Navigating Trauma as a Refugee

We are refugees.

I had hardly understood the term when the Serbian military forced my family out of my country, Bosnia and Herzegovina, in 1993. We lost everything we ever owned and loved, and had to place all our allowed belongings in one small suitcase.

The United Nations High Commissioner for Refugees’ (UNHCR’s) official definition of “refugee,” according to the 1951 Refugee Convention, is “someone who is unable or unwilling to return to their country of origin owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion.”

It became an official identity, an identity I did not understand. Nobody really took the time to explain it to me. I just remember feeling diminished. Previously, I had always possessed an extraordinarily keen sense of identity as a proud Bosnian woman, but my identity became shaped around a huge sense of loss and emptiness with which I struggle to this day. However, my identity also became one of an advocate with enormous compassion for those who suffer as I have — with the reality of living with post-traumatic stress disorder (PTSD).

From a Happy Life to a Scary Reality

As a little girl, I loved going to my nana’s home. She lived in this “magic house” in which I spent some of the happiest moments of my life, where I was allowed to dream, play and let my imagination become my storyteller and guide. Often, I would hear doves “talking” to each other. They made a sad sound — it felt almost like a warning. When I asked my nana about it, she said they often cried in pain about humankind hurting and hating each other. I did not understand it then. As a young adult, I was a happy law school student, surrounded by my family and friends. I was full of dreams and hope. I loved dancing, music, poetry and travel.

Then, suddenly and unexpectedly, everything came to a complete stop in 1992.

The happy life I knew quickly became a distant memory, as I and hundreds of thousands of Bosnians faced a raging war, which became the bloodiest and most violent conflict in Europe since the end of WWII. It was a planned aggression, a slaughter of Bosnian civilians, as well as an ethnic cleansing of the non-Serbian populations. This war, which cost over 100,000 Bosnian lives, was one I was forced to bear witness to and live through.

Surviving the War and Trauma

After surviving the war and its atrocities, as well as the loss and pain I carry from it, my family and I were welcomed to our new home and country by Exodus, a refugee resettling agency in Indianapolis. The local Church of the Nativity and its volunteers offered our family help and their warm hearts.

Upon arrival, we had nothing but our small bags with the UNHCR sign on them and a few personal belongings — and no money to count. A refugee brings only what they can carry.

We never imagined that we would live through the horrors of war and genocide; it was so unimaginable to us, because we had once lived in a peaceful democracy.

I was lucky to become a citizen of a peaceful world again in the U.S.

Finding freedom was my dream, hope, drive and purpose during the war. I developed a deep gratitude for the things I used to take for granted: the freedom to freely walk, talk and express myself, and the freedom to live. I am forever grateful to the U.S. government and its people for allowing me and thousands of others — Syrians, Bosnians and Sudanese, among others — a second chance at life. We were immigrants and refugees, but we also became neighbors, co-workers and friends.

The Aftermath of Trauma and Stigma of Mental Illness

Once we made it across the border to freedom, we were safe from bombs, gunfire and immediate physical harm. However, the memories and traumatic experiences did not disappear; they stayed deeply engrained in our psyches — and they often led to very complex mental health issues, sometimes lasting a lifetime.

After about a year into my refugee life, I reported to my family doctor, in the best English I could speak at the time, that I could not sleep; I had nightmares, felt constant fear and had “visions” of what was happening during the war. Doctors threw several terms at me — terms I could not even pronounce. I was told I suffered from PTSD, depression and anxiety, which were scary labels with no meaning at the time.

I remembered that back home, people with psychological problems were labeled as “crazy,” “dangerous” and “strange.” That was how I started to perceive myself. I felt I was damaged and somehow responsible for the way I felt. I had developed this wonderful ability to escape from that part of myself by dissociating from my feelings, the pain I was in and even my memories. I thought I had it under control. I took prescribed medications and immersed myself in working, learning English and continuing my college education. I was free, living with my family. What else could one ask for?

My approach worked — until it didn’t. As I know now, trauma has long-lasting physical and mental consequences, symptoms that must be addressed, not avoided and denied. Trauma triggers, I found, can be very powerful, throwing you down on your knees when you do not expect it. I felt as though I had no control.

In desperate attempts to treat me, doctors had me hospitalized, overmedicated and put through electro-convulsive therapy (ECT), with grave consequences.

Taking Control of My Health

After years of struggle and looking for answers, I embarked on a journey to find a doctor who would give me a CT scan on my brain. I had hoped that a better understanding of the brain and its chemical interactions might help me develop an effective treatment plan. Everything changed when I watched a TEDx speech given by Dr. Daniel Amen, a psychiatrist specializing in brain imaging to better understand the impact of brain injuries. In the speech, he mentioned that he was opening clinics across the country where imaging procedures would be available.

I began saving money and filling out the necessary paperwork — and in 2021, I scheduled a brain imaging procedure at a clinic in Chicago.

Testing took two days. In the “moment of truth,” I had a consultation with the team’s lead psychiatrist, who showed me images of my brain, and provided me with lengthy explanations of what trauma, years of depression, insomnia and anxiety had done to my brain.

I started crying and did not stop for the next few days. All my suffering and self-doubts were finally validated. My doctors helped me formulate a treatment plan with a specific medication regimen, trauma therapy, necessary supplements and exercise program. Finally, my healing could begin.

Moving Forward

With the right treatment in place, I was able to acknowledge and validate my pain — and I could even begin to celebrate my resilience. Moreover, I committed to being compassionate to others going through similar experiences.

With time, I found my voice and became an advocate through NAMI, reaching out to those who still suffer in silence. The resilience I developed through the war gave me the power to start finding myself again.

Maybe I am not the person I was before the war, but I have discovered new strengths and skills. I decided to renew my passion for writing, which I have always loved.

I will continue to be a mental health warrior. I will always speak up, especially for marginalized communities, youth and refugee populations.

Lejla Pasalic is originally from Bosnia and Herzegovina, and came to the U.S. as a war refugee in 1995. She holds an M.S. in human behavior and human services, and currently serves as a Program Coordinator for NAMI Greater Indianapolis.

Note: This article was originally published in the Spring 2023 issue of the Advocate.