Understanding effects of heat on mental health

A heat wave is affecting parts of the U.S., including much of the Southwest, through the Southeast and parts of Europe. When temperatures soar, the heat can take a toll more than just physically. Our well-being can suffer as well.

"A study of over 2 million people found an increased visit rate or incidence of people going to the emergency department with psychiatric and mental health-related concerns during periods of high heat," says Dr. Robert Bright, a Mayo Clinic psychiatrist. "It showed a higher level of visits for substance abuse, anxiety, mood disorders, and even people with schizophrenia had an increased incidence of distress or issues with their illness, bringing them to the emergency department."

Heat and emotions

A common side effect of extreme heat is irritability, which can arise from physical discomfort and disrupted sleep patterns. The fatigue from sweating, working in the heat and the lack of quality sleep can leave people feeling stressed and on edge.

Dr. Bright says that others may be irritable due to heat. That can lead to tempers flaring or even road rage.

"It's really important for people to have grace for themselves and grace for other people. Everybody's struggling. It truly is something that's affecting every one of us, so step back and try to think through these things at a cognitive high-level. This is what's happening. Recognize that and do not just react impulsively from that emotional part of your brain," says Dr. Bright.

Heat and psychiatric medications

Certain medications can heighten the risk of heat-related issues from a psychiatric and medical perspective. Diuretics, for instance, can cause increased urine output, leading to dehydration, mental status changes and confusion.

"Medications used for mental health for illnesses, such as schizophrenia or bipolar illness, can change your regulation of heat and your ability to sense that you're too hot, your ability to sweat. I've seen people walk around with heavy mink coats when it's 100 and 105 degrees outside not recognizing that because of their lack of thermo regulation or ability to regulate their body temperature," says Dr. Bright.

Dehydration can also affect levels of some medications, such as lithium—which can become more concentrated in the body and potentially lead to toxicity.

"Some medications like lithium, for example, if you get dehydrated, your lithium level can rise significantly. Lithium has a very narrow therapeutic range. And you can become quite toxic with lithium, which can be quite serious with heart arrhythmias, coma, seizures and even death, if it got severe enough," Dr. Bright says.

Drinking plenty of water and staying cool can help mitigate these risks.

What to do

And if you need help, seek help.

"If you're feeling really overwhelmed and as though you truly can't cope, then it's time to reach out for help," says Dr. Bright. "Whether that is walking into an emergency room and asking for assistance or contacting a therapist or counselor."

Finding ways to stay cool may be a good starting point to help reduce periods of intense heat. Dr. Bright says he knows only some people have air conditioning and recommends trying public spaces that may offer relief if you don't have access at home. "If you don't have a place where you have air conditioning, and if you can, go to a cool place with air conditioning, go to the mall, go wherever it might be that you can go hang out for the day, go to the library to do those things to relieve yourself of some of the stress of the heat," says Dr. Whiteside.