Forty days of war between the United States, Israel, and Iran have produced more than 5,000 dead, a $12.7 billion US military expenditure by day six alone, a blockaded shipping channel responsible for roughly 20% of global oil supply, and a ceasefire that both sides claim to have won while disagreeing on what it actually covers.

The conditional two-week pause in hostilities, brokered through a last-minute Pakistani intervention and announced on April 7, has stopped the shooting. It has not resolved any of the underlying disputes that led to it. And the psychological toll of what happened during those five weeks, on soldiers, civilians, displaced populations, and the leaders making decisions under extraordinary pressure, is only beginning to come into focus.

How It Started

The conflict began on February 28 when the US and Israel launched nearly 900 strikes in 12 hours against Iranian military infrastructure, missile facilities, and leadership targets. Iran’s Supreme Leader, Ayatollah Ali Khamenei, who had led the country since 1989, was killed during the first wave of strikes. His son, Mojtaba Khamenei, was named successor on March 8.

The killing of Khamenei was not the only leadership decapitation. Israel says it targeted and killed security chief Ali Larijani, intelligence minister Esmail Khatib, and the head of the paramilitary Basij force, Gholamreza Soleimani, along with dozens of senior figures in the Islamic Revolutionary Guard Corps.

Israeli Defence Minister Israel Katz described the opening strikes as pre-emptive measures aimed at removing threats against Israel. US Secretary of State Marco Rubio said Washington knew Israeli action was coming, which meant America had to act in the face of expected Iranian attacks on US forces.

No one explained why that particular moment demanded military action. The US and Iran had been negotiating. They appeared to be making progress. Then, on February 27, Trump said he was “not happy” with the way talks were going. Hours later, bombs began falling.

The Escalation Spiral

What followed was a rapid, multi-front escalation that most conflict psychologists would recognize as a textbook case of threat-response-counter-response dynamics spiraling beyond any single actor’s control.

Iran responded to the initial strikes with widespread missile and drone attacks on Israel, hitting Tel Aviv and other targets. The IRGC targeted Israeli government and military sites. As of March 29, Israel’s Magen David Adom ambulance service reported 19 people killed by missile fire since the war began.

But the damage spread far beyond the two primary combatants. Iran struck countries hosting US bases: Qatar, Bahrain, Jordan, the UAE, and Kuwait. At least 24 people died across the Gulf, most of them security personnel or foreign workers. A French soldier was killed by a drone at a Kurdish military base in northern Iraq. Seven Iraqi soldiers died in an airstrike in Anbar province whose origin remains unattributed.

In the Israeli-occupied West Bank, four Palestinian women were killed at a beauty salon in an Iranian missile attack.

Turkey said NATO air defenses shot down three Iranian missiles over its airspace. Azerbaijan accused Iran of attacking an airport with drones. A British military base in Cyprus was struck by a drone, though Western officials later said it had not been launched from Iran.

On March 7, Iranian President Masoud Pezeshkian apologized to neighboring countries and said the military should not attack them unless they were attacked first. Attacks continued anyway. On March 14, Hamas in Gaza took the unusual step of urging Iran to stop striking Gulf states.

The pattern here is telling. Once large-scale military operations begin, the capacity for restraint erodes quickly. Decision-makers under siege conditions process threats differently than they do during peacetime negotiations. The stress response narrows attention, prioritizes immediate survival, and makes escalation feel like the only rational option, even when it produces outcomes nobody wanted.

The Human Cost

The US-based group Human Rights Activists in Iran (HRANA) reported on April 2 that 3,530 people had been killed in Iran since the war began, including 1,606 civilians, of whom at least 244 were children.

One of the most devastating single incidents occurred on the first day. Iran accused the US and Israel of launching an attack on a girls’ school near an IRGC base in southern Iran on February 28, saying 168 people were killed, including around 110 children. The US said it was investigating. Israel said it was “not aware” of any military operations in the area. BBC Verify’s expert video analysis showed a US Tomahawk missile hit a military base near the school.

Access to Iran for international journalists has been limited throughout the conflict, and internet connectivity in the country has been almost entirely restricted. That information blackout makes independent verification difficult and compounds the psychological isolation of a civilian population already under bombardment.

In Lebanon, where Hezbollah opened a new front on March 2 by firing rockets at Israeli positions, the health ministry reported 1,345 people killed as of April 2, including 125 children. More than a million people, roughly one in every six Lebanese, have been displaced from their homes. Ten Israeli soldiers and three Indonesian peacekeepers have also been killed there.

Total deaths across the region, according to figures compiled by the chair of the joint chiefs, Dan Caine, stand at more than 5,000. Thirteen US service members are among the dead.

The Economic Shock

Iran imposed a blockade on the Strait of Hormuz, the narrow passage through which about a fifth of the world’s oil supply flows. The blockade lasted more than a month before the ceasefire required Iran to reopen it for two weeks.

US and Israeli forces also targeted Iran’s oil and gas infrastructure directly, including Kharg Island, home to a major oil terminal considered Iran’s economic lifeline, and South Pars, part of the world’s largest natural gas field. Attacks on major oil and gas hubs throughout the region prompted some of the world’s largest producers to suspend production.

Benchmark Brent crude oil rose to almost $120 a barrel, one of the largest spikes since Russia’s full-scale invasion of Ukraine in 2022. The war also triggered one of the most serious disruptions to global travel since the COVID-19 pandemic.

The economic dimension matters psychologically too. When energy prices spike and supply chains fracture, the stress doesn’t stay in the conflict zone. It radiates outward through every economy dependent on Gulf oil, affecting populations who may never hear a siren but will feel the consequences in their daily lives for months or years.

The Ceasefire and Its Contradictions

The two-week pause came together in the final hours before Trump’s self-imposed deadline. He had threatened to strike Iranian power plants and energy infrastructure, posting on social media that he would unleash “hell” if Iran did not comply. Pakistan’s Prime Minister Shehbaz Sharif and army chief Gen. Asim Munir intervened with a mediation framework, and both sides accepted. Trump posted on Truth Social that he had agreed to a double sided CEASEFIRE.

Iran’s foreign minister, Abbas Araghchi, confirmed acceptance, saying Tehran would agree to a ceasefire if attacks against Iran were halted. Pakistan declared the ceasefire in effect immediately and agreed to host delegates in Islamabad for formal talks.

Both sides promptly claimed victory. US Defense Secretary Pete Hegseth told reporters at the Pentagon’s first press briefing since the ceasefire that “Iran begged for this ceasefire, and we all know it,” adding that “Operation Epic Fury decimated Iran’s military and rendered it combat ineffective for years to come.” Iran’s supreme national security council countered that nearly all the objectives of the war have been achieved.

The terms of any lasting agreement are openly contradictory. Trump posted that Iran would hand over its enriched uranium with “no enrichment” going forward. Iran’s 10-point counter-proposal explicitly demands the right to enrich. Israel said the ceasefire does not cover Lebanon, where its ground and airstrike campaigns remain at their largest scale since the northern invasion began. Pakistan and Iran have both said a ceasefire would include Lebanon.

Attacks continued even after the announcement. Israel took Iranian missile fire. Kuwait and the UAE reported Iranian missile and drone attacks. Iranian state media reported strikes against oil infrastructure on Lavan Island.

The forthcoming talks in Islamabad represent the highest-level US-Iran engagement in nearly half a century. Whether they produce anything durable depends on whether the parties can bridge gaps that look, at this point, unbridgeable.

What Forty Days Reveals

Hegseth acknowledged during his briefing that Iran can still shoot what it has stockpiled, even if its defense industrial base has been destroyed. He said the US had prepared strikes on power plants, bridges, and energy infrastructure that Iran could not defend and could not realistically rebuild for decades.

Iran’s supreme national security council warned that they remain ready to respond with full force to any hostile action.

Asked how long US forces would remain in the region, Hegseth indicated there were no plans for withdrawal.

The US military had spent roughly $12.7 billion by day six of the conflict, with a $200 billion supplemental request pending before Congress. That figure alone should prompt a reckoning about what this war has actually achieved and at what cost. But reckonings require the kind of measured, reflective thinking that war actively suppresses.

Forty days is enough time to kill more than 5,000 people, displace a million, spike global oil prices by tens of dollars per barrel, and spend hundreds of billions. It is not enough time to resolve a geopolitical rivalry that dates to 1979. The ceasefire is a pause, not an ending. Both sides have their hands on their respective triggers and are telling the world so, loudly, on the record.

The research on decision-making under conditions of prolonged threat is clear on one thing: the longer the threat persists, the more cognitive shortcuts people use, and the worse those shortcuts tend to be. That applies to generals, presidents, and foreign ministers as much as it does to the populations living under the bombs. Two weeks is not very long. What happens when the pause expires will depend on whether anyone in Islamabad can think clearly enough to find a path that doesn’t lead back to where we just were.

Photo by Denis Ngai on Pexels