On Sunday, the Defense Ministry announced that 16,000 soldiers have been wounded in this war and that it expects around 100,000 will be wounded by 2030 when taking into account all of Israel’s wars.
Also, the ministry said at a major international conference on the issue hosted by Israel on Tuesday that 50% of those treated have experienced psychological distress,
From prior wars, out of 11,000 soldiers who have had emotional problems, around 8,000 or 70%, experienced emotional symptoms as their primary problem.
The IDF has said it is proud that 85% of its soldiers who have a potential mix of being physically or emotionally harmed by their war experiences are able to return to the battlefield and that the number of mental care providers in the army has skyrocketed.
But some experts and anecdotal evidence have raised questions about whether the atmosphere among these therapists and the battle commanders is truly conducive to handling issues like Post Traumatic Stress Disorder (PRSD) properly, or whether there is undue pressure from key officials to send soldiers back into battle even if they are only borderline stable.
In short, PTSD was a mega problem before the war and is as big or a much bigger problem since this war started.
The only reason to say that it might not be a much bigger problem is that the October 7 disaster was so fundamental and horrific that it broke the resistance within the military system to treat PTSD and on a more accelerated basis.
Prior to the war, even if army psychologists were pushing for taking PTSD more seriously, the IDF high command and top defense ministry officials still were not providing sufficient funding, resources, or backing.
That changed rapidly after October 7.
But many of the existing treatments for PTSD have major drawbacks and limited effectiveness.
In contrast, a relatively new treatment, the Stellate Ganglion Block (SGB) treatment addresses “the root cause of anxiety, depression, PTSD and Long COVID symptoms,” according to the company Stella Global’s website, which promotes its use.
“By targeting the biological source, these treatments can provide breakthrough relief where traditional methods may have fallen short,” says Stella’s website.
Stella Israel, part of Stella Global, also operates in the US and Australia. Since 2022, it has provided SGB treatments at hospitals in Tel Aviv and Haifa.
If Stella can provide the new kinds of relief for PTSD that it promises, it would not be a moment too soon, given the October 7 world in Israel.
Stella Israel General Manager Jason Blankfield and Chief Medical officer Jason Cohen noted to the Jerusalem Post that IDF Rescue Unit 669 was inside battlefield situations for 130-150 days through the end of 2025.
They said that these soldiers, along with most combat soldiers, were regularly exposed to traumatic situations and could face serious PTSD risks, though they are not always thought of as PTSD risks.
Also, PTSD and emotional harm to soldiers are just cleaned-up code phrases for problems which are often much worse than feeling temporarily depressed.
For example, Blankfield and Cohen said that the suicide rate among soldiers was always problematic, but that since October 7 it is much worse. Many observers feel that this issue is often swept under the rug so as not to undermine readiness to volunteer for combat units.
Beyond suicide, a huge volume of soldiers simply are not finding a way back to resume their lives to function as normal people, say Blankfield and Cohen.
Doctors at Shaarei Tzedek have told the Stella officials that two to five soldiers per week come in with emotional issues, but since they are not defined as terror victims and are denied various subsidized therapies, the doctors know that they will turn into chronic PTSD patients who are very unlikely to return again to normal functioning status.
What does SGB do and how does it work?
The Stella officials said, “The old model was the psychology model of care as a stand alone. Now there is a new understanding about how we can potentially treat trauma, including based on research at Walter Reed Medical Center in the US.”
“There are various biological markers from blood samples which create a good map for who needs what kind of treatment…Until now professionals were often essentially throwing spaghetti at the wall and hoping it would stick,” they stated.
They continued, “We are trying to raise awareness about what is on offer. We raised one million dollars to treat people until the broader system can keep up to better subsidize. So for Nova Festival survivors, it is completely free.” On average, reservists for the moment pay a heavily subsidized mere NIS 750 per treatment and Blankfield said that almost all patients end up getting a 50-100% discount depending on the specific circumstances.
According to the two officials, SGB is “not only the greatest treatment out there, it has huge advantages in terms of only needing two treatments. What do you have to lose? It’s only two one-hour sessions plus travel to the treatment center and it has a 75% clinical success rate.”
This 75% statistics is based on the average PCL score (The PCL –Post-Traumatic Stress Disorder Checklist— is the gold standard self-report questionnaire used to assess the severity of PTSD symptoms based on DSM criteria) for 150 patients in Israel, which decreased from 51 to 33 (meaning the severity of the symptoms decreased), based on the most recent data, according to Blankfield.
Another problem is that treatments through therapy often only go so far and then it ends. Blankfield and Cohen said that Nova Festival victims received 30 psychological treatments from the government for free, but then they are on their own.
Addressing Cannabis as a competing therapy for PTSD, they acknowledged that it helps combat sleep deprivation, but added that it carries dangers in terms of boundaries. Namely, that some people who start to use it on a limited basis medically move on to recreational use, and sometimes even overdose.
According to the Stella officials, SGB “provides noticeable symptom improvement within hours to days following the procedure. This is particularly advantageous for patients in acute distress.”
In contrast, they said that traditional talk-therapy “requires weeks to months of consistent sessions, while pharmacological therapy (drug therapy for improving PTSD symptoms) often takes 4-6 weeks to show effectiveness.”
How quickly PTSD is treated and how quickly the treatment starts having an impact can be crucial. They said that, “There are different stages of evolving trauma. If treated well and quickly, symptoms are often treatable. If left untreated for too long, it can become almost untreatable within 6-12 months.”
Next, regarding a targeted “mechanism of action,” they said that SGB “directly modulates the hyperactive sympathetic nervous system [calms down bodily organs which are too stimulated, overwhelmed, and therefore causing physical problems], a key physiological component of PTSD. This approach bypasses the broader systemic effects of medications and the subjective challenges of talk therapy.”
This is as opposed to traditional therapy, which they said, “addresses symptoms indirectly through cognitive restructuring [psycho or talk therapy] or neurotransmitter modulation [pharmacological or drug therapy], which may not sufficiently address autonomic dysregulation.” In other words, they argue that only SGB will reset a system completely and sufficiently to restore functionality or put out the “fire” which is damaging the system.
Moreover, they said that SGB has a lower risk of side effects, saying that it is “generally safe, with localized and temporary side effects…There is no systemic pharmacological impact, reducing risks associated with drug interactions or dependence.”
However, pharmacotherapy they say is “associated with side effects such as weight gain, sexual dysfunction, sedation, and increased risk of dependency in benzodiazepines,” depressants which temporarily help sedate and hypnotize people into more of a ‘zombie state’ to help reduce anxiety.
Also, psychotherapy they said while non-invasive, “can exacerbate symptoms initially as patients confront traumatic memories.”
Discussing improved treatment compliance, they argued that SGB’s “two treatments offer prolonged symptom relief, reducing the burden of ongoing treatment,” whereas they said traditional therapy “requires sustained commitment, with high dropout rates due to logistical, financial, or emotional barriers.”
Finally, they noted that SGB can be complementary to existing treatments, including enhancing the efficacy of psychotherapy by reducing hyperarousal, allowing patients to engage more effectively in therapeutic interventions. It also reduces reliance on pharmacotherapy, minimizing,” the body being overwhelmed by overmedicating.
Israeli Defense Ministry approval for SGB
It has taken time for SGB to be approved in Israel for being government subsidized. Medical communities are often a mix of purely professional and very much commercial interests, while some medical officials can get very attached to whatever treatment they are historically used to and come out as unjustifiably skeptical of new treatments as “too good to be true.”
How approved is SGB treatment now?
Walter Reed Medical Center is conducting research with the ambition of making SGB a “first line” treatment for PTSD – meaning patients can opt for it before having to try some other kind of treatment.
The US Veterans Association characterizes SGB as a second line treatment. According to the Veterans Association, it has not yet approved SGB as a first line treatment because the treatment has not been around long enough to prove its effectiveness long-term and because there have been fewer studies addressing the issues from a variety of standpoints and populations. That said, Blankfield said there is clear evidence of SGB alleviating chronic pain, especially those with Complex Regional Pain Syndrome (CPRS.)
In Israel, the Defense Ministry recently approved SGB as a third line treatment.
History of treatment
SGB Treatment has been available in Israel since mid-2022 with over 700 persons receiving treatment, 80% of whom were treated in the last year.
During the first year of the treatment, there were three to five treatments per month. But by September, the numbers jumped to 50 treatments and there were also 50 treatments in January.
In 2023-2024, around 8,000 people from the US were treated, 6,065 of them in the last year. In Australia, 600 have been treated. Blankfield said that England still has not approved the treatment, which has led some British citizens even to fly to Israel to receive it.
Citizens from Ukraine, the Czech Republic and other countries have also flown into Israel for the treatment.
Dr. Eugene Lipov first discovered some of the medical science which was the basis of SGB and published a study in 2008. But it took time to convert his findings into a treatment program and to receive bureaucratic approvals for offering the treatment to the public.
“A lot of psychiatrists have lost hope after October 7, and we hope we can bring some light back to this field,” said Blankfield and Cohen.
