Since Lebanon's lockdown began, Mohammed, 16, has had little else to do than string beads onto bracelets all day, a skill he learned in prison in Syria.
He suffers from post-traumatic stress disorder since he spent seven months in a government jail in Damascus, and already had a strained relationship with his family before confinement measures were announced in mid-March to curb the coronavirus pandemic.
After a few tense days of living with 10 other people in one tent in the dusty Lebanese border town of Arsal, Mohammed’s father decided that it was best that his troubled son live alone in a separate tent.
Although Mohammed said he was happy to have his own privacy after the move, his anxiety and depression remained.
"I barely see my friends anymore," he told The National on the phone.
Confinement measures have exacerbated mental health issues worldwide, but they are particularly noticeable among Lebanon’s refugee population.
Months before it was hit by the pandemic, the country was already suffering from its worst economic crisis, which caused massive social unrest and raised stress levels across the country.
The global coronavirus pandemic has only exacerbated the pre-existing crisis, though Lebanon has been relatively spared, with 26 deaths and 1,172 confirmed cases, including 16 among Syrian refugees.
“[Mohammed’s] symptoms increased badly because he was stuck at home. He wanted to run away from the house. He doesn’t know how to talk to his family,” said Sibelle Hajj, Mohammed’s psychologist for the last seven months. She works for Himaya, an NGO that specialises in mental health support for children.
“When triggers are this strong, people can fall back into previous states of trauma,” said Anaelle Saade, mental health supervisor for Doctors Without Borders (MSF) in northern Lebanon.
“Syrians came to Lebanon for safety, and it doesn’t give it all,” she said.
Mohammed does not want to talk publicly about why he was imprisoned in Syria, or about what happened to him during his time in prison. When he was released eight months ago, he left his mother behind in Damascus to travel to Lebanon to join his father, his second wife, and their children in Lebanon.
Prison was “very hard,” he said. Media and human rights reports have detailed the horrific abuse of many detainees, including children, with mock executions held and routine torture such as electric shocks and sexual assault.
To make things worse, Syrians who fled their country's near decade-long civil war have long outlived their welcome in Lebanon, with President Michel Aoun often saying publicly that they should go home.
Due to the volume of challenges they face, refugees find it had to prioritise their mental health and finding effective, affordable support can be difficult.
Maria, 21, arrived in Lebanon from Syria when she was 13. Soon after, she began having panic attacks and anxiety. She was prescribed medication, but it caused her to lose huge amounts of weight and develop allergies, leading doctors to initially think she had a disorder in her ovaries.
“They made a mess of me. This all made my psychological situation worse,” said Maria, who broke down into tears several times over the course of the conversation.
“All this cost a lot and my father had to borrow money … I felt that nobody could understand me.
Last summer, Maria was referred to an MSF mental health team. A general practitioner and psychologist have been trying to give her the necessary support to stabilize her condition.
Her anxiety has skyrocketed since confinement began, but she has maintained contact with her psychologist via WhatsApp and face-to-face sessions resumed last week.
It has taken her family years to understand her mental health issues.
“My parents do not think it’s shameful, but society believes it is. They think I’m crazy,” she said.
Mohammed never talks about his past with his friends, and his relationship with his father remains difficult. The coronavirus pandemic does not worry him, he said, because there have been no cases in Arsal.
“[Syrian refugees] just fled a war and now you bring them a pandemic. A pandemic will not scare them,” said MSF's Ms Saade. However, psychologists say a lack of fear is not necessarily a good thing.
“Anxiety and stress are somewhat healthy. If you’re stressed, you’ll be vigilant," said Ms Saade.
Ms Saade explained that it is healthy to have a minimum level of alertness at these times so that people are aware of the seriousness of the virus, and therefore would take the necessary preventive measures.
"Letting go is not a survival mechanism ... They’re becoming numb.”
*Some names in this article have been changed to protect people's privacy