The psychological impact of war is a profound and far-reaching phenomenon, influencing not only those directly involved in the combat but also the broader population, including civilians, families, and communities. The emotional and mental toll of war continues to be a pressing issue across the globe, with consequences that often persist long after the cessation of hostilities. Prolonged conflict, violence, and displacement leave lasting scars on the psychological well-being of individuals, resulting in a significant burden on both the affected populations and the global mental health system. 

The Emotional Toll on Soldiers and Fighters

Combatants in war zones face direct exposure to violence, death, and trauma, which can lead to several psychological problems, most notably post-traumatic stress disorder (PTSD), depression, and anxiety. According to the American Psychiatric Association, PTSD is a severe mental health condition that can develop after an individual has been exposed to life-threatening events or witnessed traumatic occurrences. Soldiers and combatants are at a heightened risk of developing PTSD due to their direct involvement in conflict.

A 2015 study published in The Lancet Psychiatry found that the prevalence of PTSD among soldiers deployed in Iraq and Afghanistan ranged from 13% to 17%. This figure is considerably higher than the general population, with veterans from these conflicts reporting more severe symptoms of PTSD. These symptoms can include flashbacks, hypervigilance, nightmares, and emotional numbness. In addition to PTSD, combatants are also more susceptible to depression and anxiety disorders, with many struggling to reintegrate into civilian life after returning from deployment. 

The Invisible Casualties of War

Civilian populations in conflict zones endure the loss of loved ones, displacement, loss of livelihood, and constant fear, all of which contribute to the development of severe mental health issues. According to the United Nations High Commissioner for Refugees (UNHCR), over 100 million people are displaced globally, with many of them living in war-torn countries. The displacement caused by war exposes individuals to additional stressors, including loss of home, community, and support systems. These experiences significantly increase the likelihood of developing anxiety, depression, and PTSD. 

The ongoing conflict between Russia and Ukraine, which escalated in 2014 and intensified in 2022, has had a severe psychological impact on the Ukrainian population. Millions of civilians have been forced to flee their homes, and the violence has caused widespread trauma.  The psychological effects of Russia's involvement in the war in Ukraine are not only felt in Ukraine but also within Russia itself. Russian soldiers returning from the frontlines of the conflict face significant mental health challenges. The civilian population in Russia also faces psychological distress, largely due to the uncertainty of the conflict and its impact on daily life

The Gaza Strip, a region caught in the Israeli-Palestinian conflict for decades, has seen profound psychological effects due to the constant violence, displacement, and blockade. The mental health of civilians in Gaza is exacerbated by the repeated cycles of conflict, airstrikes, and limited access to healthcare. In Israel, the ongoing conflict with Palestinians, including the frequent violence and terrorist attacks, has taken a significant toll on the mental health of both civilians and soldiers. A 2018 study published in The Journal of Traumatic Stress found that approximately 20% of Israeli civilians report experiencing PTSD symptoms, particularly those living in areas most affected by rocket fire from Gaza. 

The emotional toll of war on non-combatants also includes the breakdown of social cohesion. Communities torn apart by violence and displacement struggle to rebuild trust, leading to long-term consequences for the collective mental health of affected populations. Family separation, loss of cultural identity, and the inability to return to one's homeland often result in feelings of hopelessness and helplessness.

Risk Populations and Broad Risk Factors

Certain populations are at a higher risk of developing mental health issues due to their exposure to conflict. Vulnerable groups, such as women, children, the elderly, and people with pre-existing mental health conditions, are particularly susceptible to the psychological effects of war. Women and girls, for instance, often experience gender-based violence, including sexual assault and exploitation, during times of war, which can lead to long-term psychological trauma. A report by the International Committee of the Red Cross (ICRC) in 2018 found that women in conflict zones were more likely to experience depression and anxiety due to their increased vulnerability to violence.

Children, on the other hand, are especially affected by war, both through direct exposure to violence and the indirect effects of witnessing the suffering of family members and friends. The UN estimates that 250 million children are currently living in conflict zones, with many of them facing extreme psychological distress. Exposure to armed conflict during childhood has been shown to increase the risk of developing PTSD, depression, and anxiety later in life. In addition to the immediate trauma, the disruption of education and loss of stable caregivers can have long-lasting effects on children’s emotional development.

The elderly population is also vulnerable to the psychological impact of war, particularly when they face displacement and separation from family members. The stress of losing their homes and communities can lead to depression and cognitive decline. Additionally, individuals with pre-existing mental health conditions, such as anxiety or depression, are at a higher risk of experiencing exacerbations of these conditions during times of war. Factors such as anger, social isolation, and loneliness can also compound the mental health struggles faced by this demographic.

Several broad risk factors contribute to the psychological consequences of war. These include prolonged exposure to violence, loss of loved ones, the destruction of homes and infrastructure, displacement, and a lack of access to basic needs such as food, shelter, and healthcare. The absence of social support systems, coupled with the breakdown of community structures, significantly increases the risk of developing mental health disorders. The toll on mental health can also lead to chronic pain—both physical and emotional—as individuals grapple with long-term trauma.

Psychological First Aid: A Key Intervention

Psychological First Aid (PFA) is an approach designed to provide immediate support to individuals affected by trauma. Unlike traditional mental health interventions, which may require specialised training, PFA can be delivered by anyone with basic training in listening and comforting those in distress. It is designed to reduce initial distress, help individuals feel safe, and guide them toward further mental health support if needed.

Research has shown that PFA can be an effective intervention in the immediate aftermath of traumatic events. A 2013 study published in The Lancet found that PFA was associated with reduced symptoms of PTSD and depression in survivors of natural disasters and armed conflict. The key components of PFA include offering practical assistance, fostering a sense of safety and security, providing emotional support, and connecting individuals to local resources.

In war-torn regions, PFA can be particularly useful in helping survivors manage immediate emotional distress and begin the process of healing. For example, during the aftermath of the 2004 Indian Ocean tsunami, PFA was implemented in several affected countries, including Sri Lanka and Indonesia. The approach helped provide critical emotional support to survivors and played a key role in the early stages of recovery.

In regions where resources are scarce, platforms such as TalktoAngel can serve as valuable tools in offering online counselling services, making mental health care more accessible to those in need. Seeking out professional help, such as consulting the best psychologist in India, can be an important step for individuals experiencing anger, social isolation, chronic pain, and loneliness, especially in the aftermath of trauma.

Furthermore, integrating practices like mindfulness into trauma recovery can help individuals regain emotional regulation, reduce stress, and improve overall mental well-being. In war-affected populations, such mindfulness-based interventions may provide a pathway to resilience and emotional healing amidst chaos.

Counselling and Therapy: Long-Term Support for Mental Health

While PFA is an important initial response, long-term psychological support, such as counselling and therapy, is essential for individuals experiencing ongoing mental health issues due to war. Online Counselling provides individuals with a safe space to express their feelings, process their trauma, and develop coping strategies for dealing with the aftermath of war. Therapy, including cognitive-behavioural therapy (CBT) and trauma-focused therapy, is effective in treating PTSD, depression, and anxiety.

Contribution: Dr (Prof) R K Suri, Clinical Psychologist, life coach & mentor TalktoAngel & Mr. Utkarsh Yadav, Counselling Psychologist.

References:

• Hoge, C. W., et al. (2004). "Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care." New England Journal of Medicine, 351(1), 13-22.
• United Nations High Commissioner for Refugees (UNHCR) (2021). Global Trends: Forced Displacement in 2020.
• Zhou, Q., et al. (2018). "Psychological impact of war on civilians in conflict zones: A study on the Ukrainian population." European Journal of Psychotraumatology, 9(1), 14-23.
• Shehadeh, N. A. (2017). "The psychological consequences of conflict in the Gaza Strip: PTSD and the aftermath of the Israeli-Palestinian conflict." Traumatology, 23(2), 105-113.