Maddie Cole in eighth grade stopped running cross country. She’d competed the year before, but the air quality in her native Sacramento, California, was so bad that she got sick during a race; she soon learned she had asthma.

The next year the sky above Sacramento turned gray with smoke from the 2018 Camp fire. Maddie and her classmates went to school with masks on. “It felt,” she said, “like a futuristic apocalypse.”

The situation has only worsened as wildfires and their devastation have become so routine that she and her classmates are “just used to it,” said Maddie, now 16 and a junior. This fall “it was just like, ‘Yeah, California’s on fire again. It’s that time of year.'”

Neither the polluted air nor the wildfires punctuating Maddie’s adolescence are random. Both are being exacerbated by climate change, and the future they portend has left Maddie feeling helpless, anxious and scared. Climate anxiety and other mental health struggles are rampant among Maddie’s generation, according to experts who warn that young Californians are growing up in the shadow of looming catastrophe—and dealing with the emotional and psychological fallout that comes with it.

The scope of the problem is enormous.

The Earth’s temperature has skyrocketed since the Industrial Age, fueled by human activity and accompanying greenhouse gas emissions. Dramatic reductions in those emissions, and in fossil fuel use, will be necessary to prevent temperatures from reaching a tipping point by 2030, the United Nations’ Intergovernmental Panel on Climate Change warned two years ago.

Without reducing those emissions, climate change will make natural disasters, food shortages and rising sea levels even worse, experts say. The world is not yet on track to make the changes necessary to ameliorate its worst effects.

Such dire predictions can affect mental health, particularly among young people. Polls have found that climate change-related stress affects daily life for 47% of America’s young adults; over half of teenagers feel afraid and angry about climate change; and 72% of young adults are concerned that it will harm their community.

Climate depression played a central role in teenage activist Greta Thunberg’s political awakening, and according to Varshini Prakash—executive director of youth-focused climate activism group the Sunrise Movement—it’s not uncommon for her group to meet kids who have contemplated suicide over the climate crisis.

“Surveys have found that young people often experience more fear, sadness and anger regarding climate change than their older counterparts, as well as an increased sense of helplessness or hopelessness,” said Hasina Samji, an assistant professor at Simon Fraser University who has explored the mental toll of climate change on young people, in an email. In particular, “areas that suffer direct, visible effects of climate change … have been observed to face acute impacts such as trauma, shock and PTSD.”

Young Los Angeles residents described similar emotions and mental stress when contemplating the climate crisis. Kate Shapiro, 15, said humanity’s selfishness, greed and “lack of foresight” about the warming planet contributes to her depression. Sarah Allen, 25, said she shudders in “real terror” when contemplating the plight of future generations. And Sam Jackson, 29, said the enormity of the problem leaves him feeling “exhausted.”

To cope, many have become activists or taken steps to reduce their own effect on the planet. Some go vegetarian or vegan. Others have opted not to buy a car, even in car-centric Los Angeles, or are making plans to leave Los Angeles before the fires and droughts become unbearable. And a few said the looming environmental disaster has discouraged them from having children.

“As I’ve gotten to learn more about how much or how disproportionate an impact an additional American has … (I’m) less and less inclined to create a new person,” said Elliott Lee, 26, of Los Angeles.

Others are throwing themselves into climate activism as a way to deal with the stress.

Lifestyle changes “empower individuals to feel like they can act,” said Abby Austin, 23, the political lead for the Sunrise Movement’s L.A. branch—echoing medical professionals who say that even small personal actions can help people feel like broader change remains possible.

Getting involved with activism can serve a similar function. Many young Californians said volunteering with climate advocacy groups such as the Sunrise Movement or for politicians who have made climate change a central plank in their platforms has given them a sense of purpose.

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