Coping with Conflict: Managing the Psychological Impact of War

 “Wars are not paid for in wartime, the bill comes later.” – Benjamin Franklin

The scars of war aren’t always visible. Armed conflicts entail a wide series of compelling issues and consequences on mental health, extending far beyond the destruction of infrastructure, injuries and loss of life, and can persist long after the violence ends. Addressing these acute and long-term effects necessitates a nuanced understanding of the psychological challenges faced by affected populations, along with strategies to mitigate trauma during conflict.

This article examines common mental health conditions associated with war, vulnerable populations, and techniques to manage acute psychological crises.

Recognizing the Psychological Disorders

The psychological disorders most frequently encountered in war-torn populations include PTSD, depression, anxiety disorders, substance use disorders, and suicidal ideation.

Post-Traumatic Stress Disorder (PTSD) often arises after individuals experience or witness traumatic events such as bombings, shootings, or the loss of loved ones. Symptoms include flashbacks, nightmares, avoidance of triggers, and hyperarousal. The intense psychological distress caused by these symptoms can severely impair daily functioning.

Anxiety disorders also increase in conflict zones, where individuals live under constant threat of violence, displacement, or abduction. Chronic hypervigilance, panic attacks, and feelings of dread are common manifestations of anxiety in such environments.

Depression is another prevalent issue, developing as individuals cope with loss, displacement, and the destruction of their homes and communities. Feelings of hopelessness, deep sadness, and emotional numbness are common. When left untreated, depression can lead to long-term impairment and increase the risk of suicidal ideation, as individuals may struggle to see a way out of their distress.

Substance use disorders frequently arise as individuals use drugs or alcohol to cope with trauma. War often destroys social structures and healthcare systems, leaving those affected with limited options for addressing their distress. This can lead to a dangerous cycle of addiction, compounding mental health issues and further deteriorating well-being.

Suicide is an often-overlooked consequence of war, but prolonged exposure to violence, trauma, and loss significantly increases suicidal thoughts and behaviors. The overwhelming feelings of hopelessness, aggravated by untreated PTSD or depression, make individuals more vulnerable to suicidal ideation, especially in the absence of mental health support. It may also be used as a form of protesting to officials and expressing despair over the ongoing unbearable living conditions.

 Vulnerable Populations

Certain populations are disproportionately affected by the psychological toll of war.

Children are particularly vulnerable to trauma, with war disrupting their sense of safety, emotional development, and access to education. Exposure to violence, the loss of caregivers, and prolonged displacement result in high levels of emotional and behavioral problems. Children may develop PTSD, depression, and attachment disorders, which, if left untreated, can persist into adulthood and affect their overall development.

Women are often exposed to both the general trauma of war and gender-specific violence, such as sexual violence and exploitation. They are at heightened risk for PTSD, depression, and complex trauma and require targeted support.  

The elderly face significant challenges during war, particularly when it comes to mobility limitations that often prevent them from fleeing conflict zones. Many face social isolation as communities break down, which makes them especially prone to depression and anxiety.

Techniques for Managing Acute Mental Health Crises During War

Several techniques can help individuals cope with immediate mental health crises, stabilizing their emotional state of fear, panic, and distress until more comprehensive support can be provided.

Psychological First Aid (PFA) is an immediate intervention designed to support individuals during and shortly after traumatic events.  It is an evidence-informed approach that is built on the concept of human resilience. PFA focuses on ensuring safety, providing emotional support, offering practical assistance, and connecting individuals with social support systems. By addressing the immediate needs of trauma survivors, PFA can help reduce the risk of developing chronic mental health conditions.

Biofeedback technique is another effective tool which involves using electronic monitoring to help individuals gain control over physiological functions, such as heart rate, breathing, and muscle tension. By learning to regulate these responses, individuals can calm their bodies and reduce symptoms of anxiety and panic. This technique is particularly useful in high-stress environments like war zones, where immediate relaxation can prevent escalation into more severe psychological distress.

Breathing exercises are another accessible and effective technique to manage acute stress. Deep, controlled breathing activates the parasympathetic nervous system, which counteracts the fight-or-flight response triggered by danger or fear. Encouraging individuals to focus on their breath can help reduce anxiety and panic in the moment, stabilizing their emotional state.

Grounding techniques are also crucial for managing dissociation and overwhelming emotions during war. These involve focusing on physical sensations, such as touching an object or feeling one’s feet on the ground, to help individuals remain present and prevent flashbacks or intrusive thoughts from dominating their consciousness.

In extreme situations, distraction methods such as repetitive tasks or focusing on small, manageable activities can help reduce overwhelming emotions. Although this is a short-term solution, it provides immediate relief from intense psychological distress and allows individuals to regain a sense of control over their environment.

War’s Aftermath on Mental Health

The long-term psychological effects of war are profound and far-reaching, leading to chronic conditions such as PTSD, depression, and anxiety. In addition to the personal burden, it can have societal consequences. Without appropriate intervention, war survivors often struggle with unresolved trauma, which impacts their relationships, employment, and overall quality of life. High levels of psychological distress can undermine efforts to rebuild communities, hinder social cohesion, and contribute to cycles of violence as those affected with it tend to engage in aggressive behaviors.

Suicidal ideation and suicide risk remain elevated long after conflicts end, especially among individuals who feel unable to escape their psychological suffering. War-torn societies with insufficient mental health resources face the challenge of addressing these complex and persistent issues, which require both immediate and long-term care.

Current Strategies for War-Related Mental Health

Efforts to address mental health in war-affected populations often begin with immediate interventions like Psychological First Aid and biofeedback. However, long-term interventions are also necessary to address chronic mental health conditions that arise post-conflict.

Trauma-focused cognitive-behavioral therapy (CBT) is one of the most effective long-term treatments for PTSD, depression, and anxiety. CBT helps individuals process traumatic memories, challenge negative thought patterns, and develop healthy coping mechanisms.

Community-based mental health programs are essential in conflict zones where access to formal mental health care is limited. These programs train local healthcare providers and community members to offer basic psychological support and identify those in need of further care. By integrating mental health services into broader healthcare systems, these programs provide sustainable solutions for addressing mental health challenges in war-affected regions.

Public health campaigns aimed at reducing stigma around mental health are also crucial. In many cultures, mental illness is associated with shame, preventing individuals from seeking the help they need. Campaigns that promote mental health awareness can encourage people to access care, which is vital for long-term recovery and societal healing.

Final thoughts

As the American psychotherapist Peter A. Levine once said, “Trauma is a fact of life. It does not, however, need to be a life sentence.” War indeed leaves deep emotional wounds that can linger long after the last shot is fired. It is therefore crucial to address mental health in conflict zones and prioritize both immediate emotional support and sustainable long-term care.