"They are bombing us three or four hours a day. For a few weeks, they were bombing us continually," added Rizk, a fresh-faced young woman with long auburn hair pulled back in a girlish ponytail.
Her tone was as matter-of-fact as if she were explaining a drug dosage to a customer, rather than describing six months of shelling between Muslims and Christians that has devastated Beirut. The 200,000 people who remain in a city that once was home to 1.5 million have grown accustomed to long nights in bomb shelters.
Rizk routinely takes tranquilizers - available without prescription - herself.
"In the shelters, you hear the bombs exploding all around you, and the voices of people screaming in fear and crying in pain," she said.
"How else could we get some sleep through all that without tranquilizers?"
Fourteen years of war - with the last six months marked by nights of shelling unprecedented even in Beirut's torturous history - have left their mark on the Beiruti psyche. Psychiatrists say psychosomatic illness and drug addiction are soaring.
Every day dozens of patients come to the Hospital of the Cross, a psychiatric hospital on a once-scenic hillside overlooking both East and West Beirut. Today, the windows look out on buildings as scarred as the emotions of many people who live in them.
Those who are addicted to tranquilizers or heroin - made from opium poppies grown in the nearby Bekaa Valley - are admitted to dry out. Psychiatrists say they are seeing twice as many drug abusers as they did just two years ago.
Others simply come burned out from the war, complaining of insomnia, headaches, heart palpitations, rising blood pressure, an oppressive weight on their chests, the loss of appetite and upset stomachs. Some also report a strong odor to their urine, which doctors say results from a rush of adrenalin caused by fear during the bombardments.
Many have been to physicians first, and turned to psychiatrists after the doctors were unable to find any physical cause for their symptoms, said Dr. Edoard Azouri as he sat in his office at the Hospital of the Cross, filling dainty white cups with thick, muddy coffee poured from a small metal urn.
Outside the psychiatrist's window, open to the brilliance of a Beirut morning and barred to keep patients from jumping out and down a sheer cliff that drops hundreds of feet, the deadening, basso thud of mortar shells exploding arose from the embattled city. Azouri did not spill a drop; the sound has become routine, he said.
"In a situation like this, the main thing that has risen is the level of anxiety," said Azouri, a balding, bespectacled man in his 60s whose office is stripped of all but the essentials: his cluttered desk, two wooden chairs and a black Naugahyde couch against one wall.
"It's the anxiety of waiting for something to happen. And anxiety is the mother of all psychological disorders."
Sometimes, the "cure" lies in a simple respite from terror. Only occasionally have Syrian shells exploded on the hospital grounds, falling short of the ports and military posts far below in the city.
Charles Baddoura, a hospital psychiatrist, said patients arrive almost every day experiencing "brief psychotic reactions" to the war.
For example, a 19-year-old Hindu from Sri Lanka, in Lebanon looking for work, came to the Hospital of the Cross last week, suffering from delusions and hallucinations about bombing. The day before, the man had been thrown to the ground when a mortar shell exploded 30 feet away. Though he did not speak English, French or Arabic, the psychiatrists recognized the symptoms of shell shock.
In Baddoura's experience, the man can be expected to snap out of it after a week or two of bed rest.
More complex is the case of Simon, a 24-year-old soldier who was at the battlefield of Souk el Gharb during fierce fighting with Syrian troops three weeks ago. He is suffering a severe reaction to the bombing, Baddoura said, and may never be able to return to the battlefield.
"Twelve bombs fell on the building where he was barricaded," Baddoura said. "He's done nothing but cry ever since. He says he can't go back. He is suffering both fear and guilt, because crying in women is tolerated in our society, but in men, never."
Children can present especially difficult cases. Baddoura is treating one 7-year-old girl who has been experiencing something he describes as "night terrors." Far more severe than a simple nightmare, they cause her to cry for two or three hours a night without ever awakening. Her night terrors began after a shelling that occurred while her family was driving home to Beirut
from a Sunday picnic along the northern coast of the Christian enclave.
"The parents gave the child tranquilizers for a while, and she improved," Baddoura said. "But after they took her off the tranquilizers, the night terrors came back."
Usually, however, the psychiatrists find that children are more resistant than adults to the war's stresses.
"Children have flexible personalities, and can forget more than adults," said Baddoura in the small white office where he gives free consultations for two hours every morning. "Because they don't fully understand what has been lost when a home lived in by their family for generations has been bombed, they don't seem to feel the grief as much.
"An adult realizes too well what has been lost."
While it is easy to recognize the cause of anxieties here, it often is very difficult to relieve them. Sometimes, the psychiatrists at the Hospital of the Cross can offer little beyond a brief respite.
Right now, the 800-bed hospital is full. Many of the patients, distraught over the loss of relatives and homes, really do not need to be in a psychiatric hospital. In normal times, they would be treated as outpatients. But these are not normal times.
"Their homes have been destroyed by the bombardments," said Azouri. ''They are completely without resources. So we have become their refuge, offering them treatment, food, a roof over their heads and care."
That there are not many more patients clamoring for assistance is a testament to the primary, abiding institution in Lebanese life - one that has not broken down even in war - the family.
Those who are widowed, orphaned or left homeless by the bombardments usually have an extended family to lean on.
"Strong family ties give individuals a feeling of security, even in the face of great loss," said Azouri. "The individual never feels totally isolated and alone. He can rely on his family as a support system."
But the psychiatrists believe a flood of psychological problems is waiting to wash over the Lebanese people when the shelling abates. For now, the bombardments or the threat of imminent shelling have kept most people from seeking help.
"When the bombardments stop," predicted Baddoura, "we are going to see a lot more patients. In the present situation, many people are just afraid to come."
