TEL AVIV โ Prof. Eyal Fruchter, MD, former head of mental health at the Israel Defense Forces Medical Corps, is advising caution in the immediate aftermath of missile barrages from Iran, saying the first 48 hours following a traumatic event are generally not the time to begin anti-anxiety medications or hospitalize individuals suffering acute anxiety.
Fruchter, one of Israelโs leading psychiatrists and a specialist in PTSD, suicide prevention, and resilience, said early intervention should focus on restoring stability and agency rather than medicalizing acute stress reactions.
โIn the immediate aftermath of a traumatic event, especially within the first 48 hours, people experiencing anxiety related to ongoing war should remain surrounded by friends and their social support network whenever possible,โ Fruchter said in a statement shared with the media.
He cautioned against self-medication with alcohol or cannabis and against beginning anti-anxiety prescriptions during the initial phase following trauma, unless clinically necessary.
โDuring the first 48 hours after a traumatic event, it is generally not the time to begin anti-anxiety medications, to self-medicate with alcohol or cannabis, or to hospitalize individuals suffering from acute anxiety,โ Fruchter said.
Instead, he emphasized practical and grounded measures.
Encourage hydration. Maintain physical presence with supportive family and friends. Ask questions that help individuals regain a sense of agency by making choices, even small ones. Invite them to engage in basic tasks.
โSupport them in functioning, choosing, and gradually reclaiming their sense of position and control,โ he said.
Fruchter also advised structured recounting of events focused on facts rather than emotional interpretation.
โEncourage a clear, structured recounting of events, focusing on facts rather than emotions. These are the core guiding principles in the early phase,โ he said.
Israel has faced repeated missile and drone barrages in recent days as part of escalating hostilities with Iran and Iranian-aligned groups. While Israelโs air defense systems have intercepted many incoming projectiles, the sustained threat has heightened anxiety across civilian populations.
Mental health professionals in Israel have reported a surge in stress-related symptoms, including sleep disruption, panic reactions, and acute anxiety, particularly among children and elderly residents in high-risk areas.
Fruchter currently serves as co-founder and director of medical and scientific affairs at ICAR Collective, Israelโs Collective Action for Resilience. The nonprofit was established in 2024 following the October 7 attacks and subsequent war to coordinate national trauma recovery efforts.
ICAR works across Israelโs public health system, academic institutions, and nonprofit organizations to accelerate trauma healing and build resilience at both individual and collective levels.
According to ICAR, the organization has mapped the work of more than 400 care organizations and engaged with over 180 leaders to improve coordination and reduce duplicate services. Its goal is to transform Israelโs fragmented trauma response into what it describes as a coordinated, data-driven national model.
Fruchter spent 24 years in the IDF, where he led its mental health division and oversaw behavioral and emotional screening and treatment processes. He previously served as chief executive officer of Maale HaCarmel Mental Health Hospital and as head of the mental health division at Rambam Health Care Campus.
He has published more than 100 scholarly articles on PTSD, suicide prevention, and psychiatry. He earned his medical degree from the Technion Israel Institute of Technology and completed psychiatric training at HaEmek Medical Center. He also holds a masterโs degree in health management from Ben Gurion University of the Negev and was a visiting scholar at the University of Southern California.
For communities facing ongoing security threats, Fruchterโs guidance reflects an approach rooted in trauma-informed care that prioritizes stabilization before pharmacological intervention.
Mental health experts note that acute stress reactions in the immediate aftermath of danger are common and do not necessarily develop into long-term disorders. Structured support and restoration of routine are often key protective factors.
Fruchter stressed that while early hospitalization is generally not recommended for acute anxiety alone, individuals exhibiting severe symptoms, suicidal ideation, or inability to function safely should seek professional medical evaluation.
As Israel continues to navigate sustained security threats, public health leaders are increasingly emphasizing resilience, community support, and coordinated care to help citizens cope with collective trauma.
