Heatwaves can be very dangerous for people with some serious mental health conditions – particularly schizophrenia.
The current warm weather sweeping across the UK has already resulted in record-breaking temperatures for September.
And while it’s a relief to finally experience something resembling summer – even if it is quite late in the year – it’s important to understand the health risks.
Bipolar disorder and major depression can make people more vulnerable to intense heat – but it’s those with schizophrenia who are most exposed to the weather, according to studies.
Schizophrenia is a long-term condition which can cause a range of psychological symptoms, according to the NHS, and is often described as a form of psychosis.
Symptoms can include hallucinations, delusions, people not looking after themselves, wanting to avoid others and feeling disconnected.
Its cause is still unknown, and while many people recover, they can have relapses. Many patients take medication to help combat their symptoms.
Mental health charity Mind suggests that fewer than 1 in 100 people in any given year are diagnosed psychotic disorders, including schizophrenia, in the UK – however, it is still important to understand the dangerous impact heatwaves can have on those with such a condition.
An epidemiologist at the British Columbia Centre for Disease Control, Michael Lee, told the Washington Post about a study where it found people with schizophrenia were over 200% more likely to die in a heatwave than in normal conditions.
That’s a lot. For context, those who have a chronic kidney disease are 36% more likely to die in a heatwave, and those with coronary artery disease were 18% more likely to die.
He also noted that climate change means heatwaves are only going to become more common.
As psychiatrist and schizophrenia specialist at Oregon Health and Science University, George Keeper, told Science.org: “There’s a whole host of things that people with this very unfortunate illness are vulnerable to.”
During a record-breaking heatwave in Canada back in 2021, researchers found 8% of people who died had schizophrenia.
That might be a number of factors which could explain why schizophrenia makes people more vulnerable during heatwaves, including the medication normally prescribed to them.
Antipsychotics typically dehydrate those taking them, by suppressing their own ability to sweat meaning their bodies are less able to cope with the high temperatures.
But, even if those with schizophrenia don’t take the medication, they may already have difficulties with regulating their body temperature.
This correlation was first discovered in the 1930s, although the exact reason remains unclear to this day.
Experts have theorised schizophrenia might have an impact on the brain’s hypothalamus, which regulates body temperature.
Alternatively, the condition may impact the brain’s dopamine levels – and dopamine, the feel-good chemical, can stop the body understanding when it needs to cool itself down.
This is when sweat glands push sweat to the surface so it can evaporate and cool the skin.
Meanwhile, blood vessels dilate, moving blood away from the heat of the interior and towards the skin to cool off.
Even so, the body cannot withstand high temperatures for a long period of time – which is where conscious decisions, like staying out of the sun, come in.
If the body starts to notice it is getting too hot, blood pressure decreases, meaning so organs get less oxygen, proteins in the cells of the body break down and intestines can develop holes, and kidneys stop working.
But those with schizophrenia might not realise when temperatures are getting to an unbearable point.
Psychosis can make people forget where they are and what they’re doing – meaning they forget to look after themselves.
This means they may not take precautions such as staying in the shade, avoiding the sun at the peak of the day and drinking enough water – and they may even put on extra layers of clothing in extreme heat, the Washington Post suggested.
Schizophrenia can trigger social isolation, too – again, meaning the individual in question is less likely to look after themselves in harsh conditions.
Faydra Aldridge, Chief Executive of Officer of the BC Schizophrenia Society, told BC Centre for Disease Control, it’s essential to understand how this mental health condition affects people.
She said: “As demonstrated by the recent research, because individuals living with schizophrenia are more susceptible to heat-related illness, it is essential that families and caregivers are aware of the increased risk, identify potential risk factors and take prompt action to help their loved one during a heat wave.”