The mentally ill:
Heat poses a special risk for those struggling with mental illness.
YUMA - When she’s able to keep the voices under control, Teresa Jimenez Dupee hears a spelling bee in her head: a refrain of voices forming long words like superfluous, magnificent and commodities.
But sometimes the voices are more sinister. They tell Jimenez Dupee she’s not pretty, not smart. They say no one will listen to her because she’s crazy.
And they can get worse in the heat, when getting out of bed some days takes an “act of courage.”
Jutting out from the Arizona side of the Colorado River, Yuma often appears high on “hottest cities in the U.S.” rankings. This year’s summer was not a record-setter for the city, but temperatures were hardly mild, with at least five days where the temperature reached 115 degrees or higher, according to the National Weather Service.
In Yuma’s downtown, in a squat brown building, the heat was felt even more sharply.
Sylvia Flores runs the Yuma outpost of Hope Inc., a non-profit behavioral-health center that helps its members manage mental illnesses including schizophrenia, bipolar disorder and depression.
When the temperatures climb, Flores notices the changes in the people she works with. They become more irritated as springtime hastens into summertime. Their eyes get more dilated. They are more blunt. Heat takes an extra toll on people with mental illness.
Out of all the people who died of heat-associated causes in Maricopa County in 2016, around 15 percent had a history of mental illness, according to an Arizona Republic analysis of autopsy reports.
A little more than 4 percent of those who died had a medical history of schizophrenia. Nationally, 1.1 percent of the U.S. adult population has schizophrenia, according to the National Institute of Mental Health.
Some medications, including certain types of antidepressants and antipsychotics, block the body’s ability to regulate its temperature, said Dr. David Eisenman, a professor of medicine at the University of California, Los Angeles. This puts behavioral-health patients at a higher risk for heatstroke and other heat-related illnesses.
Jimenez Dupee said she’s had heatstroke four separate times. She is prescribed the antidepressant desvenlafaxine and the antipsychotic haloperidol, both medications Eisenmann said would affect the way a body thermoregulates.
Last year, she passed out after stepping out of her truck, which does not have air-conditioning. She said the incident warranted a trip to Yuma Regional Medical Center.
“It’s very stifling when you get in the car,” she said. “It’s like an anxiety attack. You suffer from those a lot more in the summer than you do in the winter.”
Flores has lived in Yuma her whole life. She spent summers traveling with her parents from farming job to farming job, working in packing houses where she would be assigned tasks such as placing stickers on melons.
The heat, to her, is manageable for people who have known it their whole lives. Flores remembers running barefoot to the neighborhood pool in the heat of the day because her parents couldn’t afford sandals and they didn’t want to wear tennis shoes.
“Growing up in Yuma, it’s hot,” she said. “But not as hot as it is now. It’s getting hotter.”
At Hope Inc., Flores starts warning her members about heat early in the season, around April. She wants to make sure they are drinking plenty of water instead of guzzling soda or coffee.
Larissa Flores, Sylvia’s daughter and an outreach specialist at the center, notices that heat becomes a seasonal roadblock for members, who may struggle to take care of themselves. “They don’t like to go on their walks,” she said. “They don’t keep up with their medications. So we see a lot of them struggling and being irritable and not themselves.”
Pale, with fair skin, Rachel Milligan spends much of her days inside during the summer. She has bipolar disorder and hears voices. The heat wears on Milligan during her daily walk from her apartment to the Fry’s grocery store a few blocks away. Some days, she will put her groceries away and then just sit with the air-conditioning blasting. She sits until her body’s cooled down.
“Summer, it takes my breath away,” she said.
Milligan doesn’t have a car and tries to take walks as often as she can, to get her exercise in. But, “it’s just too hot. It’s horrible.”
Environmental coverage on azcentral.com and in The Republic is supported by a grant from the Nina Mason Pulliam Charitable Trust. Follow The Republic’s environmental reporting team at OurGrandAZ on Twitter, Facebook and Instagram.