Conflict does not end when the guns fall silent. For millions of survivors worldwide, the psychological aftermath of war, displacement, and violence persists for years, often for a lifetime. Understanding the common mental health conditions following conflict trauma is essential for designing effective interventions, reducing stigma, and ensuring that survivors receive the care they deserve. Drawing on the latest global research, this article examines the most prevalent disorders affecting conflict-affected populations, from post-traumatic stress disorder and depression to prolonged grief disorder and substance use.
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The hidden epidemic: mental health in conflict zones
The scale of mental health needs in conflict-affected areas is staggering. According to the World Health Organization (WHO), an estimated 22% of people who have experienced war or conflict within the previous 10 years have depression, anxiety, post-traumatic stress disorder, bipolar disorder or schizophrenia. Among conflict-affected populations, approximately 13% have mild forms of depression, anxiety and post-traumatic stress disorder, while moderate or severe mental disorders affect 9%. For context, people living in countries that have experienced armed conflict are five times more likely to develop anxiety or depression than the rest of the world.
The International Federation of Red Cross and Red Crescent Societies (IFRC) reports that around 1 in 5 people living in conflict-affected areas experience a mental health condition such as depression, anxiety, or PTSD, yet for depression alone, fewer than 1 in 10 receive adequate care. This treatment gap—often exceeding 90% in low- and middle-income countries—represents one of the most pressing humanitarian failures of our time.
Post‑traumatic stress disorder (PTSD)
PTSD is the mental health condition most commonly associated with war and conflict trauma. The WHO defines PTSD as a condition that develops after exposure to potentially traumatic events such as war, accidents, or sexual violence, characterised by re‑experiencing symptoms (intrusive memories, nightmares, flashbacks), avoidance symptoms (avoiding reminders of the event), and hyperarousal symptoms (heightened vigilance, exaggerated startle response).
While the global lifetime prevalence of PTSD is estimated at 3.9% of the world population, rates are dramatically higher in conflict settings. For people exposed to violent conflict or war, the rate of PTSD is more than three times higher—15.3%. The WHO specifies that PTSD rates are especially high following sexual violence, and people with PTSD may also have depressive disorder, anxiety disorders and substance use disorders.
A 2024 meta‑analysis published in General Psychiatry, which pooled data from 38,595 articles and 64,596 participants, estimated a prevalence of 23.70% for PTSD symptoms among war‑afflicted civilians, with the highest rates occurring during active conflict years and in low/middle‑income countries. A separate meta‑analysis of war survivors between 1989 and 2019 found point prevalences of 26.51% for PTSD and 23.31% for major depression, with an estimated 316 million adult war‑survivors globally suffering from PTSD and/or major depression in 2019, almost exclusively in low/middle‑income countries.
The WHO South Sudan office emphasises that post‑conflict or protracted crisis settings carry a particularly high burden of PTSD.
Depression and anxiety disorders
Depression and anxiety are the most widespread mental health conditions in conflict settings, often occurring together and frequently accompanied by PTSD. A large‑scale systematic review and meta‑analysis of 57 studies found a prevalence of 25.60% for depressive features among war‑afflicted civilians. A separate meta‑analysis reported a point prevalence of 23.31% for major depression, with 55.26% of those affected by PTSD presenting with comorbid major depression.
For anxiety, the aggregate prevalence in populations experiencing conflict or war is 30.7%. A 2025 systematic review and meta‑analysis covering Palestine, Sudan, and Yemen found anxiety prevalence of 34% and PTSD prevalence of 38%, with higher rates among displaced groups and children.
The WHO notes that in conflict‑affected settings, depression increases with age and is more common in women. The Lancet study that established the one‑in‑five estimate reported a 22% prevalence (95% uncertainty interval 18.8 to 25.7) of depression, anxiety, PTSD, bipolar disorder, or schizophrenia across conflict zones, with mild conditions affecting 13% and moderate‑to‑severe conditions affecting 9%.
Prolonged grief disorder and complicated grief
Conflict does not only kill—it leaves behind millions of mourners whose grief may become chronic and disabling. A 2024 study in the Journal of Traumatic Stress examined Iraqi internally displaced persons who fled their hometowns due to the ISIS conflict and had lost an important person within the previous five years. The impact of loss and separation manifested in complicated grief symptoms in more than half of the affected population, often accompanied by PTSD.
The study identified four classes: a low‑symptoms class (17.6%), a complicated grief class (33.7%), a PTSD class (12.1%), and a comorbid PTSD+complicated grief class (36.7%). The sudden or violent death of a loved one was identified as a distinguishing factor for PTSD, while separation was associated with comorbidity.
Research from the Max Planck Institute for Demographic Research reveals the scale of conflict‑related bereavement. In Syria, each conflict death leaves an average of four parents and/or children bereaved; in the State of Palestine, more than 3.5 relatives per death; in Ukraine, more than two per death. By the end of 2023, an estimated one out of every 20 individuals in Syria, one in 65 in Afghanistan, and one in 67 in the State of Palestine had lost a child to conflict. The researchers project that even if all armed conflicts ended immediately, high levels of bereavement will persist for decades.
Substance use disorders
Substance use disorders are an under‑recognised but increasingly documented consequence of conflict trauma. Refugees appear to be at enhanced risk for substance use disorders while having less access to services. A 2025 cohort study of refugees in Germany found that among treatment‑seeking refugees with substance use disorders, clients consulted mostly due to cannabis use (44.8%) or opioid use (20.1%). Refugees with substance use disorders had significantly higher rates of mental and physical comorbidities and were more likely to have been victims of violence.
In conflict‑affected populations, substance use often serves as a maladaptive coping strategy. A UNHCR needs assessment in Burundi found that substance use, including cannabis, is increasing among adolescents, with 70% of adolescent refugees in Musenyi reporting feelings of hopelessness and suicidal thoughts. The WHO notes that emergencies can contribute to harmful substance use, and pre‑existing substance use disorders are often exacerbated by the stresses of conflict and displacement.
Somatic symptoms and somatoform disorders
In many conflict‑affected and displaced populations, psychological distress is expressed through physical symptoms rather than emotional complaints—a phenomenon known as somatisation. A UNHCR needs assessment in Burundi reported high levels of psychosomatic symptoms among Congolese refugees, alongside widespread anxiety, depression, post‑traumatic stress, and insomnia. The assessment also identified local idioms of distress used by Congolese refugees: “msongo wa mawazo” (literally “confusion in the mind”) to describe stress and anxiety, and “huzuni” to denote deep sadness or grief—revealing the cultural framing of mental health experiences.
Studies among military personnel from conflict zones have found somatoform‑spectrum disorders in psychiatric patients, with conversion disorder being the most common presentation. The relationship between somatic symptoms and PTSD is well‑established, with the magnitude of somatisation phenomena correlating with the presence and severity of post‑traumatic stress symptoms.
The reality on the ground: research from active conflicts
Recent research from active conflict zones provides stark illustration of the scale of mental health needs. A 2025 cross‑sectional study of Palestinian adults in Gaza after one year of war found alarmingly high rates of mental health symptoms: 72.7% of participants reported moderate to severe depression, 65% reported moderate to severe anxiety, and 83.5% met the threshold for probable PTSD (PCL‑5 ≥ 33). A substantial proportion had lost a family member (45.7%), experienced a military siege (82.5%), witnessed someone being killed or injured (80.5%), and lost their work due to the conflict (42.7%).
A 2024 study of internally displaced people in Cabo Delgado, Mozambique found even more extreme prevalence: 74% had PTSD, 64% had depression, and 40% had anxiety. The likelihood of developing PTSD was 2.2 times higher in females and 4.8 times higher among individuals exposed to war for 12 weeks to a year compared to those exposed for 11 weeks or less.
A UNHCR assessment of Congolese refugees in Burundi in 2025 found that mental health problems are now the second leading cause of reported morbidity in the health centre, after malaria. Despite this burden, less than half of those in distress seek professional help, with refugees primarily turning to religious leaders (32%) and family members (30%), while only 1% access trained mental health professionals.
Comorbidity and the treatment gap
Mental health conditions following conflict trauma rarely occur in isolation. A meta‑analysis of war survivors found that over half of those with PTSD also meet criteria for major depression. The same study estimated that war‑survivors carried a burden of 3,105,387 disability‑adjusted life years (DALYs) associated with PTSD and 4,083,950 DALYs associated with major depression. The treatment gap is particularly acute in low‑ and middle‑income countries, which lack sufficient funding and qualified professionals to provide evidence‑based psychological treatments for such large numbers of affected people.
The IRFC highlights that in Ukraine, 56% of people report needing psychological support either immediately or on a regular basis, yet only 19% report being able to access mental health care.
Refugees and displaced populations: a higher burden
Refugees and internally displaced persons (IDPs) carry a disproportionately high burden of mental health conditions. The UNHCR Integration Handbook states that most studies find that at least one out of three asylum seekers and refugees meet diagnostic criteria for depression, anxiety, and PTSD, with up to 44% reporting having survived torture in some resettlement countries. While many refugees show remarkable resilience, daily stressors in resettlement contexts—including systemic oppression, xenophobia, language barriers, and fragmented social support—can lead to further mental health problems.
A recent UNHCR assessment of Congolese refugees in Burundi found widespread emotional distress, with 83% of refugees reporting feeling so severely upset about the war that they tried to avoid reminders, with 31% feeling this way most of the time. In one transit centre, 83% of refugees reported feeling so afraid that nothing could calm them down, with 47% feeling this way most of the time.
Conclusion
The common mental health conditions following conflict trauma—PTSD, depression, anxiety disorders, prolonged grief disorder, substance use disorders, and somatic symptoms—affect tens of millions of survivors worldwide. The evidence is unequivocal: one in five people in conflict‑affected areas has a mental health condition, and the rate of anxiety and depression is five times higher than in the rest of the world. Yet the treatment gap remains vast, with far fewer than half of those in need receiving adequate care, and only a tiny fraction accessing trained mental health professionals.
These conditions do not exist in isolation. They co‑occur, compound one another, and are shaped by ongoing stressors—poverty, insecurity, family separation, and disrupted social networks. Effective responses require integrated, scalable, culturally adapted interventions that move beyond the individual to address community‑level needs. As the WHO South Sudan office reminds us, mental health is not a luxury to be addressed once food, water, and medicine are secured—it is the foundation upon which all other recovery efforts depend.
Explore more insights on trauma, recovery, and mental health at Centre for Elites:
Neurobiology of Trauma and Stress Responses — understanding the brain’s survival circuits and how trauma reshapes nervous system function.
For authoritative guidance, visit the World Health Organization’s mental health in emergencies page, the UNHCR mental health and psychosocial support hub, and the International Society for Traumatic Stress Studies.
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Watch a full Playlist here: Counselling and Rehabilitation of Conflict Victims