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PSYCHOLOGICAL AND PHYSICAL HEALTH IN TIMES OF WAR
The Lasting Impact of War on Health
by Inna Petrovska
War leaves more than just physical destruction — it profoundly impacts the mental and physical health of those who live through it. Whether civilians or soldiers, the psychological toll of war crosses borders, leaving deep and lasting scars.
CommonPsychological Effects of War
When examining the psychological impact of war, it’s crucial to understand that trauma manifests in diverse ways, deeply influenced by an individual’s role and experiences during the conflict. Research shows that military veterans often face unique psychological challenges compared to civilians. However, trauma doesn’t discriminate—civilians can be profoundly affected too, with rates varying based on factors like proximity to conflict and personal experiences.
Despite varying exposure levels, there’s a common thread that binds all those affected by war: the fundamental human response to extreme stress and danger. Whether soldier or civilian, the brain’s response to trauma involves similar neurological pathways.
According to research by Dr. Steve Sugden, MD, at the Huntsman Mental Health Institute (HMHI), three primary populations are susceptible to war-related psychological trauma:
• Civilians residing in conflict-affected areas
• Military personnel engaged in combat on both sides
• Individuals exposed to war-related content through various media channels
These groups can develop similar trauma profiles, with prevalent symptoms including:
• Post-Traumatic Stress Disorder (PTSD)
• Clinical depression
• Chronic anxiety
• Hypervigilance
So, as we can see, the psychological impact of war is not always confined to those directly involved in the frontline, but can cross borders and affect individuals who may be far removed from the physical battleground.
The Global Psychological Impact of War
Today, violent conflicts are at their highest since World War II, affecting over 2 billion people globally. The mental health impact of these conflicts spreads like radiation, transcending borders. War-induced anxiety and uncertainty undermine global safety perceptions, demonstrating that mental health issues spread faster across borders than economic crises.
In Ukraine, where the full-scale Russian invasion enters its third year today, feelings of loss, uncertainty about tomorrow, and constant threat of death have become integral parts of many people’s lives. Numerous Ukrainians grapple with profound grief and depression, their emotional difficulties compounded by unresolved loss and the inability of many to return home. These psychological consequences of war create a heavy burden that war survivors carry for a lifetime.
The weight of this burden often manifests in severe psychological conditions. According to the World Health Organization (WHO), one in five people (22%) who have experienced war in the last decade will face mental health disorders such as depression, anxiety, post-traumatic stress disorder (PTSD), bipolar disorder, or schizophrenia.
How War Reshapes Health Statistics
According to a comprehensive meta-analysis, the prevalence of war-related mental health disorders is widespread and alarming. Studies show that 28.9% of individuals who have lived through war experience depression , with rates varying between 3.2% and 79.6%, depending on the conflict.
Civilians tend to suffer higher rates of depression compared to military personnel. Similarly, 30.7% of those exposed to war report symptoms of anxiety, with civilians displaying a significantly higher prevalence (38.6%) than military personnel (16.2%). This stark difference can be attributed to the fact that civilians often find themselves unprepared for the chaos and unpredictability of war, while soldiers are trained to cope with high-stress situations, which can mitigate certain anxiety-related responses. The sense of helplessness civilians experience, compounded by the destruction of their homes and threats to their families, fuels their anxiety.
However, it’s essential to recognize that military personnel endure their own set of psychological challenges, distinct from those civilians face. Soldiers may report lower levels of anxiety, but their mental health struggles are far from negligible. They are more likely to suffer from conditions such as moral injury and survivor’s guilt, which complicate their psychological recovery. These feelings often stem from the traumatic experiences of combat, the loss of comrades, and the ethical dilemmas encountered in war. While civilians and military personnel experience post-traumatic stress disorder (PTSD) at similar rates—25.7% and 21.3%, respectively—the emotional burdens for soldiers are shaped by their direct role in combat and the weight of responsibility, which can be just as debilitating, if not more so.
The psychological toll of war doesn’t just manifest in mental health issues—it also has profound effects on physical health.
Prolonged stress, particularly the type caused by war (distress) , alters our neurobiology and weakens the body’s ability to cope. This distress activates the amygdala, our brain’s “panic button,” making us hyper-reactive to fear and anxiety-inducing stimuli. Constantly being in a state of high alert exhausts the body, leading to the suppression of functions like libido and the immune system. Over time, the depletion of dopamine, a key “happiness hormone,” results in apathy, depression, and emotional fatigue. During war, the cerebral cortex, responsible for regulating behavior and empathy, also suffers, making individuals less tolerant, less able to manage emotions, and more prone to conflict.
The impact of this stress response extends to chronic physical conditions. The persistent release of cortisol and adrenaline contributes to insulin resistance, raising the risk of diabetes. Simultaneously, stress-induced inflammation can damage arteries, raising the chances of heart disease, heart attacks, and strokes. War trauma also accelerates blood clotting, further increasing the risk of cardiovascular events.
In the context of the ongoing Russian terror in Ukraine, these health consequences have become particularly severe. The number of patients there with diabetes has increased by more than 20%, heart attacks by over 16% and strokes by more than 10% . The stress and disruption caused by the war have also led to an anticipated surge in neglected cancer cases, as many are unable to access medical care due to displacement, occupation or psychological paralysis. The chronic nature of these conditions, intertwined with mental health issues, creates a vicious cycle, where physical health deteriorates further as mental health worsens, making recovery even more challenging.
To sum-up
There is a complex connection of mental and physical health that underscores the long term impact of war on both civilians and military personnel. While the statistics may show different mental health outcomes for these groups, the underlying trauma and distress are universal, deeply affecting all who are exposed to the horrors of wars.