The battle beneath the skin: Gaza's mental health patients continue to suffer

Even prior to the most recent Israeli assault on the besieged Gaza Strip, 27-year-old Mohammed had been suffering from obsessive-compulsive disorder (OCD) and anxiety, conditions he had been diagnosed with in 2018.

"The war was indescribable. At night, the Israeli army used a new strategy, launching 40-50 rockets at a rate of every two to three minutes," he told The New Arab.

Over the last three years, Mohammed – who works at a local mini market – had been suffering from OCD irrationally, overthinking thoughts of his mother dying right in front of his eyes, that he would be homeless, that someone would hack his mobile while he was showering and post his nude pictures on the internet, aor that he would shortly be diagnosed with cancer.

Deteriorating living conditions in Gaza has created psychologically disturbed generations, causing a flurry of mental illness

So, he resorted to the Gaza Community Mental Health Programme "(GCMHP) in 2019.

"A psychiatrist and a psychologist have been helping me since 2019. During 2019 and 2020 they had been using cognitive-behavioural therapy, as well as medicine," Mohammed said, "I have made great progress since June 2020."

Psychiatric patients in Gaza suffer from stigma, so they hide their illness.

When Israeli war planes started their airstrikes on Gaza in May this year, new compulsive obsessions invaded Mohammed's mind.

"Once the war erupted, my mind became again full of obsessions such as Israel would strike our home and my family and I would live in UNRWA schools, my family members would be killed by airstrikes and I would become an orphan," he said. "Whenever I went out of my home to buy something necessary, I would think that I would be targeted. These obsessions used to hit my mind at least 50 times per day during the 11 days."

He continues, "Before the war, I used to write my obsessions down on a paper and logically analyse them. Then, I realised they were an illusion and tried to continue my life. I tried to do this many times during the war, but what I found was that almost all of my compulsive ideas were logical as I saw tens of families who did not belong to the resistance wiped from the civil registration."

Mohammed was one of the hundreds of psychiatric patients who could not reach their psychiatrists or psychologists because of the Israeli airstrikes.

"The second problem was I could not reach my doctors because GCMHP was closed due to the war. My medicine was about to run out so I went to three local pharmacies to buy it but they refused as I did not have a prescription. Thank goodness! On the last day of the war, I still had two pills left."

As soon as the ceasefire came into effect at 2 am on May 21, Mohammed went to the streets to celebrate surviving with tens of thousands who did the same thing.

"I was the happiest man in the world when the war ended because I believed my suffering would end," he said. "Now I feel pretty good. My psychiatrist told me that I could recover again quickly as the war-related obsessions will diminish shortly."

Huda (real name withheld) is 37-years-old and has suffered from anxiety since 2019 after she was diagnosed with breast cancer.

 "I have three children and throughout the war, I had been working hard to make them feel safe, despite my anxiety and cancer," Huda said.

"The war has worsened my condition. My anxiety reached unprecedented levels during the 11 days to the extent that I just managed to sleep just two to three hours each day," she said, "the worst thing was I, as a mother, could not protect or reassure my children. The only thing I could do for them was to sleep in the same room to die or live with together."

The psychological effects of the war will be clear in the coming months

"A mother who has a child in normal conditions faces fears and pressure. There is nothing like Gaza. I am always afraid of wars and worried to lose my kids. The environment here is harsh and we lack the necessities of a decent life. Helplessness and anxiety suffocate me. All I want is no more wars and to live safely," Huda said.

Fadel Ashour, a psychiatrist, told The New Arab that the deteriorating living conditions in Gaza have created a psychologically disturbed generation, causing a flurry of mental illness.

He pointed out that the psychological effects of the war will be clear in the coming months.

"What greatly affected patients was that they could not reach or contact their doctors," Ashour said, "causing many of my patients to relapse. For others, their medicines ran out, so they called me to give them a prescription, but I could not because my clinic was closed due to the war."

Dr Yehia Khader, the director-general of the Mental Health Department at the health ministry in Gaza, emphasised that psychiatric patients must have a comfortable and safe environment to recover, otherwise, their illness will exacerbate.

"Some patients have relapsed due to the war which caused disorders even to the 'normal' population," he said. "Another reason is some of them could not reach their doctors and others doubled their doses as they could not control their symptoms."

In the coming months, Gaza is going to have more cases of post-traumatic stress disorder, anxiety and depression, Khader concluded.

Ahmed Sammak is a freelance Gaza-based journalist with a bachelor's degree in Media and Mass Communication from Gaza’s Al-Azhar University. Now, he is studying for a Higher Diploma in translation at Gaza’s The Islamic University. Ahmed works as a freelance journalist for Mondoweiss, The New Arab, Al-Monitor and Pal-Think Corporation for Strategic Studies.

Follow Ahmed on Twitter:  @Ahmedsammak95