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INTERVIEW

Israeli strikes on Lebanon: How to cope with the psychological impact

Incessant Israeli strikes are causing stress and panic among the population in Lebanon, psychiatrist Dr. Georges Karam tells L’Orient Today. As the conflict is likely to expand in length and intensity, here is some advice on how to cope.  

Israeli strikes on Lebanon: How to cope with the psychological impact

Smoke rises from the site of an Israeli airstrike that targeted a neighborhood in Beirut’s southern suburbs late on Oct. 6, 2024. (Credit: Fabio Bucciarelli/AFP)

Since Sept 23., when Israel escalated its military campaign in Lebanon in the south and east of the country, as well as Beirut's southern suburbs, the sounds of heavy Israeli bombings have filled people’s days and nights across Lebanon with panic and stress. The sounds of these explosions torpedo through cities and villages, rattling windows and shaking buildings — inciting fear and terror among hundreds of thousands of civilians. These strikes, often on residential areas that the Israeli army claims are Hezbollah military targets, show no signs of stopping.

Mental health specialists have already raised grave concerns that people in Lebanon are experiencing an “ongoing traumatic stress disorder” after living through the last year of war between Hezbollah and Israel, which began on Oct. 8, 2023, before this dramatic escalation.

Dr. Georges Karam, a geriatric psychiatrist and executive director at Beirut-based mental health charity Institute for Development, Research, Advocacy and Applied Care (IDRAAC) highlights that loud airstrikes are the top complaint among his patients, causing stress and sleep disruption. While only an end to the strikes can stop the terror, he offers advice on managing mental health during these difficult times.

OT: What impact does living through continuous air strikes and the incessant sound of drones have on people’s mental health?

Karam: The constant sounds of strikes are affecting us big time because whenever you hear the bombing, you know there is a risk to your safety. That puts us in a constant state of alertness — where we either have to fight, flight or freeze through the situation.

Even as I am speaking to you now on Monday Oct. 7, I can see the fumes coming from a strike on Dahiyeh [the southern suburbs of Beirut]. Also, continuously hearing that buzzing sound of the drone above means you are constantly on edge. You don't know if that drone is just surveying or if they might decide to hit you.

Read also:

Lebanon war: 'We are in an ongoing traumatic stress disorder'

When your body is in these kinds of stressful situations, it releases stress hormones called cortisol, which help you “fight or flight” to save yourself. The problem is that this is supposed to be secreted only once — when there is a real threat — which should happen once a month or once a week, maximum. But when you experience the constant bombardment you’re having this cortisol secretion every five minutes, and your coritsol level keeps going up, damaging your physical and mental health.

You become stuck in a constant fight or flight response, which is what we call “chronic stress.” This can make you more prone to getting infections, aches and pains in your body. For example, you can experience shortness of breath, heartburn, indigestion, back pain and shoulder pain as the big muscles in your neck and shoulders tighten up. It can also cause headaches, vertigo and sweating. And if you have pre-existing physical, medical or mental health conditions, those will get worse.

OT: Some people say they are hearing phantom bombardments, or are very sensitive to noise. Why is that?

Karam: It is a psychological thing that can happen because you are constantly on alert. You are constantly trying to differentiate between what is dangerous and what is not. So even if you hear a door closing or a car starting, you are still hyper-sensitive and you cannot relax. This adds to the exhaustion because your brain cannot switch off. You are constantly “on.”

OT: What should people do when they hear the strikes and are in an area that is far enough away to be safe?

Karam: The fastest thing that you can do to calm down is a deep breathing exercise. You can do it wherever you are when you hear the explosion — be it working, driving, or in bed.

I do this exercise myself. I take a deep breath from my mouth for four seconds. I hold my breath for four seconds, and I breathe out for four seconds. By doing that five times repeatedly your body will calm down automatically.

Alternatively, lie on your bed. Say to yourself “I am going to relax my shoulders.” Focus on the sensation, and then work through your body. You can relax your muscles just by thinking about it.

Have something minty, like tea or mint candy. Mint has a cooling effect.

OT: Many of us cannot sleep because of the bombardments. How can we cope with it?

Karam: Sleep deprivation can be used as a form of torture. We all need eight hours of sleep to function. It has an impact on your concentration, energy and motivation at work. Plus, you will become much more irritable.

It is very important to keep your routine and exercise as it will give a signal to your brain that things are normal — which will automatically make you more relaxed. Exercise is the best reliever, like yoga or going to the gym. The more relaxed you are, the better you will sleep.

There are a few steps to follow before you go to bed. First, identify a safe place at home to sleep. If not, the whole time your brain will be on alert. If you sleep in a bed near big windows and you are worried they will break, change the location of your bed, or even your bedroom.

Try meditating to cool your brain down. Focus on the present moment and block everything else out. Find something positive to think about, even in this difficult situation. For example, if you are in good health, if you still have an income, if you still have a roof over your head — that is something positive and something to be grateful for.

Do not read the news before you sleep. Don’t look at screens one hour before bed. Do not use alcohol to get to sleep, and don’t take sleeping medication without a doctor’s prescription.

If you have been affected by this article or are struggling with your mental health,  free help is available. The Lifeline 1564 is the National Emotional Support and Suicide Prevention Hotline run by Embrace in collaboration with the National Mental Health Program. Calls are anonymous. If you are going through emotional distress, or want to be referred to mental health services, you can call the lifeline.

Since Sept 23., when Israel escalated its military campaign in Lebanon in the south and east of the country, as well as Beirut's southern suburbs, the sounds of heavy Israeli bombings have filled people’s days and nights across Lebanon with panic and stress. The sounds of these explosions torpedo through cities and villages, rattling windows and shaking buildings — inciting fear and terror...