Brody Hayes has always struggled with the heat. That’s despite living in Brisbane for their entire life, where summer temperatures regularly climb past 30C.
Heat has a profound impact on their mental health.
On oppressively hot days, Hayes finds it hard to function at work and complete daily tasks. They become irritable and say their anxiety "goes through the roof".
Hayes says their mental health suffers when the weather heats up. Credit: Supplied
My body struggles to regulate that and I just can't. I definitely do notice that I go downhill.
Hayes, 31, works in the mental health sector running an LGBTIQ+ special interest group for a peak body and previously worked as a youth peer support worker.
During heatwaves, Hayes says they would often notice mood changes among their clients.
"I definitely noticed that when I was working with them, the suicide feelings and stuff like that would escalate [with the heat] because they just struggle to cope and I think it has the knock-on effect for everyone around us."
Hayes says they're privileged in the sense that they have access to air conditioning and relatively cool spaces in their home. Still, when the temperature rises, Hayes says it can be an isolating and frustrating experience — particularly because they can't drive a car.
"Being able to navigate walking to the bus stop and walking to the train station or something like that is harder," they say.
"[Maintaining] my independence and my functioning is difficult because I get so hot and bothered and cranky and my mental health goes down."
Hayes says during long, intense heatwaves, there's little respite at night and the day’s frustrations will carry over to the next day through those sleepless, sticky nights, having a "knock-on" effect on their mental health.
"I struggle to get out of bed even some days because it's just so much energy."
- This is part three of a three-part series exploring the adverse impacts of climate change on mental health and wellbeing. and
The problem with heat
Heat's debilitating effects on mental wellbeing are well-documented in scientific studies.
Heat is associated with an increase in a range of mental health issues and social problems.
When temperatures rise, so does aggression, domestic violence, issues associated with mental and behavioural disorders — including self-harm — and mental health emergency presentations and hospital admissions.
One study that monitored emergency mental health presentations at Sydney’s Westmead Hospital found that presentations among women rose steadily when temperatures hit between 28C and 38C.
As climate change causes global temperatures to edge upwards, increasing the intensity, frequency and duration of heatwaves, the mental health of populations is set to suffer.
Dr Cybele Dey, a child and adolescent psychiatrist from the University of NSW, says the role of heat in exacerbating mental health issues is under-discussed considering "how widespread heat is and how many people are being impacted by it".
Emergency department mental health presentations go up during heatwaves. Source: AAP / Paul Miller
"Certainly when I talk to people who are say, working in a police setting, working in a domestic violence refuge setting, they were making plans around that," she says.
In her work as a psychiatrist, Dey says she has seen the extra pressures placed on the public health system as heat increases.
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"When I started back in 2001 in psychiatry, there might be a couple of young people who would present in a 24-hour period to major teaching hospitals with suicidal distress. Fast forward over the next two decades, that has increased and increased."
Rates of youth suicide and suicidality have been on the rise in recent years, even . In NSW, presentations to emergency departments by people aged between 10 and 24 rose by 8.4 per cent annually across the five years to 2020, according to research published in the Australian and New Zealand Journal of Psychiatry.
While Dey says that people may point to other stressors in the lives of young people, such as social media or online bullying, heat seems to be a significant contributor to the rise in emergency mental health presentations.
One study led by Dey found youth suicidality presentations in NSW appear to increase by 1.3 per cent for every 1C rise above average daily mean temperature.
Extremely hot days can lead to increased isolation, as more people stay in their homes to avoid high temperatures. Source: Getty / bymuratdeniz
Adults are also susceptible to the mental health effects of heat. Dr Lucas Hertzog, a sociologist from Curtin University, says the stress of heat "interacts with the social realities" a person is already experiencing.
It adds another layer in a combination of elements that may lead to mood changes, cognitive impairment and psychological distress.
Hertzog led a study published last year that looked at the number of suicides in Australia that could be attributed to climate change-induced heat.
The authors found that from 2000 to 2019, approximately 0.5 per cent (or 264 suicides) could be attributed to anomalous hot days caused by climate change.
The people most vulnerable to heat
Heat can also exacerbate symptoms experienced by people living with underlying mental health conditions.
One 2021 study of mental-health-related emergency department visits in the US found an 8 per cent increase on the hottest days of summer among people living with mental health conditions, which ranged up to 11 per cent for certain diagnoses.
Further complicating these effects are the ways that particular medications, including some psychiatric medications, make it harder for the body to regulate body temperature. Some antipsychotics and antidepressants can make people more susceptible to heatstroke by reducing sweating and the body's ability to cool itself down.
Keisha Healy, a 24-year-old mental health worker from Melbourne, says that the medication she takes for her mental health makes her more sensitive to heat and sunlight. Healy also lives with a chronic physical condition and says that, in combination with the side effects of her medication, it can "ramp up" the discomfort and danger of hot days.
"Quite often, I will be turning down social invitations or social obligations because I just can't do things when it's that hot. It's just not on the cards for me," she says.
"And then I feel like I'm either letting people down or I feel like I'm missing out on whatever is happening in the world because I just can't be a real human in that space."
Dey says the impacts of heat are often worse for those who are affected in multiple ways.
Even those living without mental health conditions can be vulnerable to its effect on mental wellbeing.
For Grace (last name redacted for privacy), a 29-year-old living in western Sydney with multiple physical chronic health conditions, hot days make her feel extremely alone and anxious.
"My experience over the last couple of years is getting worse and worse," she says.
Every year it is getting hotter - every year – so that's the number one thing I've noticed and that impacts me I guess in a way that's different to someone who doesn't have the health conditions I have.
On hot days, Grace's migraines and chronic fatigue are exacerbated. Her body naturally has difficulty regulating temperature, and she'll often find herself virtually trapped sitting in her apartment with an ice pack or in the bath with a flannel to cool down.
"There's this feeling of being left out or ignored, or just left to fend for myself," she says.
"Emotionally, it's like just being let down and isolated and feeling like I'm in this alone."
Dr Cybele Dey says that cities need to adapt to provide better shelter so people can continue to move freely, even on extremely hot days. Source: AAP / Steven Markham
Fighting heat for mental wellbeing
Beyond individual strategies for cooling down, such as using air conditioning or fans wherever possible, experts stress that system-wide measures need to be taken to protect people's mental health in the coming years.
Dey says that cities need to implement novel methods of keeping people cool, such as installing sun shelters or cooling mechanisms in bus stops, that allow people to move relatively freely even on extremely hot days.
She also stresses that frontline services such as police, hospitals and family and domestic violence services will need to be better resourced in the long-term to deal with the increased demand as the number of hotter days rises.
However, both Dey and Hertzog agree that climate action is the key political force needed to combat this growing problem.
Hertzog says governments must "address the causes, not the consequences" when it comes to climate change-related impacts on mental health.
Dey, who is a member of the advocacy group Doctors for the Environment Australia, says it comes down to a need for the world to transition away from fossil fuels.
"That is what's driving these increases in heat, which are already baked in over the next several decades," she said.
"But we can make a difference to how much worse that gets by a rapid transition off fossil fuels, now."
