How violence in Kashmir has cast a long shadow on mental health
Post-Traumatic Stress Disorder (PTSD) is by definition a mental health condition that is triggered by a terrifying event — either experiencing it or witnessing it.
Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Most people who go through traumatic experiences may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.
Getting effective treatment after PTSD symptoms develop can be critical to improving functioning.
Kashmir and PTSD
According to a recent study published by Doctors Without Borders (MSF) in the British Medical Journal, the estimated prevalence of mental distress in adults in the Kashmir Valley was 45 per cent.
Researchers had identified 41 per cent of adults with probable depression and/or probable anxiety — and 19 per cent with probable PTSD.
In yet another study from April 2017, Rayees Mohammad Bhat et al, from the department of Psychology, Government Degree College Baramulla, Kashmir, surveyed 1,000 young college students from Baramulla, Kupwara and Bandipora districts of the northern region of the Kashmir Valley.
The fact is that these districts are being reported as the most affected with violence as a result of armed conflict.
In the study, the authors argued that these three districts are the most violence-prone regions of the Kashmir division because they include the LoC (line of control) hemming neighbouring Pakistan Occupied Kashmir — an important point is that this part of Kashmir comprises densely forested areas that make it a fertile terrain for terrorist hideouts.
Quite obviously, it then sees a greater presence of personnel from the armed forces too — this leads to more encounters between militants and the armed forces. Sometimes, the civilians get caught in the skirmish, thereby inviting more fear and intense protests.
The findings of this study demonstrated the significant role of conflict exposure in increasing the risk for PTSD.
The study showed a high prevalence of PTSD symptoms (49.81 per cent) among the respondents.
The results also suggested that direct or perceived exposure to armed conflict was associated with an increased risk of developing PTSD symptoms — this heightened risk was significantly associated with both the nature and frequency of traumatic events experienced by the respondents.
Factors such as the feeling of living in conflict, a family member being killed or missing, the perceived risk to life, media coverage of the violence, and higher level of personal exposure to conflict emerged as key predictors of post-traumatic distress.
Children of conflict
Although traumatic events find varied prevalence in most societies, the prevalence is higher in industrialised societies.
Over the last three decades or so, Kashmir has been a chronic conflict zone, leading to the deaths of thousands of people, family instability, sexual abuses and deep damage to property. Added to this have been various natural disasters such as earthquakes, snowstorms and a ravaging flood.
All these factors have contributed to the trauma people in the region have been consistently undergoing.
A majority of children diagnosed with PTSD were in the age group of 11-15 years.
The problem has led to marked deterioration in the academic performance of these students.
In all the studies, it was found that most of the cases were from rural areas as compared to urban areas. The reason for this was attributed to violent and traumatic events occurring at a higher frequency in the hinterland.
About 75 per cent children suffering from PTSD belonged to the lower socio-economic strata, 25 per cent from the middle class.
The alleviation
A review of the literature on resiliency and recovery following traumatic events identified the following as protective factors for developing PTSD, meaning those who engaged in these did not endure long-term suffering:
a) Continuous contact with and support from important people in your life
b) Disclosing the trauma to loved ones
c) Identifying as a survivor as opposed to a victim
d) Use of positive emotion and laughter
e) Finding positive meaning in the trauma
f) Helping others in their healing process
g) Holding the belief that you can manage your feelings and cope
It is thus time for Kashmiri society to get together to fight and help others battling PTSD. It can be done. We must only take heart.