Effects of War and Terrorism on Mental Health

Sk Zafar Ali

In Europe and the United States, psychiatric conditions like adjustment disorder, PTSD, depression, and panic disorders are often reported in high numbers among survivors of conflict situations like terrorist attacks. In this article, we’ll discuss them and also look at how conflict situations/zones are linked to similar conditions in India.

The 9/11 attacks on the twin towers is probably the most high profile terror strike in modern history. Over ten thousand people were present at the scene and thousands more were exposed through the media and/or stories of the survivors – and every single one of them was at risk to develop PTSD. Since 2001, several studies have looked at the prevalence rates of PTSD as a result of 9/11. A study conducted two months after the attacks reported that 11.2% of NYC residents had PTSD, and the number was 4% for the whole of United States. Unsurprisingly, people closer to the scene were at a significantly higher risk of developing PTSD. Another study that looked at PTSD rates among the 109 mental health professionals who provided relief after the attack reported that seven developed PTSD due to direct exposure to stressors at the scene. Five more developed PTSD from hearing first person accounts of the people who were at ground zero during the attacks.

Studies concerned with the long term effects of the attacks on mental health paint a more positive picture showing human resilience and strength. In spite of the high rates of PTSD following the attacks, most people have recovered completely over time, of which some recovered as soon as 6 months after the attacks.

In 2008, India was shaken by a terror attack on Mumbai - the attacks of 26/11 killed 166 people, injured many more, and permanently tainted India's diplomatic relations with Pakistan. While there have been no large scale studies to gauge the extent of the attacks' effects on the mental health of Mumbaikars, individual cases of PTSD continue to be reported till date. Among the worst affected were the police officers and the civillians at the scene, and although the police personnel were put on EDMR (Eye Movement Desensitisation and Reprocessing) trauma therapy, no such option was made available for the vast majority of the affected civillians. There have been multiple cases of Mumbaikars suffering from PTSD and not even knowing it; and in on such case, the PTSD had resulted in structural changes in the patient’s brain, affected his fear centre, and changed his response to sudden stimuli. With proper medication and counselling, he’s now on his way to leading a normal life.

While the number and intensity of terrorist attacks decreased around the developed world in 2017, India (along with some Middle Eastern countries; more on that later) continues to witness low-intensity conflicts in various parts of the country. These instances of violence were linked to various factors like terrorism, religious extremism, regionalism, and Naxalism. Such conflicts can affect the mental health of those affected in one of two ways – consequences as a result of direct exposure to violence, resulting in conditions like PTSD and panic disorders; and consequences as a result of living in stressful social and material conditions for a long time, resulting in unemployment, poverty, malnutrition etc. thus, leading to anxiety and depression. Kashmir is a good example – the low intensity conflict over there for decades has documented an increase in cases of depression among non-combatant civilians. Young men and women have been hit particularly hard – the constant fear of being caught up in the clash between militants and the army has to take a heavy toll on their mental health. Moreover, while the world moves on to a better standard of living with advancements in technology, the Kashmiri youth has to be prepared for newer forms of warfare like cyber-warfare and bio-terrorism.

Similar patterns have been observed in the Middle Eastern countries ravaged by war, particularly Syria, Yemen, and Palestine. The human rights violations are just the tip of the iceberg – people’s seemingly normal lives were uprooted overnight and now they’re living in the constant fear of being killed. Very few countries are willing to take in refugees and the whole fiasco is now effectively a humanitarian crisis, which will result in the death of millions of innocents, if not addressed soon.