Wildfires are a threat to mental health that can linger even years later

Thousands of people who are under evacuation orders or warnings amid some of the worst wildfires in the history of the Los Angeles area face threats not just their physical safety but also their mental health.

Editor's note: Editor’s Note: If you’re struggling with mental health due to wildfires, call 1-800-985-5990 to reach the Disaster Distress Helpline. Call 988 to reach the Suicide and Crisis Lifeline.

(CNN) — Dr. Jyoti Mishra personally knows how much stress can come with a wildfire. The associate director of the UC Climate Change and Mental Health Council and associate professor of psychiatry works at the University of California, San Diego. Her city isn’t currently experiencing wildfires, but her LA-based family has fled to her home.

“All our family from LA is here with us, and we’re happy they’ve made it,” Mishra said Thursday. “We’re hoping their home is safe up there, but we don’t know yet.”

Uncertainty about losing a home or a neighborhood is one factor, studies have showed, that can contribute to an increase in mental health problems among people who experience wildfires.

Mishra’s research on the 2018 Camp Fire in Northern California showed that people who were personally affected by wildfires were significantly more likely to have anxiety, depression and post-traumatic stress than members of communities that had not been exposed to a fire.

“It can also make you feel cognitively impacted, as well,” Mishra said. “Our work has shown that it’s hard to pay attention to a singular thing when everything around you feels like it’s threatening you.”

That means the hundreds of thousands of people who are under evacuation orders or warnings amid some of the worst wildfires in the history of the Los Angeles area face threats not just their physical safety but also their mental health – and not just immediately after the fire passes. Mishra’s studies have also showed that some people experienced problems months, or even years, after wildfires.

Major smoke events impact mental health

In the immediate term, several studies have found, wildfires can be destabilizing and cause people to feel stressed and to experience feelings of anger, sadness, shock, depression and frustration. People may also lose their appetites, have trouble sleeping or have nightmares, and they may turn to drugs or alcohol to self-medicate, studies show.

Depression, anxiety and trauma can affect even more people long-term, even if they never had such mental health concerns before, and research shows that post-traumatic stress disorder can linger three months to even a decade past a wildfire.

It isn’t just the uncertainty of knowing what happens to your neighborhood. It’s also the smoke itself, according to Dr. Yang Liu, chair of environmental health at the Rollins School of Public Health at Emory University.

His 2024 study showed an association between emergency department visits for anxiety disorders and exposure to wildfire smoke. The effect was more pronounced in women, girls and older adults, with major smoke events significantly amplifying this risk.

“Inhaling a lot of smoke can trigger an anxiety disorder. LA’s air quality level is 10 to 20 times above the national center, so it’s certainly a severe smoke event for the entire Southern California region. Certainly, the LA metro region is engulfed by heavy smoke,” Liu said.

People should protect their physical and mental health by staying out of the smoke as much as possible, he said.

“People should take precautions and close windows, avoid doing outdoor activities, and if they have a HEPA filter in their A/C system or a standalone air filter, they should turn it on,” Liu said.

It’s not just adults who should take precautions. Although children can be more resilient, Cedars-Sinai child and adolescent psychiatrist Dr. Sabrina Renteria said, they can also feel more helpless when a wildfire is in the area.

Renteria said the fires have not reached where she lives in Marina del Rey, but her house keeps losing power from the strong winds, and the Cedars-Sinai emergency room where she works often sees more children with mental health concerns when there are wildfires.

“We absolutely anticipate that this will have a huge uptick in mental health issues with children,” Renteria said.

How to cope with trauma

Children are intuitive, she said, and can sense when something is wrong, so adults need to help them cope by being honest about what’s happening and talking to them about how they’re feeling.

“I think openly communicating with their child, saying ‘yes, I’m feeling really sad today.’ Or explaining that ‘there’s a lot of things around us that’s been troubling me,’ and you can give examples, but then you can talk to them about how you’re going to cope with this,” Renteria said.

Children and adults alike should get professional help if feelings like anxiety or depression linger.

Renteria said it’s also important to get children back to their routine, classes and friends as quickly as they can, to whatever extent is possible.

“Just so they have this sense of stability, because children can be very easily destabilized when their routine is sporadic,” she said.

Teens and children mimic their parents and loved ones, “so it’s also very important that, if you’re experiencing a tragedy, that you practice and display good coping mechanisms,” Renteria said. “So it’s important for a parent to take care of themselves, as well.”

Something as simple as listening to music can help the body destress naturally, she said; so can deep-breathing exercises.

“It helps slow your body’s natural response to anxiety and stimulates the vagus nerve, and it calms your whole body,” Renteria said.

Mishra also recommends mindfulness exercises. Being mindful and present in the moment and not letting the traumas of the past slip into the present can help heal the brain, she said.

Volunteering to help people in the community can be healing, Renteria suggests. Talking with others who also experienced the wildfires can also help children and adults acknowledge how they’re feeling and to find common ground in their experiences, but it’s important to be aware of how they’re responding.

“When you’re communicating with other people, it shouldn’t be a bunch of doom and gloom, especially in front of your child. And for teachers too, since children take cues from their elders,” she said.

Children and adults should limit how much news and social media they see. Adults could also check out news stories before watching them with their children and then have a conversation about them. They might want to use the stories as an opportunity to point out the good work first responders and volunteers are doing.

“In many times, for these kinds of disasters, we put them in this framework of doom and gloom, but we need to shift that to a survive-and-thrive framework, where the planet that we have is just one planet and that if we all work together, we can make better things happen,” Mishra said.

People also need to be careful not to isolate themselves in the wake of the wildfires, she said. Those who have stronger family connections and community support are more resilient, her research shows.

“Collective healing is needed,” Mishra said.

People who are watching the wildfires from far away should be sure to keep friends and family in California in mind.

“Definitely reach out to others,” Mishra said.

There are also ways to help meet the basic needs of people who fled their homes quickly, without food or funds, by contributing directly.

“Just so that they can get by on a day-to-day basis and focus on rebuilding instead of having to worry about where they are going to get dinner today,” Mishra said. “These are just little things that we can all help out with others, because eventually, with climate change, this is not something that’s isolated to a region. It may happen one day to any of us.”

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