Harden the f#@& up!

Lately I have been thinking about shifting tides in global psychiatry. For instance the Americanisation of mental illness is becoming increasingly evident, as is the overwhelming propensity for people to pathologise everything that is not neurotypical. Indeed, there is also a growing temptation to diagnose away bad behaviour, or attempt to find some reason why people might just be A-holes. Look at Tiger Woods, after being busted repeatedly burying his iron in the rough, does he man-up and acknowledge that hes a guy-whore with more money than sense? Does he hell...he books himself into rehab for his "sex addiction".

Now other poor sods are finding that after the demise of the Hope and Change Hoe-Down in Copenhagen, their impending demise is making them, well, a bit teary:

Brought to the brink by climate change

Mardi Tindal, the newly elected moderator of the United Church of Canada, returned from last month's climate change summit in Copenhagen with a deep malaise. Not a true clinical depression, but an anxious despair that reduced her to weeping.
"The difference between depression and what I was experiencing is that I wasn't suppressing or finding myself in a place of isolation," she said in an interview about her "lament," and how it helped her to see "the truth about the condition of my own soul."
She was so disappointed by the meeting's failure to reach a binding deal that she broke down in the car one day as her husband drove toward their home church in Brantford, Ont.

The article then trots out a U.K. psychiatrist, Lisa Page:

Dr. Page cites "preliminary evidence" of more extreme possibilities: that suicide increases above a certain temperature threshold; that schizophrenia increases as populations become more urban; and that "impulsivity and aggression could be triggered during periods of hot weather."

One minute we're talking about someone having a bit of a cry, and the next its suicide and schizophrenia?! I certainly hope Dr. Page has to defend those findings, because we already know that linking suicide with temperature is a rather tenuous association, and that in fact suicides rates tend to be highest in northern Europe. The top five countries for suicide according to the WHO are:
1. Lithuania.
2. Belarus.
3. Russia.
4. Kazakhstan.
5. Hungary.

Which would indicate to me that this might have just as much to do with a socio-politico-economic climate than a meteorological one.

Presumably, Dr. Page is referring to a recent article that examined suicide data from Italy over the last few decades and came to a rather zig-zaggy conclusion that Italian men were more likely to suicide when it was warmer. (But not Italian women. Go figure.) The authors themselves even note that:

It is worth mentioning the somehow speculative character of our interpretation of results, to be weighted against other possible contributing mechanisms

.
Really? You think?

Swiss researchers also set out to look at the relationship of seasonality to suicide, thinking that they would find evidence supporting the classical hypothesis that suicides peak when its warmer. Probably because they didn't think to hook this study up to climate change, they discoverered something completely different instead:

To summarize, the results show unexpected associations between monthly suicide and temperature data. Contrary to overall seasonality, the associations based on monthly residuals emerge mainly during the winter months. In analogy to the overall seasonality, suicides that are performed outdoors appear to play again a major role. The results suggest that temperature and similar meteorologic variables contribute little to our understanding of the overall seasonality in suicide, even though the meteorologic variables are involved indirectly in various ways.

Translation: Instead of finding that suicides are higher when its warmer, they discovered that most suicides correspond with winter, with a secondary peak during summer when people are more likely to suicide in the great outdoors.

We also know already that rates of schizophrenia are higher in people who are born in winter in climates with low levels of winter sunlight exposure. The most striking epidemiology came from the high level of schizophrenia in second generation Afro-Carribean migrants to the United Kingdom. Schizophrenia has thus been linked with a low level of maternal vitamin D during the third trimester. (To joint the long list of other diseases that seem to be linked with inadequate vitamin D levels: Heart disease, diabetes, cognitive impairment, cancer...theres more, but I have a short attention span and got bored listing them.)

If I met an individual in person who was feeling really down about the fact we are all going to die of climate by tuesday because Copenhagen went bosoms up, I would be very sympathetic to them. I'm not a bitch or anything. You can't go around making judgements about other peoples feelings. Feelings are personal and trying to negate someone else's is futility on the level of pushing manure up a hill with a pointy stick. However, on a population level, I would like to request that everyone feeling climate angst of this nature watch this delightfully educational clip (warning: Very foul language included. Don't watch if you are F-word phobic):

If you think I'm crazy, you should see the other guy

Given the long precedent set by (some, I said some, alright?!) psychologists of screwing things up royally, it has previously been put forward that climate change denial is a mental disease.
Luckily for global mental health, the head-shrinkers at the Bristol University of the West of England were on to it, and organised a conference to examine why the denialist response to the AGW threat is (and I quote) "tragically inadequate".

Not content to leave it at throwing around the adjective "tragic", lead organiser and all 'round caring guy Professor Paul Hoggett said:

"We will examine denial from a variety of different perspectives: as the product of addiction to consumption, as the outcome of diffusion of responsibility and the idea that someone else will sort it out, and as the consequence of living in a perverse culture (that) encourages collusion, complacency (and) irresponsibility."

Ever since signing a US visa waiver many years ago, I have wondered what "moral turpitude" is. I mean, I ticked the "No" box when asked if I had engaged in activities thereof, but deep down I always wondered. Maybe I had engaged in acts of moral turpitude and not known it. Do you think "collusion, complacency and irresponsibility" fits the definition? Please tell me it fits...

Bristol UWE is the same well adjusted mob that is helping to bring us the nowhereisland project, as reviewed by Anthony Watts at his excellent blog.

Anyway, no news yet whether climate change denial will find its way into the DSM -V (thats the psych diagnosis bible for the uninitiated), but given that they included homosexuality as a mental illness of one form or another up until the 1980's, I'm not holding my breath.

Another related mental illness that may make its way into the DSM is "Climate Change Delusion" as incorporated into a major depressive disorder with psychotic features. First reported in the Australian and New Zealand Journal of Psychiatry, psychiatric clinicians at the Royal Children's Hospital in Melbourne treated a young man with apocalyptic delusions concerning climate change, that culminated in severe emotional distress and suicidal ideation and behaviour.

"The patient had also developed the belief that, due to climate change, his own water consumption could lead within days to the deaths of ‘millions of people’ through exhaustion of water supplies. He quoted ‘internet research’ to substantiate this. The patient described that ‘I feel guilty about it’, had attempted to stop drinking and had been checking for leaking taps in his home to prevent the catastrophe. He was unable to acknowledge that the belief was unreasonable when challenged."

Water, water everywhere, nor any drop to drink: Climate change delusion. Wolf J and Salo R.

Since this initial presentation, the Royal Children's reported more cases of climate change being incorporated into delusions, and an increasing number of children presenting with nightmares of apocalyptic climate change scenarios. Perhaps the inevitable upshot of this issue discussed previously.

Whilst the young man in question undeniably suffered from an acute mental illness, it is telling that the form his psychosis took is not that far removed from what is commonly propagated in the media, including a palpable sense of personal guilt. In the words of the authors:

"Clinicians caring for psychotic patients have long noted that delusional systems are determined by ideas and beliefs to which the individual has been exposed."