Three Years After October 7: Prolonged War Leaves Psychological Toll on Israelis

As Israel marks three years since the Hamas-led attack of October 7, the psychological burden on the country's society remains stark, with rising rates of post-traumatic stress disorder (PTSD) among children, many adults struggling with daily life because of mental health problems, and an increase in suicides among soldiers, according to experts who spoke to Al Jazeera.

About 1,200 people were killed in the attacks on villages and military posts in southern Israel, while Israel's military campaign in Gaza since then has killed more than 74,000 Palestinians. Gaza has been left largely uninhabitable after a wave of destruction that a United Nations commission of inquiry concluded amounted to genocide. Israeli society, meanwhile, continues to function, but beneath the surface, the attacks, the war and rocket strikes have piled further psychological strain on the population.

New research shows that one in five Israelis reports severe difficulty in daily functioning because of mental health, according to the National Mental Health Barometer conducted by the Clalit Health Services research institute and the Myers-JDC-Brookdale Institute.

Among children and adolescents, a separate Clalit study shared with Al Jazeera recorded a 121 percent increase in psychiatric emergency cases compared with the period before the war. Behind those figures are families living with loss and with worry about what lies ahead.

A family living with loss

In an online seminar for journalists organized by Clalit Health Services to mark the anniversary, Irit Ben Arye recounted how her husband, Haim Ben Arye, drove south to help evacuate survivors from Kibbutz Be'eri. It was one of the communities attacked by Palestinian gunmen on October 7, 2023.

The 52-year-old bus driver came home in tears, she said. About two weeks later, he took his own life.

The couple had been married for 30 years and had eight children. Irit worries about the long-term effects on them. Recounting to journalists what she told her children after her husband's death, she said: "You have to seek help, if something is bothering you, if you are in pain, in the dark, you feel you are alone."

"Cry, ask, break something. Let yourself be noticed, let us recognize that you are in pain."

The Ben Arye family is not alone in its psychological strain. In fact, one-third of Israel's population feels they need mental health treatment, according to the National Mental Health Barometer report. Half said their recreational activities have been affected, while 35 percent said they have difficulty forming and maintaining close relationships.

Growing up on alert

Israel's strikes on Iran and retaliatory missile attacks have brought further periods of fear and disruption to civilian life. With missiles and air raids hitting Israel at various points since October 7, ordinary activities can become calculations about access to shelters and the risk of another attack.

Professor of psychiatry Eric Vermetten of Leiden University Medical Center in the Netherlands told Al Jazeera that this pattern of repeated exposure to danger can lead to long-term psychological problems. "Repeated attacks, sirens and displacement turn ordinary decisions – where to sleep, whether to send children to school, how to plan for tomorrow – into questions of safety," he said.

"Maintaining that state of alertness is exhausting: sleep is severely fragmented, concentration declines, and anxiety, irritability or withdrawal can put serious strain on relationships," he added.

Drawing on the records of some five million members, Clalit Health Services' assessment shows that psychiatric emergency cases among children and adolescents more than doubled during this period.

Professor Edgar Jones of the Institute of Psychiatry, Psychology and Neuroscience at King's College London told Al Jazeera that people respond differently to prolonged conflict. Some adapt and develop coping mechanisms.

But if a person experiences the destruction of their home or the death of a relative, they may develop post-traumatic illness or depression, he said. "Many in this group will become weary of war if their daily lives continue to be disrupted and threatened."

"Everyone has a breaking point," Jones said.

The psychological toll on soldiers

The effects of the prolonged war are also evident among those carrying out Israel's military campaigns. Soldiers, including young recruits, have been deployed to Gaza, where a United Nations commission of inquiry concluded that Israel committed genocide against Palestinians.

"For reservists, constantly switching between combat and civilian life can leave them with little or no time to reconnect with family or to process their experiences – loss, guilt, shame, anger, despair – before returning to duty," Vermetten said.

Jones added: "When they look back at what they were ordered to do, or failed to do, they may experience moral injury."

"This arises when their actions challenge their view of themselves, sometimes leading to feelings of guilt, shame and anger at themselves."

Israeli parliamentary data recorded 279 suicide attempts among serving soldiers from January 2024 to July 2025. Combat soldiers accounted for 78 percent of suicides in the military in 2024. These figures do not include veterans who took their own lives after leaving the service.

Vermetten cautioned against treating suicide as an inevitable consequence of prolonged war, but said that "conflict, loss and isolation can increase vulnerability" in soldiers who later take their own lives.

A toll across the region

The psychological fallout from Israel's military campaigns extends far beyond its own population. Since October 7, 2023, Israel's attacks on Gaza and Lebanon, as well as strikes on Iran, have brought death, destruction and displacement across the region, leaving children especially vulnerable to long-term harm.

UNICEF estimates that in Lebanon, 770,000 children have experienced psychological distress, while nearly two-thirds of households say their children are anxious or nervous. The conflict has also deepened years of economic crisis, leaving families struggling to meet basic needs as well as support their children.

In Gaza, the scale of destruction and displacement has eroded the foundations on which psychological recovery depends, with hospitals and homes destroyed across the strip.

UNICEF estimates that more than a million children need mental health and psychosocial support, while much of the population is suffering hunger, amid strikes that have continued despite the so-called "ceasefire" last October.

"Children know that trauma does not end when the bombs stop," Jonathan Crickx, head of communication for UNICEF in the State of Palestine, said in February.