Unseen Scars
Understanding the Long-Term Mental Health Impact of the Beirut Blast and Similar Traumatic Events
by Lana Kamareddine and Lea Bdeir
Why should we study the effect of exposure to a blast on mental health? It happened years ago and didn’t affect us that severely. Right?
Well, no. Not only is mental health a personal issue, but it is also an essential part of public health. It affects people profoundly on an individual, community, and societal level. The impact of the Beirut blast and other ongoing tragedies on mental health will be examined in this blog post, which serves as a reminder of the importance of mental health research for improving the lives of people as well as the larger community.
Beirut Blast: The Psychological Aftermath of Experiencing Traumatic Events
Trauma, in its various forms, can manifest as emotional, psychological, and even physical distress following exposure to traumatic events. Such distressing events include exposure to bombs, strikes, explosions, and war.
The explosion that occurred in Beirut in August 2020 had dire humanitarian implications, resulting in fatalities, injuries, and mass population relocation. The tragedy has had a significant negative influence on survivors’ mental health, leading to collective trauma, nightmares, despair, and anxiety (Rayes, 2021).
To better understand the effect of this exposure, we can make use of previous literature that can provide insight into what we have experienced in Lebanon. One study aimed to investigate the relationship between disasters and mental health. Although the social and economic costs of disasters are usually evaluated, the psychological toll that individuals suffer is immeasurable. First and foremost, it is important to stress that disasters are usually unanticipated occurrences that leave people surprised. At first, they can try to run away from the harsh reality and ignore their losses, which leaves them more open to stress and worry (Makwana, 2019). This feeling of lack of control and despair is a major trigger for developing depression and anxiety and could lead to detrimental effects on the collective mental health.
Al Hariri et al. (2022) conducted a study that aimed to evaluate the psychological disturbances of survivors of the explosion who sought care at the Emergency Department (ED) at the American University of Beirut Medical Center (AUBMC). The results showed that two-thirds of the survivors portrayed symptoms of PTSD and such symptoms were correlated with depression, symptoms of concussion, younger age, and the female gender.
Another study that shows the effect of exposure to blasts on mental health investigated traumatic brain injuries (TBI) resulting from blast exposure during wartime. The results found that anxiety and affective disorders, such as Post-Traumatic Stress Disorder (PTSD) and depression, frequently accompany blast injuries, and there exists a significant overlap in their diagnostic features (Rosenfeld & Ford, 2010).
This research highlights the profound and lasting impact that traumatic events, such as the Beirut blast, can have on the mental well-being of survivors.
Disasters Affecting Communities Around the World
The world as a whole is subjected to a disheartening reality in which political conflicts leave deep scars on the affected communities. Men, women, and children alike are exposed to a vicious cycle of gruesome war atrocities in Palestine. Particularly for children, who are a vulnerable population, the continuous exposure to violence caused by political turmoil and the ongoing war can have significant long-term consequences on their development. Previous research has portrayed that children can be directly affected by exposure to trauma and indirectly affected by adults’ reactions to traumatic events, which can be categorized as primary and secondary traumatization (Thabet, 2008).
Palestinian children and adolescents have sustained a great number of physical injuries due to the ongoing political violence in Palestine. A study conducted by Khamis (2008) aimed to examine the occurrence of PTSD and the co-occurrence of other psychiatric disorders, specifically anxiety, and depression, in children and adolescents who were physically injured and attained permanent disability during the Al-Aqsa intifada in Palestine. The study showed that 76.5% of the adolescents met the full criteria for PTSD diagnosis, and the individuals who presented PTSD symptoms were more likely to report higher levels of comorbidity with depression and anxiety. Fatalism, geographic location, and negative coping styles were significant predictors of the outcome variables.
Adversity knows no borders, leaving a lasting imprint on societies worldwide. One study explores the factors influencing the onset of PTSD symptoms in children and adolescents following the 2013 Boston Marathon terrorist attack. The results found that high levels of media exposure to traumatic events, such as terrorist attacks, are associated with greater onset of PTSD symptoms in children and adolescents, also leading to sleep problems and behavioral withdrawal (Busso et al., 2014; McDermott et al., 2013). This can be generalized to the events of the blast in Lebanon, and the current tragedies in Palestine as we continue to watch the events unfold on our devices. Intriguingly, anxiety was found to be a predictor with statistical significance for PTSD scores (McDermott et al., 2013). This can also explain the results of Busso et al. (2014), where PTSD symptoms overlap with anxiety leading to changes in sleep and behavior.
There have also been noted gender disparities in responses, with women more prone to display internalizing behaviors like sadness and withdrawal, and men more likely to act aggressively or display externalizing symptoms. Depression is more prevalent than one may think, with women twice as likely as men to have clinical depression. There is a statistically significant difference in the likelihood that females will report mental health issues during adolescence (Covey et al., 2017).
Unraveling the Neural Impact: PTSD and Abnormal Brain Activation
Furthermore, studies have found abnormal patterns of neural activation in people with PTSD, with functional neuroimaging revealing a disruption in the normal inhibition of the amygdala by the medial prefrontal cortex, both in basal and threat conditions. The affected brain areas, such as the basal frontal lobes and temporal poles, are associated with the regulation of emotions, judgment, and memory. This can sometimes mimic psychological illnesses or complicate their course (Rosenfeld & Ford, 2010).
Resilience in the Face of Adversity
While the effects of blasts on an individual’s cognition are profound, it is essential to recognize the incredible resilience that individuals and communities can demonstrate in the face of adversity. Access to appropriate mental health support, community resources, and social connections can play a valuable role in the recovery process. Quota et al. (2012) evaluated the impact of a psychosocial intervention using teaching recovery techniques on the mental health of children who were subjected to war in Gaza. Results showed that posttraumatic stress symptoms (PTSS) were significantly reduced. Therefore, school-based interventions could be implemented as a preventative method, where they could help promote positive coping skills such as social support.
Resilience is essential for fostering one’s mental, social, and physical health. It is strongly related to positive psychology and promotes bettering one’s quality of life and personal development. It is possible to address resilience from both a personal and a collective standpoint. Another protective element that affects a person’s quality of life following a disaster is coping mechanisms. Good coping strategies involve anticipating obstacles, accepting setbacks, and overcoming hardship in order to help people manage stressors more effectively (Makwana, 2019).
References
- Al Hariri, M., Zgheib, H., Abi Chebl, K., Azar, M., Hitti, E., Bizri, M., Rizk, J., Kobeissy, F., & Mufarrij, A. (2022). Assessing the psychological impact of Beirut Port blast: A cross-sectional study. Medicine, 101(41), e31117. https://doi.org/10.1097/MD.0000000000031117
- Busso, D. S., McLaughlin, K. A., & Sheridan, M. A. (2014). MEDIA EXPOSURE AND SYMPATHETIC NERVOUS SYSTEM REACTIVITY PREDICT PTSD SYMPTOMS AFTER THE BOSTON MARATHON BOMBINGS. Depression and Anxiety, 31(7), 551–558. https://doi.org/10.1002/da.22282
- Covey, H. C., Grubb, L. M., Franzese, R. J., & Menard, S. (2017). Adolescent Exposure to Violence and Adult Anxiety, Depression, and PTSD. Criminal Justice Review, 45(2), 073401681772129. https://doi.org/10.1177/0734016817721294
- Herringa R. J. (2017). Trauma, PTSD, and the Developing Brain. Current psychiatry reports, 19(10), 69. https://doi.org/10.1007/s11920-017-0825-3
- Khamis, V. (2008). Post-traumatic stress and psychiatric disorders in Palestinian adolescents following intifada-related injuries. Social Science &Amp; Medicine, 67(8), 1199–1207. https://doi.org/10.1016/j.socscimed.2008.06.013
- Makwana, N. (2019). Disaster and its impact on mental health: A narrative review. Journal of Family Medicine and Primary Care, 8(10), 3090–3095. https://doi.org/10.4103/jfmpc.jfmpc_893_19
- McDermott, M., Duffy, M., Percy, A., Fitzgerald, M., & Cole, C. (2013). A school based study of psychological disturbance in children following the Omagh bomb. Child and Adolescent Psychiatry and Mental Health, 7(1), 36. https://doi.org/10.1186/1753-2000-7-36
- Rayes, D. (2021). The Beirut Explosion’s Impact on Mental Health. THE TAHRIR INSTITUTE for MIDDLE EAST POLICY. https://timep.org/2021/02/11/the-beirut-explosions-impact-on-mental-health/
- Rosenfeld, J. V., & Ford, N. L. (2010). Bomb blast, mild traumatic brain injury and psychiatric morbidity: A review. Injury, 41(5), 437–443. https://doi.org/10.1016/j.injury.2009.11.018
- Thabet, A. A., Abu Tawahina, A., El Sarraj, E., & Vostanis, P. (2008). Exposure to war trauma and PTSD among parents and children in the Gaza strip. European child & adolescent psychiatry, 17(4), 191–199. https://doi.org/10.1007/s00787-007-0653-9
- Qouta, S. R., Palosaari, E., Diab, M., & Punamäki, R. L. (2012). Intervention effectiveness among war-affected children: a cluster randomized controlled trial on improving mental health. Journal of traumatic stress, 25(3), 288–298. https://doi.org/10.1002/jts.21707
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