War severely affects a child's mental health

Many children living in conflict zones have lost their homes through shelling, have been displaced from their neighbourhoods, and have had to leave their friends and family. — ICRC

Childhood trauma refers to experiences that cause significant stress and overwhelm a child’s ability to cope.

These experiences are often frightening, dangerous, or violent events that pose a threat to a child’s physical or emotional well-being.

Childhood trauma can have long-lasting effects on a child’s development and overall mental and physical health.

Traumatic events can vary widely but the common ones include physical abuse which is any form of physical violence directed at the child and sexual abuse, which constitutes any non-consensual sexual activity involving a child, including molestation, rape, or exposure to sexual content.

Emotional trauma may involve constant criticism, belittling, or humiliation, while emotional neglect, which is also a kind of abuse refers to ignoring, rejecting, or consistently failing to provide emotional support.

Coping with a severe illness, medical procedure or injury can also result in psychological trauma.

Many children living through events like earthquakes, floods and other disasters also struggle with trauma.

However, living in war zones, experiencing combat situations, or being forcibly displaced due to conflict have a much higher propensity to cause psychological trauma in children.

The psychological effects of war on children can be severe and long-lasting as it disrupts the normalcy of childhood.

As they transition into adulthood, they may grapple with post-traumatic stress disorder (PTSD) in the form of flashbacks, nightmares, severe anxiety, and uncontrollable thoughts related to traumatic events.

In such situations, children too can display increased anger outburst and aggression and have difficulty in controlling impulses.

They may also struggle with constant worry, feelings of hopelessness, loss of interest in activities, and changes in sleep and appetite.

Trauma hinders social interactions, academic performance, and in certain situations leads to suicidal tendencies.

Children with PTSD have difficulty in forming meaningful attachments with their loved ones.

When the grow up

Childhood trauma often leads to chronic mental health conditions in adulthood if left untreated.

Adults with a history of childhood trauma have difficulty trusting others and this can hamper the formation of healthy, long-term relationships.

They may also struggle with intimacy, and this can affect romantic relationships.

Disrupted education in a war zone along with the effect of trauma can limit career options as an adult.

Even when employed, difficulty in managing stress and interpersonal relationships can impact job stability and performance.

Unresolved childhood psychological trauma can also manifest as physical symptoms in adulthood.

These psychosomatic symptoms can lead to chronic health issues.

An individual who has experienced ongoing traumatic events can develop PTSD, which can be tackled with different therapies. — 123rf.com

Additionally, a significant proportion of such adults resort to unhealthy coping strategies such as substance abuse and worrying levels of alcohol intake.

Adults with the baggage of past trauma may struggle with parenting leading to increased family stress and marital conflict even if they are no longer in a war environment.

They are also more vulnerable to an abusive relationship or victimisation in various forms.

Some individuals, with appropriate support, therapy, and coping strategies, can develop resilience and find meaning in their harrowing conflict or war experiences.

There are many well known figures who channel their experiences into advocacy, helping others and raising awareness about the psychological effects of severe psychological trauma.

One of them is Whoopi Goldberg, a famous actress who developed PTSD after witnessing two planes collide in midair as a child.

Such psychological decompensation can easily occur in people living their everyday lives in uncertain, war-like conditions.

Quite often, these psychological injuries, or what are known as “invisible injuries”, go on to have a far greater impact on the individual than any physical injury they may have suffered.

Distance doesn’t matter

Just last week, I examined a patient who relapsed into PTSD after following the events in the recent international conflict that has captured the attention of the world.

This demonstrates that even if we are thousands of miles away from the actual scene of war, we are still susceptible to severe psychological decompensation.

Our Prime Minister Datuk Seri Anwar Ibrahim summed this aptly when he said this in the recent sitting of Parliament: “Unless we are made of wood or our hearts are cast in stone, it is impossible not to be moved, shocked and repulsed by the spectacle of killing and mayhem being perpetrated, even as we are gathered here in this august House.”

While childhood trauma can have profound and lasting effects, early intervention, therapeutic support, and a supportive environment can significantly mitigate these effects, helping individuals lead fulfilling lives in adulthood.

PTSD can be treated with psychotherapy protocols like trauma-focused Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR) along with appropriate medications when needed.

These tools can be transformative for people whose lives are clouded by trauma they experienced, years or even decades ago.

War simulation impact

In non-war situations too, exposing children to simulated war scenarios at school has the potential to cause psychological effects.

The impact can vary based on the children’s age, temperament, the realism of the simulation, and the way it is presented.

Actress Whoopi Goldberg developed PTSD after witnessing two planes collide in midair as a child. — Filepic

It will also depend on whether the children were briefed accordingly.

Younger children, in particular, might not be able to distinguish between reality and simulation, leading to immediate fear and anxiety.

Even after understanding it is a simulation, some children might develop long-term anxiety about real-world violence and conflict.

They might find it hard to concentrate on studies, especially immediately after the simulation or if they continue ruminating about it.

In some cases, especially if the simulation is highly realistic, children might exhibit PTSD-like symptoms, such as nightmares, flashbacks or hypervigilance.

If exposed to such simulations frequently, children might become desensitised to violence, leading to reduced empathy and emotional response to violence.

In such cases, violence might become normalised, impacting their understanding of conflict resolution and acceptable behaviour.

Some children might imitate aggressive behaviour they witnessed, especially if they perceive it as a solution to problems.

Others might withdraw socially, finding it difficult to trust others due to perceived threats.

Children might develop maladaptive coping mechanisms, such as denial or avoidance, which can affect their emotional growth and problem-solving abilities although with proper guidance, some might learn healthy coping mechanisms and resilience.

Parents might also experience anxiety and concern about their child’s emotional well-being.

However, responses can vary based on cultural norms and societal attitudes towards violence and conflict.

Some children might be more resilient than others.

Proper debriefing sessions can help mitigate some negative effects by allowing children to express their feelings, ask questions, and understand the difference between simulation and reality.

When such simulations are conducted within a structured educational context with clear explanations and support systems, the negative effects might be reduced.

While simulations can be educational tools, it is crucial to consider the psychological impact on children.

Schools and educators must handle such scenarios with care, ensuring age-appropriate content, providing psychological support, and fostering a safe environment for children to express their emotions and concerns to prevent serious psychological and behavioural repercussions.

Childhood trauma can have a profound impact on a child’s emotional, social and cognitive development.

The lingering effect can lead to various mental health issues in adult life resulting in anxiety, depression, PTSD and difficulties in forming healthy relationships.

Early intervention, support and appropriate evidence-based therapy can help mitigate the effects of childhood trauma and promote healing and resilience in affected individuals.

Prof Datuk Dr Andrew Mohanraj is a consultant psychiatrist, the Malaysian Mental Health Association president, Taylor’s University Impact Lab on Mental Health & Wellbeing director and a former consultant in mental health and substance abuse at the World Health Organization. For more information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.