How the effects of war have imprinted PTSD in civilians and paralyzed populations in states of ill mental health
By: Maria Mian
Content warning: mentions of trauma, armed conflict
From conducting groundbreaking research on cures for illnesses to innovating new technologies for screening, diagnosis, and treatment, humans have advanced immensely in the field of health and well-being. Unfortunately, we have also created our own disease - war. When nations engage in armed conflict, it results in mass destruction in all aspects of life. Lives are lost, resources are sparse and infrastructure is destroyed - all leading to catastrophic effects. One effect is the emergence of diseases and illnesses caused by continuous fighting conditions. Mental illness is a serious issue that profoundly affects individuals in conflict zones. This article will outline investigations on the prevalence of PTSD in populations that have been victims to intense fighting over the years.
Post traumatic stress disorder (PTSD) is categorized as a psychiatric disorder that is triggered by traumatic stimuli of events that individuals have either witnessed or experienced (Mayo Clinic, 2018). As outlined by the American Psychiatric Association, traumatic events can include a natural disaster, a serious accident, a terrorist act, war/combat, rape, sexual violence or serious injury (Torres, 2020). Although originally observed in veterans returning from both World Wars, it must be clear that PTSD is not only prevalent in soldiers. It can affects any individual regardless of age, gender, ethnicity, culture, or religion. When individuals have PTSD, they may experience various symptoms including flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event (Mayo Clinic, 2018).This in turn further affects an individual's overall mental wellbeing and disrupts their ability to complete daily tasks. Over the years, numerous studies have been conducted to observe the prevalence of PTSD in individuals inhabiting intense conflict zones.
One of the longest raging conflicts in history, lasting almost 2 decades, occurred in Afghanistan, tearing the country apart and costing the lives of thousands. Individuals of all ages have suffered unimaginable conditions and the country is still struggling to recover. The continuous fighting has displaced millions of individuals and has left irreversible physical and psychological impacts on many. As seen in one study that surveyed 799 adult household members aged 15 years and above, “62% of respondents experienced at least four trauma events during the previous ten years” (Murthy & Lakshminarayana, 2006). Similarly, when researchers collected data on symptoms of mental illnesses, they found that 67.7% respondents had symptoms for depression, 72.2% for anxiety, and 42% had symptoms of PTSD (Murthy & Lakshminarayana, 2006). It was also found that women and disabled individuals had a lower mental health status, further demonstrating the detrimental effects of violence on the population's mental health.
The country of Iraq is another region with a history of continuous conflicts beginning in the 1960’s to 2003. From battling several coups, the Iran-Iraq war, an anti-Kurdish campaign, it was after the Gulf war when the UN imposed economic sanctions on the country, causing severe detrimental effects on the health and wellbeing of Iraq’s citizens (Murthy & Lakshminarayana, 2006). One study looked deeper into the mental health of individuals caught in the conflict regions. By collecting data from 45 Kurdish families in two camps, researchers found that 87% of the children had PTSD and 60% of their caregivers suffered from similar trauma (Murthy & Lakshminarayana, 2006). Another study found that due to lack of social support, the mental wellbeing of individuals exponentially decreased.
Palestine has been a victim of intense conflict leading to severe and irreversible effects on citizens mental health and wellbeing. Many children are born into fighting zones and are raised in such conditions. This causes young individuals to be exposed to traumatic events from birth and throughout their childhood further impacting their development. To further investigate the effects of growing up in conflict zones, researchers from the Gaza Community Mental Health Programme conducted a study on children aged 10-19 years. They found that of the participants studied, 32.7% suffered from PTSD symptoms requiring psychological intervention, 49.2% from moderate PTSD symptoms, 15.6% from mild PTSD symptoms, and only 2.5% had no symptoms (Murthy & Lakshminarayana, 2006). When separating participants according to biological gender, it was revealed that boys had higher rates of PTSD at 58% while girls had slightly lower at 42% (Murthy & Lakshminarayana, 2006). Profound differences were also found between PTSD symptoms and living conditions as children in camps showed a significantly higher proportion of PTSD (84.1%) compared to children living in towns (15.8%) (Murthy & Lakshminarayana, 2006).
Post traumatic stress disorder can have profound effects on daily life and can interfere with everyday living. One study investigated the perception of living conditions of Palestinians during the Second Intifada, a period of intense fighting. It was found that 46% of parents report observing aggressive behavior in their children (Murthy & Lakshminarayana, 2006). Along with impacts on behavior, social aspects were also shown to be impacted by conflict-driven stimuli, as 38% of participants noted inferior school results while 27% reported bed wetting behavior, and nightmares were common in 39% of children studied (Murthy & Lakshminarayana, 2006). Data sourced from many studies in the past 10 years by the Gaza Community Mental Health Center found that the majority of the trauma faced by children was due to events caused by the rippling effects of war. Of the children studied, 95% had trauma due to witnessing funerals, 83% due to witnessing shooting, 67% seeing injured or dead strangers, and 62% due to having family members injured or killed. It was also found that children living in bombardment areas had severe levels of PTSD (54%) while 33.5% suffered from moderate levels and 11% from mild or doubtful levels (Murthy & Lakshminarayana, 2006).
Sri Lanka is another country that has been facing mass internal conflict for decades between two groups, Sinhala and Tamil. To study the effects of constant fighting on the psychological well-being of civilians, researchers conducted an epidemiological survey. From the study, it was found that only 6% of the population had not experienced any war-related stress. 94% of the population was suffering from war-issued stress (Murthy & Lakshminarayana, 2006). When further digging into proportions of individuals facing various mental health issues, it was found that 27% of individuals suffered from PTSD, 26% from anxiety disorder, 25% major depression, and 15% from alcohol and drug misuse (Murthy & Lakshminarayana, 2006). With the constant fighting, many women were forced to fill the role of both breadwinner and caregiver, adding extra responsibilities on themselves and further leading to additional stress. This, in turn, also had effects on higher mental health issues in children and adolescents (Murthy & Lakshminarayana, 2006).
In a world where individuals across different fields of study are working together to create solutions and treatments for some of the deadliest ailments, it is quite unfortunate that we have created and continue to fuel one of the most dangerous diseases to exist. War not only impacts the individuals fighting, but the innocent civilians caught in crossfire and the overall global community who watch in horror from the safety of their homes. In this article, the prevalence of PTSD due to conflicts was reviewed and clearly demonstrates that constant fighting and violence has a profound effect on individuals' mental wellbeing. It is now the year 2022, and one would think that the world has learned its lesson by realizing the pain and suffering war causes. Unfortunately, the current global situation appears to show no reflection upon the past and current suffering that millions of individuals are facing in regions all across the globe. The effects of war are harsh, often irreversible, and unnecessary altogether. Time will tell whether the world can clean up its act and cure this deadly disease or permit this suffering to continue, allowing history to repeat itself once more.
Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD). Mayo Clinic. Retrieved February 26, 2022, from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
Murthy, R. S., & Lakshminarayana, R. (2006, February). Mental health consequences of war: A brief review of research findings. World psychiatry : official journal of the World Psychiatric Association (WPA). Retrieved February 26, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472271/#:~:text=War%20has%20a%20catastrophic%20effect,and%20economic%20fabric%20of%20nations.
Torres, F. (2020, August). What is posttraumatic stress disorder? What Is PTSD? Retrieved February 26, 2022, from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd#:~:text=Posttraumatic%20stress%20disorder%20(PTSD)%20is,sexual%20violence%20or%20serious%20injury.