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(Bloomberg) — When psychotherapist Caroline Hickman was asked to help a child overcome a fear of dogs, she introduced them to her Labradoodle, Murphy.

“You get the child to feel confident in relation to the dog and teach the child skills to manage a dog,” she says. “You build the skills, build the competence, build the confidence, and then they’re less scared of dogs generally.”

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Climate anxiety is a different beast, Hickman says. “We don’t 100% know how to deal with it. And it would be a huge mistake to try and treat it like other anxieties that we are very familiar with that have been around for decades. This one is much, much worse.”

Read More: Climate Anxiety Can Feel Like ‘There’s No Safe Harbor’ 

In the most critical cases, climate anxiety disrupts the ability to function day to day. Children and young people in this category feel alienation from friends and family, distress when thinking about the future and intrusive thoughts about who will survive, according to Hickman’s research. Patients obsessively check for extreme weather, read climate change studies and pursue radical activism. Some, devastatingly, consider suicide as the only solution. And Hickman isn’t the only expert seeing this. In her book A Field Guide to Climate Anxiety, Sarah Ray describes a student who had such severe “self-loathing eco-guilt” that she stopped consuming much at all, including food. 

Most people’s concern about global warming isn’t that pronounced. It can be difficult to pin down exactly what climate anxiety is, and therefore what to do about it. Especially for adults, there’s still a stigma in admitting that it’s severely affecting your life. But therapists report they are grappling with a rise in demand from clients who say climate change is having a profound effect on their mental health, and studies suggest the angst is increasingly widespread. Existing professional methods for dealing with anxiety aren’t always suitable in these situations. For the counseling community, the situation calls for a new playbook.

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In 2021, a study of 10,000 children and young people in 10 countries, co-authored by Hickman and published in The Lancet Planetary Health, found that 59% were very or extremely worried about climate change and more than 45% said it had a negative effect on their daily life. A survey of mental health professionals in the UK, published last year in The Journal of Climate Change and Health, found that they perceived “significantly more” patients describing climate change as a factor in their mental health or emotional distress, an increase the participants expected to continue. Frustratingly, climate anxiety can also overlap existing mental health problems, making it difficult to analyze in isolation.

Therapists told Bloomberg Green that they typically see an uptick in patients struggling with climate anxiety when climate change is in the news; often around the time of a UN climate conference, a major scientific report or an episode of severe weather. Scientists working on climate change were among the first groups they saw experiencing this type of anxiety, therapists said, and those groups are still struggling. Among the close to 300 people who responded to a Bloomberg Green readers’ survey about climate anxiety, just under one in five said they discuss the issue with a mental health professional.

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One respondent, Natalie Warren, a 42-year-old UK expat living in Sydney, Australia, told us that while she isn’t in therapy, she had felt a strong urge to act. Climate anxiety felt different to a previous mental health challenge: it is external, rather than internal, she says. 

“There’s nothing wrong with someone who’s suffering from climate anxiety,” she says. “It’s not them that needs fixing.”

How Therapists Diagnose and Treat Climate Anxiety

So what are therapists actually doing in their treatment rooms? The first point is they’re not making any diagnoses, as anxiety about climate change isn’t a disorder. “We consider it much more as an understandable response to a real and rational danger,” says Patrick Kennedy-Williams, a clinical psychologist based in Oxford, UK. Working with someone who has social anxiety or a phobia is partly about “recalibrating their sense of risk and threats,” he says — realigning the fear with the actual threat level. That isn’t usually the case with climate change, he says, because “the threat is real.”

Also, there’s no “classic case” of climate or eco-anxiety. Some patients may need to discuss direct experience with climate impacts, such as a flood or wildfire destroying a home, while others might, for example, want to talk about their guilt at watching others suffering, or struggles with friends or family who are dismissive or hostile. People might not even say they’re feeling “anxiety,” he says, instead using words like trauma, grief and depression. “It doesn’t fit neatly into our way of thinking about mental health,” Kennedy-Williams says, “probably because the climate crisis and our relationship with the climate crisis is a lot more multifaceted than that.”

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Climate anxiety often ends up being linked to many other dilemmas in the normal course of a person’s life, including big choices like whether or not to have children, where to live or what to do for work. Many of these questions are already highly stressful and emotional. The problem of whether or not to have children, in particular, is one around which Kennedy-Williams has seen “huge amounts of distress” in the therapy room, he says.

Kennedy-Williams compares his experience with patients struggling with climate anxiety to working with people struggling with activity-limiting illnesses or medical difficulties, where clear solutions aren’t often available. “You can’t just say, ‘Actually I’m sure there’s nothing to worry about. I’m sure everything will be fine,’” he says. Instead, he tries to help patients “thrive and find joy in difficult circumstances.” 

Some anxieties are linked to specific triggers, which can be directly addressed and resolved. But climate change is more wide-ranging. Global warming is also not resolvable by any one person, so it’s impossible to gain a sense of confidence and control over the problem. “You can’t personally resolve it,” says Hickman. “You can go off and do your recycling, and become an activist, or do X, Y, Z, but it’s a global problem. It’s not personal.” Many patients also feel that those in power are asleep at the wheel, adding to a sense that no one is in control, she says.

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Perhaps one of the most surprising aspects of anxiety over climate change: It can also be linked to climate denial. Experts said the two can be understood as different manifestations of the same feeling. “The conspiracy theorists are reassuring,” says Hickman. “If you can’t tolerate anxiety, you will then spin off into believing somebody who gives you false promises.”

Overcoming all of these feelings is key to action actually being taken to solve the climate crisis. Fear and disempowerment lead people to turn inward, focusing on self-preservation and survivalism, rather than the more collective means needed to actually address climate change as an issue, says Louise Edgington, a British educational psychologist specializing in climate psychology, who works primarily in schools.

“Wellbeing is not just about nice hugs and feeling good,” she says. “It’s a crucial part of actually making the changes we need to make.”

Read More:  They’re Not Like Regular Dads. They’re Climate Dads

So how to address it? Leslie Davenport, a Washington state-based therapist, co-developed a course for other professionals seeking ways to treat patients struggling with climate-related mental health issues. She highlights two broad types of coping strategies: internal and external.

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She likens climate anxiety to holding a ball under water. Eventually, your arm will get tired, and it will pop up — it can’t be suppressed forever. Internal strategies can include learning to calm your nervous system down, taking conscious breaks and focusing on your mental narratives. External strategies include finding ways to take action in whatever way is most appropriate, whether that’s donating money or joining a local community group for clean air.

“I’d say as much as half of our climate anxiety has to do with the feeling of not being efficacious to do something about it,” says Ray, who is also a professor and chair of environmental studies at California State Polytechnic University, Humboldt. Doing something in a group rather than alone can be helpful. “The thing that reduces the climate anxiety is being part of a collective…where people care as much as you do. You’re not the only one.”

Channeling anxiety in this way can turn into serious action. Opposition to the Dakota Access Pipeline and groups like Pacific Climate Warriors were motivated — in part — by their anxiety to do something radical, Ray says. It can also motivate others to run for public office. Warren, the survey respondent from Sydney, who has two young children and works in finance, ran for and represented the Greens on her local council between 2017 and 2021.

One of the many parents who responded to Bloomberg Green’s survey, Warren says that what drives her now is the inevitable conversation she will one day have with her boys. When they ask “How did you let it get so bad?” and “Why weren’t people doing anything?” she wants to have something real to tell them: “I need to be able to tell them that I tried.”

Readers, we want to hear from you. What has helped you cope with your worries or stress around climate change? What advice would you have for others who may be struggling? Please take our brief survey.

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