Extreme heat events, often characterized by persistent “heat domes,” significantly increase risks to mental health by disrupting cortisol regulation and restricting access to coping mechanisms. According to Dr. Laurie Ballew, a doctor of psychiatric medicine at Four Rivers Behavioral Health, rising temperatures correlate with spikes in irritability, domestic violence, and psychiatric emergency room visits as the body struggles to maintain homeostasis.
How Does Extreme Heat Affect Mental Health?
Heat stress impacts the body’s endocrine system, specifically affecting cortisol—the hormone responsible for managing stress. Dr. Ballew explains that when individuals cannot perform their usual stress-relieving activities due to excessive temperatures, cortisol levels rise. This physiological shift can manifest as increased anger, irritability, and the exacerbation of pre-existing mood disorders like depression.
Ballew said that when we have heat domes like this, we often see more suicides, more domestic violence, and sometimes more crime, noting there is data to show that.
The Intersection of Medication and Temperature Regulation
Individuals managing chronic health conditions face heightened risks during heatwaves. Dr. Ballew notes that many common medications—including those for blood pressure, diabetes, and various psychiatric conditions—can impair the body’s natural ability to regulate internal temperature.

- Psychotropic medications: Can alter how the body responds to heat stress.
- Blood pressure and diabetes drugs: Can affect temperature regulation.
- Dementia and cognitive impairment: Older adults on multiple medications are at a risk of developing delirium if they become dehydrated.
Why Do Heatwaves Lead to Increased ER Visits?
Emergency rooms often see a surge in patients with psychiatric conditions, such as schizophrenia or bipolar disorder, during extreme heat. Dr. Ballew, who previously worked with emergency psychiatric services at the University of Louisville, reports that the combination of physical stress and the inability to cool down often leads to crises. When the body is physically taxed by heat, it becomes harder for patients to maintain the emotional stability required to manage chronic mental health conditions.
Dr. Ballew recommends shifting outdoor activities to the early morning or late evening. If you are on prescribed psychotropic medication, continue taking it as directed, not take extra in an attempt to feel better, but focus heavily on hydration and avoiding direct sunlight.
Recognizing the Warning Signs of Heat-Related Illness
Heat exhaustion and heat stroke are medical emergencies. Dr. Ballew advises the public to monitor for these specific symptoms:
- Confusion.
- Feeling cold and clammy in high heat.
- Extreme irritation.
If these symptoms appear, immediate medical intervention at an emergency department is necessary.
Frequently Asked Questions
Can heat cause depression?
While heat does not cause depression directly, it can exacerbate existing mood disorders. When extreme weather prevents people from engaging in activities that help manage their mental health, such as walking, it can affect our mood.
Does alcohol help me stay cool?
No. Dr. Ballew warns against consuming alcohol because it’s going to dehydrate us.
Should I stop taking my psychiatric medication during a heatwave?
No. Dr. Ballew stresses that patients should continue taking psychotropic medicines as directed, not take extra in an attempt to feel better.
Are you or someone you know struggling with the mental health impacts of the current heatwave? Stay connected with local health resources and prioritize hydration. For more health-related updates, subscribe to our weekly newsletter or check our community wellness archive.







