The 2025 Summer Heatwave: Implications for Patients With Psychiatric Disorders

Although the song states "Summertime and the living is easy," the extreme heat associated with summertime can be troublesome for patients with psychiatric disorders, Rebecca Barbee, PA-C, CAQ-Psych, told Psychiatric Times in an exclusive interview. Barbee, a physician assistant at Southlake Psychiatry in Davidson, North Carolina, shared tips on how to approach the topic of extreme heat to prepare patients and their caregivers so they can enjoy summertime.

For instance, she likes to remind patients that psychiatric medications may make it more difficult to regulate body temperature, making patients more sensitive to extreme heat.

“Psychiatric medications can either make us sweat to excess, reduce our ability to sweat, or even indirectly affect our body's thermostat,” Barbee said she tells patients. “The hypothalamus is our body's thermostat, and a lot of the neurotransmitters that we are touching on and working on in psychiatry affect the hypothalamus.”

Inevitably, the heat may be part of the informal conversation as a patient enters the room or even begins a televisit, and that is the perfect opportunity to touch upon these issues, she said.

“Now is not the time to push through in these outdoor activities. We need to listen to our body,” Barbee tells patients and their families. “We need to stay hydrated, not just with water, but making sure we get electrolytes, reducing things that can dehydrate us, such as alcohol or caffeinated drinks.”

She also reminds patients to take breaks as needed. “If we have to be outside for a time period, make sure we have somewhere where we can get into air conditioning or at least into shade,” she added. Barbee also reminds patients about sweat wicking clothing and cooling accessories.

Although prevention is key, Barbee said patient education should also include the signs and symptoms of heat intolerance. “That can be sweating too much or not sweating enough,” she explained, and said care may be needed if patients are “feeling faint or dizzy, [or report] excessive thirst, confusion, fatigue.”

Additionally, Barbee likes to remind patients that the medications themselves are also susceptible to heat issues. “Storage of medications is incredibly important,” she said. “If we are storing our medications in a hot car or outside or in damp areas, that can actually break down and affect the overall efficacy of medications.”

Ultimately, having open communication with patients is key, Barbee said. “We need to tell our patients to stay cool out there, take breaks, pay attention.”

Ms Barbee is a physician associate at Southlake Psychiatry in Davidson, North Carolina. She serves on speaker bureaus for Neurocrine Biosciences, Axsome Therapeutics, and Alkermes. She has also served as advisory board participant for Supernus Pharmaceuticals and Axsome Therapeutics. Ms Barbee has a passion to reduce the stigma around mental health and promoting increased access to mental health care and education of both clinicians and the general public.