GRSJ224/Medicalization of Eco-Anxiety in Youth

Overview

In 2017 the term eco-anxiety was formalized. In November of 2019, at the first International Summit on Psychology's Contributions to Global Health, a resolution was singed by more than 40 global psychological associations "acknowledging climate change poses a serious threat to mental health". Children are specifically vulnerable to the psychological impacts of climate change, with child psychologists reporting an increasing "number of kids and young adults are being treated with psychiatric drugs in order to reduce the emotional stress and exhaustion caused by eco-anxiety". Kaczmarek describes "medicalization [as] interpreting newer and newer aspects of reality, including human behaviour, in medical terms, and treating them as medical problems rather than [a] social, political or existential ones". This process of medicalization is evident in the recent naming and pathologizing of eco-anxiety in youth.

Formalization of Eco-Anxiety

Labelling by the American Psychological Association

In an official release from the American Psychological Association (APA) in March of 2017, released in response to the growing concern that climate change was having on mental health, eco-anxiety was formally defined as "a chronic fear of environmental doom". This report also recognized that symptoms can present either as a direct link to experiencing climate change in an acute (for example, climate change influenced natural disaster) or chronic (for example long term climate change uncertainty for the future) capacity.

Eco-Anxiety has been called by many alternative names, including: ecological grief, solastalgia, climate depression, environmental melancholia, ecosickness, Anthropocene Disorder, eco-awareness, and petromelancholia.

Symptomology

The APA lists symptoms of eco-anxiety very similar to clinical anxiety, including:

• trauma and shock
• PTSD
• compounded stress
• strains on social relationships
• depression, anxiety, and suicide
• substance abuse
• aggression and violence
• loss of autonomy and control
• loss of personal and occupational identity
• feelings of helplessness and powerlessness
• fatalism
• long-term changes to emotions including fear, anger, or exhaustion

Findings in Youth

In a survey of 2000 8-16 year olds, youth reported feelings of frustration and anxiety about the state of the planet, with 73% and 22% saying they were worried or very worried, respectively, about the state of the planet currently. Of these 2000 youth surveyed, "17% said they had their sleeping and eating habits affected by their concerns", and a wide majority of them don't feel anyone, including people in power, are listening to their concerns about climate change. Adults have also been found to suffer eco-anxiety, however the impacts are disproportionately affecting young adults, "with 47% of 18-34 year olds [saying] the stress they feel about climate change affects their daily lives" ; although this study was not undertaken with those under the age of 18, it does not feel a far stretch to assume their eco-anxiety levels and resulting daily stresses would also be high.

Controversy

Caroline Hickman, a psychologist and researcher, insists that "climate anxiety isn't a pathology. It's a reasonable and healthy response to an existential threat", whereas the hallmarks of most anxiety disorders are an unreasonable response to threat. As such, eco-anxiety is not yet listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but there is a possibility that this could change in the future. Currently, medicine is offered as the solution to eco-anxiety, an inherently non-medical condition. This situation offers an example of what Kaczmarek has termed "over-medicalization", where the medicalization of eco-anxiety has been wrongly applied, and eco-anxiety is both poorly explained by medicine and poorly healed by it's tools.

Greta Thunberg

Swedish teen environmental activist Greta Thunberg became the figurehead for youth environmental activism, and it's associated eco-anxiety, when she started her Fridays for Future protest in August of 2019.

Management Strategies

Medicalized Strategies

Caroline Hickman, a psychotherapist and researcher who studies "children's attitudes towards climate change" and is a member of the Climate Psychology Alliance, states most supports for eco-anxiety come from doctors, biological medications, and Cognitive Behavioural Therapy (CBT). She also notes that "none of [these are] particularly appropriate in response to the climate emergency".

Non-medicalized Strategies

Some youth are taking part in climate action to help ease their eco-anxiety, including getting involved in local climate organizations, making lifestyle changes, and participating in climate strikes. Globally, youth have sued their governments for failure to protect their fundamental rights to live in a healthy environment, and in Colombia and the Netherlands, they've won. Youth lawsuits in other countries such as Belgium, Ireland, Canada, Uganda, New Zealand, Australia, and Norway are ongoing.

Best Approaches

The risks of over-medicalizing eco-anxiety by applying medical strategies to treat it include adverse consequences such as "overprescription, adverse side effects caused by medication, iatrogenic diseases, suboptimal expenditure and waste of public or private money, stigmatization and inadequate reactions to a problem (e.g. attempts to address a social or political problem at the level of molecular intervention in individuals’ bodies)." Taking these concerns into consideration, applying non-medical strategies to the treatment of eco-anxiety may be the best approach for youth.