Posttraumatic stress symptoms, alexithymia, and financial distress among adults in Beirut, Lebanon: a cross-sectional study amid overlapping crises

In the aftermath of a disaster, the human mind often struggles to make sense of what has happened. Sometimes, the trouble is not just remembering the event, but feeling the emotions that come with it. When people find it difficult to identify or describe their own feelings, psychologists call this alexithymia. It is like having a fog inside the mind that makes it hard to tell the difference between anger, fear, or sadness. This emotional confusion often travels hand-in-hand with post-traumatic stress, a condition where the body and mind remain stuck in a state of high alert long after the danger has passed. At the same time, the practical realities of life, such as losing a job or watching savings vanish, create a different kind of pressure known as financial distress. While these three elements—emotional confusion, trauma symptoms, and money worries—are often studied on their own, they rarely exist in isolation. In places where crises overlap, such as economic collapse followed by a massive explosion, these factors likely weave together to shape how people recover. Understanding how they connect is essential for helping communities heal.

In Beirut, Lebanon, researchers set out to untangle this complex web. The city has endured a series of crushing blows in recent years, including a severe economic crisis, a global pandemic, and the catastrophic explosion at the port in 2020 that devastated neighborhoods and displaced thousands of families. To understand the psychological toll of these overlapping events, a team of scientists from Beirut Arab University and other local institutions conducted a survey of 388 adults living in the city. They did not look for a single cause of suffering but rather examined how probable post-traumatic stress, alexithymia, and financial distress appeared together in the population. The team used established questionnaires to measure each factor: one to check for stress symptoms, another to gauge the ability to understand emotions, and a third to assess how worried people were about their money. They also asked participants about their age, job, marital status, and exactly where they were living when the blast occurred, dividing the city into zones based on the level of damage.

The results painted a picture of a population carrying a heavy burden. About 30 percent of the people surveyed showed signs of probable post-traumatic stress, a rate that varied depending on how close they lived to the explosion. In the zone that suffered the most damage, nearly half of the residents met the criteria for stress symptoms. However, the study found that where a person lived was not the only factor at play. The researchers discovered that the ability to understand one's own emotions was a powerful predictor of mental health. Roughly 38 percent of the participants struggled with alexithymia, and this difficulty was strongly linked to higher rates of stress symptoms. In fact, when the researchers analyzed the data to see which factors mattered most, alexithymia emerged as the factor with the strongest association with post-traumatic stress in the multivariable model. People who could not name their feelings were far more likely to be suffering from trauma symptoms than those who could.

Financial worry also played a significant role in the mental landscape of Beirut. Nearly 44 percent of the participants reported high levels of financial distress, and this worry was closely tied to both age and marital status, with older adults and those who were divorced facing the greatest strain. The study showed that money troubles and emotional confusion often fed into each other; those who struggled to understand their feelings were also more likely to be in deep financial trouble. When the researchers looked at the combined effect of these issues, they found that people experiencing both high financial distress and alexithymia were at the highest risk for post-traumatic stress. Interestingly, while the location of the blast mattered, the specific zone a person was in did not remain a significant predictor once the researchers accounted for emotional and financial factors. This suggests that the internal state of a person and their economic reality might be just as critical to their recovery as the physical distance from the explosion.

The study also highlighted a specific group that is bearing a heavy load: healthcare workers. Despite making up a smaller portion of the sample, medical professionals showed higher rates of both alexithymia and post-traumatic stress than other workers. The researchers noted that the demands of their jobs, especially in the chaotic aftermath of the disaster, likely contributed to this. The pressure to remain calm while treating the injured, combined with the difficulty of processing their own fear and grief, may have led many to suppress their emotions, a coping mechanism that can worsen long-term stress. The authors emphasized that while their study cannot prove that one factor causes another, the connections they found are clear and strong. They concluded that helping people in crisis requires more than just treating trauma; it demands addressing the emotional fog that clouds their minds and the financial instability that keeps them on edge. For a city still reeling from multiple disasters, the path forward may depend on integrated support that heals the mind and stabilizes the wallet at the same time.