Behavioral Health Brief: Exploring the Prevalence and Treatment of Eco-Anxiety
By Karen Magruder, LCSW-S
Social Work Today
Vol. 23 No. 2 P. 10

The climate crisis has arrived, and polar bears are not the only ones who are suffering. How can social workers help clients keep their cool in a warming world? It’s widely recognized that social workers abide by the person-in-environment approach, but conceptions of the environment often focus on the social, economic, and political environment without fully acknowledging the impact of the natural environment. Climate change is already having negative impacts on both the health1 and mental health2 of vulnerable populations across the globe, and social workers are increasingly responding to the call.3 Clinical social workers, in particular, are beginning to see increased emotional distress about the impacts of climate change.4 Media campaigns meant to inform and inspire action, like the 2006 Time Magazine cover featuring a polar bear on a melting iceberg and the caption “Be worried. Be very worried,” stoke fear among readers.5 With “climate emergency” being named the Oxford Dictionary word of the year in 2019,6 and a record 4,290% increase in Google searches of “eco-anxiety” the same year,7 these issues are clearly gaining widespread attention.

What Is Eco-Anxiety?
Before discussing eco-anxiety, it’s helpful to distinguish it from eco-grief, which is backward facing, mourning a loss of what used to be. Often associated with Indigenous communities mourning forced relocation,8 solastalgia is a “longing for a home community that has been shaped by climate change to go back to the way it was before.”2 Climate grief has been categorized as a disenfranchised grief, where there are “no socially prescribed methods for engaging or acknowledging” it.9

On the other hand, eco-anxiety tends to look to the future with worry and concern about what is yet to come.10 Key components of eco-anxiety include worry about future generations, feeling disturbed, mental health symptoms, and helplessness/frustration.11 Eco-anxiety can be subclinical in nature or, in more serious cases, can reach “pathological” levels.12 The term “climate anxiety” is sometimes used to describe the same phenomenon,13 though this definition is narrower, referring specifically to worries about the climate crisis.14 Comparatively, eco-anxiety encapsulates nonclimate-related environmental issues such as environmental racism in the disposal of toxic waste.15

Diagnosing Eco-Anxiety
Eco-anxiety is not classified as a disorder under the DSM-5-TR,16 but it’s increasingly recognized as a concern by mental health professionals. Symptoms of eco-anxiety include sleeplessness and intense worry, which in some cases can lead to dramatic changes in behavior.16 In young children, red flags include regression behaviors (eg, thumb-sucking, bedwetting), withdrawal, poor concentration, and sleeping or eating disturbances.2 It can also affect daily functioning and even lead to self-harm and substance use disorders.2 As more mental health care providers note clients presenting with features of ecoanxiety, 17 scholars are working to develop and validate tools to reliably measure climate anxiety.13 Being unable to stop or control worry is the most common feature, followed by an inability to stop thinking about environmental losses and feeling anxious about one’s personal responsibility to improve environmental conditions.18 In extreme cases, worry that interferes with daily life or wellbeing can morph into a more serious mental health condition, as was the case with a 17-year-old girl whose preoccupations with water scarcity developed into a delusional disorder.19 A young New York University graduate student was recently featured in a Vice interview in which she described experiencing despair and panic attacks as a result of fears about Arctic sea ice melting.20 One study even found that roughly one-third of individuals with obsessive-compulsive disorders often incorporate energy-saving rationale into compulsions, checking that light switches and water faucets are turned off.21

Prevalence
Eco-anxiety is a growing concern, particularly among younger people.10 In a recent global survey of more than 10,000 young people, 84% of respondents aged 16 to 25 were at least moderately worried about climate change.22 A Yale study found that 43% of Americans are either “alarmed” or “concerned” about climate change,5 while another report indicated two-thirds of the United States population are at least “somewhat worried” about it.23 Survey respondents who were “very worried about the effects of global warming” doubled between 2014 and 2018.2

This is not only an American phenomenon; distress about the global environmental crisis has been documented internationally, including in Canada,24 Europe,25 Australia,26 the Pacific Islands,27 and Asia.28 Additionally, a systematic literature review found that mental health impacts of climate change, such as PTSD due to extreme weather events, were disproportionately found in vulnerable or historically marginalized populations such as older adults, children, and individuals experiencing homelessness, poverty, and substance use disorders.29 The evidence points to eco-anxiety being not only a focus of clinical attention but also a social justice and equity issue.

Treatment

Validation
Rather than an irrational phobia, these fears are well-founded due to a number of environmental crises, such as animal depopulation, melting glaciers, coral bleaching, and extreme weather.16 Reports on climate change in the media have evolved from distant gloom-and-doom prophecies to “an unsettling reality unfolding before our eyes.”17 Still, those suffering from eco-anxiety often receive the message that they are being “snowflakes” and that their views are “alarmist.”2 Likewise, clients wrestling with the natural consequences of these feelings, such as hesitancy to have children,30 tend to be pathologized as being overly dramatic. Therefore, clinicians should first and foremost validate eco-anxiety as a natural response to a distressing situation.31 As Maslow’s famed hierarchy of needs asserts, threats to safety and shelter supersede other needs like social connection or achievement.32 Climate educator Jennifer Atkinson, PhD, has received feedback on her eco-anxiety seminar indicating that “just knowing … that there’s a name for this condition makes me feel less abnormal. I’m not alone.”2 Being able to express those fears in a safe holding environment can itself be a powerful therapeutic tool.2

Taking Action
Eco-anxiety can lead to inaction by paralyzing those afflicted.2 Those who worry about the fate of the planet may feel a sense of learned helplessness, as any individual action may seem futile.2 The eco-anxiety clients feel can be framed as a practical motivator to help address the problem,12 which can reduce this sense of powerlessness and increase feelings of control over their own actions.16 For instance, a 2015 documentary featured how the Hurricane Healing Gardens project restored a place of joy and tranquility.2 Instilling hope that these actions can make an impact can be helpful,33 but it’s important not to overcorrect and abandon rationality with unreasonably “rosy” predictions of the future.5 Social workers also should guard against an overzealous, unsustainable response that leads to burnout, balancing taking action with practicing self-care.

Therapeutic Interventions
Given that those with eco-anxiety often have trouble sleeping, difficulty enjoying social situations, or experience interference with working and studying,18 behavioral interventions hold promise for addressing these symptoms. For example, therapists can encourage clients who feel that distressing climate dialogue is “inescapable”34 to avoid overexposure to traumatizing images by limiting media exposure to manageable levels.2 Another actionable step to minimize feelings of vulnerability could be to develop a climate safety plan, which enhances self-perceptions of resilience and mental preparedness.2 Classic behavioral activation techniques and behavior scheduling can also be leveraged to help clients cope with eco-anxiety.33

Cognitive interventions have proven useful in addressing the anxiety element.16 A small but growing base of therapeutic intervention tools can be used, such as a worksheet to map eco-grief.9 Another focus of clinical attention could be addressing moral injury—forgiving ourselves and others for contributing to greenhouse gas emissions.9 Scholars are also beginning to apply therapeutic modalities such as acceptance and commitment therapy,35 existential approaches,12 developing gratitude,2 and trauma work2 to target eco-anxiety specifically.

Eco-Therapy
Eco-therapy “provides individuals with an opportunity to explore their relationships with nature.”36 This could include horticulture, animal-assisted therapy, wilderness excursions, nature-based mindful meditations, or even therapy conducted in natural settings.37 Nature immersion can help children develop resilience that mitigates eco-anxiety and encourages longer-term engagement in climate action when they are older.2

Social Support
Having a safe place to process concerns with like-minded companions can be very beneficial.2 For instance, a Climate Cafe is an “informal, open, respectful, confidential space to safely share emotional responses and reactions” to the climate crisis. These are also rising in popularity.38 There’s also a 10-step nonprofit network support group for climate grief known as the Good Grief Network.39 Additionally, the Climate Journal Project is “an online community that provides guided reflections and challenges, designed to help you build resilience against eco-anxiety so you can live with greater joy and purpose as we face major environmental changes ahead.”40

Looking Ahead
Although progress is being made toward raising awareness about eco-anxiety and determining best practices for treating it, there is significant work to be done. Social workers can be a part of these pioneering efforts.

— Karen Magruder, LCSW-S, is an assistant professor of practice at the University of Texas at Arlington School of Social Work and a Doctor of Social Work student at the University of Kentucky. She also manages a free social work education resources YouTube channel and a private practice providing therapy, clinical supervision, and tutoring for the Association of Social Work Boards licensing exams.

References
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