Amidst the chaos of the Maui wildfires, many individuals managed to escape the deadly inferno, some in heart-pounding escapades. However, their ordeal might be far from over. The pernicious aftermath of wildfire exposure doesn’t evaporate once the flames are quelled, according to experts. Recent research suggests that inhaling minuscule particles from wildfire smoke might lead to cognitive deficits, which could manifest in as little as six to 12 months or even years down the line.
Surviving a near-death experience also heightens the likelihood of post-traumatic stress, bearing symptoms such as depression, sleep disruptions, anxiety, and the heavy burden of survivor’s guilt, researchers reveal.
Marc Weisskopf, a professor at Harvard T.H. Chan School of Public Health specializing in environmental epidemiology and physiology, stresses the primary importance of survival but points out the unfortunate vulnerability survivors face regarding the enduring effects on the brain caused by such exposure.
For some wildfire survivors, grappling with cognitive struggles post-blaze has been dubbed “fire brain.”
Living with the Residue of the Flames
Randy Gerhardt, 66, and his wife Sandi Knapp Gerhardt, 55, narrowly escaped the 2018 Camp Fire in California – the state’s deadliest and most destructive wildfire. They noticed immediate changes in themselves. Though they could vividly recall the original items they were searching for – a tool, a lawn game – they struggled to identify the replacements they had procured. On other occasions, they entered rooms with no recollection of their intent.
Previously, Gerhardt, a retired Frito-Lay salesman, thrived in a whirlwind of work and hobbies. Post-fire, he found himself unable to complete tasks, let alone muster the motivation to initiate them.
“This was different from mere stress,” Gerhardt explained. “You wonder why you’re so ineffective. I’d have a list and zero interest in tackling it. Even my bills, they’d pile up untouched for weeks.”
Rebuilding their home in Paradise, which typically would have taken Gerhardt a short time, extended into an unusual two years. Friends inquired about the progress, only to find him procrastinating.
Two years after the wildfire, the Gerhardts joined a group of other couples living in trailers on a friend’s property, united by their shared experience. They referred to themselves as “forever friends,” offering solace, sharing stories, and a reminder that they weren’t alone.
It was within this group that Gerhardt first heard the term “fire brain.” In subsequent conversations with emergency room doctors, his suspicions were validated: what he was enduring was both real and a common occurrence among fire survivors.
Labeling his emotions and behaviors alleviated his sense of brokenness. “I felt justified,” Gerhardt said. “I wasn’t losing my mind. My experiences were typical – I wasn’t feeble.”
Confronting Trauma in the Age of Climate Change
Dhakshin Ramanathan, an associate professor of psychiatry at the University of California, San Diego, distinguishes trauma from surviving climate-related natural disasters from that arising from isolated events like car accidents or assaults. He emphasizes that the environment typically represents a refuge, a source of healing. When this positive sanctuary transforms into a threat, coping becomes a daunting task.
The added anxiety stems from the uncertainty of potential re-exposure to the disaster. “Climate-induced stress becomes a sustained ordeal that defies easy solutions,” Ramanathan notes.
A study following the Camp Fire found that over 30 percent of directly exposed individuals exhibited symptoms of post-traumatic stress, significantly higher than those in non-exposed communities on the West Coast. Indirectly affected individuals from the wildfire-stricken area also displayed symptoms, albeit to a lesser extent.
Laura Nelson, 39, fled the Camp Fire with her pets, only to find herself ensnared in an hours-long traffic jam. Loneliness dominated her life as she camped out in her car for months before relocating to Oregon. In this new environment, she encountered symptoms like tinnitus, vertigo, intrusive thoughts, and nightmares.
Nelson’s mental health challenges extended beyond mere isolation; they were further compounded by misunderstandings within her new community. She struggled with reconciling her losses, often convinced she still owned belongings lost in the fire. Amid the mental fog, her condition deteriorated, and she even confronted thoughts of suicide.
“I was utterly alone,” Nelson confides. “It became overwhelming and isolating, prompting unprecedented thoughts.” Although the medication was prescribed, it couldn’t provide the remedy she sought.
Guilt is also accompanied by increased anxiety and depression in survivors. Andrea Roberts, a senior research scientist at the Chan School, explains that survivors often grapple with irrational self-blame, convinced they could have done more to aid others. This sense of guilt can inflict lasting psychological damage.
Cognitive Struggles Beyond the Wildfires
The Camp Fire study delved into cognitive functioning six months to a year post-fire, using the Flanker task to assess the ability to focus amidst distractions. Results indicated a 20 percent deficit in those exposed to wildfires compared to their non-exposed counterparts.
Inhaling particulate matter can incite inflammatory responses in the body, potentially affecting brain processes. The study revealed heightened activity in the left frontal brain region, particularly pronounced among wildfire-exposed individuals.
This aligns with the common trajectory of mental health following a traumatic event, according to Irva Hertz-Picciotto, professor of public health sciences at the University of California, Davis. A burst of heightened awareness post-trauma can transition into a crash, marked by deep depression, around the six-month mark.
Inflammation and the Brain: A Complex Relationship
Historically, scientists concentrated on the impact of inhaling smoke particles on the cardiovascular and respiratory systems. Kent Pinkerton, a professor at UC-Davis School of Medicine, reveals that breathing through the nose under stressful conditions serves as a filter, depositing particles there rather than in the lungs. However, particles can travel via cells responsible for the sense of smell, inducing inflammation in the brain.
Chronic inflammation, when it occurs, can be perilous. Neuroinflammation, provoked by intense wildfire exposure, occurs on a rapid scale, Weisskopf explains. The initial inflammation is a protective response, similar to a fever or injury, but it can evolve into a chronic state with enduring effects.
Toxic metals, like lead and iron, can hitch a ride on these particles, making their way to the brain. The effects of trauma likely influence future brain diseases, with PTSD serving as a significant risk factor for later dementia.
The combined effects of inhaling wildfire smoke and trauma pose a perplexing enigma for scientists to dissect. Jyoti Mishra, lead author of the Camp Fire study, conveys that the puzzle pieces are there – particulates entering the brain, prompting inflammation, interacting with emotions and cognitive systems – yet the precise fusion remains a mystery.
For survivors in Maui facing an arduous path ahead, Laura Nelson offers this advice: “Take it slow. Grieving and healing take time. Sometimes, you’ll experience all stages of grief in a single day; other times, it’ll span years.”