Anyone who's weathered August in New Orleans knows it's one of the most difficult months of the year — and not just because of the vise-like heat that bears down from the sun and rises up from the concrete to put a squeeze on the city's functioning. It's also the zenith of hurricane season, the nadir of tourism season, the anniversary month of Hurricane Katrina, and beside all that, there seems to be a general funk in the air. According to Cecile Tebo, a licensed clinical social worker who spent 10 years working with the New Orleans Police Department (NOPD), this perception isn't just in our heads ... well, in a way, it is.
"Heat definitely exacerbates any mental health issue," Tebo says. "Working with the NOPD crisis unit, we were always looking for trends, and in July and August we'd see an increase in calls for people with depression and post-traumatic stress disorder (PTSD)."
Heat alters brain chemistry by increasing the levels of adrenaline in the blood, which leads people to be more agitated, impulsive and violent, Tebo says.
"Cortisol levels are raised, and so are epinephrine and oxytocin," says Dr. Jeff Gardere, a clinical psychologist who visited New Orleans in July to speak at the National Urban League Conference. "These hormones have some negative effects: people get angrier; people have a little more road rage and are more irritable."
People with mental illness are especially susceptible to the effects of altered brain chemistry. "Heat in general can really increase anxiety, and if you have a chronic mental illness, any change in your body chemistry is going to affect your mental health," Tebo says.
Gardere says exercise is a great way to stave off depression and stabilize moods; however, it's not always feasible to exercise outdoors when the heat index tops 100 degrees, and not everyone has access to air-conditioned facilities. This is another summer stressor: heat-induced immobility.
"People aren't going to walk around the block when it's 105 degrees," Tebo says. "We know all the benefits of exercise, and it is hard to find a place inside to do it." Heat can prevent people not only from getting adequate exercise, but also from getting out of the house to socialize, which can lead to isolation and depression. "It's harder getting from point A to point B, so people don't do it, and it sets this spiral of isolation," Tebo says.
While hunkering down in the air conditioning can be isolating, it's still a luxury not available to everyone. "Families who struggle with finances don't have the level of air conditioning other people have, and having warm households can lead to stress and family violence as well," says Rob McClain, CEO of Family Service of Greater New Orleans. Rebecca Garside, clinical director of that group, echoes this. "If we're looking at Maslow's hierarchy of needs, your physical conditions have a lot to do with psychological systems," she says. "We see a lot of financial stress in the summer."
Financial stress is a hydra-headed problem: Children are out of school, which means their care and feeding falls more heavily on the parents, and parents who are seasonally employed or work in the service industry may have fewer opportunities to make money. "If you work in the service industry — bars, hotels — they suffer during this time because there isn't much tourism," McClain says. "I hear (clients) saying all the time, 'I can't wait until October.'"
Natalie Jayroe, president and CEO of Second Harvest Food Bank of Greater New Orleans, says the agency created the Summer Feeding program in 2010 so children receiving free or reduced-cost breakfasts and lunches from their schools would not go hungry during the summer. "Working people are finding it harder and harder to make ends meet," Jayroe says. "We see more need year-round, but summer is always a time when we have more concerns. The usual supports may not be there for people, and I think that does lead to increased anxiety."
While the children Jayroe services may be concerned about where their next meal is coming from, McClain and Garside see children who suffer from mental health issues that have continued since Hurricane Katrina, and who have no access to resources that could help them. Schools also refer children to agencies like Family Services.
"Oftentimes, schools do provide support for families, and in the summer there is more stress as well," Garside says. "In schools, if children have trouble, teachers refer them to Family Service, Children's Bureau, Kingsley House ... in the summer, you don't have that level of vigilance."
Children and adults alike feel the stress of hurricane season, and as Hurricane Katrina's anniversary looms, they may experience heightened anxiety. "We see a lot more symptoms related to anxiety in the summer due to the trauma of Katrina," McClain says. Garside adds, "Especially for adolescents who as young children weren't able to process it. We see a lot of issues as a result." Tebo says families with the means to take summer vacations may hesitate to do so, fearing a storm will develop when they're out of town. Whether they stay or go, any tropical disturbance can trigger PTSD symptoms.
"When something starts to brew in the Gulf, people start reliving their experience with Katrina to the point that they feel like they are in the flood," Tebo says. "There's stress, angst, panic attacks. ... It's sad and shocking. You would think at this point we would be over it. But you have war veterans that never get over war."
Certain populations are more vulnerable to stress and less resilient when it comes to weathering trauma, and people who aren't getting professional help may self-medicate. "Many people with mental illness treat themselves with drugs and alcohol, and (in New Orleans) alcohol and drugs are pretty accessible," Tebo says. "We're kind of a draw for ... those with mental illness." Heat also increases the metabolism of alcohol, Garside points out, which can affect good judgment. "We see an uptick in violence with male and female perpetrators (in the summer)," McClain says.
Warning signs to look for in yourself and others include sleep and eating issues, isolation, unresolved grief, not enjoying things you usually do, and any traumatic life changes, Tebo says.
There are a number of resources available: Tebo recommends calling 211, a 24-hour crisis intervention and community help line, to connect with resources. Physically, we can do our best to do some type of exercise when the weather and circumstances permit. Gardere says he finds aromatherapy helpful, adding that a lavender plant or oil can bring down stress levels. Tebo advocates maintaining social interaction by visiting friends or volunteering. "Working with others and sharing your skills and talents is one of the best mood uplifters I know," she says. Jayroe says Second Harvest is always looking for volunteers; people can call 734-1322 or visit www.no-hunger.org for more information.
Tebo encourages people suffering from anxiety, depression and other mental illnesses to reach out for help.
"(Mental illness) is seen as a weakness, or that we have done something to create it. It is time to get over those stigmas," Tebo says. "People get better, but you have to be willing to take the hand of another to walk you through it. If you make that choice, you're going to get so much better."