Climate change and eco-distress

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Target exams

Red flags

• Fever, confusion or collapse on a hot day in a patient on antipsychotics or anticholinergics — heat stroke until proven otherwise; exclude NMS, serotonin toxicity and sepsis
• Coarse tremor, vomiting or ataxia during a heatwave in a lithium-treated patient — check a level, do not assume relapse
• Calling a summer deterioration a 'relapse' without a temperature, a lithium level and a fluid history
• Pathologising a proportionate response to a real threat — eco-anxiety is not a diagnosis
• Dismissing climate distress as 'just the news' in a young person whose functioning has visibly dropped
• Closing post-disaster follow-up at two years when the burden peaks again around a decade
• Routine single-session debriefing of a whole disaster-affected community
• Imposing your own climate views inside the therapeutic frame, or advocating in a way that recruits patients