Rana*, a 35-year-old Lebanese woman and eldest daughter, took on responsibility for her family after her father’s death in 2019, even as she was grieving. Years later, conflict displaced her and her family, further shaking her sense of safety and stability. Over time, her distress began to manifest through severe physical symptoms—her heart would race suddenly, she struggled to breathe and experienced choking sensations, severe stomach and shoulder pain, dizziness and a constant fear that something was medically wrong. Panic attacks became a daily occurrence, leading to frequent emergency-room visits.
Rana’s physical condition affected her daily life. She stopped working for more than two months, avoided leaving home, withdrew socially and could not drive. She relied on sedatives to fall asleep and often cried for weeks. Behind her symptoms were unresolved grief and distress related to displacement. The disappearance of a close friend and the end of an important relationship deepened her sense of insecurity.
Rana is not alone in her mental health struggles. Manal* is a young mother who had recurring panic attacks linked to unresolved trauma following a major medical procedure. She experienced intense physical symptoms—including heart palpitations, shortness of breath, muscle tension and extreme fatigue—which led her to believe that she was experiencing multiple medical emergencies. The increasing frequency and intensity of these episodes significantly affected Manal’s sleep, appetite and overall well-being, and her condition required urgent psychological support to prevent further deterioration.
Then there’s 9-year-old Serine, who lives with her mother and maternal grandparents. Her parents are divorced, and she sees her father once a week. Serine grew up watching her parents argue and fight, which affected her emotional well-being. Over time, she began to show symptoms of anxiety. Her academic performance deteriorated, she had difficulty concentrating in class and she became increasingly afraid to participate in recreational and social activities. She gradually withdrew from her peers and often suppressed her emotions. According to her mother, Serine frequently repeated phrases such as “I don’t want.”
Over time, Serine’s condition worsened. She experienced intense fear, withdrawal, frequent crying and sleep disturbances. As a single parent, Serine’s mother found it difficult to accept her daughter’s emotional state. She became frustrated when Serine refused to attend school or participate in activities. This dynamic contributed to increased feelings of guilt and anxiety for both Serine and her mother.
A Grim Reality
Rana, Manal and Serine’s experiences point to the grim reality in Lebanon today—as the country navigates one of its most difficult periods in recent years, millions of people urgently need mental health and psychosocial support (MHPSS). Conflict in the Middle East has spilled into Lebanon, displacing more than a million people. The fighting has damaged homes and critical civilian infrastructure, restricting access to healthcare, MHPSS, protection services, schooling, water and sanitation.
“The emotional and psychological toll is enormous because, over the past couple of years, Lebanon has endured many multi-layered crises,” says Anil Kangal, Country Director for International Medical Corps in Lebanon. “People had already been living with repeated displacement, fear, grief, uncertainty and economic stress. Children are showing clear signs of emotional turmoil, and women and caregivers are under intense pressure in overcrowded shelters, where they have little or no privacy. We’re seeing a lot of anxiety, distress and sleep disruption.”
Yet access to mental health care remains limited. At a time when the country’s economy is suffering, the affordability of healthcare remains a major challenge. There’s also a deep-rooted cultural stigma around seeking mental health care, as many people fear social ostracization.
International Medical Corps has worked in Lebanon since 2006 and continues to provide lifesaving health, nutrition, MHPSS and protection services to communities in need through more than 40 primary healthcare centers (PHCCs). In addition to seeing people at their facilities, these PHCCs have deployed mobile medical teams to reach displaced and underserved populations.
Through close coordination with Lebanon’s National Mental Health Program, International Medical Corps has expanded access to MHPSS services through 26 PHCCs that are implementing the national mental health integration model. We also support PHCCs’ efforts to provide emergency mental health services. Together, these interventions have enabled communities affected by conflict, displacement, loss and uncertainty to access psychological first aid and other interventions, as well as case management and awareness activities that help them strengthen coping capacities, address emotional distress and regain a sense of stability and hope.
Rana’s Journey
Rana says her family had a limited understanding of her psychological condition and that they often blamed her for her unemployment and isolation. This lack of awareness increased her emotional distress until she found support from our team at the Watta el Msaitbe PHCC in Beirut, which prepared a comprehensive, multidisciplinary mental health care package tailored to her needs. Her support plan included:
- sessions focused on emotional well-being and coping strategies;
- consistent follow-up and holistic support; and
- psychiatric consultations to monitor and manage her clinical condition.
Through these interventions, Rana began to understand the connection between distress, anxiety and her physical symptoms. Psychoeducation helped her recognize that panic attacks, while frightening, were not life-threatening. She learned breathing and grounding techniques, worked on identifying negative thoughts and gradually began confronting situations she’d normally avoid, such as driving and social engagement. With supervision, she gradually stopped taking sedatives—a major milestone in her recovery—which strengthened her confidence and independence. Rana’s case manager provided consistent follow-up and emotional support, reinforcing coping strategies and supporting continuity of care. This coordinated approach helped ensure that Rana was not treated solely for symptoms but instead received holistic support.
Gradually, Rana overcame the fear that dominated her life. Her panic attacks have largely stopped, and she has begun to sleep through the night without medication. She has also returned to work, started driving again and has reconnected socially.
Manal’s Journey
Manal found similar support at the Labweh PHCC. Her case manager, Hidaya, created a safe space for Manal to express her concerns and introduced her to coping strategies, including breathing techniques, grounding exercises and behavioral-activation techniques to help manage anxiety symptoms. Additionally, International Medical Corps facilitated psychiatric consultations, during which Manal was diagnosed with panic disorder.
The right diagnosis at the right time helped Manal receive appropriate treatment. “Recovery takes time,” Hidaya says. “It involves follow-up with specialists, ongoing monitoring, appropriate medication and gradual build-up of routines and daily habits. Each step plays an important role in moving forward.”
Manal is adhering to the care plan and treatment, and has shown significant improvement. She has not experienced panic attacks for more than a month, and has gradually resumed daily activities. Her energy levels and overall well-being have improved, enabling her to engage more actively in her personal and social life.
After Serine’s parents reached out to our MHPSS case-management team at the Kfarsaroun PHCC in Koura, north of Lebanon, we developed an individualized care plan for Serine, which included:
- regular sessions with a child psychologist;
- follow-up by a case manager; and
- structured psychosocial activities, such as play and art therapy.
Through these interventions, Serine learned to manage her anxiety, express emotions and re-engage with peers and daily activities. We also involved her parents throughout the process, helping them learn practical skills to better support Serine at home through improved communication.
Serine made meaningful progress in applying these strategies, which increased her emotional resilience. Academically, her concentration, grades, participation and overall performance at school improved. “I’m so happy to see Serine talk about her feelings more openly and participate with her classmates at school,” says Serine’s mother. “It was very difficult for us at first, but now I notice a big difference in her confidence while interacting with other children.”
Today, Serine is more confident, socially engaged and emotionally expressive. We continue to support her and her family as they adjust to changing family dynamics following her parents’ divorce.
Rana, Manal and Serine are among the hundreds of Lebanese who have found hope and healing in their mental health journeys with our support. Their experiences show that even amid conflict, displacement and uncertainty, recovery is possible when people have access to timely and holistic mental health care. As communities across the country continue to face challenges, we remain committed to providing them with the support they need to build resilience and hope for the future.
Learn more about our lifesaving work in Lebanon, or read the latest situation report about our response to the conflict in the Middle East.
*Names have been changed to protect identity.