In the face of doom: How one Toronto clinic is helping patients deal with eco-anxiety

It remains unrecognized as a diagnosable mental illness, yet eco-anxiety—defined by the American Psychological Association as a “chronic fear of environmental doom”—is believed to affect as many as three in four Canadians. A Toronto psychiatrist named Dr. Nate Charach is working to help his patients feel less fearful and more empowered to do something about climate change. “I was feeling like my role as a general outpatient psychiatrist was not addressing the (climate) emergency that we’re thinking about,” Dr. Charach told the Medical Post. “So I started running a psychiatry group—which I spell with “tree” at the end, like ‘psychiatree’ to help patients feel motivated to take action against climate change.” The psychiatree groups, which Dr. Charach launched at the start of 2023 at Michael Garron Hospital’s Child and Adolescent Psychiatry Clinic, run for about six sessions, with each successive session designed to take patients through different stages—from understanding what they’re feeling and why to feeling emboldened enough to affect change. “I think of it like stages of a change model,” explained Dr. Charach. “In addictions we have this precontemplation stage where people don’t even think about their problem. Then they move to contemplation where they’re starting to think about it, and then to preparation and then to the stage where there’s action. As physicians, our role is to move people to the next stage of change.” Read: Net-zero healthcare by 2050: What Canada needs to succeed But how do patients—and their doctors—know if their concerns about the planet fall into the category of eco-anxiety that could require treatment? Dr. Gili Adler Nevo, a psychiatrist who leads the Child and Adolescent Anxiety Clinic at Michael Garron Hospital, said many people have some level of concern about climate change. But there are those whose lives can become dysfunctional because of what she calls “eco-fear.” “You would see people who are not enjoying their life because they have that worry in the back of their minds all time,” she said. “You will see people who are frozen, who think there’s no point looking at their future. There are a lot of Gen Zs, for example, who are thinking of not having children because they’re distressed about climate change.” In some extreme cases where patients feel complete hopelessness, there may be a risk of suicidal thoughts, said Dr. Charach. “I think there’s a spectrum, like there is with any kind of mental health issues,” he said. “At the extreme end of the eco-anxiety spectrum, there may be people who feel they may as well give up because everything is doomed.” Read: Dangerous fungus is becoming more prevalent. Scientists believe climate change could be to blame Dr. Adler Nevo said younger people tend to be more worried about climate change than older generations—an observation supported by a 2023 University of Lakehead survey that found 73% of Canadians aged 16 to 25 saw the future as frightening because of climate change and about 65% said they were either sad or anxious because of threats to the planet. That negative feelings often become exacerbated because younger people have fewer means to make positive changes, added Dr. Adler Nevo. “That’s an important discrepancy, and that creates that feeling of helplessness,” she said. Dr. Charach said he said he hopes to see other practitioners offer something similar to his eco-anxiety groups. “If there are people out there who are interested in doing this kind of work, I’m open to collaborating because I’d like to see this spread as much as possible,” he said. “The more people we have who are motivated to do something for the environment, the more we can make a difference with climate change.” Read: Boy who died from asthma amid wildfire smoke is ‘face of climate crisis,’ doctor says

In the face of doom: How one Toronto clinic is helping patients deal with eco-anxiety

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