“It Drags Your Spirits Down”: Examining Mechanisms of Anxiety and Depression In Water-Scarce Urban Environments

Background and Purpose: The United States is experiencing ever-worsening water scarcity (Meehan, 2025). However, this issue has long been plaguing communities across the Western hemisphere (Akhmouch, 2012) and its affects on mental health are well-documented (Wutich et al., 2020; Young et al., 2019). As water scarcity continues to expand in the United States, understanding the mechanisms by which water scarcity produces mental distress will be necessary for practitioners to formulate interventions. This research aims to fill in this gap by examining how water scarcity may produce and be associated with feelings of anxiety and depression, particularly for urban residents . In doing so, this research offers the possibility of drawing transnational lessons for confronting these issues in other urban communities.

Methods: This study draws on 20 interviews with adults residing within San Cristobal de las Casas, Chiapas, Mexico, as part of an ethnographic investigation into the water crisis in the area. Participants were recruited via purposive sampling, based on long-term residency within the city, experience with water scarcity, and self-reports of experiencing mental distress due to the lack of water. In-person interviews were audio-recorded, and then transcribed and analyzed in DeDoose. Analysis entailed flexible coding (Deterding & Waters, 2021) wherein transcripts were indexed by protocol topics then analyzed using focused analytic codes and respondent attributes to validate cross-case conceptual relationships.

Findings: Analysis reveals four core mechanisms by which feelings of anxiety and depression emerged: 1) Moralized stress from responsibilization; 2) Cognitive load from resource preoccupation; 3) Secondary economic trauma; and 4) Environmental powerlessness. The first involved residents engaging in self-blame for misusing limited water supplies, often reporting that they would berate themselves if they did not notice a faucet dripping, for example. The second involved residents spending an immense amount of time worrying about accessing water in such a way that often impaired the completion of other tasks or generally impaired their mood. The third was derived from residents often speaking about the economic stress from having to acquire water by other means. Finally, the fourth theme was residents’ sense of powerlessness or hopelessness around getting access to water or water issues being resolved, often leading to a sense of alienation and despair. Taken together, these findings grant insight into how residents experience the mental distress of water scarcity and the mechanisms by which that scarcity imposes negative mental health outcomes.

Conclusion and Implications: Findings highlight that water scarcity produces mental distress through specific psychosocial and neurocognitive mechanisms that exist outside of physiological dehydration. These mechanisms provide a roadmap for 'eco-social' clinical practice that resists the individualization of environmental trauma. Specifically, interventions must move beyond standard coping strategies to include material-aid models that alleviate resource preoccupation. Furthermore, these findings suggest that utility justice must be reframed as a primary mental health intervention. As water scarcity becomes a domestic reality in localities across the United States, social work practitioners and policymakers must treat infrastructure investment as a strategy for mitigating anxiety and depressive disorders in frontline urban communities.