We’d thought that PTSD was finally being given the respect it deserved; and then a reporter for the New York Daily News claimed that test-firing an AR-15 at a gun range gave him temporary PTSD, so loud were the explosions.

It turns out many more of us — millions, perhaps — have undiagnosed and untreated PTSD and don’t even know it, according to a new report put together by the nonprofit ecoAmerica, Climate for Health, and the American Psychological Association.

It’s certainly not difficult to see how a natural disaster like a hurricane or a flood could cause anxiety and depression, especially in children, but of course the 70-page report doesn’t stop there.

“Ecoanxiety” — the feelings of loss, helplessness, and frustration due in part to people’s inability to feel like they are making a difference in stopping climate change — is affecting more and more people not in the direct path of climate disaster and leading to PTSD, substance abuse, suicide, violence, trauma, fatalism, and more.

One of the study’s key takeaways in supporting individuals struggling to cope psychologically with climate change is to foster optimism, which TIME recently proved it hasn’t been doing for at last half a century now.

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