Anxiety and Depression Of the 305 migrants seen in first consultations, 39% presented symptoms of anxiety such as constant worry, fear, panic, restlessness, while 31% presented symptoms of depression, such as sadness, loss of interest, hopelessness, and thoughts of death. It is often difficult to distinguish symptoms of depression from symptoms of anxiety. For example, a person may be primarily depressed, but s/he may also behave aggressively and report feelings of tension and stress. I am constantly crying. I am very worried about how long I will have to stay here. Being in the detention center makes me feel desperate. Iraqi woman, in her forties I feel stressed and I am exhausted inside the detention center. I have been here for more than a month. I am afraid for my two children I left behind. I feel that I have been in here forever. Pakistani man, in his early twenties For many patients, distress and sadness were reflected in different somatic complaints such as general body pain, headaches or stomachaches. As an Afghan man in his early twenties told us: “I was very healthy before I came here. Since I am here I suffer from headaches and I feel very weak. I am in constant worry.” Sleeping disturbances (falling/staying asleep) are common for both anxiety and depression and were reported amain complaint by 5% of MSF patients. Overcrowding and constant noise in the cells contributed to the lack of sleep. I cannot sleep even for an hour. I have not slept for more than a month, since I arrived here. I feel sad and I cannot stop thinking. I always think about my past. Afghan man, in his early twenties Suicide attempts or suicidal ideas are common risk factors in depression. Three point two percent (3.2%) of MSF’s patients attempted suicide or self-harm because they felt detention was unbearable or because they wanted to protest about the length of detention. I have been detained for four months already and nobody explained to me why I am being detained or for how long I will be detained. If I am not released I will try to kill myself again. Afghan man, in his late twenties I see nightmares that I am deported and I am in prison. I am very scared about the future. I just want to live like a human being. If the situation does not change I will kill myself. Iraqi man, in his early twenties MSF’s experience shows that detention has detrimental effects on the wellbeing and mental health of migrants and asylum seekers. For most of them, detention is a painful and dehumanising experience. Symptoms of anxiety and depression were observed in the majority of the patients. Moreover, detention contributed to the further suffering of many migrants who had already been through trauma in their countries of origin and during their hazardous journey. Detention exacerbates existing symptoms, hinders the healing process, and contributes to new traumas and psychological distress. © Giorgos Moutafis 22