|Year : 2015 | Volume
| Issue : 2 | Page : 45-47
"To the ends of the earth and beyond": Psychological aspects of circumpolar expeditions
Rajesh Sagar, Raman Deep Pattanayak
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
|Date of Web Publication||20-Jan-2016|
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sagar R, Pattanayak RD. "To the ends of the earth and beyond": Psychological aspects of circumpolar expeditions. J Mental Health Hum Behav 2015;20:45-7
|How to cite this URL:|
Sagar R, Pattanayak RD. "To the ends of the earth and beyond": Psychological aspects of circumpolar expeditions. J Mental Health Hum Behav [serial online] 2015 [cited 2020 Oct 1];20:45-7. Available from: http://www.jmhhb.org/text.asp?2015/20/2/45/174586
"Exploration is in our nature. We have lingered long enough on the shores of the cosmic ocean. We are ready at last to set sail for the stars."
In the modern era, the humans have increasingly begun to explore the extreme ends/poles of the earth facing harsh environmental conditions, overcoming both physical and psychological challenges. While the initial sojourns to north and south poles were by made by the early explorers like Martin Frobisher, Cook, Ernest Shackleton etc., however in the more recent decades, there have been a growing number of scientific expeditions, in addition to adventure, military and commercial purposes. Three main types of circumpolar expeditions include: (a) Polar treks by solo explorers/teams, usually undertaken in summer; (b) summer camps for scientific or commercial exploration: lasting from few weeks; and (c) polar research stations - year round extended stays, mostly confined indoors. The research paper by Khandelwal et al.  in this issue of the journal focuses on the psychological health in a summer team of an Indian expedition to Antarctica.
India is currently among the very few nations with more than one permanent station at the Antarctica (Maitri, Bharathi). With its first scientific expedition in 1981 and establishment of Dakshin Gangotri base soon after, the Indian Antarctic Program is a multi-disciplinary and multi-institutional program running under the control of the NCAOR (National Centre for Antarctic and Ocean Research), Ministry of Earth Sciences, Government of India.  Polar work groups are active during both the summer and the dark winter-over period, though the number of stationed personnel reduce considerably during the winter months (March-September). Disciplines studied at Maitri Station include atmospheric sciences, meteorology, earth sciences, glaciology, human biology and medicine, biology, environmental sciences, engineering and communications. The medical specialists stationed at Maitri often undertake studies on human physiology and areas including behavior sleep patterns.  Comparable stations exist at the Arctic and are operated by several nations, including India (Himadri). Though, the human presence in circumpolar areas has become relatively safer and little more commonplace and accessible with availability of advanced technology/internet, however, the living and work conditions still involve a large number of physiological and psychosocial stressors. Such extreme environments may serve as "natural laboratories" in which many questions of psychological interest may also be studied since the conventional social norms are usually stripped away in extreme environs. 
Certain psychological aspects merit a special attention with regard to the extended polar expeditions, as discussed below. These aspects should be considered before, during and after the expedition.
First, the mental health screening and assessment is an integral part of the medical tests before any long duration polar expedition. The Department of Psychiatry, AIIMS, New Delhi has been regularly involved in the psychological assessments of the applicants for the India's Antarctic expeditions. The psychological assessment includes a special focus on mental health issues, pattern of substance use and psychological aspects such as coping abilities and resilience to deal with stresses. The extreme weather, total darkness in the winters, and physical isolation from rest of world coupled with near-impossible rescue and evacuation in emergency situations poses a great deal of stress on an individual.  Further, at polar work stations, the personnel, their work and backgrounds are diverse, such as cooks, technical personnel, scientists, physicians, etc., requiring teamwork, and healthy interpersonal relationships for an optimal adaptation. Prevention of adverse psychological outcomes is best accomplished by assessments geared to screen-out the candidates who may have trouble coping with polar life. It may include a structured interview by psychiatrists or clinical psychologists, use of relevant instruments and reviews of employment and interpersonal and socio-occupational functioning. Adding a psychological test battery would improve the odds of selecting good performers, and reduce the odds of selecting poor performers. For example, Grant et al.  recently described the SOAP instrument (Selection of Antarctic Personnel battery) consisting of nine well-known psychological instruments.
Second, the "optimal" personality factors which are suitable for polar expeditions needs to be looked into. The personality factors are one of the predictors of behavioural adaptation and work performance. From the existing research, it appears that the "ideal" personality for short- and long-term missions differ remarkably from each other.  While a high need to achieve and high adventure-seeking is compatible with short-term missions, but the candidates found suitable for long-duration missions are those with a low level of neuroticism, emotional stability, introverted but socially adept, low demand for social interaction, sensitivity to needs of others and not getting bored easily and high tolerance to lack of acheivement. ,,, Characteristics of effective polar groups include effective leadership and shared decision making.
Third aspect is that of psychiatric symptoms experienced during a long duration mission to the circumpolar regions. Some of these may be subclinical, subthreshhold conditions which can nonetheless contribute to impaired functioning. This has been described from the times of 19 th century expeditions, for example, almost all crew of the Belgica expedition to Antarctica experienced possible depressive symptoms during long extended winter and to relieve the same, the members were made to sit around large fires during winters.  However, the psychiatric issues have started gathering a formal recognition only in the recent decades. The incidence of DSM-IV psychiatric disorders was found to be 5.2% among members of an extended Antarctica expedition (220 men and 93 women).  Mood disorders were the most common diagnoses, accounting for 30% of all diagnoses, followed by adjustment disorders (28%), sleep-related disorders (21%), personality disorders (12%), and substance-related disorders (9%). Generally, psychiatric disorders account for 1-5% of all station sick-calls or outpatient visits at research stations in the Antarctic.  Commonly reported psychiatric symptoms by people on polar expeditions include sleep disturbances (difficulty falling sleep and staying asleep), somatic symptoms (fatigue, aches), impaired cognitive abilities (memory, attention, reasoning), negative affect (depression, anger, anxiety), and interpersonal conflict and irritability. , There is a consistent association of mood with season as also seen in studies on U.S soliders deployed in Alaska,  with an increased risk of seasonal affective disorder with decreased exposure to bright light during the winter months.
Fourth, the medical and physiological changes which occur in the human body in polar environs need to be studied, especially with link to and implications for mental health. There have been studies on cold physiology, UV light exposure, endocrinology, chronobiology and immunology at the polar regions.  In a winter expedition at Antactica, Reed et al.  found evidence of a baseline increase in the thyroid stimulating hormone (TSH), along with the release of higher levels of TSH in response to a challenge with intravenous thyroid hormone. Subjects showed a more rapid production and clearance of tri-iodothyronine (T3) and this is now well recognized as "polar T3 syndrome."  Further research has linked these physiological and hormonal changes with alterations in mood and cognition. Mild vitamin D deficiency was present in 10% subjects at baseline, which increased to seven 35% subjects during the polar winter after 6 months.  Early work indicated that the Antarctic winterers had lowered immunological responsiveness, which was attributed to reduced environmental immunological triggers, combined with psychosocial and physical stresses during the Antarctic winter stay. Recent work has revealed diminished cell-mediated immunity and an accompanying increased reactivation and shedding of latent viruses, raising long term health implications. 
Fifth aspect is the "salutogenic" or the positive mental health outcomes , and these can co-exist alongside the negative experiences. While most psychological research in polar environments has focused on negative consequences, the effects can be in the form of "salutogenesis" (as opposed to pathogenesis), that is, a sense of positive growth and meaning in one's life.  This can translate into an enduring, positive psychological wellbeing and meaningfulness in life. Salutogenic experiences are related to a heightened self-efficacy, achievement, depth of insight, improved relations with others, and many other favourable changes. Further support was provided by a study of American naval crew who had better health records, lower hospitalizations after their return from winter in Antarctica and more successful careers than a control group who had volunteered and passed the screening tests, but had never been deployed.  Promotion of salutogenic experiences is best accomplished by screening for suitable personality traits, and optimal training before expedition. 
Sixth aspect relates to the implications and extrapolations for space psychology research. The polar regions have often been suggested as surrogates for the exploration and human colonization of Mars and space flights, especially because of logistical constraints and restricted number of samples for study in latter situations. In particular, Antarctica's greater isolation from mankind, its acultural environ makes it a useful analogue to space psychology. ,
It is also equally important to focus on the qualitative aspects of research which may provide a deeper insight into the nature of problems and coping mechanisms used by explorers. For example, inductive coding of log diary/interviews of a female polar explorer during her 84-day attempt to reach north pole identified 4 broad areas of stressors, including environmental conditions, personal challenges (pain, fear), available resources, and slower speed of expedition progress. Findings highlight the importance of expedition preparation and coping efficacy in managing the demands. 
The psychiatric issues in other kind of extreme environments also need an attention especially the areas situated at a high altitude with no accessibility to mental health care. For example, Leh at an altitude of 8000-25000 feet, is accessible only by air during winter. In a health mela (2008) at Leh, Jammu and Kashmir, in which faculty from Department of Psychiatry, AIIMS also participated, a total of 190 patients were seen during the 3-day consultations with experts. The diagnosis ranged from depressive (40%) and anxiety (15%) disorders to schizophrenia and other psychotic disorders (19%).
In future research, there is a need for continued studies on the psychological effects of polar environs and expeditions to improve out understanding about human behaviour in extreme, isolated environments This is a vast area which has recently only begun to be explored. In the short-term, there is a need to further develop and refine the guidelines for the screening and selection of individuals for different types of polar expeditions, in addition to developing effective methods to provide psychological support, and training to cope with the stress of isolation, confinement, and harsh environments.
To conclude, the psychological impact of circumpolar expeditions usually range from subsyndromal to milder disorders, to very uncommonly, severe disorders and psychological maladjustment. It is important to consider both negative as well as positive mental and behavioural aspects of polar expeditions, and develop screening tools and training strategies to maximize the performance in the extreme environments.
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