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War and its effect on Mental Health in Afghanistan


Afghanistan may have been in mainstream news a few weeks back, with people liking and sharing videos, images, messages etc. about their people and the experience they’re going through. There was much to say about what the Taliban did when they were last in power, who were able to escape this fate, the role of the countries around the world in facilitating the war, the economic implications, and much more. But what we often forget is that the war hasn’t ended. What’s more, is that the impact it has will leave generations of people affected by it. 

Models of trauma have been developed since World War II when it began to be studied in greater detail. Historical trauma theory is a relatively new concept based on the premise that populations that have been historically subjected to long-term, mass trauma such as colonialism, slavery, war, genocide, etc exhibit a higher prevalence of disease even several generations after the original trauma occurred. 

Understanding the role of historical trauma might influence the current health status of racial or ethnic populations, providing new directions and insights for eliminating health disparities. So when we think of the atrocities against all the individuals who have been subject to genocide, countries that have been under colonial oppression and are still facing the brunt of it, and those who are still targeted and subject to prejudice and discrimination, we need to take into account that they bring with them the trauma of their ancestors with them. 

Collective trauma refers to a cataclysmic event shattering the basic fabric of society. Putting aside the horrific loss of life that occurs in such situations, collective trauma is also a crisis of meaning. The process of a group’s making meaning from trauma starts with a collective trauma, which transforms into collective memory, and then culminates in a system of meaning that allows groups to redefine their identity and future direction. When it comes to victims, the memory of the trauma that they experience can be adaptive for group survival, but also elevates existential threats, prompting the search for meaning, and the construction of a trans-generational collective self. In the case of the perpetrators, the memory of trauma poses a threat to collective identity that might be addressed through denying history, minimizing culpability for wrongdoing, transforming the memory of the event, closing the door on history itself, or by accepting responsibility. The acknowledgment of responsibility from the perpetrators often comes with disidentification from the group. The perpetrators face dissonance that occurs between historical crimes and the need to uphold a positive image of the group which may be resolved, but it can also prompt the creation of a new group narrative acknowledging the crime and using it as a backdrop to accentuate current positive actions of the group. It must be remembered that for both victims and perpetrators, deriving meaning from trauma is an ongoing process, continuously negotiated within and between groups. This process is responsible for debates over memory, but also holds the promise of providing a basis for intergroup understanding.

War has an adverse impact on combatants and non-combatants, both physically and emotionally. The most threatening physical consequences of war are death, injury, sexual violence, malnutrition, illness, and disability. Post-traumatic stress disorder (PTSD), depression, and anxiety are some of the commonly seen psychological effects. War spreads terror and horror disrupting lives and severing relationships and families, leaving individuals and communities extremely distressed. Distress can occur in terms of feelings of anxiety and sadness, hopelessness, difficulty sleeping, fatigue, irritability or anger and/or aches and pains. This experience of distress is normal and tends to improve for most people over time. 

We have seen and learned that most people affected by emergencies such as war experience psychological distress, which for most people improves over time. According to the World Health Organisation (WHO), the odds are that among people who have experienced war or other conflicts in the previous 10 years, 1 in 11 of these persons will have a moderate or severe mental health disorder. 1 in five individuals who live in areas affected by conflict is estimated to experience depression, anxiety, post-traumatic stress disorder, bipolar disorder, or schizophrenia. As with the general population, depression tends to be more common among women than men, with depression and anxiety becoming more common as people get older. 

However, it has been seen that the prevalence of common mental health disorders such as depression and anxiety can more than double during a humanitarian crisis. Persons with severe mental health conditions become highly vulnerable in such situations as they are in dire need of access to mental health care and other basic needs. Such issues are worse when the individuals come from rural areas, or areas that are harder to access. 

Interestingly enough, despite the tragic nature of these events and their adverse effects on mental health, emergencies have shown to be opportunities to build sustainable mental health systems for individuals in need. History has shown us that war trauma leads to a wide range of psychological consequences and disorders which can be quite disabling to individuals and their families. During a war, an individual’s existing resources become strained to cope with all demands of the trauma they suffer. This makes the survivors’ role of managing their own mental conditions highly important and relevant as a way of reducing the resulting suffering. Sadly, the role of the individual themselves is often ignored or trivialized by other concerned individuals. The self-efficacy and resilience people have are important factors that are not to be underestimated and should be built upon. Reaching solutions are generally more satisfying and long-lasting when the affected individual has taken a positive active part in finding them. Encouraging one’s use of one’s own resources and experiences and using one’s own problem-solving skills can be extremely beneficial and sufficient for survivors to feel enabled. Engaging survivors and focusing on promoting their recovery and social inclusion along with self-help skills that make them feel more positive about their own conditions is also an important aspect in facilitating mental well-being. Even taking small steps can help reduce the development of learned helplessness and reduce the risk of psychiatric morbidities.

We need to understand that mental health disorders aren’t something that can be overcome with a few medications. They cause a marked change in how a person perceives themselves, their environment, and their way of living. They influence the way people understand the world around them. It takes having access to required resources such as medications, therapy, and a stable environment to cope with the distress that characterizes a mental illness. 

International guidelines generally recommend services from basic services to clinical care, and it has been stated that mental health care needs to be made available immediately for mental health problems as part of creating a holistic health response. How situations of war are dealt with, determines how we handle crises and is an important concern for us to work on.

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2 Responses

  1. I must thank you for the efforts youve put in penning this site. I am hoping to check out the same high-grade blog posts by you in the future as well. In fact, your creative writing abilities has motivated me to get my very own blog now 😉

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