It is out there to be serious about mental health these days, specially with the numerous cases of suicides which been rising. But how aware are the citizens of India about the exodus of children who have been victims of PTSD amidst the political insurgency for decades?

Kashmir, a pulchritudinous state of India, now declared as a union territory (UT) has been a victim of the political skirmish which has, in turn, diddled the indigenous beings of Kashmir leading to death of thousands of people including family members, sexual abuse, damage to property and various natural disasters, namely- earthquake and snowstorms. According to reports, majority of the people suffer from PTSD (Post Traumatic Stress Disorder). As the name suggests, the psychiatric disorder arises in wake of traumatic events. The events are digested and affect each person differently. 

In Kashmir, majority of the children are diagnosed with PTSD. The age group to which these children belong to were above 6 years of age and maximum belonged to 11-15 years of age. The children diagnosed with Abnormalities in brain electrical activity on electroencephalogram were also noted. Children with PTSD were found to perform poorly by affecting their attention, abstract reasoning and executive functioning. Children diagnosed with PTSD were detected in schools because of their behavioural changes and their deteriorate performances. Maximum minors affected belong to rural areas as compared to the urban areas.  Following the figures, 75% of the children belonged to the lower middle class, followed by middle class which entailed 25% respectively. 

Post-Traumatic Stress Disorder consists of risk factors which affects the children to a great extent; lower educations, lower intelligence, absence to social support, sexual harassment, lower socio-economic status, family history of psychiatry illness, multiple traumatic events- are some of the risk factors. Unfortunately, 49% of the children have been witnesses to death of a family member or close friends, followed by arrest, torture of a close relative or being caught up in cross-firing and hearing about the death of a close relative. It is absolutely unimaginable as to what the future of this country has to go through. Kashmir has been regarded as the place called “heaven on earth” but the heaven contains a hell within which largely ignored. Amidst this turmoil , the emphasis ought to be put on the psychological distress, a scar invisible yet the power of changing the entire personality of the human being, affecting the course of their actions and changing the outlook of life, for life.

The destruction of educational infrastructure, in addition to the unlawful detentions, leaves a lifelong impact on children, perpetuating a cycle of trauma, fear and bitterness. The literacy rate in Kashmir is 54.4% as compared to some parts of India, which have resulted in 65% 

The following 3 dimensions which were focussed were shown by the affected for a month which proved them to have paediatric PTSD- 

1. The affected re-experienced the event with deteriorate recollections in the form of dreams, flashbacks, with psychological and psychical distress.

2. They persistently avoided the stimuli associated with trauma that might recall the memories or events of the trauma.

3. There was also an increase in arousal in the form of hyper vigilance and exaggerated startled response, experienced difficulty in sleep, irritability.

In children older than 6 years, there was a repetitive play occurred in which themes or aspects of traumatic events were expressed. They also experienced frightening dreams without recognizable content, a dream which the minors aren’t able to express and even dissociative reactions (eg flashbacks) in which they felt the traumatic events were recurring. Such reactions may occur in continuum, and the most extreme expression of their feeling is expressed by complete loss of awareness of the present reactions.

The unfortunate events lead to persistent and exaggerated negative beliefs about the oneself, others and even the world. In other words, they express themselves by stating, “I am Bad”, “The world is bad and dangerous”, “My whole life is ruined” or “My entire nervous system is ruined”. This leads them to have distorted cognition about the cause and consequences of the events which leads them to blame themselves or others for it.

In order to recover from this the children are subjected to maladaptive method of coping. It was recorded that females prefer for maladaptive method of coping more than males who were associated with PTSD in Kashmir. Most of these patients were even aware what they suffering from and indulged in self-medication, for even somatic issues which included headaches, stomach aches, palpitations, breathlessness, anxiety, panic attacks, loss of appetite etc, which eventually leads to addiction. Popularly benzodiazepine, opioids, and cannabis. In contrast to world reports, alcohol was the used the least (4.8%).

Amidst this turmoil, the children residing in a place regarded as “heaven on earth” go through hell every single day. Not a single day can they have a goodnight’s sleep, a sleep without the fret of being a victim to the worst thought of never seeing the face of a family member anytime. three-year-old boy described the sequence of events leading to the killing of his grandfather. The minor had been subjected to extreme events, events from which even veterans aren’t able to cope up from.  

Picture reference: https://medium.com/@ovaiskarni /psychological-impact-of-armed-conflict-on-kashmiri-children-97c76e77bef1