Enab Baladi – Yamen Moghrabi

In the middle of Damascus, a smartphone captured a man walking naked near one of the capital’s most famous squares, the Umayyad Square, under a scorching sun and temperatures exceeding 40 degrees Celsius. This scene was repeated three times in different areas of the city within one week and widely circulated on social media. One of these instances involved a girl bathing in a public park.

Public reactions on social media ranged from regret over the state of the country to reminders that the people’s conditions have reached an unbearable level of misery. Some comments focused on the impact of prisons, the security grip, and the injustice experienced by hundreds of thousands of Syrians.

War leads to economic, security, and social pressures and changes in society’s shape, customs, and behaviors. This can be observed in Syria in various control areas, including those controlled by the Syrian regime, where economic problems, security grip, and the decline of basic services are more pronounced than in other areas.

Behaviors such as appearing in public without clothes or talking loudly to oneself in public places seem to be on the rise. While these manifestations might be due to the pressures of war and crises that do not seem to have a near solution, they could also be classified as psychological disorders needing specialist consultation.

No official or specialized entity has explained the repeated appearance of naked people on the streets of Damascus, and no media outlets operating within regime-controlled areas have published exclusive interviews with them up to the moment of publishing this report. Hence, it is not possible to know if this is a form of protest or if the individuals involved suffer from some disorder. However, in both cases, it prompts a discussion on how war conditions reflect on social behaviors in society.

Psychological pressures

In Damascus, the Ibn al-Nafis hospital, which specializes in mental illnesses, receives between 20 to 30 patients daily for various cases resulting from stress and difficult economic conditions, according to statements by its director, Ayman Dabboul, published by local radio “Sham FM” in June 2022. At that time, the number of admitted patients was 500, alongside 400 others in external hospitals.

Economic circumstances alone are not the primary cause of disturbances; war pressures also play a role, according to psychiatrist Mohammad Abu Hilal.

Abu Hilal told Enab Baladi that wars and crises create a set of significant pressures on humans, including psychological and emotional pressures and traumas. They also lead to anxiety and depression due to living in an unstable and frightening environment.

There are also social, economic, security, and educational pressures, among others, that lead to long-term impacts on individuals and communities, requiring multi-dimensional interventions to alleviate them.

According to the World Health Organization (WHO), 5% of adults globally suffer from depression, a common psychological disorder.

Additionally, over 700,000 people die by suicide each year, making it the fourth leading cause of death among 15 to 29-year-olds.

In Syria, there were three specialized mental health hospitals: Ibn Rushd in Damascus, Ibn Sina in rural Damascus, and Ibn Khaldun in Aleppo. The al-Mouwasat Hospital includes a psychiatric department and an outpatient clinic. The same applies to the Syrian regime’s Ministry of Defense and the Tishreen Military Hospital.

A World Health Organization report released in 2020 indicated that 75% of people in Syria who suffer from mental illnesses receive no treatment.

Decreased sensitivity to society

Mohammad Abu Hilal indicated in his conversation with Enab Baladi that it is not possible to diagnose the psychological condition of the individuals appearing in the videos that spread last week. Still, pressures lead to psychological illnesses and strange behaviors, including “reduced social inhibition,” where the sensitivity to society and its views diminishes, prompting the affected individual to engage in socially unacceptable behaviors, such as walking naked.

However, he also mentioned that it could not be definitively stated that this behavior results from a psychological disorder due to the lack of a clear medical diagnosis. The phenomenon requires social studies to understand and explain these cases in depth.

According to statements by Zaher Hajo, the director-general of the General Authority for Forensic Medicine, reported by the local Athr Press news site, Syria witnessed 146 suicide cases in 2023, with 99 cases involving males and 47 females within regime-controlled areas, a decline from 175 cases in 2022.

Poverty affects 90% of Syrians, and 70% of the population, around 15 million Syrians, need humanitarian assistance, according to United Nations figures.

The humanitarian aid appeal costs 11.1 billion dollars, the largest globally, and water security is absent, making Syria one of the most drought-prone countries.

Regime-controlled areas also suffer from weak services and infrastructure, frequent power outages, declining purchasing power, and medical crises reflected in deteriorating services in government hospitals, high treatment costs in private hospitals, and recurrent medication crises.

Post-crisis behavior stages

Pressures lead to various behaviors comprising several stages:

Stage One: Also known as the immediate stage, includes rapid reactions such as shock, panic, and flight responses, or defensive behaviors like seeking a safe haven and acting with extreme caution.

Stage Two: The short-term adaptation stage, where individuals develop coping strategies with their new circumstances, such as relying on others, seeking social support, and attempting to return to normal routines.

During this stage, individuals might also adopt avoidance behaviors, avoiding places and people linked to the crisis.

Stage Three: The long-term adaptation stage, including lifestyle changes like moving to new areas, changing jobs, and developing new skills.

It also involves protective behaviors, such as heightened attention to personal security and reliance on personal resources.

Stage Four: Post-crisis, divided into psychological adaptation, during which individuals may develop new behaviors like independence and improved social skills.

Individuals might also seek community integration by participating in public activities and rebuilding social networks.

Stage Five: Long-term impacts, including permanent behavioral changes like constant caution, security awareness, and changes in life’s priorities and values.

It also includes compensatory behaviors, such as developing new interests and participating in activities supporting mental health.

These stages might vary between individuals based on personal factors like personality, personal history, and available support. However, generally, the pressures resulting from crises can shape new behaviors at each stage.

Source: Mohammad Abu Hilal – Psychiatrist