CSC: 3-day nat’l holidays

KUWAIT CITY, Feb 17, (KUNA): Feb 25 and Feb 26 would be an official holiday on the occasion of Kuwait’s National Day and Liberation Day, the Civil Service Commission (CSC) announced Monday.

Feb 27 (Thursday) would also be a holiday because it falls between a public holiday and the weekend, the CSC said in a statement.

Dr Abdullah Al Hammadi (above), a psychiatrist, speaking to the Arab Times, says 30 years after the invasion of Kuwait, there are still wounds inflicted by the brutality of the Iraqi occupation, that haven’t healed. A debilitating condition known as Post Traumatic Stress Disorder (PTSD) still plagues a sizeable

number of citizens.

Thirty years after the invasion of Kuwait there are still wounds inflicted by the brutality of the Iraqi occupation that haven’t healed. A debilitating condition known as Post Traumatic Stress Disorder (PTSD) still plagues a sizeable number of citizens. Its symptoms range from anxiety, depression, irritability, insomnia, and aggression to emotional withdrawal, loss of memory, and the sense of a foreshortened future. If left untreated it can become a chronic, disabling condition.

According to psychiatrist Dr Abdullah Al Hammmadi, PTSD is a longterm affliction from which the people of Kuwait will suffer for years to come, as do many American veterans of the Vietnam War and survivors of other armed conflicts around the world.

Speaking to the Arab Times at his office at the Kuwait Center for Mental Health, Dr Al Hammadi said, “We are following the studies and literature from the United States and we see the same patterns, so we know that PTSD is not peculiar to Kuwait. The disease is the same, whether the patient is in America, Kuwait, or anywhere else in the world. The condition is definitely on the rise worldwide due to the large number of armed conflicts as well as natural disasters.”

PTSD develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the victim or the person may have witnessed a loved one or even a stranger being harmed. PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic or violent incidents, such as mugging, hijacking, rape, being kidnapped, child abuse, a car accident, plane crash, bombings, or natural disasters such as floods, fires, earthquakes, typhoons, hurricanes, or tsunamis.

Dr Al Hammadi points out that whereas the percentage of those who develop PTSD after a natural disaster is relatively low, at around twenty per cent, the figure climbs dramatically to around eighty per cent for survivors of violent incidents such as rape and torture. In the latter cases the victims suffer pain and humiliation, and endure the fear of losing their lives. Studies have shown that it is particularly the survivors of man-made traumas that often feel a lasting sense of terror, horror, endangerment, or betrayal.

PTSD is prevalent in Kuwait as a result of the widespread torture and cruelty that occurred during the Iraqi occupation from August 2, 1990 to February 26, 1991. According to Dr Al Hammadi, symptoms usually begin within three months of the traumatic incident but occasionally there is a delayed onset and they don’t start to manifest themselves until years after the initial traumatic event.

Symptoms can surface at any time and even a mildly stressful event can ignite the original trauma and cause an individual to keep suffering recurring trauma. This was the case when Saddam Hussein frequently threatened Kuwait during the years after the occupation. With nerves still raw and the psyche so vulnerable, the former Iraqi president was able to cause real injury to the traumatized people in post-occupation Kuwait simply by broadcasting one of his menacing speeches.

As Dr Al Hammadi recalls, “This threatening behavior made people in Kuwait suffer from feelings of worry, fear, and insecurity. The painful memories were made to recur time and time again.”

However, according to the psychiatrist, even the death of the perpetrator of the violence, in this case Saddam Hussein, does not bring an end to the misery of those affected by PTSD. “These people have undergone biological changes in the brain. They have actually been physically damaged and they are suffering from a real illness that needs to be treated.”

Dr Al Hammadi points out that those affected by PTSD as young children during the occupation are now adults dealing with a variety of manifestations of the disease. “PTSD when started from childhood can have diverse longterm effects for the individuals when they become adults. Psychological complications include personality problems such as anti-social personality and borderline personality. People suffering from the latter condition are usually unstable in their emotions, their thinking, behavior, and interpersonal relationships. They may also be paranoid. Substance use disorder, that is to say drug abuse, and anxiety and depression are other major disorders associated with complications of PTSD.”

Sadly, it is not just the PTSD patient who suffers. The condition also often takes its toll on close family relationships and friendships. “That’s why one of the major areas we try to address is to help patients adjust their social functions regarding their marriage and relations with family, friends, and coworkers,” Dr Al Hammadi says.

“PTSD patients may have trouble communicating with their spouse or their children, relations deteriorate, and there is a rise in divorce cases. The condition can also affect their work and we have seen a rise in early retirement. Depression, which can be caused by PTSD, is the most prevalent work disability disorder on record.”

Dr Al Hammadi is a pioneer in the field of PTSD treatment in Kuwait and is the first doctor to establish a specialized PTSD clinic. In 1991 he became the Director of the Al Riggae Specialized Center, established by the Kuwait government in order to rehabilitate the survivors of Iraqi torture. At the Center, Dr Al Hammadi supervised a team of adult and pediatric psychiatrists, clinical psychologists, social workers, general physicians, and nurses who worked to help those afflicted with PTSD.

Dr Al Hammadi states that during the occupation some 15,000 people were captured by the Iraqis and later released. At the end of the war, more than 6,000 Kuwaiti prisoners returned home from Iraq. A large number of them had been subjected to physical or psychological torture, or both, and many were in need of treatment for PTSD.

In 1993, when the Center conducted a screen study to determine the incidence of PTSD in the community, it became apparent that the problem was more widespread than initially suspected. The medical team noted that while some individuals made a spontaneous recovery from PTSD, others went on to develop a variety of symptoms. Painful memories often occur in the form of vivid flashbacks or recurrent nightmares that can be accompanied by rapid heartbeat, sweating, and anxiety attacks. Some PTSD sufferers shy away from people, places, or activities that trigger these memories and they may become forgetful and withdrawn or even feel numb and unable to experience emotion.

According to Dr Al Hammadi, those with PTSD are also more likely to have health problems such as diabetes, high cholesterol, high blood pressure, and other coronary issues. “Although the consumption of alcohol is not usual in our society, it is significant and proven that those with PTSD are more in contact with alcohol and drugs. This is a reality that shouldn’t be hidden or shied away from. These people are suffering and their alcohol and drug abuse is an attempt to numb themselves and escape from intrusive memories.”

The last screening studies of the incidence of PTSD in Kuwait were carried out in 1994 and 1998. In both studies the results showed that twenty five per cent of the population was affected. New studies need to be done to determine the current rate of PTSD, but psychiatrists don’t expect much variation in the percentage.

“Based on the findings of PTSD studies in the US, we can expect the rate to stay roughly the same,” says Dr Al Hammadi.

When Riggae Specialised Center closed, the team of mental health professionals was shifted to the Kuwait Center for Mental Health near Al Sabah Hospital. The treatment for PTSD patients involves a multidisciplinary approach that includes psychotherapy, mainly cognitive behavioral therapy (CBT), and pharmacology.

Psychotherapy is often referred to as “talk therapy,” Dr Al Hammadi explains. Included in cognitive behavioral therapy, for example, is exposure therapy, which helps people face and control their fears. Cognitive restructuring is another method of CBT that helps people make sense of their bad memories.

Other therapies that benefit some PTSD patients are strategies that help them identify and deal with guilt, shame, and other feelings about the trauma; relaxation and anger control skills; and advice focusing on exercise habits, diet, and how to get better sleep.

According to Dr Al Hammadi, since depression is a major symptom of PTSD, the drugs commonly prescribed for the condition are non-addictive antidepressants.

Of course understanding and support from friends and relatives is extremely important for PTSD sufferers. The better informed that family and friends are about the disease, the better they are able to help the patient cope with it.

Websites like the US Department of Veterans Affairs National Council for PTSD offer a wide variety of strategies. They include advice ranging from engaging in physical activity together, to being a patient and positive listener, and forming a support system by encouraging activity with family and friends. Those caring for someone with PTSD are also reminded that they need to take care of themselves as well and that they should ask for help if necessary.

With the global increase in violent crime, terrorist incidents, and armed conflict on the one hand, and more and more severe natural disasters as a result of climate change on the other, an ever growing number of individuals will have to deal with PTSD and its consequences. In Kuwait, thirty years after the Iraqi invasion, people still struggle with the symptoms of PTSD but now, according to Dr Al Hammadi, increasing numbers are taking advantage of psychiatric care.

“Compared to ten years ago, people are more aware of the psychological impact on health and wellbeing. They now see psychology and psychiatry in a different way. In the past, people suffered by themselves either due to the stigma of seeking medical help, or because of a refusal to recognize their condition, or because they didn’t know there is treatment for PTSD.

“I credit social media with this increase in awareness and change of attitude. More and more people realize that the symptoms of PTSD are a normal reaction to an abnormal situation, and it’s ok to have symptoms, but it’s not ok not to seek help.”

Photo and story by Claudia Farkas Al Rashoud