Syrian children suffer from 'toxic stress' after 6 years of war, new report says

In the worst cases, Syrian children turn to drugs and self-harm, advocates say.

— -- Nagham lost her entire family in an airstrike last year in Idlib in northwestern Syria. After that, the girl, who was 6 years old at the time, moved to a refugee camp, where she stayed with a family. She refused to eat and was scared of anyone who came close to her.

This is how Taghreed Baaj, a psychological counselor with Shafak, a charity in northwestern Syria, describes one of the Syrian children who made the biggest impact on her. Baaj helped Nagham move to a refugee camp for orphans and still visits her every once in a while.

After nearly six years of war, Syrian children like Nagham suffer from “toxic stress,” a condition that comes from experiencing frequent and continued difficulties, such as the extreme violence of the Syrian conflict, and is likely to have a life-long impact on children, according to a new report conducted by Save the Children and its Syrian partners, including Shafak.

“What affects children the most is losing one of their parents or siblings,” Baaj told ABC News. “It gives children a mental shock. Inside Syria, children generally suffer from lack of education and lack of good nutrition.”

Save the Children, with Shafak and other Syrian partners, interviewed more than 458 children, adolescents and adults across seven governorates in Syria for “Invisible Wounds,” a new report on the mental health of Syrian children.

In the study, 84 percent of adults and almost all children said that ongoing bombing and shelling is the main reason for psychological stress in children’s daily life. Half of the children who are still able to attend school said they never or rarely feel secure there, while 40 percent said they don’t feel safe to play outside, even right outside their homes.

More than 70 percent of adults said that children increasingly wet their beds and nearly half of the adults say they have seen children who have lost the ability to speak or developed speech impediments since the start of the crisis.

“What has been clear over the last six years is that children are carrying the brunt of the war,” Misty Buswell, Save the Children's regional advocacy director for the Middle East, told ABC News. “They have seen homes and schools destroyed and seen family members and friends killed. We talk a lot about post-traumatic stress disorder -- but there is no post, the children are still in the middle of it."

In some of the worst cases, children turn to drugs -- hashish, opium or whatever is available, said Save the Children -- while others attempt self-harm. In besieged areas of Syria, children as young as 12 have attempted suicide, which was unheard of before the war, Buswell said.

“We are seeing anecdotally more attempts at self-harm, suicide attempts and turning to drugs and alcohol attempting to escape,” Buswell said.

At least 3 million Syrian children under the age of 6 have only known war, and millions more have grown up in fear during the conflict.

“Some of the things we were surprised by are the numbers of children who are affected,” Buswell said. “We know that it’s widespread but it’s hard to actually find anyone who will say 'this isn’t a problem' or that they don’t see children exhibiting at least some of the symptoms of toxic stress.”

Buswell described the findings as a “real warning” to end the violence in Syria. If the war continues and children keep being exposed to dangers with limited or no access to education, they will not be able to rebuild their country, she said.

“If the generation of children who are going to have to rebuild their country aren’t equipped to do that and they don’t have the tools, then the country remains devastated even after the conflict is over,” she said. “We have to make sure that the level of violence directed at children isn’t the new normal and recognize that it is children who are suffering the most.”