I first became aware of it at a small clinic in a peaceful area of north London, where a therapist casually mentioned that three of her new clients that month had come in discussing wildfires they had never seen firsthand. not a loss. not a divorce. not at work. fires. Speaking with clinicians these days gives me the impression that the types of distress that patients present with have changed.
It’s difficult to diagnose climate anxiety, or eco-anxiety, as some still refer to it. The DSM does not include it. However, therapists in North America and Europe consistently report the same thing: clients who arrive with intrusive thoughts about food systems, melting glaciers, wildfires, and the futures of unborn children. Nearly 60% of 10,000 youth in ten countries who participated in a 2021 Lancet survey said they were extremely concerned about climate change. Nearly half claimed that it was interfering with their daily lives.
By most accounts, therapists were ill-prepared. The prevailing paradigm for the past thirty years, cognitive behavioral therapy, frequently helps clients confront unrealistic ideas. However, what occurs if the idea is genuine? When the patient has actually read the IPCC reports, and the Earth is actually warming? This is one of the few presentations where clinicians are reluctant to “reframe” anything, a number of them have told me with a hint of unease.
Rather, a new vocabulary is emerging. radical confirmation. existential counseling. Coping that is focused on action. A small group of American psychiatrists founded the Climate Psychiatry Alliance, which has been promoting the notion that eco-anxiety is, if anything, a reasonable reaction to an unreasonable circumstance. For a profession predicated on the idea that anxiety typically reveals more about the individual than the outside world, this is an uncomfortable position.
Patients who are younger appear to be the heaviest. Clinical psychiatry professor Elizabeth Haase of the University of Nevada has talked about preschoolers sobbing on TikTok over animals killed by severe weather. According to a 2025 PNAS study, about 20% of Americans between the ages of 16 and 24 claimed that their fear of having children stemmed from concerns about climate change. That number surpassed 30% among those who had personally experienced a severe weather event. It’s difficult to ignore the fact that this is not the same as the existential fear of past generations. It’s particular. tied to forecasts and dated.
Additionally, there is a class question that is not frequently asked. The lazy notion that eco-anxiety is a luxury of the wealthy is complicated by the fact that people in developing nations typically worry far more than those in wealthy, air-conditioned nations, according to Anthony Leiserowitz of Yale.
It’s still unclear if therapy is the best setting for all of this. Turning climate distress into a clinical issue, according to some academics, runs the risk of medicalizing a moral response. Others believe that the consultation room is one of the few settings where emotions are acknowledged without being minimized or politicized. It appears that both can be true simultaneously.
The quiet accumulation is more difficult to ignore. More therapists are being asked to listen to people who are grieving over something that hasn’t quite happened. Forecasts continue to come in. The waiting areas continue to fill up. Additionally, a different kind of attention is gradually being learned by the profession.