The Dilemma of Pre-Traumatic Stress Disorder
A few days ago my friends and I were discussing our futures, and we began expressing anxieties about what the world will look like in 20 years. Terrifying visions of an uninhabitable future planet filled our minds as we recalled predictions of extreme weather events, mass extinction, and no sign of political intervention. Upon sharing these concerns, we found ourselves unable to comfort each other or come to any reassuring conclusion. The truth of the matter is, we have every reason to be scared. We aren’t catastrophising – with climate change we are facing a real catastrophe.
In recent years, terms like ‘eco-anxiety’ and ‘climate grief’ have emerged to describe this climate-related distress that has led to some experiencing what has been referred to as ‘pre-traumatic stress disorder’. This distress about the future of our planet is becoming an increasingly prevalent issue, but perhaps more worrying is that the distress is becoming increasingly justified.
What exactly is pre-traumatic stress disorder?
Unlike other climate-related mental health matters, pre-traumatic stress disorder (Pre-TSD) is explicitly linked to an established mental health condition, post-traumatic stress disorder (PTSD). It mirrors the symptoms of PTSD such as feelings of helplessness, anxiety, upsetting mental images, and intrusive thoughts. The difference is that pre-traumatic stress relates to an event in the future rather than in the past.
Trauma has long been considered to refer to past events, but people suffering from pre-traumatic stress are showing us that this is not always the case. This disorder crucially reminds us that knowing something terrible is going to happen can be as stressful as when it is actually happening. We have seen this phenomenon in soldiers prior to going to war, climate scientists discovering catastrophic atmospheric changes, and now in young people concerned about climate change. Even though many of us in developed countries are yet to be directly impacted by the effects of climate change, knowing that we one day will be is enough to cause significant distress.
Despite the climate crisis posing a bigger threat to humanity than any other issue we have ever faced, it repeatedly falls to the bottom of governments’ priorities because those in power view climate change as a future problem – unlike other more imminent issues like the cost of living crisis. However, Pre-TSD shows us that even people who are yet to be physically impacted by the climate crisis are already experiencing serious psychological impacts. Acting on climate change should therefore be just as important as addressing these other issues.
Who is it affecting?
Although anybody can be affected by this condition, it is no surprise that young people seem to be taking the brunt of it. Despite their minimal contribution to the climate crisis, they are the ones who are going to be here when the consequences of past generations’ actions come to fruition. The distress young people are experiencing as a result of this is so severe that children as young as 15 are suing their governments for psychological damage and violations of their human rights, caused by their lack of climate action.
Additionally, those with pre-existing mental health issues are more prone to pre-traumatic stress, exacerbating the challenges of the most vulnerable.
What makes this condition so complicated is that this ‘disordered’ response is hardly irrational. In fact, the psychiatrist, Lise Van Susteren, who coined the term pre-traumatic stress disorder has gone back and deemed the word ‘disorder’ inappropriate (and suggested ‘condition’ be used instead) as disorder implies that the response is not rational. In reality, it could be argued that those who are not reacting with anxiety are the ones with disordered thinking.
This gives the condition a unique complexity because a therapist cannot tell someone suffering with it that they are wrong – the concerns of these people are completely justified. Other mental health issues such as anxiety and depression are often based around warped views of the world or of oneself, but in the case of climate-related pre-traumatic stress it is an accurate view of the world that is causing the distress. This means it cannot be resolved with medication or affirmations from therapists that their beliefs are inaccurate. The entire backbone of Cognitive Behavioural Therapy (CBT), the most common therapy treatment, is shattered. There are no faulty cognitions or beliefs in this condition – the world really is in great danger and to say that it isn’t would be a lie.
That being said, I would argue that giving this stress a name that so closely mimics PTSD – a condition that is already well-known and taken seriously – can help grab public attention. As well as this, having a familiar disorder to base our understanding around can help us conceptualise it and take more necessary action than when climate anxieties have more abstract names, such as ‘solastalgia’ (which may not instantly resonate with us).
So, what can we do?
The silver lining to pre-traumatic stress is that because the traumatic event has not happened yet, we have the opportunity to change the outcome if we act now.
1. Validate sufferers concerns
Instead of trying to downplay the issue and lessen concerns, we should be validating the concerns of young people. A large reason pre-traumatic stress disorder becomes so difficult to deal with is because sufferers feel like nobody else is taking climate change seriously and so they carry more of the weight of the burden. In order to help these people (and our planet), we must share this burden and make climate change a priority in every society.
2. Encourage sufferers to harness their stress
Whilst stress is a deeply unpleasant feeling, we experience it for a reason. The human stress response has been conserved throughout evolution because it is what allows us to take action when we are faced with a threatening situation. Stress increases secretion of key hormones such as cortisol and adrenaline and increases blood flow to the brain to boost alertness and performance.
An inspiring example of this is Greta Thunberg, who suffered severe mental health difficulties due to the climate crisis, and channelled this distress into action. She reminds us that we need to be stressed, saying “I don’t want you to be hopeful. I want you to panic. I want you to feel the fear that I feel every day. And then I want you to act.”
3. Improve support
While stress can have some positive effects, nobody should be expected to live with the symptoms of pre-traumatic stress. Of course, some stress is motivating, but studies show that too much stress leads to anxiety and burnout that ultimately hinders productivity. We need to implement the right support so that those suffering can manage their stress in a healthy way and not fall into a pit of despair.
Looking back, there was comfort to be found in the conversation I had with my friends, because even though we had good reason to be scared, it was comforting knowing none of us were alone in these fears. In fact, if I could go back, I would remind them that feeling anxious and having conversations like this is a step towards solving the problem. The solution to pre-traumatic stress disorder is not therapy or medication, it is communication and action. This action needs to come from more than just the individuals suffering from Pre-TSD. While they are important, we cannot rely on individual lifestyle changes to tackle an issue as large as climate change; We need our leaders to finally take responsibility and address this mental and ecological crisis with large-scale system changes instead of allowing the burden to fall on society’s most vulnerable.