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Mashooque Birhamani and his group were in Dadu, in Pakistan’s Sindh province to raise awareness about climate change and its impacts when a woman approached them saying that she had broken her fingers. They looked quite normal to Birhamani and company, but she kept repeating that they were broken. Some of the locals finally explained that her fingers were fine, but that the woman had not been herself for some time now, following the string of natural calamities in Sindh.
Birhamani is the CEO of Sujag Sansar, an organization that works to promote development and human rights in Sindh. But since the devastating flooding in 2022 in Pakistan, and the other disasters that have followed, Sujag Sansar has been working to help ease the immediate difficulties brought by these calamities, as well as their long-term impacts, through a mix of relief camps and theatre shows.
After noting a marked increase in feelings of distress, anxiety and low moods among the communities it worked with, however, the non-profit decided to include mental-health intervention camps whenever it could.
“Despite the fact that our theater programs and workshops hadn’t been geared toward mental health till now, once we are there, if someone approaches us, we do want to help,” Birhamani tells Asia Democracy Chronicles. “But we can’t always do so because we don’t have the resources.”
Yet there are apparently still times when they do a double-take when meeting people like the woman who said she had broken her fingers. After all, what is now being referred to as “eco-anxiety” manifests itself in many ways, which is why psychiatrist Manzoor Ali Jamali, who works with Sujag Sansar in its relief camps, says that creating more awareness about it is important.
“Anxiety can have psychosomatic symptoms, so it can often take five to eight years just for someone to understand they even need to come to a psychiatrist,” Dr. Jamali says. “And even then there is stigma.”
He says that among the psychosomatic symptoms are stomach issues, chest pain, and headaches, along with fatigue, low moods and even distorted perceptions of what is happening – such as what was apparently being experienced by the woman Sujar Sagar encountered in a low-income, rural community in interior Sindh. Other experts say eco-anxiety can also lead to depression, post-traumatic stress disorders, and even suicide.
Disaster distress
Climate anxiety, or eco-anxiety, is described as feelings of distress or worry related to the effects of climate change. Over the last couple of years, more and more climate experts have been looking at eco-anxiety as something being experienced by both victims of climate change and environmental activists.
In 2022, the World Health Organization (WHO) even issued a policy brief urging mental health to be included in climate action. This is because, it said, climate change “is increasingly having stronger and longer-lasting impacts on people, which can directly and indirectly affect their mental health and psychosocial well-being.”
More recently, an article published in June by the journal Environmental Research noted that several studies had associated “poor mental health outcomes” with “six types of extreme weather events: floods, storm surges, typhoons, cyclones, extreme heat, and riverbank erosion.”
Source: Bath University in the U.K. and Climate Psychiatry Alliance
All these weather events have long been par for the course for South Asians, who currently number about 2.07 billion. In the last two decades or so, however, these calamities have not only worsened, but have also become more frequent. Indeed, climate change effects have made the monsoon season in South Asia erratic, unreliable, and even dangerous, with both extreme flooding and severe droughts having drastic impacts on the lives and livelihoods of hundreds of millions of people.
“Previously, in Bangladesh we had 13 festivals in 12 months,” says climate activist Sohan ur Rahman. “Now we had 13 disasters in 12 months.” All these disasters, he adds, were “extreme” ones.
“I visited the flood victims and they keep saying there’s water in their heart and their mind,” he says, describing some of his field encounters. “They’ve never seen this level of water. We can give them relief, but we need support to help address their mental health.”
Unfortunately, he says, there is simply not enough awareness and resources for mental health care in Bangladesh or elsewhere in South Asia. Rahman also observes that when disasters and difficulties become constant, people stop paying attention.
This even as Samridha S J B Rana, a Ph.D candidate in clinical and health psychology at the University of Edinburgh, points out that the “content of climate anxiety” within the global South is still lacking, with current discourse dominated by Western experience.
“If we really want to understand the eco-emotions people [in the global South] are going through,” says Rana, who is currently doing field work on the impact of eco-anxiety in India, “we need to bridge the language gap for them to be able to talk about their experiences compared to the global North.”
Disaster-management expert Dr. Tasdik Hasan agrees, saying, “There is a gap in the socio-cultural variation of how this anxiety manifests. What South Asian countries or the global South faces is different from a Western context.”
“For example,” he says, “hurricanes in the U.S. cause climate anxiety. But in South Asia it’s more immediate, and tied to everyday disasters. Bangladesh, for example, has faced the worst flooding in its history, and the entire region is facing extreme heat waves.”
Rana, for his part, stresses, “Natural disasters are increasing, so we need to be developing coping and adaptation strategies from a physical and psychological perspective. Yes, we are making some progress on physical adaptation strategies. But that is incomplete without building emotional coping and resilience to help people cope with the outcomes they face.”
Two groups, one problem
“Climate disasters and climate change add on to the existing miseries of everyday life,” comments Yasir Husain, founder of Climate Action Center in Karachi, explaining the complexities of eco-anxiety in South Asia. “There’s even less trust in the fact that the government can do anything.”
Community workers and environmentalists like Husain and Rahman divide those suffering from eco-anxiety into two categories: one made up of young activists, the other of victims. But Rahman, who is from the coastal region in Bangladesh that has been affected badly by changing weather patterns, suffers dual impact from being both an activist and a victim.
As a victim, his anxiety can come from a fear of unknown and changing futures. For many others, it can come from losing the very little possessions and livelihoods they have, and of their world changing or disappearing completely because of the effects of climate change.
As an activist, Rahman’s anxiety is tied with consistently dealing with the uncertainty of the future, as well as having to put up with the slow pace of change that can sometimes lead to a sense of helplessness.
“So one is directly people who have lost homes, faced disasters,” Husain says, noting the differences between the two groups. “The other is people who are more aware, Gen Z especially. They say, ‘We are used to the chaos, (but) we expect everything to just fall apart.’ They prepare for the worst, and they don’t trust things to be the way they were before.”
Community workers and activists in South Asia have noticed something else. Says Birhamani: “This mental health crisis also seems to be affecting women disproportionately.”
This is largely because of the patriarchal system that is dominant in South Asia and which places women and girls at a disadvantage. Extreme and frequent natural calamities only exacerbate the difficulties faced by the region’s female population, with women and girls struggling with far less financial resources than men, even as they deal with childbirth and child-rearing, along with a myriad of household tasks. Research has also shown climate change as leading to early marriages in South Asia.
Shunned and sidelined
The stigma surrounding mental health problems, however, is genderless across the region. In much of South Asia, many still believe that mental illnesses are the results of lack of religiosity or signs of supernatural possession, and therefore bring only shame to one’s family.
There are even people who do not believe mental illnesses exist and assume that those who claim to have such only want attention. Unsurprisingly, even those exhibiting symptoms are not allowed to seek help or are simply misunderstood.
At the same time, mental health issues – as well as climate change – are also often left by the wayside amid growing concerns such as poverty, lack of food, homelessness, diseases, and emerging new viruses.
Dr. Hasan says of the typical state disaster response: “We don’t include mental health professionals in rescue teams. Economic priorities are given precedence over mental health by governments. They are focusing on immediate economic resilience but they are not focusing on long term mental health resilience.”
Rana, who has been working first-hand with disaster-affected communities in India, meanwhile says, “’Roti Kapra Makan (food, clothes and housing),’ is a popular slogan in South Asia, and giving up on climate seems like a fair thing to give up if it gives them their aspirations.”
He explains the popular mindset about climate change by recounting, “One man told me, ‘I care about air pollution, but if I can’t feed my family, then what’s the point of thinking or caring about air pollution?’”
In Pakistan, Husain and his team at Climate Action Center are trying a bottom-up approach. They work directly with communities to build resilience and adaptation methods.
“It’s a rescue-relief kind of thing,” says Husain, “but it gives you hope that if you band together, you can help each other. There’s a lot of community effort and the realization that we have to organize ourselves.”
“When all else fails we have to do it ourselves, and we try to exist in that,” he says. “So on the anxiety side, being able to work together with other people is a great experience.” ◉
