After nearly three years, Israelis carry war’s psychological toll in different ways

Reservists repeatedly called up for duty, families burying loved ones, evacuees still displaced from their homes, and people experiencing financial strain—each group is carrying a different weight and carrying it differently.

By Pesach Benson and Omer Novoselsky, TPS

After nearly three years of war, there is no single story of how Israelis are coping with its psychological toll.

A new review of 68 studies finds that mental-health outcomes vary sharply depending on what people experienced, how long they were exposed and what vulnerabilities they carried into the war—pointing to a need for more targeted, long-term follow-up rather than a one-size-fits-all response.

“There is no single psychological trajectory across the Israeli population,” Dr. Michal Cohen, one of the study’s lead researchers, told The Press Service of Israel.

“Population-level averages can obscure very different patterns of distress and recovery among different groups.”

That warning sits at the heart of a new review from the Israel Center for Addiction and Mental Health (ICAMH) at the Hebrew University of Jerusalem, which pulled together 68 studies to produce the most complete picture yet of Israel’s mental health two years into the war—and found that addiction, one of the most common ways people cope with prolonged trauma, has received surprisingly little research attention.

The findings, published in the peer-reviewed Frontiers in Psychiatry, paint a picture that is more complicated and more human than a simple story of a traumatized nation.

There isn’t one Israel when it comes to trauma, the researchers found. There are many.

Reservists repeatedly called up for duty, families burying loved ones, evacuees still displaced from their homes, and people experiencing financial strain—each group is carrying a different weight and carrying it differently.

The study was led by Cohen and Prof. Mario Mikulincer of ICAMH, along with doctoral student Maor Daniel Levitin of ICAMH and Tel Aviv University, working with the Israel Center for Addiction.

Uneven Wounds

Among reservists, certain experiences stood out as especially damaging: close combat, handling human remains, and physical injury were all tied to higher rates of post-traumatic stress.

Anxiety and depression, meanwhile, showed up widely but stuck around longest in people still living under strain, whether that meant reservists repeatedly called up for duty, families still out of their homes, or households facing repeated missile alerts and financial pressure.

Perhaps the most surprising finding is about what has not been studied enough: addiction. Out of 68 studies, only three looked at it.

Two found that people were drinking or using drugs more, especially those with heavier exposure to the war and higher psychological distress.

A third study, on gambling, found that the increase showed up mainly in men who had no history of gambling problems but who struggled to manage their emotions.

Anxiety and depression, the researchers also found, weren’t just uncomfortable feelings—they were affecting people’s ability to function at work, at home, and in daily life, even when their symptoms appeared mild on paper.

Cohen told TPS-IL it’s too early to say what the next decade holds. “Any ten-year forecast would exceed what this review can support,” she said.

But two things already stand out clearly. “The first is pre-existing vulnerability, including prior psychological difficulties and socioeconomic strain. The second is exposure that was more acute, cumulative, or prolonged,” she said.

She pointed to reservists’ families as a telling example—often quietly absorbing economic strain and extra household burdens on top of everything else.

She also flagged groups nobody is really tracking: active-duty soldiers, military families, children, and teenagers. And she raised something easy to overlook—that grief doesn’t stop at the family door.

Friends, grandparents, and teachers can be devastated by a loss and still fall outside the definition of “bereaved” that support systems use.

Asked what she’d change first, Cohen told TPS-IL, “I would recommend moving away from a one-size-fits-all response toward more targeted, longitudinal identification and follow-up based on the type and duration of exposure, existing vulnerability, and day-to-day functioning.”

She also urged caution about one popular assumption: that because women reported more distress in the data, men must be doing better. That gap, she said, may say more about who feels comfortable asking for help than who actually needs it.

Treating Trauma That Won’t End

Eiyar Segall, who spent 20 years as a mental health officer in the Israel Defense Forces (IDF) and now works as a clinical social worker specializing in trauma, was not involved in the study.

She told TPS-IL that one of the biggest problems she sees is not clinical but occupational: Soldiers who have spent months living at wartime intensity are struggling to slow back down to ordinary life.

“I see a very great difficulty in returning to a mental operating system of routine and citizenship,” she said.

She’s also noticed something shifting in how employers treat reservists. Early in the war, bosses gave soldiers room. “Not anymore,” she said. “At first it was very empathetic, but now they want the employee here.”

Segall said the nature of this war itself makes healing harder because trauma treatment usually depends on people understanding that the danger is over—and for many Israelis, it isn’t.

“With prolonged exposure to an event there is no end; things happen over and over again,” she told TPS-IL, describing children who are sent running for shelters again and again during rocket fire.

For reservists still serving, she said, therapy often becomes about survival rather than healing: getting through the next month, not resolving what happened.

Watch for withdrawal, irritability, a loss of interest in things that used to bring joy, and disrupted sleep, Segall advised—all early signs that someone’s struggling more than they’re letting on.

Her broader prescription: start building resilience early, through relationships, community, and a sense of purpose, long before a crisis hits.

The study’s authors say the real answer — whether these symptoms fade or develop into persistent mental-health conditions — will only come with years of long-term follow-up.