Exhausted by four years of war and economic hardship, Syrians are suffering from an epidemic of mental illness, from suicidal adults to children plagued by recurring nightmares.
The number of Syrians with mental disorders has increased by a quarter since 2011, the health ministry said last month, revealing the extent of the damage for the first time.
Forty percent of Syrians are in need of psychosocial support and there has been a surge in suicide attempts.
In a clinic in the centre of Damascus, a 55-year-old woman complained of chest pain and heart palpitations, but her cardiologist insisted it was not heart disease.
She suddenly burst into tears, the doctor recounted.
“Two of my sons have died in the fighting. My third son is in prison and I haven’t heard anything from him,” she told him.
The doctor said four out of 10 patients who consult him — often displaced individuals whose quality of life has worsened dramatically — suffer from mental illness.
“They are depressed and anxious because of the conflict, and this sometimes translates into psychosomatic symptoms,” he told AFP, asking not to be named.
– Anxiety and nightmares –
Syria’s conflict has left more than 210,000 people dead and 11.4 million displaced since it broke out in March 2011 with anti-government protests that escalated into a full-blown civil war.
With the rise of the brutal Islamic State jihadist group, a solution to the crisis seems further away than ever.
“Cases of depression and of post-traumatic stress disorder — which lead to stress, anxiety, and nightmares — have increased by 30 percent,” said a psychiatrist who also requested anonymity.
In his tiny clinic in a commercial neighbourhood of Damascus, the psychiatrist said the emotional damage of war affects adults and children alike.
He said Syria’s population had been rendered psychologically and physically “fragile”.
“People are afraid of violence and they’re anxious about their future.”
A pharmacist in the neighbourhood of Qassaa, in central Damascus, said the effects had been alarming, with sales of sleeping pills and anxiety medication up 30 percent since 2011.
“Every day, more than 20 customers come in asking for these medications, but I only sell to the four or five that have a prescription,” he said.
– Entire generation devastated –
The conflict has set the Syrian economy back decades with infrastructure destroyed, the currency plunging 80 percent in value and half the population unemployed.
“We are desperate. The killings continue. There is no diesel for heating, no electricity. Syria’s gas is expensive. I don’t know what to do with my future,” said Abu Samer, owner of a large furniture store devoid of customers.
The psychiatrist warned against the long-term effects of the war.
“An entire generation is devastated. We will see even more physical and mental disabilities at the end of the war, because for now, people are preoccupied with their basic needs, like heating and food,” he said.
Sabah, a 40-year-old woman, said her two-year-old daughter suffered from the compulsive disorder trichotillomania — a compulsive urge to pull out one’s own hair.
“We used to live north of Damascus. The gunfire was intense and there were a lot of raids. The trouble disappeared when we changed neighbourhoods,” she said, adding that she takes painkillers herself.
The Sisters of Charity of the Good Shepherd, a Catholic support centre in the capital, was dedicated to victims of domestic violence before the war.
Now it provides psychological support to displaced Syrians.
Racha Taireh, a psychologist working at the centre, said calls for help from distressed individuals had more than doubled since 2011, and totalled 7,885 between 2011 and the end of 2014.
Children are often the first psychological victims of war and may suffer persistent symptoms, doctors say.
Ali, five, and Kawa, seven, have regular nightmares.
It is no wonder — the family lives in Jaramana, a Druze-Christian suburb southeast of Damascus which has suffered heavy bombing.
“At night, they wake up terrified. The little one wets his bed, and he never wants to be alone,” their father Mohammad said.