What happens when most of a society has PTSD?

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Writing for the Dart Center for Journalism and Trauma, Judith Matloff and Robert Nickelsberg look at the effects of decades of strife upon the disputed South Asian province of Kashmir. A third of Kashmir’s residents suffer from psychological distress (in the United States, that number is around 6 percent to 8 percent) and the region’s few psychiatrists are so overwhelmed – one small clinic saw over 100,000 visitors last year – that they can do little more than rush through minutes-long consultations and hand out prescription medication as if it were “Tootsie Rolls at Halloween.”

kashmir

Clouds gather over Kashmiri peaks, photo by Brian Guest via Flickr

Practically everything that can cause PTSD has coalesced in Kashmir — loss, fear, distrust, random violence, a sense of powerlessness. The unrelenting Indian occupation fuels despair. Stress affects nearly everyone: the men routinely frisked on the street, the women forced to beg when their husbands vanish and the children given up to orphanages. Kashmir illustrates what researchers have long suspected: that prolonged exposure to direct confrontation results in still greater anguish. People don’t get used to violence; they grow more vulnerable.

Suicides are up in the region – despite strong taboos among the Muslim populace – and the community’s psychological state deteriorates further with every passing year. “‘The accumulation of events results in higher levels of distress,’ (Kaz de Jong, a mental health advisor with MSF-Amsterdam) explains. ‘What you see in chronic conflict is that self-support mechanisms and resilience go down.’ Instead of getting stronger, the afflicted just get more desperate.”