This summer is breaking records day after day for highest temperatures. There is more going on aside from the fact that excessive heat can make a person feel miserable. Heat waves and mental health problems go hand in hand. This is especially important this summer as large swaths of the USA, Europe and elsewhere experience unprecedented temperatures. Waves of extreme heat are difficult and even deadly for the homeless, elderly, and individuals who suffer from mental health problems.
How Deadly Is the Heat for Those With Mental Illness?
A study by the British Columbia Center for Disease Control (BCCDC) showed that individuals with mental illness have a higher incidence of deaths related to the heat than rest of the population. For individuals with schizophrenia the risk of heat-related death is three times that of the general population.
How Does the Heat Affect Individuals With Mental Illness?
For years psychologists and psychiatrists have known that severe heat increases the incidence of interpersonal violence, hate speech, and suicides. About one percent of Americans suffer from schizophrenia, two and six-tenths from bipolar disorder, and six and nine-tenth from major depression. People with all three of these mental health conditions are especially prone to having problems made worse by excessive heat. Practical things to do are to make sure that such individuals have access to air conditioning where they live or access to facilities where they can come and be cooled off. To the extent that such individuals are incapacitated, their care givers need to be aware of the dangers of excessive heat.
Why Does the Heat Bother Folks With Mental Illness So Much?
Simple explanations include the fact that when it too hot at night people do not sleep well and can even become sleep deprived. Individuals who suffer from severe cases of mental illness may not be aware of what is happening and especially not aware of the risks of excessive heat. This is often especially the case with people with severe cases of schizophrenia and major depression. The basic fact is that when a person is in a space where the temperature gets into the 120 degree range they can die without sufficient hydration and relief from the heat. The sad fact is that patients with conditions like schizophrenia may go about wrapped in layers or clothing or heavy winter garments at these times, unaware of what is going on and the risks. Social isolation is an added risk with these individuals as there is nobody to help them understand or cope.
Psychiatric Medicines That Are Dangerous in the Heat
There are medicines that are necessary for mentally ill patients that can be dangerous in extreme heat. Individuals with bipolar disorder may be taking lithium. Unfortunately, this medicine becomes toxic when a person gets dehydrated which can happen in extreme heat. Clozapine, which is used for schizophrenia, is an anticholinergic and stops sweating which is a defense against the heat. Tricyclic antidepressants can cause excessive sweating which can then lead to dehydration. Because many of these individuals may not recognize the risks they face of may not be able to ask for help they are particularly vulnerable during heat waves.
The answer in all of these cases is not to stop taking necessary medicines. Rather it is to get the person cooled off, into a cooler area, make sure they are getting sufficient liquids and maintain constant vigilance.
Spreading Awareness of Mental Illness and Risks of Excessive Heat
Because so many individuals with mental illness are unable to care appropriately for themselves, it is important that caregivers and public servants like the police are aware of the risks for the mentally ill during severe heat waves such as are now happening across the US, Europe and elsewhere. The majority of those with mental illness who are at risk from extreme heat are under care in facilities where caregivers are aware of the risks and there is generally air conditioning. However, there are many mentally ill among the homeless. Those who routinely deal with the homeless need to be aware of heat risks for the mentally ill and how to mitigate those risks.
