Wildfires and smoke are affecting our mental health

Oregonians have had yet another summer impacted by wildfires and lingering smoke. The immediate threat of fires is traumatic for those whose homes and businesses are directly in the path of a blaze. But the smoke from these fires spreads farther than the flames themselves, and has led to weeks of unhealthy, or even hazardous, air in cities around the region. David Eisenman is one of the few scientists who has studied the mental health impacts of wildfire smoke. His work also focuses on solastalgia — the specific grief people feel when a landscape we love is lost or dramatically altered. Eisenman is a professor of medicine and public health at the University of California, Los Angeles and the director of the UCLA Center for Public Health and Disasters. We talk with him about his work.

This transcript was created by a computer and edited by a volunteer.

Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. Oregonians and people up and down the West Coast have been enduring another ever longer fire season. The immediate threat of fires is obviously traumatic for those whose homes and businesses are directly in the path of a blaze. But the smoke from these fires spreads hundreds or even thousands of miles further, leading to weeks or months of unhealthy air. All of this takes a toll. David Eisenman studies the impacts of wildfires and wildfire smoke on mental health. His work also focuses on the specific grief people feel when landscapes we love are lost or are dramatically altered. Eisenman is a professor of medicine and public health at UCLA where he directs the UCLA Center for Public Health and Disasters. David Eisenman, welcome toThink Out Loud.

David Eisenman: Oh, well, thank you for having me.

Miller: Thanks for joining us. What got you started on this research?

Eisenman: Well, I went to study a fire that occurred in Arizona many years back called the Wallow Fire. We went to five towns that surrounded the land, the national forests, that had burned. And really very few structures and no lives were lost in those five towns. But everyone, wherever I went, kept saying the same thing to me which is, “I feel like I’m grieving the loss of the forest.” As a doctor -- I’m a doctor -- I could hear the sound of bereavement in their voice. It sounded like what I see in my patients when they’re bereaving the loss of a loved one. And this really brought my interest up. How can this loss of the forest affect people so deeply, and is there a concept that can get at this? So we started to do that research many years back.

Miller: It’s striking that you focused first on a fire that seems like it was very destructive but not to buildings and not to human life. Because those are two of the metrics that we focus on a lot to talk about how serious a fire is. We talk about acres burned. But human lives or structures are so high up on what we often talk about in terms of the impact of the fire. Is that what you were expecting to find when you went there? The people talking about grieving this lost forest?

Eisenman: No, not at all. I think rightly, as with any researcher who is new to the topic, I had my biases built by what I’d seen on TV, from the media, which is a focus on homes lost and people evacuating. And this of course is really primary; it still remains primary. Those are the real traumas that occur. But, the other thing is that, as people who live out in the wilderness or on the urban-wilderness interface know, people move there for a reason. They want to have that landscape and nature surrounding them. It brings them a lot of their life and it becomes part of their reason for living. It becomes part of their soul even. And so the loss of that is really important. It becomes a real distress. It’s losing part of the meaning in your life.

Miller: You use a word to describe this particular kind of grief that I had never heard before: solastalgia. I’m not even sure if I’m pronouncing it correctly. Can you define it for us?

Eisenman: Yes, you are pronouncing it correctly. Solastalgia, it’s a beautiful word I think. It’s a neologism that was coined by a philosopher named [Glenn] Albrecht about two decades ago. It is the loss of solace that one feels when their treasured land is destroyed. I mean, there are many definitions, but that’s one I’ll give you right now. It was originally described in connection to land that was lost from strip mining in West Virginia and the loss of the Appalachian forests and the loss that people felt from that loss of forest, that Appalachian residents felt. As well as also described among Australians suffering from the drought there and the loss of landscape from that. And it’s since been applied to other losses of place from natural disasters and now increasingly from climate change.

Miller: The term, it feels almost spiritual to me. And I’m wondering if that implies that the response to it can’t or shouldn’t solely be the standard Western clinical psychological response.

Eisenman: Yeah. On the one hand.. Well, I think there are many ways to approach it. I did take a somewhat mental health approach in my original research. And that was to show that higher rates of solastalgia, endorsed by people in these towns that I mentioned, correlated with higher rates of mental distress a year later. And I think that’s valid. I think that that loss can precipitate or exacerbate any mental health challenges that occur from something like a wildfire or any kind of other acute destructive occurrence. And I think that’s important because it also paves the way to some sorts of novel community wide mental health approaches that you can imagine. So you can imagine how getting the public involved in land reforestation might also be helpful to them. But you don’t want to lose sight of this as a spiritual problem, too. We don’t want to medicalize this too much and we need to learn more about this and sort of figure out how do we use this term correctly.

Miller: We put out the word to our listeners to ask how fire and smoke, that are getting worse every year, how it’s been affecting their mental health. We got a couple voicemails that came in. Let’s listen to one of them right now.

Voicemail 1: This is Cam Newton calling from the Warner Mountains east of Lakeview, Oregon. And we have suffered through three fires, two of which are still burning, the Bootleg and the Cougar Peak Fire, creating some really nasty air quality in the area in general. We in the mountains have been spared a lot of that, but it has definitely taken the joy out of summer to a large degree. Plus we’re getting lots of smoke from the major California fires coming up the spine of the Sierra. And so it’s really been a tough time.

Miller: David Eisenman, we’ve been talking so far about the loss of a forest specifically from the fire. But here our caller is talking more specifically about smoke. What have you learned about the mental health effects of wildfire smoke?

Eisenman: Your caller said something that really struck me, which is, he’s feeling the loss of the joy of summer. And that’s profound. We’re talking about this experience possibly occurring for summers from now on, to some of these same communities.

Miller: Just the end of a season, the death of a season.

Eisenman: Yeah. You might get a much shorter season; you might get June and July where it’s summer. But by late July, it’s over because you can expect smoke to be blanketing your summer. So what happens? Now you are not going outdoors as much. You’re not physically active like before. You’re not socially active with barbecues and get-togethers like you were before. You’re not vacationing in the same place. You may actually have very practical effects on your work. You may need to relocate for weeks and months at a time and some people may decide they just can’t live like this and want to relocate forever to another part of the country. So we are talking about the threat that I think people are starting to pick up on, of the loss of a season. That’s profound. That’s a really profound spiritual and psychological and social and economic loss we’re facing.

Miller: Let’s listen to another voicemail which actually has a lot of echoes of what you’ve just been talking about.

Voicemail 2: My name is Cynthia and I live in Sunriver, Oregon and this has been a really tough year as far as the smoke from the fires. We had to leave town multiple times. Not because we were impacted by actual evacuations or anything, but because the smoke was so bad that we had to get out of town to breathe. I would say two or three weeks that we were actually gone. And we’re retired, so we have that option. Those folks who don’t have that option, it must be just really, really incredibly difficult for them.

Miller: David Eisenman, we’re talking about a couple of things at once here, or many things at once. But among them are the potentially serious physical effects from exposure -- ongoing exposure -- to high levels of smoke. And also the mental health effects of long term exposure to high levels of smoke. Is it possible to disentangle those two?

Eisenman: Well, so far there have been plenty of studies that have looked at the health effects on the lungs, for instance, and the heart of exposure to smoke. We have not seen adequate studies of the effects on mental health in the same way, those kind-of epidemiologic studies that tell us that populations that have these repeated, chronic exposures to wildfire smoke are going to have higher rates of mental health disorders. Through any number of mechanisms: you can postulate a bunch of ways that that might occur, from the toxic effects of the smoke -- which are quite important -- to the kinds of social and economic effects that we just were talking about, all of which can combine to together create mental health disorders. So we haven’t seen really good studies like that. We have been trying to get them funded, so far unsuccessfully, unfortunately. I think that’s been a real blind spot in our scientific funding in this nation.

Miller: I have to say, maybe I shouldn’t be surprised, but I got the sense that societally we were turning a corner in terms of more awareness of and less squeamishness in talking about mental health, in every way in this country. But it seems like funding wise, is it fair to say it’s still lagging behind physical health in problematic ways?

Eisenman: Funding is definitely lagging behind in general on mental health. And most of mental health has not reached the same priority as physical health has, including research and funding. I would say that also wildfires really have not grabbed the attention of the East Coast establishments that fund most of the research in the United States. You know, the NIH is mostly filled with people from East Coast universities and they just don’t experience wildfire smoke like we do out west..

Miller: Huh, and they’re the ones who have a lot of control over purse strings..

Eisenman: Yeah..

Miller: Although it is worth noting that this year smoke went from western fires; it went through Canada and all the way to New York City. So there were days when the smoke levels were worse in New York City than in Portland from western fires.

Eisenman: Yes. And I think that is going to help change things. Still the story, though, that is promoted, that we see on television, is of homes burning, often large homes burning, and the feeling that these are vacationers losing their homes, not primary residents. So there’s a kind of bias that’s built into the way it’s been presented to Americans.

Miller: You’ve done some research on a particular subset of people affected by wildfires: people who chose to stay in their homes, perhaps not heeding calls to evacuate. What have you learned about the effects of that decision on their mental health?

Eisenman: It’s a very interesting topic. In the few studies that have been done on this, up to 10% of some communities’ residents report not evacuating and staying behind instead to protect their home and their neighbors’ homes from the wildfires. Now these people are often well skilled in doing that, but they’re not professionally connected to a firefighting agency. Now, we know from studies of firefighters, professional wildland firefighters dealing with these massive fires, that there are high rates of post traumatic stress disorder and depression from the trauma of that experience. We know nothing about the same mental health consequences in these, I’ll use the word civilian firefighters. And they’re facing, sometimes, the same potential trauma without any of the connection to the support services. Who knows if they’re insured, if they have health insurance. So we really need to learn more about that.

Miller: I can imagine that breaking at least two ways. On the one hand, as you were noting, this group of people could be exposing themselves to more trauma, more smoke, more proximity to danger. But on the other hand, they’re doing something and I can imagine that that agency and that action could be psychologically beneficial. Am I off base?

Eisenman: Absolutely you’re right. Again, we don’t want to problematize and medicalize something that is also having a benefit. This ties into all kinds of talk about community resilience and we’re all for that. And I’ve spoken to some of these firefighters, these civilian firefighters, and they’ll do it again. But they also recognize that they’ve had real problems adjusting after the firefight. That their drinking increased, they had sleepless nights, they were more irritable and fighting with their loved ones afterwards. So, the trauma was real. And so we can have both: we can have both help for people who need it as well as empower the people who want to stay behind and fight.

Miller: We’ve been talking about the effects of wildfires and smoky air on mental health. Rebecca Pelly Marie noted, “It made everything I already struggled with significantly worse.” Let’s listen to one more voice mail.

Voicemail 3: Hi, this is Cooper Morrow calling from Bend Oregon. And, yeah, I think the new fire season that we have here in Central Oregon is stressing me out greatly; it does every summer. These longer, drier, hotter summers just seem to get worse and worse. So, sadly, I think my future in Bend is going to be short lived and I’ll probably be departing since I really don’t like the dry, hot summers or the smoky August and September. So, definitely impacting my decision to live here and it’ll probably end next spring.

Miller: It’s worth pointing out of course that, for any number of reasons, a lot of people don’t have the ability to just pick up and move. But I want to expand this conversation now. I mentioned at the top that you’re the director of the UCLA Center for Public Health and Disasters. That’s disasters plural. Do you have a sense for how a wildfire might be different from a hurricane or a tornado or an earthquake in terms of the trauma it can leave in its wake?

Eisenman: That’s a very interesting question. I think the earthquake, hurricane trauma is very visible and often shared by the nation and I think that makes a difference. It’s recognized that you’re undergoing this trauma and there’s a lot of national outpouring for that. The wildfires don’t tend to get that same sort of response; they’re very regional, very local. We don’t know the names of all the different wildfires that are going on even in our own parts of the world.

Miller: And you certainly don’t necessarily know the name of the fire that caused the smoke that’s above you.

Eisenman: That’s right. I think that the smoke is actually in some ways more consequential at a population level than the fire. The fire clearly is traumatic to the people who have to evacuate, who lose homes, who lose loved ones. There’s no doubt about that. But those numbers are small compared to the number of people who are exposed to wildfire smoke. As you heard from your caller, we’re now seeing people who are saying they’re going to have to move away, from this climate-change-induced disaster, somewhere else. I think we’re going to see that more and more from wildfires. And these are going to join the groups that we’re gonna be calling climate refugees in a sense: people who are moving because their lives are already negatively impacted by wildfire smoke.

Miller: But where they can go that’s not going to be affected in a very serious and potentially traumatic way by climate change. Those places are getting fewer and fewer and further between. We have just a minute left. And this is maybe not a fair question. But are there obvious policies that your work so far leads you to advocate for?

Eisenman: [Laughs] I’d like to see more research on this. We need to have the numbers that we can go forward to the policymakers and the politicians and get resources. We need to be able to say, this is the amount of people who are being harmed by the mental health effects of wildfire smoke. This is specifically who is being harmed in which ways. And we need to develop programs and protections against that. Until we really have the data, no one’s going to really take this seriously.

Miller: David Eisenman, thanks for your time today. I appreciate it.

Eisenman: My pleasure. Thank you.

Miller: David Eisenman is a professor of medicine and public health at UCLA. He is the director of UCLA’s Center for Public Health and Disasters.

Contact “Think Out Loud®”

If you’d like to comment on any of the topics in this show or suggest a topic of your own, please get in touch with us on Facebook or Twitter, send an email to thinkoutloud@opb.org, or you can leave a voicemail for us at 503-293-1983. The call-in phone number during the noon hour is 888-665-5865.