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Perspective
Coping with eco-anxiety: An interdisciplinary perspective for collective
learning and strategic communication
Hua Wang
a,
*, Debra L. Safer
b
, Maya Cosentino
b,c
, Robin Cooper
d
, Lise Van Susteren
e
,
Emily Coren
b
, Grace Nosek
f
, Renee Lertzman
g
, Sarah Sutton
h
a
University at Buffalo, The State University of New York, Department of Communication, 359 Baldy Hall, Buffalo, NY, 14260, USA
b
Stanford University, Department of Psychiatry & Behavioral Sciences, 401 Quarry Rd, Stanford, CA 94305-5722, USA
c
University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, CH-3000 Bern 60, Switzerland
d
University of California, San Francisco & Climate Psychiatry Alliance, 1132 Dolores St., San Francisco, CA 94110, USA
e
George Washington University, Department of Psychiatry and Behavioral Sciences, 1609 Connecticut Ave NW, Washington DC, 20009, USA
f
University of British Columbia, Allard School of Law, Allard Hall, 1822 E Mall, Vancouver, BC V6T 1Z1, Canada
g
Project InsideOut, 353 Eleanor Drive, Woodside CA 94062, USA
h
Environment & Culture Partners, 539 Broadway, Tacoma WA 98402, USA
ARTICLE INFO
Article History:
Received 29 June 2022
Accepted 23 January 2023
Available online 26 January 2023
ABSTRACT
Anthropogenic climate change and ecological crisis are affecting people’s mental health. One such manifesta-
tion, eco-anxiety, is anxiety in the form of negative, troublesome, and automatic physiological, cognitive,
emotional, and behavioral reactions to climate change and ecological degradation. The speed, scale, and
severity of unfolding environmental crises will continue to exacerbate experiences of eco-anxiety. Scholars
and practitioners are still in the early stages of understanding and addressing the phenomenon. To help pri-
oritize future endeavors, we advocate for an interdisciplinary approach to address the urgency and complex-
ity of eco-anxiety, which can be understood in the context of a larger problem facing humanity. We provide
an eco-anxiety primer based on recent scoping reviews and seminal empirical research. Additionally, we rec-
ommend four opportunities for collective learning and strategic communication: (1) motivational and
actionable message framing, (2) storytelling for social and behavior change, (3) knowledge sharing and
linked resources, and (4) positive deviance for complex problem-solving. We hope this article will benefit
health practitioners, media professionals, academic researchers, policy makers, community leaders, climate
activists, and other stakeholders.
© 2023 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-
ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Keywords:
Eco-anxiety
Climate change
Ecological degradation
Mental health
Interdisciplinary
Collective learning
Strategic communication
Mara, a 24-year-old university student, seeks help for anxiety. She
describes feeling paralyzed when thinking about climate change and
the future.“I want to be a mother someday but feel guilty about
bringing a child into this distressed world. I keep wondering what the
point of anything is. It’s hard to study or make friends.”
Leon, 51 and a father of three, requests treatment for panic attacks.
They started last year after he and his family evacuated their home
again due to wildfires. “My asthma is worse and I have attacks of
intense anxiety about my kids’future. I avoid being outside in case I
have trouble breathing. My wife and children are worried and want
me to get help.”
Isabel, a 16-year-old climate activist, wants support due to ruminat-
ing about the climate crisis to the extent that she can’t focus on
schoolwork. “I don’t understand why my government isn’t respond-
ing to climate change with more urgency! The environment’s
destruction feels so personal. I’m often afraid, sad, and feel
powerless.”
The opening vignettes are composites based on our practitioner
co-authors’clinical experience. They demonstrate that the climate
change crisis is taking a toll on people’s mental health [1,2]. Recent
systematic reviews have shown that the negative impacts of climate
change are complex (e.g., direct and indirect, immediate and delayed,
acute and chronic); particularly detrimental among the most vulner-
able (e.g., victims of natural disasters, youth, indigenous communi-
ties); manifest cognitively, emotionally, and physically; and affect
behaviors, relationships, and overall wellbeing [2]. One such manifes-
tation is anxiety related to the ongoing anthropogenic climate change
and ecological degradation, referred to as eco-anxiety [3,4]. Mara,
* Corresponding author.
E-mail address: hwang23@buffalo.edu (H. Wang).
https://doi.org/10.1016/j.joclim.2023.100211
2667-2782/© 2023 The Author(s). Published by Elsevier Masson SAS. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/)
The Journal of Climate Change and Health 9 (2023) 100211
Contents lists available at ScienceDirect
The Journal of Climate Change and Health
journal homepage: www.elsevier.com/joclim
Leon, and Isabel (pseudonyms) are examples of individuals struggling
with eco-anxiety.
Results of an international survey in 32 countries from fall 2018 to
spring 2022 (N= 12,246) showed that, on average, 47% of participants
reported being very or extremely worried about climate change, with
the highest level of concern reported in Spain at 78% [5]. Participants’
climate change related worry was negatively linked to mental well-
being [5]. Similarly, a 2021 survey among adolescents and young
people across 10 countries (N= 10,000) found 84% at least moder-
ately worried about climate change, 59% very or extremely worried,
75% thinking the future is frightening, and 62% feeling anxious [6].
Other smaller scale surveys have shown similar trends in the Philip-
pines, Poland, UK, Germany, France, and Belgium [7−10]. On June 13,
2022, the American Medical Association officially declared climate
change a public health crisis [11]. The speed, scale, and severity of
the unfolding climate and ecological crisis will only continue to exac-
erbate people’s experiences of eco-anxiety.
Scholars and practitioners are still in the early stages of under-
standing the phenomenon of eco-anxiety and clarifying its definition
and management for appropriate clinical and non-clinical settings
[4,12,13]. The goal of this article is two-fold: (1) to provide an eco-
anxiety primer based on recent scoping reviews and seminal empiri-
cal research published in high-impact journals; and (2) to identify
opportunities for collective learning and strategic communication to
coordinate efforts moving forward.
An eco-anxiety primer
Eco-anxiety generally refers to an individual’s cognitive, emo-
tional, physiological, and behavioral response to ecological doom
[3,4,14]. Without using the exact label, deliberation about eco-anxi-
ety began in 2007 and has gained more traction in recent years
thanks to work by Glenn Albrecht, Susan Clayton, Caroline Hickman,
and Ashlee Cunsolo among others [4,13-16]. Various other related
terms have been used in the literature such as climate anxiety, envi-
ronmental distress, eco-angst, eco-guilt, eco-paralysis, climate grief, and
solastalgia [2-4,13,15]. In this writing, we use eco-anxiety as an
umbrella term.
Eco-anxiety is conceptually multifaceted [4,17] and operationally
multidimensional [5,7,18,19]. Uncertainty, unpredictability, and
uncontrollability are three fundamental characteristics of climate
change and ecological degradation that can cause individuals psycho-
logical distress and manifest as eco-anxiety [3,4,12]. The condition
overlaps with general anxiety disorder and other mental health dis-
orders in the form of negative, troublesome, and automatic reactions
to a felt threat [3,4,12]. However, most empirical studies on eco-anxi-
ety to date surveyed the public or low-risk groups with smaller and
unrepresentative samples [1]. Rigorous research is needed to more
completely understand individuals’experiences of eco-anxiety, clar-
ify its distinct characteristics and contextual factors, and articulate its
relationship with other mental health conditions [3,4].
Experiences of eco-anxiety often include dystopian thoughts and
apocalyptic perceptions about the future, negative and sometimes
intense emotions such as fear, anger, dread, guilt, grief, and despair,
as well as behavioral manifestations such as insomnia and panic
attacks [3,4,12,13]. Causes and triggers of eco-anxiety vary from
direct exposure to traumatic extreme weather events like floods, hur-
ricanes, and wildfires to maladaptation to long-term environmental
changes like land loss, water scarcity, and pollution [2,20]. Eco-anxi-
ety can also manifest in individuals without direct experience of cli-
mate change, simply from the awareness of the potential existential
threat it presents [4].
Eco-anxiety is currently not considered a mental health disorder
and has no formal guidelines for clinical diagnosis or treatment [21].
Rather, it is a set of responses ranging from normal reactions to envi-
ronmental threats to more overwhelmed states that impair daily
functioning. Severe eco-anxiety can overlap with clinical mental
health disorders and may require professional evaluation and treat-
ment [4,13,22,23].
Scholars have warned about stigma that may be associated with
pathologizing eco-anxiety when most individuals who experience it,
especially young people, may not require clinical treatment [24,25].
For many, habitual worry about climate change and environmental
degradation has been linked to constructive, adaptive, and pro-envi-
ronmental responses [20]. We are at a juncture where the develop-
ment of actionable steps to better serve the global community,
especially those most in need, is called for. We need to address this
growing phenomenon and develop more equitable solutions (Fig. 1).
Health professionals are improving ways to communicate climate
concerns and translate understandings to greater empowerment and
action [26]. Their voices are imperative for climate change communi-
cation and transformation [27,28]. Much of the eco-anxiety literature
draws heavily from psychology and psychiatry. However, the urgency
and complexity of ecological and climate crisis demand an interdisci-
plinary approach. The Lancet One Health Commission is an important
example of such an effort within different fields of medicine and ecol-
ogy [29].
A multilevel, dynamic, and adaptive framework is needed to guide
collaboration and collective action. Significant groundwork has been
developed for interdisciplinary work in systems science [30], political
economy [31], public health [12,32], and communication and media
studies [33]. Although scholars and practitioners may not always use
the same terminology or recognize similar efforts in other disciplines,
these frameworks essentially all include micro-, meso-, and macro-
Fig 1. Understanding Eco-anxiety and Asking Meaningful Questions.
H. Wang, D.L. Safer, M. Cosentino et al. The Journal of Climate Change and Health 9 (2023) 100211
2
level actors who are interconnected and embedded in a larger con-
text; the change and influence among actors interact and evolve over
time. Therefore, the climate and ecological crisis seems intractable
and requires innovation to tackle [34].
Health professionals will continue to identify diverse causes of
eco-anxiety, focus their understanding of individual experiences
across high-risk groups, and solidify their recommendations for cop-
ing and treatment. However, other disciplines can help advance these
efforts by providing opportunities for innovative thinking and prac-
tice, such as with a sociological perspective regarding structures and
connections in society; a political scientific approach to tension, con-
flict, and social movement; and communication strategies for
patient-provider interaction, social support, community outreach,
and public engagement [4,22,33,35].
Recommended collective learning and strategic communication
Motivational and actionable message framing
Media coverage of climate change related disruption and ecologi-
cal crisis can evoke eco-anxiety [4]. Current messages about climate
change are overwhelmingly negative, both linguistically and visually,
contributing to a sense of doom and gloom [36]. Hope is central to
humanity’s survival and flourishing [37]. Yet some caution that hope
alone is not a panacea [38,39]. We should be mindful about the dia-
lectics in eco-anxiety (e.g., hope vs. hopelessness, certainty vs. uncer-
tainty, and nature as comfort vs. nature as threat) [40] in clinical
work and in mass communication. Message framing needs to be tai-
lored towards specific audience needs by enhancing the motivational
mechanisms to appeal to them. Hope consists of goals, pathways, and
agency, which are closely connected to behavioral intention and
action [37,39,41] as demonstrated by constructive journalism [42].
We advocate for messages purposefully structured to increase
human agency and facilitate climate action [36,43], as supported by
the social identity model of pro-environmental action (SIMPEA) [44]
as well as the recent integration of self-determination and self-efficacy
theories [45]. We urge scholars and practitioners to experiment by
operationalizing the messaging strategies in more nuanced manners
as opposed to a general statement such as in the Hornsey and Fielding
study [38]. For example, research suggests that advocacy messages
sequenced with the significant consequences of climate change,
actionable solutions, and a call to action are effective [46].Education
around concrete actions and opendialogues, along with active engage-
ment, can reduce the risk of eco-anxiety [12]. Seeking supportive social
connections and engaging in local communities can boost personal
and collective efficacy and provide a buffer for eco-anxiety [47].Future
research should examine the effectiveness of strategic message fram-
ing and of specific media content related to coping with eco-anxiety.
Storytelling for social and behavior change
For over 50 years, storytelling in popular media, (e.g., entertain-
ment-education) has been purposefully created and disseminated for
social and behavior change [36]. Using an elaborate narrative format,
compelling presentation, intentional role modeling, and collaborative
efforts, entertainment-education has prevented HIV/AIDS and
unwanted pregnancies for millions, paved the way for new legisla-
tion on domestic violence, and begun to help accelerate climate
change empowerment and action [36]. For example, the National
Resources Defense Council has been helping the media and entertain-
ment industry to incorporate climate themes and boost public
engagement through their newly established Rewrite the Future pro-
gram [36]. A prototype television drama series called Rhythm and
Glue has been proposed to address the most urgent climate issues
and, more importantly, illustrate realistic and constructive engage-
ment [36,43].
As health professionals continue to advance knowledge, accurate
information, and effective coping strategies for eco-anxiety, these
can be translated from academic and clinical research to mass media
production. Major storylines in popular media programming and
behavioral modeling of main characters can raise awareness, reduce
stigma, and facilitate local and specific engagement through linked
resources.
Knowledge sharing and linking resources
Having access to resources and the capacity to use them effec-
tively is a crucial part of creating climate resilience among people
experiencing eco-anxiety. We advocate for an interdisciplinary
approach that breaks down the silos in individual fields through
knowledge sharing between mental health professionals and col-
leagues in media production, constructive journalism, and science
communication. Organizations such as Climate Psychiatry Alliance
and Climate Psychology Alliance are working to offer resources,
including a “toolkit”for eco-anxiety. The American Psychological
Association Task Force on Climate Change has encouraged interna-
tional research workshops, reviews, and white papers in multiple
areas of psychological as well as multidisciplinary research related to
psychology and climate change [26]. Additionally, there is an ongoing
collaborative effort to include a “climate hotline”as part of the com-
munity resources offered by the essential community services num-
ber 211. Ultimately, a centralized platform, or a system of linkages,
would enable the collection, aggregation, sharing, and tailoring of
eco-anxiety resources for systematic monitoring and effective inter-
ventions at a larger scale.
Positive deviance for complex problem-solving
Positive deviance is an asset-based approach to health behavior
and social change that enables communities to discover and act on
local wisdom [48,49]. Its premise is that every community has out-
liers who find better solutions for problems than their peers. These
individuals are “positive deviants”because their outlier practices
deviate from the norm but arrive at successful outcomes. Thus,
instead of utilizing an outside expert’s prescription and traditional
persuasion strategies, the community engages in a process of self-dis-
covery and vetting to reveal local wisdom.
Positive deviance has been used worldwide since the 1980s to
tackle complex and urgent health and social issues such as childhood
malnutrition, sex trafficking, and hospital acquired infections [48,49].
It has also been applied to mental health and used to examine, for
example, psychological resilience among Dutch youth [50].In52
vocational schools serving disadvantaged students in Rotterdam,
researchers worked with the partners to define positively deviant
schools: in impoverished neighborhoods, with 150 or more students
of whom at least 50% had immigrant backgrounds, scored 10 or
below on the standardized student psychological resilience tess (the
mean value across all 52 schools was 16), and no access to extra
resources [50]. Two schools met these criteria. Ten positively deviant
behaviors were discovered by collaboration between the researchers
and the school teachers, staff, and students. These behaviors, against
all odds, helped the students build strong psychological resilience,
setting them apart from other schools [50].
As public health practitioners and researchers establish and
improve standardized measures of eco-anxiety [5,7,18,19], it will be
helpful and revealing to look for “positive outliers”(e.g., those who
are most susceptible to eco-anxiety in terms of key characteristics
yet demonstrate significantly better psychological resilience and cli-
mate actions). Often invisible yet highly effective, positively deviant
practices can be amplified in similar communities and applied at
regional, national, or global levels.
H. Wang, D.L. Safer, M. Cosentino et al. The Journal of Climate Change and Health 9 (2023) 100211
3
Conclusion
The relationship between climate change and mental health, and
its manifestation as eco-anxiety, is a growing global concern. Eco-
anxiety is a growing global concern for climate change and mental
health. In this article, we advocated for an interdisciplinary approach
to understanding and addressing this relatively new phenomenon.
We provided an eco-anxiety primer based on recent scoping reviews
and seminal empirical findings. We also offered four recommenda-
tions as opportunities for collective learning and strategic communi-
cation. Eco-anxiety is part of the climate change and ecological crisis;
it is part of a “wicked problem”that requires fresh eyes and innova-
tive approaches. We hope this article can immediately benefit health
practitioners, media professionals, academic researchers, policy mak-
ers, community leaders, climate activists, and other stakeholders.
Declaration of interests
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influ-
ence the work reported in this paper.
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