{"id":49069,"date":"2020-11-19T14:23:44","date_gmt":"2020-11-19T13:23:44","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=49069"},"modified":"2020-11-19T14:23:44","modified_gmt":"2020-11-19T13:23:44","slug":"our-children-face-pretraumatic-stress-from-worries-about-climate-change","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/19\/our-children-face-pretraumatic-stress-from-worries-about-climate-change\/","title":{"rendered":"Our children face \u201cpretraumatic stress\u201d from worries about climate change\u00a0"},"content":{"rendered":"<p><em><span style=\"font-weight: 400\">Children are particularly vulnerable to the psychological trauma from current extreme weather events. They can also be harmed by the fear of future harms, writes <\/span><b>Lise Van Susteren<\/b><\/em><span style=\"font-weight: 400\"><em>. Adults have the power to do something about it.\u00a0<\/em><\/span><\/p>\n<p><span style=\"font-weight: 400\">The scientific consensus is overwhelming: serious harms related to anthropogenic climate change will increase in intensity and frequency for years to come (<\/span><a href=\"https:\/\/climate.nasa.gov\/effects\/\"><span style=\"font-weight: 400\">https:\/\/climate.nasa.gov\/effects\/<\/span><\/a><span style=\"font-weight: 400\">). This century, resulting resource scarcity, geopolitical upheaval, and humanitarian crises will render parts of the world uninhabitable. Without meaningful action our children face an increasing toll of physical and psychological injury.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Today\u2019s floods, storms, droughts, heat waves, wildfires, and pandemics related to climate change traumatize us. But trauma can also arise from fears of future threats, giving rise to \u201c<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26366328\/\">pre-traumatic stress<\/a>.\u201d<\/span><span style=\"font-weight: 400\">\u00a0<\/span><\/p>\n<p><b>Angry, terrified, and in despair<\/b><\/p>\n<p><span style=\"font-weight: 400\">As expert witness on the psychological damages to <a href=\"https:\/\/www.ourchildrenstrust.org\/s\/Doc-271-1-Van-Susteren-Expert-Report.pdf\">21 youth plaintiffs suing the US government for climate inaction<\/a>, I reported on their stressful and dominating feelings of powerlessness, uncertainty, and abandonment.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Children are protesting in the streets to demand climate action. Many report feeling angry, terrified, and in despair. Some see no purpose in life, believing the world will soon be unrecognizably damaged, or that they may soon be dead.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Experiencing or witnessing life threatening events can cause deep and persistent psychological trauma. If severe this can lead to post traumatic stress disorder (PTSD). Children <a href=\"https:\/\/doi.org\/10.1037\/a0020775\">have been diagnosed as having PTSD<\/a> after <a href=\"https:\/\/doi.org\/10.1037\/0022-006X.64.4.712\">experiencing extreme weather events<\/a><\/span><span style=\"font-weight: 400\">. Symptoms may appear months later, sometimes triggered by a new trauma. PTSD may also be diagnosed after indirect<\/span> <span style=\"font-weight: 400\">exposure to trauma, from reflecting on traumatic experiences that relatives or friends have endured or even, simply, from repeatedly hearing details of traumatic events.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The capacity to heal from the psychological impacts of traumatic events depends on many factors. When disasters are experienced as entirely \u201cnatural\u201d healing may be less arduous: perhaps we more readily accept that we are powerless over fate. But when the injury or loss reflects human error, carelessness, or negligence, healing may be complicated by thoughts that the event could have been avoided (<\/span><a href=\"https:\/\/static1.squarespace.com\/static\/571d109b04426270152febe0\/t\/5cafa8de085229a0ee2a35f5\/1555015906660\/Doc+271-1+Van+Susteren+Expert+Report.pdf\"><span style=\"font-weight: 400\">https:\/\/static1.squarespace.com\/static\/571d109b04426270152febe0\/t\/5cafa8de085229a0ee2a35f5\/1555015906660\/Doc+271-1+Van+Susteren+Expert+Report.pdf<\/span><\/a><span style=\"font-weight: 400\">)<\/span><span style=\"font-weight: 400\"> We know that natural disasters are not entirely natural anymore: their frequency and intensity reflect the ongoing choices humans are making.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Having some control over how we respond to current climate disasters can bolster our resilience, facilitating recovery. We may have time to choose to flee or hunker down. Impacts may be experienced in phases, helping us muster the psychological defenses needed at each moment. Shared experiences mean victims can lean on each other, providing community solidarity.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Psychological harms from worries of future disasters are different. There is no reminding ourselves that the stress is a remnant of the past. Our options to control the situations envisioned are few, engendering helplessness.<\/span><\/p>\n<p><b>Damaging life-long consequences<\/b><\/p>\n<p><span style=\"font-weight: 400\">Chronic stress can permanently<\/span> <span style=\"font-weight: 400\">affect brain development as well as brain functioning. Exposure to climate related stress during early development may have damaging life-long consequences, including <\/span><span style=\"font-weight: 400\">maladaptive behaviors, memory problems, problems with attention, diminished inhibition, difficulty regulating emotions, i<\/span><span style=\"font-weight: 400\">mpaired decision making, impaired problem solving, behavioral problems, and priming for future stressful events (<\/span><a href=\"https:\/\/static1.squarespace.com\/static\/571d109b04426270152febe0\/t\/5cafa8de085229a0ee2a35f5\/1555015906660\/Doc+271-1+Van+Susteren+Expert+Report.pdf\"><span style=\"font-weight: 400\">https:\/\/static1.squarespace.com\/static\/571d109b04426270152febe0\/t\/5cafa8de085229a0ee2a35f5\/1555015906660\/Doc+271-1+Van+Susteren+Expert+Report.pdf<\/span><\/a><span style=\"font-weight: 400\">)<\/span><\/p>\n<p><span style=\"font-weight: 400\">Psychological and behavioral problems can interrupt schooling and social life. <\/span><span style=\"font-weight: 400\">High levels of stress over time can also cause physical harm: <\/span><span style=\"font-weight: 400\">cardiovascular damage, <\/span><span style=\"font-weight: 400\">hormonal changes and infertility,<\/span><span style=\"font-weight: 400\"> and compromised immune function.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Exposure to trauma can also alter the expression of genes. (https:\/\/doi.org\/10.1016\/j.neubiorev.2014.11.013; <\/span><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1038\/ncomms6466<\/span><span style=\"font-weight: 400\">; https:\/\/doi.org\/10.1086\/598822) Even in the absence of the trauma, this activated state can be passed down to future generations epigenetically. Thus the trauma that children are experience due to acute and chronic climate stress could have transgenerational impact.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Climate disruption requires immediate action to reduce multigenerational psychological harm. Calls for a UN led strategy to protect the mental health of young people should be loud and unrelenting. Funding for regional resilience councils is needed to assess, and prepare for, local risks (<\/span><a href=\"http:\/\/www.theresourceinnovationgroup.org\/intl-tr-coalition\/)\"><span style=\"font-weight: 400\">http:\/\/www.theresourceinnovationgroup.org\/intl-tr-coalition\/)<\/span><\/a><span style=\"font-weight: 400\">.<\/span><span style=\"font-weight: 400\"> Academic institutions must deploy their vast resources to work with communities to find solutions. Educating medical professionals to become experts and advocates for healthy climate policy must become a requirement. Mental health professionals are at the core of the call for behavioral change, justifying a new subspecialty in climate and mental health.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Our children cannot be relieved of their fears with words. Real menace is thrusting them into existential uncertainty. We must acknowledge that children\u2019s psychological wellbeing is on the line. Holding ourselves accountable now for their outrage and despair is crucial, not only for taking meaningful action but also to show them that we care. Unless we act, the injustice they and future generations face will have them regard adults today as depraved and demented to have stood by knowing what would happen. Intergenerational injustice such as this meets a definition that has a name: <a href=\"https:\/\/portal.ct.gov\/DCF\/1-DCF\/Child-Abuse-and-Neglect-Definitions\">child abuse<\/a>.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Children do not want to hear from adults about what a good job they are doing to save the world. As the teenage climate activist Greta Thunberg has said, \u201cI don\u2019t want you to be hopeful. I want you to panic. I want you to feel the fear I feel every day. And then I want you to act.\u201d<\/span><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Lise Van Susteren<\/strong>, <\/span><span style=\"font-weight: 400\">psychiatrist in private practice in Washington, DC. Lise Van Susteren recently authored the book <\/span><\/em><span style=\"font-weight: 400\">Emotional Inflammation<\/span><em><span style=\"font-weight: 400\">, with Stacey Colino.\u00a0<\/span><\/em><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Competing interests<\/strong>: I<\/span><span style=\"font-weight: 400\"> have read and understood the BMJ Group policy on declaration of interests and have no relevant interests to declare.<\/span><\/em><\/p>\n<p><span style=\"font-weight: 400\"><strong>Provenance and peer review<\/strong>: Commissioned; not externally peer reviewed.<\/span><\/p>\n<p><span style=\"font-weight: 400\">This article is part of a series commissioned by\u00a0<\/span><i><span style=\"font-weight: 400\">The BMJ<\/span><\/i><span style=\"font-weight: 400\">\u00a0for the World Innovation Summit for Health (WISH) 2020.\u00a0<\/span><i><span style=\"font-weight: 400\">The BMJ<\/span><\/i><span style=\"font-weight: 400\">\u00a0peer reviewed, edited, and made the decisions to publish. The series, including open access fees, is funded by WISH.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Children are particularly vulnerable to the psychological trauma from current extreme weather events. They can also be harmed by the fear of future harms, writes Lise Van Susteren. Adults have [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/19\/our-children-face-pretraumatic-stress-from-worries-about-climate-change\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":48249,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[266,263],"tags":[],"class_list":["post-49069","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-climate-change","category-global-health"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Our children face \u201cpretraumatic stress\u201d from worries about climate change\u00a0 - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/19\/our-children-face-pretraumatic-stress-from-worries-about-climate-change\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Our children face \u201cpretraumatic stress\u201d from worries about climate change\u00a0 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Children are particularly vulnerable to the psychological trauma from current extreme weather events. 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