Environmental distress in children: Recognizing and responding to eco-anxiety

Climate change is considered one of the dominant threats to global mental health in the 21st century, with growing concerns from scientists, health care providers (HCPs), policymakers, and the public.¹ The pediatric population is particularly vulnerable to environmental distress, also referred to as eco-anxiety, due to weather-related tragedies.² Eco-anxiety has been described as intensified emotional, mental, or physical distress stemming from the disastrous changes in the climate.³ The climate crisis uniquely affects youth, as they go through critical stages of psychological, physical, social, and neurological development.² This article aims to examine the psychological and emotional impacts of climate change on children and the integral role pediatric HCPs play in the promotion of mental health by addressing eco-anxiety among youth.

Scope and urgency of the problem

The climate crisis is a human rights issue that is endangering and harming fundamental human needs.⁴ The intersection of human rights, climate change, and climate anxiety is now being recognized by health and legal experts around the world.² Eco-anxiety has been found to cause psychological or emotional consequences ranging from mild distress to depression, anxiety, posttraumatic stress disorder, substance abuse, and suicide.⁴ In qualitative studies, children have reported experiencing anger, grief, confusion, betrayal, and abandonment because of adult inaction toward climate change.² The American Public Health Association reports that 45% of children suffer depression after a natural disaster.⁵ In a 2021 survey of 10,000 children and youth (aged 16 to 25 years) from 10 countries, more than half reported each of the following emotions: sadness, anxiety, anger, powerlessness, helplessness, and guilt.² More than 45% of the young respondents stated that their negative feelings about climate change adversely affected their daily functioning and lives.² A significant number of respondents reported negative thoughts about climate change, including that they think the future is frightening (75%) and that people have failed to take care of the planet (83%).²

This survey by Hickman et al (2021) also demonstrated that large numbers of young people globally have feelings of betrayal regarding the failure of governments to acknowledge or act on the crisis in an urgent manner or respond to their alarm, evidently resulting in negative psychological sequelae.² Having youth endure the psychological harms of climate anxiety and moral injury may constitute treatment that is cruel, inhuman, degrading, or even tantamount to torture.² Climate criminology is emerging as children and youth increasingly turn to legal action to validate their despair and demand accountability for government inaction on the climate crisis.² Although eco-anxiety may not yet be defined as a mental illness, with more research needed, the realities of climate change alongside governmental failures to act are likely to increase the risk of developing mental health problems due to chronic, long-term, and potentially inescapable stressors in the vulnerable pediatric population, as they lack the power to reduce, prevent, or avoid such stressors.

The psychology of environmental distress

Complex forms of eco-anxiety, such as adaptive and maladaptive types, and trauma have been identified with intergenerational effects noted, especially where environmental damage involves loss of a way of life or culture.⁴ Youth are encountering a multitude of stressors without ample resources to mitigate or avoid them.⁴ Children facing a future damaged by climate change will need strong support to cope, adapt, and thrive.⁴ Nearly half of the youth (48%) who talked with others about climate reported that other people had ignored or dismissed them.⁴ Although eco-anxiety cannot be eliminated due to the realities of climate change, the Climate Psychology Alliance states that health care providers can support individuals and communities by allowing the expression and exploration of their emotions to build resilience.⁴ It is not only essential to acknowledge how real eco-anxiety can be for children, but also to actively support them as compassionate listeners and guide them toward healthier coping strategies informed by a hopeful, action-oriented outlook.⁵

Eco-anxiety: An emerging global
health concern

When considering the health effects of eco-anxiety, it is prudent to focus on vulnerable populations, such as older adults, the chronically ill, those with mental illnesses and mobility impairments, and notably children. Children experience eco-anxiety more intensely, as the youth of present and future generations will bear an unacceptably high disease burden from climate change and will have to endure the climate crisis for their whole lives.^3,4 Climate change poses a risk to mental health due to exposure to chronic stress during childhood that has a long-lasting impact and can increase the risk of developing mental health problems.⁴ Psychological experts state that heightened eco-anxiety can lead to symptoms such as panic attacks, loss of appetite, irritability, weakness, and sleeplessness.⁴ Other signs of anxiety in children to be aware of include fatigue, headaches, stomachaches, bedwetting, uncontrolled outbursts, constantly worrying or having negative thoughts, withdrawal behavior, feeling tense and fidgety, and poor concentration.⁵ Other marginalized communities affected by climate change are those from lower socioeconomic groups who are disproportionately affected because of disparities in infrastructure and health resources.⁴ Further isolation of the most vulnerable can occur with severe weather events that damage social support systems and mental health infrastructures.⁴

Promoting pediatric mental health and well-being

Eco-anxiety is associated with young people perceiving that they have no future, that humanity is doomed, and that governments have failed to respond sufficiently to the climate crisis.² The climate crisis has important short and long-term implications for pediatric physical and mental health because of acute and chronic environmental changes, including natural disasters, changing landscapes, and increasing temperatures, which can be traumatic for children.² As the global community works toward protecting children from the impacts of climate change, not only parents and caregivers, but most importantly, pediatric HCPs can play a vital role in helping children adapt to the existence of a changing world.³ As caregivers, advocates, educators, and sources of emotional support, pediatric HCPs can provide direct health care and age-appropriate educational resources, participate in interdisciplinary collaboration, organize pediatric initiatives and advocacy through membership in professional associations, and use their influence to offer evidence-based action to shape climate and health policy decision-making processes.

As part of their anticipatory guidance, pediatric HCPs can educate parents and caregivers to be aware, monitor, and limit the constant barrage of negative news about climate change on their children’s technological devices, social media platforms, or when watching excessive television coverage of an extreme weather event, as these disturbing exposures can cause distress.^5,7 One tool used by community advocates to foster mental well-being about the emotional impacts of climate change is the Climate Emotions Wheel to help identify and bring awareness to emotions as the first step to coping with them effectively (Figure).⁶ Pediatric HCPs can engage with community health resources, such as the Climate Mental Health Network, which offers evidence-based tools, programs, and guidance to help communities better understand how climate-related emotions influence collective and individual well-being and how to respond effectively.⁶ By fostering a sense of hope, pediatric HCPs can help children avoid a sense of fatalism and channel eco-anxiety into action.⁷ Globally, there are growing numbers of young climate activists connecting, discussing, educating, and empowering themselves to take positive action on climate change and turn their feelings of hopelessness into hope.⁷ Encouraging children to participate in environmental activism through eco-friendly projects, conservation efforts, and activities such as planting trees or organizing a community clean-up can provide hope and empowerment with positive solutions that can make a difference and help buffer their eco-anxiety about the planet’s future.⁸ Pediatric HCPs have the collective ability to advocate for policies that protect the health and welfare of children by serving as a voice for children in the societal response to this global threat.⁹ Finally, pediatric research needs to be developed and expanded to generate public health adaptation, mitigation, and resilience measures to protect children, with a focus on vulnerable communities and environmental justice.⁹

Conclusion

Climate change has taken center stage as a worldwide health care issue. As pediatric HCPs, we must consider the physical, psychosocial, cultural, ethical, legal, and political factors of climate anxiety in children and young people to protect their mental health and well-being.⁴ Pediatric HCPs can contribute unique perspectives on mental health risks in children linked to climate change and are in a distinct position to empower children and families to navigate environmental changes with resilience, knowledge, and informed action. By validating the fears and pain of children’s eco-anxiety, balanced with offering hope as well, pediatric HCPs can ensure a healthier future for the next generation.

References

1. Clayton S, Manning C, Speiser M, Hill AN. Mental health and our changing climate: impacts, inequities, responses. American Psychological Association, ecoAmerica. 2021. Accessed July 29, 2025. https://www.apa.org/news/press/releases/mental-health-climate-change.pdf
2. Hickman C, Marks E, Pihkala P, et al. Climate anxiety in children and young people and their beliefs about government responses to climate change: a global survey. Lancet Planet Health. 2021;5(12):e863-e873. doi:10.1016/S2542-5196(21)00278-3v
3. Climate anxiety: mental health experts' advice on coping with worries about climate change. UNICEF. 2025. Accessed July 29, 2025. https://www.unicef.org/parenting/mental-health/climate-anxiety
4. Dodds J. The psychology of climate anxiety. BJPsych Bull. 2021;45(4):222-226. doi:10.1192/bjb.2021.18
5. Climate changes health: mental wellness. American Public Health Association. 2025. Accessed July 29, 2025. https://www.apha.org/topics-and-issues/climate-health-and-equity/mental-wellness 
6. Climate emotions wheel. Climate Mental Health Network. 2025. Accessed July 29, 2025. https://www.climatementalhealth.net/wheel
7. Understanding and coping with eco-anxiety. Mental Health Commission of Canada. 2025. Accessed July 29, 2025. https://mentalhealthcommission.ca/resource/understanding-and-coping-with-eco-anxiety/
8. Karl C. Raising resilient earth stewards: Understanding and addressing eco-anxiety in children. Eco Worries. 2025. Accessed July 29, 2025. https://ecoworries.com/raising-resilient-earth-stewards-understanding-and-addressing-eco-anxiety-in-children/
9. Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A; American Academy of Pediatrics, Council on Environmental Health and Climate Change; Council on Children and Disasters; Section on Pediatric Pulmonology and Sleep Medicine; Section on Minority Health, Equity, and Inclusion. Climate change and children's health: building a healthy future for every child. Pediatrics. 2024;153(3):e2023065504. doi:10.1542/peds.2023-065504