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AS IT IS - Arab Spring Violence Damaging Mental Health in the Middle East

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This Syrian man suffered major burns in an air strike in Idlib province last September.
This Syrian man suffered major burns in an air strike in Idlib province last September.

From VOA Learning English this is As It Is.

Welcome back! I'm Caty Weaver in Washington.

Hundreds of thousands of people have been killed in Arab countries since the political unrest known as the Arab Spring began three years ago. Many others have been jailed or disappeared. But the violence does not only affect people physically. Today we tell about how the situation is affecting the mental health of people in the Middle East.

"You get isolation or social isolation…but you can get aggression…"

Then we tell about new patients for a treatment that doctors have used on soldiers with post-traumatic stress disorder. Doctors say prolonged exposure therapy seems to help young girls who have suffered sexual abuse.

"Most of the girls…actually lost the diagnosis of PTSD and really did very well…"

Mental health in the Arab Spring and helping victims of sex abuse… today on As It Is.

Our first story comes from the northern Lebanese city of Tripoli. Many Syrians have fled to Lebanon to escape the conflict in their homeland. Among them is a six-year-old boy from the Syrian town of Hama. He pushes aggressively into the center of a circle of refugee children to list the dangers he faced in Syria from exploding rockets. The little boy explains the picture he has made of a house and an artillery battery.

Mohamed Khalil is a psychiatrist, specializing in treatment of mental disorders. He says it is not unusual for refugee children from the two-and-a-half-year Syrian war to draw weapons. He says they also often change quickly from hyperactive behavior to emotional withdrawal.

Victims of suspected chemical attacks by Syrian forces.
Victims of suspected chemical attacks by Syrian forces.

Dr. Khalil says children who have seen inhumane acts and violent death often return to behaviors seen in younger children. He says they might suck their thumbs or wet their beds. And he says they often have frightening dreams and experience restless sleep.

"You get isolation or social isolation, and they don't want to speak to people but you can get also aggression, and the main toys for children is guns."

Dr. Khalil says there is a public health crisis across the Middle East right now. He says it gets little or no attention from the media or international aid organizations.

There are no good estimates on the number of people suffering from mental health problems in the Middle East. But mental health experts say violence and political unrest is causing severe depression, anxiety and post-traumatic stress disorders.

The problems are often left untreated. Ahmed Abdellah is a psychiatrist in Egypt's capital, Cairo. He says cultural shame about mental health problems can interfere with efforts to help people.

He says three years of civil conflict in Egypt is harming the mental health of its people.

"The problem is there's a gap between what is going on in the society and between what is in clinics and in psychiatric institutes, especially the governmental institutes. Nowadays we have massive numbers of post-traumatic stress disorder cases. But you will not find maybe any of these cases in psychiatric departments."

He says people are left to suffer when they could be helped. But also he says more problems are created when victims of PTSD do not get treatment.

"To leave somebody with trauma untreated, this opens him and the society for more aggression, you are open for more stress and we are open to more violence, actually. If you have maybe tens of thousands, maybe more of people who are suffering, you couldn't expect them to work, to share, to intervene, to interact."

Young people are especially suffering. There are as many as 50,000 displaced Syrian children under the age of 16 in Lebanon. Dr. Mohamed Khalil estimates that at least one third of them are at risk of developing PTSD.

Mental health experts often use a treatment called "prolonged exposure therapy" to help soldiers returning from battle. It is considered the first step in treating soldiers who suffer from post-traumatic stress disorder. Now, researchers have found the treatment can also help adolescent girls who were sexually abused as children. Christopher Cruise reports.

In prolonged exposure therapy, or PET, patients are asked to remember and then talk about the feelings and thoughts that cause them to suffer. They do this until these memories are no longer painful.

Edna Foa is a clinical psychologist at the University of Pennsylvania. She helped to develop prolonged exposure therapy for PTSD. She says young women who were abused at an early age often get what she calls "supportive counseling." But she says that kind of treatment usually helps them for only a short period of time.

"It kind of reduces the pain on the short run; but in the long run, it actually maintains the symptoms and, and actually generate(s) chronic post-traumatic stress disorder."

Dr. Foa and her team amended the PET program to meet the emotional maturity level of young people. Then they compared it to supportive counseling in a group of 60 sexually-abused girls. All the girls suffered from PTSD, and were 13 to 18 years of age. Each girl got 14 sessions of either PET or supportive counseling. Each meeting lasted about 60 to 90 minutes.

Dr. Foa says during treatment, those who received PET had a larger decrease in PTSD symptoms and depression, compared to the other girls. They also had a greater improvement in the quality of life.

"Most of the girls in, who received prolonged exposure actually lost the diagnosis of PTSD, and really did very well even a year after -- because we followed them up to a year after the treatment."

Dr. Foa says social workers in community mental health centers can be trained in prolonged exposure therapy in just four days.

I'm Christopher Cruise.

And I'm Caty Weaver. That's all the time we have today. Tune in tomorrow at this time for As It Is with June Simms.

Thanks for joining us.

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