Table 4.

Summary of mental health conditions assessed in association with wildfire exposure across reviewed literature

Mental health outcome(s)	Definition	Global prevalence
Depression, Depressive Symptoms, and MDD	Characterized by feelings of sadness, guilt, tiredness, hopelessness, low self-worth, loss of interest, and poor concentration [171]. MDD is defined by the lifetime absence of mania and the presence of a major depressive episode, which occurs when five depression symptoms are experienced during a 2-week period [172].	4.4% (depression) [171]
Anxiety and GAD	Characterized by feelings of worry, tension, and intrusive thoughts that are future-oriented, and may elicit physiological responses such as rapid heartbeat, sweating, and panic attacks [173]. GAD is defined by at least 6-months of these persistent symptoms, resulting in significant distress and/or impairment [174].	4.0% (anxiety) [175]
PTSD	Triggered by exposure to stressful events and is often characterized by intrusive memories of the trauma, distressing dreams, and flashbacks [176].	3.9% [177]
Psychological Stress or Distress	General terms that cover multiple conditions, including depression, anxiety, stress, or PTSD, and are linked to multiple negative health outcomes [178].	36% [179]
Substance Use	Characterized by the inability of a person to control their use of drugs, alcohol or medication despite negative effects [180].	2.2% [181]
Resilience	While there are many, evolving definitions of resilience [182], the American Psychological Association defines it as “the process and outcome of successfully adapting to difficult or challenging life experiences, especially through mental, emotional, and behavioral flexibility and adjustment to external and internal demands” [183]. In the context of wildfires, resilience can be thought of as the ability to psychologically respond to the disruptions and trauma caused by a wildfire, with relatively small sustained impacts to one’s mental health and well-being.	Highly variable depending on the study population [184, 185]
Insomnia	A sleep disorder characterized by having difficulty falling asleep, staying asleep, or getting good quality sleep [186].	10–30% [186]
Suicidality	Characterized by the risk of attempting suicide, which is indicated by suicidal thoughts, ideations, and/or plans [187].	9.9% (aggregate lifetime of suicidal plan) [188] 18% (aggregate lifetime of suicidal ideation) [188]
Self-Esteem	In simplistic terms, self-esteem encompasses how one views themself. However, it also serves as the foundation for other important mental constructs such as self-identity, self-image, and self-meaning [189].	Not applicable
Coping	In the context of wildfire exposure, coping can be defined as the way individuals manage their stress and distress levels following their experience of the adverse wildfire event [190].	Not applicable
Anger	While anger is a commonly felt emotion, “clinical anger” is defined by “heightened intensity, frequency, and duration of anger” which may lead to disruptions in work, relationships, and overall well-being [191].	Highly variable depending on the study population [192, 193]
Paranoia	“A condition characterized by delusions of persecution or grandiosity that are not as systematized and elaborate as in a delusional disorder or as bizarre as in paranoid schizophrenia” [194].	Highly variable depending on the study population and delusion type [195, 196]
Post-Traumatic Growth	“Positive psychological changes experienced as a result of the struggle with trauma or highly challenging situations” [197].	A meta-analysis showed that 52.3% of people who experienced trauma also experienced moderate-to-high post-traumatic growth [198].
Well-Being	“A positive state of emotional, psychological, and social health, characterized by a sense of contentment, resilience, and the ability to effectively cope with life’s challenges” [199].	Highly variable depending on the study population [200].