More than 45 per cent of those questioned said feelings about the climate affected their daily lives said Dr AjinkyaElaborating on it Dr Ajinkya said Studies have shown a correlation between heatwaves and higher rates of violent crime and aggression Even just a one or twodegree Celsius increase in ambient temperatures can lead to a 35 per cent spike in assaultsDuring heatwaves people are less likely to engage in outdoor activities or social interactions due to the health risks associated with extreme heat People change their daily routines to cope with the heat which can disrupt normal activities and social connections This leads to social isolation which negatively impacts mental health he said and added that studies have found a 22 per cent increase in mental healthrelated deaths for every 1degress Celsius rise in the average temperatureMany psychiatric medications like lithium certain antidepressants or antipsychotics with high anticholinergic effects impair the bodyrsquos ability to regulate temperature or increase sensitivity to heat which can lead to heat intolerance and dehydration further impacting mental health he notedVulnerable populationsCertain groups are more vulnerable to the mental health impacts of the heatwave When asked about it Dr Ajinkya noted that elderly people children and those with preexisting mental health conditions are at greater riskldquoElderly people children and infants have a hard time regulating their body temperature which makes them more susceptible to heat stress Chronic health conditions like cardiovascular and respiratory diseases can aggravate due to heat causing the elderly stressrdquo he saidElaborating on how those with existing mental health conditions can be affected he said ldquo Individuals with mental health conditions may have less capacity to implement coping strategies during extreme heat which can worsen symptoms of anxiety depression and suicidality Some psychiatric medications like lithium and certain antidepressants or antipsychotics with high anticholinergic effects affect the bodyrsquos ability to regulate temperature increasing the risk of heat intolerance and dehydrationrdquoDr Anshu Kulkarni who is based in Mumbairsquos Bandra said that those who are exposed to extreme weather conditions constantly or come from lowincome backgrounds are also susceptible to experiencing aggravation of mental health issues due to heatwaveldquoWorkers who are exposed to high temperatures are known to have more psychological distress Communities where they do not have resources to sustain and are fighting the poverty line are the most vulnerable Some susceptibility usually seen is either environmental or geneticrdquo Dr Kulkarni saidHeatwaversquos impact on brain functionWhen asked about how extreme climatic conditions affect brain function both Dr Ajinkya and Dr Sonal said that brain functioning gets impacted due to physiological effectsDr Sonal explained that during extreme heat conditions one experiences dehydration and there is a significant loss of potassium One of the commonly known side effects of lower potassium levels she noted is delirious behaviourApart from that being exposed to extremely hot weather could lead to heatstroke Dr Ajinkya noted that the heatstroke is caused because of poor blood flow to the brain due to the hot weatherHe said ldquoHigh temperatures can affect the production and regulation of neurotransmitters like serotonin and dopamine which are crucial for mood regulation and cognitive function Serotonin keeps levels of aggression in check Disruption in these neurotransmitters can lead to mood disorders and impaired cognitive performance By 2090 it is estimated that climate change could be responsible for up to a 5 per cent increase in all crime categories globallyrdquoMitigating the mental health impacts of heat wavesMoreover the healthcare system was under immense pressure with hospitals overwhelmed by patients suffering from heatrelated conditions This has made it difficult for those experiencing mental health crises to access the care they needDr Kulkarni noted that with weather changes the number of admissions to mental health facilities also increased She said that awareness about mental health is crucial in addressing the increased demand for mental health issues as wellldquoIf primary healthcare professionals like physicians can identify that someonersquos mental health is under duress due to weather and maybe if need be refer people to mental health professionals it will help the public Secondly I feel that at the individual level as well if parents are aware they will be able to inculcate in their progenyrdquo she saidShe added that people could also practice things like five minutes of mindfulness can assist in dealing with the mental impact of heatwaves She also said that NGOs who work with persons from lowincome backgrounds can also connect them with mental healthcare providersDr Sonal like Dr Kulkarni recommended practicing mindfulness and also practicing breathing techniques to lower irritability the professional working with Wockhardt Hospital said that practicing yoga can help in lowering irritabilityEchoing similar thoughts to those of Dr Kulkarni Dr Ajinkya said identifying highrisk patients and developing personalised care plans including medication reviews and regular checkins are critical steps in keeping those struggling mentally well during excessive heatHe suggested accessing telehealth services and helplines that offer crisis intervention to ensure an individual receives mental health supportThe experts said educating patients about hydration cooling measures and medication modifications is critical as is training healthcare personnel to recognise and respond to heatrelated mental health disordersDr Ajinkya said that at the community level building wellpublicised cooling stations and organising volunteer wellness checks can help vulnerable peopleBoth Dr Ajinkya and Dr Kulkarni said that if the development of green spaces is promoted it can also help mitigate the urban heat