In the context of ongoing armed conflicts in Libya, Syria, Yemen, and Iraq, it is vital to foster nuanced understandings of the relationship between health, violence, and everyday life in the Middle East and North Africa. In this article, we explore how healthcare access interacts with humanitarian bureaucracy and refugees' daily experiences of exile. What are the stakes involved with accessing clinical services in humanitarian situations? How do local conditions structure access to healthcare? Building on the concept of "therapeutic geographies," we argue for the integration of local socio-political context and situated knowledge into understandings of humanitarian healthcare systems. Using evidence gathered from participant observation among Syrian and Palestinian refugees in Lebanon, we demonstrate how procedures developed to facilitate care-such as refugee registration and insurance contracting-can interact with other factors to simultaneously prevent and/or disincentivize refugees' accessing healthcare services and expose them to structural violence. Drawing on two interconnected ethnographic encounters in a Palestinian refugee camp and in a Lebanese public hospital, we demonstrate how interactions surrounding the clinical encounter reveal the social, political, and logistical complexities of healthcare access. Moreover, rather than hospital visits representing discrete encounters with the Lebanese state, we contend that they reveal important moments in an ongoing process of negotiation and navigation within and through the constraints and uncertainties that shape refugee life. As a result, we advocate for the incorporation of situated forms of knowledge into humanitarian healthcare practices and the development of an understanding of healthcare access as nested in the larger experience of everyday refugee life.

I explore the historical and cultural shifts that underlie the normalization of the term dépréshen and the emergence of public psychiatric discourses in 1990s Iran. I do this by investigating the cultural sensibilities of a particular generation, the self-identified 1980s generation, and the ways they situate what is perceived as dépréshen in social anomie and the memories of the Iran-Iraq war. I argue that psychiatrization of psychological distress in Iran was not simply a de-politicizing hegemonic biomedical discourse, but that the contemporary Iranian discourses of psychological pathology and social loss evolved in public, hand-in-hand, through the medicalization of post-war loss. Psychiatric subjectivity describes conditions where individuals internalize psychiatry as a mode of thinking, and performatively articulate not only their desires, hopes, and anxieties, but also historical losses as embodied in individual and collective brains. I underscore my interlocutors' simultaneous historicization and medicalization of their dépréshen, arguing that psychiatrically medicalized individuals are performative actors in the discursive formation of both biomedical and social truth. Dépréshen, in the larger sense of the word, has become one way to navigate ruptured pasts, slippery presents, and uncertain futures.

Most debates on postwar mental health focus on clinical evaluations of veterans' and civilians' individual experiences of wartime 'trauma'. But the psychological afterlife and the social discord that wars create cannot be reduced to a clinical artifact of individual trauma or be divorced from the historical and cultural meanings that it carries. Generations of war children will continue to remember, process, and work through cultural changes that quietly inscribe past war experiences in their daily lives. This article examines one such cultural shift, namely the medicalization of the memories of the Iran-Iraq War. It illustrates how individuals' PTSD-like symptoms or alleged depreshen turn the seemingly desocializing act of medicalization on its head, and how diagnosis can become a cultural resource to resocialize the war in the sanitized language of biomedicine. It further suggests that moving beyond an individual and clinical rendition of trauma requires the integration of an anthropological understanding of illness and its cultural situatedness into medical pedagogies.

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