Amid the ruins of Israel's war, Palestinians in Gaza struggle with mental health and trauma

After a supposed 'cease-fire' on 10 October to the genocidal Israeli war on the Gaza Strip, its aftermath continues to haunt Palestinians in Gaza who endured two relentless years of bombardment.

The outcome of this war is no longer measured by numbers alone—deaths, the wounded, and destroyed homes, but by the countless silent stories buried deep within: crippling fear, anxiety attacks, loss of identity, and the collapse of Gaza's social fabric, friends, neighbours, extended families, and the neighbourhoods that once held their memories.

According to a recent review by the World Health Organisation, rates of post-traumatic stress disorder, depression, and anxiety in Gaza have surged dramatically, directly linked to violence, loss, and displacement.

The psychological and social effects of war do not end with a ceasefire; they begin afterwards, the moment people realise they are no longer the same.

Speaking to The New Arab, residents in Gaza described how, when the massacre stops, not everything returns to its former form.

"Everything becomes a distorted version of the past. The child who once laughed is now silent, the mother who once sang whispers only prayers, and the street that once teemed with life has become a path where survivors tread cautiously," said Gaza-based journalist Mohammed Odwan.

"Even when reconstruction begins, rebuilding homes cannot heal the inside. Memories cannot be mended with cement, and no donor conference can restore peace to the soul," he added.

Amid this psychological and moral devastation, individual stories unfold, telling of an unbearable collective pain.

The survivor who lost himself

In his mid-thirties, Ahmed worked as a carpenter in a small workshop in Gaza's Zeitoun neighbourhood before the war.

He was known for his smile and his devotion to his family. Then, on one night, an Israeli missile struck his home, killing his wife, his three children, and his siblings who had taken refuge there.

Miraculously surviving the attack, he was pulled from the rubble unconscious and speechless. In the days after the strike, he sat silently inside a tent his relatives pitched on the ruins of his home. He neither spoke nor ate.

"We thought he'd lost his mind, but he was just trying to understand what had happened. There was no home, no family, no work. He was a stranger among us," Ibrahim, his brother, told TNA.

Ahmed's voice returned only in the form of sudden screams at night. He would wake up, shouting his children's names and running between the tents, according to his brother. His family sought psychiatric help, but the lack of medication made it impossible to stabilise his condition.

"The doctor said his case needed long-term treatment," his brother added, "but the medicine was unavailable."

One night, Ahmed tried to end his life by hanging himself with a piece of cloth. His brother found him in time. After being saved, Ahmed cried and said, "Everyone I love is under the ground. I don't want to live as a stranger to them."

Currently, Ahmed lives in a small room inside a temporary psychiatric centre in Gaza City, withdrawn from the world and refusing to meet strangers.

 "The war took everything. I don't even have myself any more," his brother said.

A girl who grew up in fear

In a temporary camp in central Gaza City, 14-year-old Layan sits in silence, her face pale and thin.

"Ever since the day she saw the bodies of our neighbours after the bombing seven months ago, she hasn't been the same. She screams at any sound, even a bird passing over the tent," her mother told TNA.

Layan was once an excellent ninth-grade student who dreamed of becoming a doctor. Israel destroyed her school and killed three of her friends. Since that day, she has withdrawn into herself, asking questions her mother cannot answer: "Did they feel pain when they died? Or did they leave quickly?"

During the night, she cries out and trembles. "She wakes up screaming that we'll all die," her mother said. They tried to seek psychological support, but the centres are overcrowded.

According to the Palestinian Ministry of Health, more than 80 per cent of Gaza's children suffer from chronic fear and recurring nightmares.

"Childhood no longer exists here […] My daughter is growing up before her time, in a place that knows nothing but sadness," Layan's mother said.

The silence of trauma

For Umm Khaled, a resident of the al-Sabra neighbourhood in central Gaza, grief has taken a different shape. She never cried over her loss when the Israeli army killed her five sons. Every morning, she steps outside her tent to sweep the small yard and carefully arrange five empty teacups.

Her neighbour, Halima Doghmush, watches in silence. "She's waiting for her sons who were killed in the bombing on 7 May," she told TNA.

When the news of their deaths arrived, Umm Khaled did not scream or collapse. She sat motionless, staring at the ground, according to her neighbour.

"We expected her to break down, but she didn't," the neighbour recalled.

Since then, she has refused all psychological help and every offer of support, choosing instead to remain among the ruins of her home.

Gaza-based psychologist Rawan Ghayada told TNA that Umm Khaled suffers from what specialists call "shock freeze", a state in which emotions cease as the mind becomes trapped in the moment of trauma.

"She isn't refusing help out of stubbornness. Her mind is still living at the instant of the explosion," she said.

Unhealed wounds

The stories of Ahmed, Layan, and Umm Khaled reflect a society living on the edge of collapse. Abdullah Al-Jamal, director of Gaza's Psychiatric Hospital, told TNA that the psychological reality is "tragic beyond description."

"Every person here carries some form of trauma, loss, or chronic fear," he said, adding that the war destroyed the health infrastructure entirely.

"Clinics were damaged, the only mental health hospital was destroyed, and many staff members became victims themselves; some lost children or homes. They now treat others while needing treatment themselves," he added.

Before the war, Al-Jamal says, Gaza's mental health services met around 80 per cent of needs; now they cover barely 20 per cent.

"Eight clinics are gone, and there's a severe shortage of antidepressants and antianxiety drugs. We face patients in total breakdown with nothing to offer but listening," he explained.

He warns of cases never seen before: "Children have lost their speech after watching loved ones being killed. The hair of children and young people turns grey overnight. Men attempt suicide because they see no reason to live. These are wounds to the soul, not just symptoms."

Al-Jamal fears the trauma will persist for generations. "The children in the camps today could grow into a generation defined by fear and mistrust," he said. "If rehabilitation doesn't start now, we will face a broken society for decades."

Though international organisations have set up temporary support points, the efforts fall short.

"We operate inside schools and tents, without privacy or stability," Al-Jamal explained. "Medications are half what they were before the war. We’re trying to save an entire society with almost nothing."

"The war is over, but its trauma has just begun. When people return to their destroyed homes, when children see their empty desks, that's when the real collapse begins. We're working with broken tools, facing an unhealed wound that refuses to close," he added.