As our weekly therapy session drew to a close, my patient, a young woman in her early 20s approaching college graduation, said that she had been feeling a lack of motivation, but that it felt different from her usual depressive symptoms.
A worrisome climate change report had recently been published, and she felt paralyzed by uncertainty of what the world is going to look like. She asked, “How can I decide where I want to go? Will it even be safe to live in California when I’m older?”
Many of us are feeling a sense of powerlessness and despair over climate change and its harmful effects. As a psychiatrist, I have noticed a growing trend among patients in my private practice suffering from what mental health professionals are calling eco-anxiety and climate grief.
Psychedelic therapies may have a growing role in supporting this unique trauma and grief. By exploring and utilizing these tools in our sessions, some of my patients have experienced a reduction of their anxiety symptoms, more acceptance and awareness of their emotions and increased energy and motivation toward environmental activism.
Many of my patients have been affected by long stretches of wildfire smoke exposure and have experienced mental fogginess and irritability because of poor air quality or post-traumatic stress disorder related to wildfire evacuations.
Some of my younger patients are concerned about planning for an uncertain future, including decisions about going to college or whether to have children. Others are feeling heightened anxiety and stress about more profound existential concerns about the fate of the planet and its ecosystems.
Eco-anxiety and climate grief are unlike other issues in psychiatry because the feelings extend to something greater than ourselves and our personal narrative.
The effect of climate change on mental health is a new area in psychiatry and psychology. Climate mental health covers a broad spectrum of emotional and psychological responses. Many people, including some of my patients, feel anxious and powerless from a displaced emphasis on personal responsibility and action, rather than the larger responsibility of corporations and governmental policymaking.
This field also looks to address the mental health consequences of displacement from extreme weather events such as hurricanes and wildfire, especially for vulnerable populations.
Over the last decade, there has been a surge in research into psychedelic therapies to treat psychiatric illnesses such as depression and post-traumatic stress disorder.
Numerous clinical trials have shown that psychedelic therapies, namely psilocybin and MDMA (commonly known as ecstasy) are safe and effective for conditions such as PTSD, depression, end-of-life anxiety and alcoholism. While MDMA and psilocybin are not yet FDA approved, one notable medication already available is ketamine, which is a dissociative anesthetic with psychedelic properties.
Psychedelic medicine-assisted therapy also can support a patient in exploring the enormous and complex feelings associated with eco-anxiety and climate grief. In a study published in 2019, people who had a single experience with psychedelics (mostly psilocybin) were more likely to report feeling a relatedness or connection with nature. Beyond the obvious counterpoint to our often busy and occupied lives, encountering a sense of a larger living process can help us remember the preciousness and impermanence of this life and our planet.
In my clinical practice, patients using oral ketamine plus psychotherapy have experienced breakthroughs and new insights when working with the intention of navigating eco-anxiety. Many patients said they felt connected to a sense of oceanic oneness, reminding them of the meaningful interconnectedness of their lives with others and offering context for their personal narrative.
While less transcendent but equally valuable, space to explore and process the difficult feelings of climate grief during sessions with ketamine has been helpful for other patients.
Being with — rather than avoiding — painful emotions is part of the foundation of the psychedelic-assisted therapy approach. There is an emphasis on learning how to allow feelings without needing to fix them or turn them into a problem to solve. This can be particularly helpful in navigating the sense of urgency and feelings of helplessness often associated with climate crisis-related anxiety.
Psychedelics can also teach us how to experience and hold intense emotions that feel too much to bear, allowing for the ability to observe our suffering in a new way. And they can help us access courage and the motivation to organize and act in the face of fears.
Psychedelic therapies offer a framework different from conventional psychiatry, which often focuses on symptom management with daily medication and open-ended therapy.
Psychedelic therapies help patients discover and address the root cause of their mental health issue through time-limited, medicine-assisted sessions couched in psychotherapy. This allows the patient to discover deeper shifts and relational changes to that material.
In my extensive clinical practice centered around psychedelic therapy, I have witnessed countless instances where my patients have transcended their sense of self to connect with an extended or environmental consciousness. This experience has been reported widely and repeatedly in the history of psychedelic medicine use, including in many psychedelic therapy clinical trials.
For some, these expanded states bring a grounded sense of calm or peace. Profound psychedelic experiences also change the way we see each other and the world around us, often leading to a sense of ecological care and responsibility.
It’s important to note that psychedelic therapies are not for everyone. There are medical and psychiatric contraindications, and they vary depending on the type of psychedelic medicine being considered. If you’re interested in psychedelic therapy, check with your doctor to determine if they are an appropriate option for you. You can use this directory to find a psychedelics-knowledgeable mental health expert or find resources on the Climate Mental Health Network.
I also recommend the book, “Active Hope: How to Face the Mess We’re in with Unexpected Resilience and Creative Power,” by Buddhist scholar and environmental activist Joanna Macy and physician Chris Johnstone. In a YouTube video called “Climate Crisis as a Spiritual Path,” Macy encapsulates this moment.
“We are living members of a living planet,” she says. “We are like cells in a living body. That body is being traumatized. So of course we feel it.”
Emily Willow, MD, is a board certified psychiatrist, researcher, educator and advocate for psychedelic medicine. She is the founder of the ClearSight Center in San Francisco.
We welcome your comments on this column at OnYourMind@washpost.com.
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Psychedelic therapy may help with climate change anxiety – The Washington Post
