PADUCAH — As a Weather Authority Alert warning of extreme heat continues through Friday, July 3, a Paducah psychiatrist is sharing the effects of severe heat on mental health as well as tips to keep the mind and body healthy.
Dr. Laurie Ballew, a doctor of psychiatric medicine at Four Rivers Behavioral Health, said extreme heat can have a great number of effects on mental health. She said heat can lead to a variety of health and behavioral concerns by affecting the body’s level of cortisol, a steroid hormone produced by the adrenal glands that helps the body respond to stress.
Dr. Laurie Ballew stressed the importance of hydration and limiting exposure to bright sunlight during extreme heat.
Ben Overby
“When people are stressed, they have increased cortisol, and of course this heat has put a lot of stress on people because they can’t perform their usual activities,” Ballew said. “They can’t go outside and do the activities they enjoy, so that increases stress. Increased stress and increased cortisol can cause irritability in people, it can cause anger in people. When we have heat domes like this, we often see more suicides, we see more domestic violence, and we see sometimes more crime. There’s data to show that.”
Ballew said heat can also create conditions to exacerbate mood disorders like depression. She said one of the symptoms of depression is a person no longer enjoying normal activities they used to enjoy, and extreme heat can make something as simple as taking a walk for fresh air inaccessible.
“Let’s say one of the things they enjoy doing is going out and taking a walk,” Ballew said. ”They’ve just started coming out of the depression, they’ve started walking again, and then we’re under this heat dome. You can’t get out and walk unless you get up at four or five in the morning, because by eight o’clock it’s already in the 80s, the humidity is already up, so it’s too hard to get out and do our normal activities. That can make us depressed. Anytime we can’t do the things we enjoy doing, it tends to affect our mood.”
According to Ballew, severe heat can also disrupt sleep due to body temperature being unable to cool down, especially for those on certain medications.
“So many people are on medications, not just psychiatric medications, not just psychotropic drugs, but they’re on drugs for blood pressure, for diabetes, and those drugs can affect our temperature regulation,” Ballew said. “Then you add this high heat to it, then it’s even harder to regulate temperature for the body, and it’s more difficult to go to sleep.”
Four Rivers Behavioral Health on June 30.
Ben Overby
Ballew said dehydration affects the heart’s ability to pump and the kidneys ability to perfuse, which can contribute to delirium. She said it is especially important for those on psychiatric medications or medications for hypertension or diabetes to stay sufficiently hydrated during severe heat.
“An older person who might have dementia, and then they’re on multiple medications and they don’t stay well hydrated, they could become delirious very easily,” Ballew said. “People who are schizophrenic and who are on antipsychotics, it’s very important that those individuals stay cool and stay well hydrated, and if they don’t, then they could be in danger of overheating.”
Ballew said to look out for warning signs of heat stroke or heat exhaustion such as confusion, feeling cold and clammy in high heat, or extreme irritation. She said these symptoms are likely signs that someone should be taken to an emergency room.
“When I worked at the University of Louisville, we had an emergency psychiatric service there, and it wasn’t unusual in the summertime — in weather like this — to get more people who had psychiatric illness such as schizophrenia, bipolar disorder, or mood disorders in the ER,” Ballew said. “Why? Because they were stressed. They get that increased cortisol, maybe their blood pressure goes up, they become more irritable and angry, potential for violence. So we would see more of those folks in the psychiatric ER.”
Ballew also shared advice for how to protect oneself from the effects of heat, suggesting trying to only go out in the early morning or late in the evening if possible, covering one’s head and wearing light clothing. She also said those taking psychotropic medicines should continue to take them as directed, not take extra in an attempt to feel better. Overall, Ballew said the most important way to take care of one’s mental health during severe heat is to try to stay as cool as possible and stay well hydrated.
“We don’t take our brain off and set it over here on the shelf — the brain gets some of the same nutrients that our body does,” Ballew said. “So one thing we need to do is try to stay well hydrated, drink more water than we ordinarily do, not imbibe in alcohol because it’s going to dehydrate us and not get out in the bright sun.”