Summer and mental health

Impact of SSRIs in summer

Self-care for your mental health is important year-round, but in summertime there are specific ways we can take care of ourselves. Certain antidepressants, such as serotonin-norepinephrine reuptake inhibitor (SNRI) medication and antipsychotic medication, can affect body temperature regulation (also known as temperature dysregulation) and make you more sensitive to heat. This is because they interfere with the hypothalamus, the part of the brain responsible for temperature regulation. This is often listed as a potential side effect, so it’s important to check your medication’s accompanying leaflet if you’re concerned, you can discuss this this with your prescribing doctor, psychiatrist or pharmacist. 

Some examples of medication this includes are:

• Antipsychotic medications such as amisulpride (brand name Solian), aripiprazole (Abilify), clozapine (Clozaril, Denzapine, Zaponex), lurasidone (Latuda), olanzapine (Zypadhera, Zyprexa), paliperidone (Invega, Xeplion), quetiapine (Seroquel, Seroquel XL), risperidone (Risperdal, Risperdal Consta), chlorpromazine, flupentixol, and haloperidol. 
• Tricyclic antidepressants such as amitriptyline, imipramine, doxepin, mianserin, and trazodone. 
• SSRIs such as sertraline, citalopram, and fluoxetine.
  

Some medications increase sweating, meaning you are more likely to become dehydrated, while some decrease sweat production. Medications can also impair your ability to think clearly, or simply change your tolerance to hot temperatures. It is always important to understand the wider impact your medication may have, so read and retain the information leaflet.  To understand any medication that you may be taking in both the short-term and long-term, you can go to the NHS’s medication directory to find out how they work, the possible side effects, interactions and common questions.  

If you find it difficult to stay cool during the summer, continue reading for some tips on how to cope with hotter temperatures. 

Heat exhaustion and heatstroke 

While heat exhaustion and heatstroke can affect anyone, you may feel the impact more if you take psychiatric medication. It’s important to know the signs, as well as know how to treat and prevent it. 

Signs of heat exhaustion can include: 

• feeling sick or being sick  
• being very thirsty 
• dizziness 
• tiredness or weakness 
• headache 
• excessive sweating 
• a high temperature 
• Clammy skin, or a change in skin colour 
• fast breathing or heartbeat  
• cramps in the arms, legs and stomach 
• Irritability (particularly in children) 
• Delirium (often in older adults) 

Sometimes, anxiety and panic attacks can mimic symptoms of heat exhaustion as the heat can induce physical symptoms such as increasing our heart rate. Find out how you can cope with anxiety in the heat.

If you believe you or someone else might be experiencing heat exhaustion, it’s important to cool down and drink fluids as soon as possible. Move to a cool place or into the shade, lie down if possible, and cool the skin with ice or cool water. If you or the person affected still feels unwell after 30 minutes, it’s important to seek medical help as this may be a sign of heatstroke and require medical attention. 

Heat exhaustion is preventable, below are just some of the ways you can avoid or reduce it’s affects:   

• Drink plenty of cool drinks such as water, or rehydrating drinks such as sports drinks which contain sodium. 
• Stay out of the hottest temperatures, usually between the hours of 11 a.m. and 3 p.m. 
• Wear light, loose and breathable clothing.. 
• Avoid extreme exercise. 
• Avoid dehydrating drinks such as alcohol. 
• Find nearest air conditioned place such as shops, cafes, libraries etc.  
• If you feel overheated, you can run cold water on your wrists to quickly cool down. 

Self-image in the summer 

Another way your mental health might be affected by the summer is through your self-image. If your are uncomfortable with your body image or appearance, summer might be a difficult time. You may feel uncomfortable with wearing clothing that shows more skin, displays self-harm scars, or triggers body dysmorphic disorder (BDD).  

You can read more about body image and mental health on our website, or read other people’s experience with their own body image. 

Circadian rhythm and melatonin 

Melatonin is the body’s sleep hormone, responsible for maintaining our circadian rhythm and making sure we have a quality sleep-wake cycle. Since darkness prompts the brain to produce melatonin, and production slows or stops during daylight, changes in the amount of daylight we experience can throw off our circadian rhythm, potentially disrupting sleep. This is especially true during summer, when days are longer, and winter when there are shorter hours of daylight.  Since sleep is important to maintaining a healthy body and brain, it’s important that we see plenty of daylight during the summer but also try to stick to a regular sleep cycle. 

Sleep may also be disrupted by hotter temperatures. If you find that summer temperatures affect your sleep, you can: 

• If possible, open a window at night and use a fan to circulate the air.
• Sleep with a lighter bed sheet.
• Use an ice pack to cool your pillow or sheet just before bed. 
• Use an eye mask if the early morning light interrupts your sleep. 

Stay hydrated 

Dehydration is common but may particularly affect people with poor mental health or who struggle with temperature regulation. You may also be more likely to become dehydrated in summer if you experience excessive sweating, if you drink alcohol, or if you are active, such as exercising. 

Some tips for staying hydrated in summer include: 

• Keep cold water readily available in the fridge and top up when you run out. 
• Use an insulated water bottle and take it with you everywhere. You can purchase water bottles that keep water cold for 24 hours.
• Alternatively, you can purchase water bottles that feature hourly intervals, encouraging you to drink a certain amount every hour. These can be a great way of ensuring you’re drinking your recommended daily amount. 
• Hydrating sports drinks are particularly helpful for staying hydrated as they often contain increased sodium. 

Get outdoors 

Getting outdoors is important for your mental health throughout the year, though you may not always feel like it. Outside of the hottest times of day (usually between 11 a.m. and 3 p.m.), try to go out for a small walk every day. A little light exercise can be great for boosting your mood by triggering the body’s release of endorphins, which promote a sense of wellbeing. 

You could also try the following activities to boost your mood:

• Meditation or mindfulness outdoors, such as in a park or a quiet nature setting. Even simple breathing exercises can help to boost your mood and lower stress.
• Organise to meet friends or family outside in an area with available shade, instead of somewhere indoors. You could take your own picnic and refreshments.
• Bring your workplace outside. You could suggest to host walk and talk meetings with colleagues outside or have lunch with a colleague in the local park.

For more information on how Mental Health UK is here to support you, find out what help and programmes we have available or learn more about mental health conditions.