What psychological problems Ukrainians face during the war

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The war in Ukraine created a huge need for psychological support of the population – from psychological first aid to complex psychological support. People have experienced fear, trauma and isolation, and they show symptoms of anxiety, depression and stress. Near the front line and in territories retaken by Ukraine, the mobile clinics of Doctors Without Borders provide assistance to rural residents, most of whom have survived months of fighting, violence and hostilities. “[25 лютого] I had a birthday. Almost on the birthday of the war… We hid in the basements. They [російські військові] they drove around the village on tanks and armored personnel carriers,” explains 74-year-old Anatoliy Andrievskyi from the village of Myrolyubivka, Kherson region. Anatoliy Andrievskyi, Myrolyubivka, Kherson region, 2023, author: Yuliya Trofimova/Doctors Without Borders “Of course, it’s scary. You go to bed and think – who knows what will happen by morning. Will you get up or not? And as himself – that’s in general. It’s good when you’re alone to chat with someone, but he himself was…” Anatoliy Andrievsky learned about psychologists from local residents. Now he’s thinking about turning to them for help. One of the main obstacles on the way to psychological support is the stigma associated with mental disorders, and the shame residents feel when seeking psychological support, especially in rural areas. Although Doctors Without Borders consultations are available to everyone, most of our patients are elderly women. “Men also feel powerless, helpless, and this cannot help but affect the internal state. Something must be done about this, because both the family and the person themselves suffer from it,” explains Tetyana Baranets, a psychologist at Doctors Without Borders. Mental health support with the help of the community Far from the front line, in Kirovohrad region, people who fled combat, trying to cope with trauma, fear and anxiety. Displaced families, mostly women with children, are adjusting to a new life. “This is Bonnie, from the video game. He is doing well and he likes to sleep,” explains eight-year-old Vanya, showing his toy. 9-year-old Ivan in a shelter for displaced persons, Kirovohrad region, 2023, author – Yuliya Trofimova / “Doctors without Borders” The boy lives with his mother in a shelter for displaced persons forcibly displaced people. In August 2022, his family was evacuated from Vugledar in Donetsk region. Many children who became forcibly displaced people because of the war miss their homes, friends, past life and teachers. “My youngest son Vanya felt a very strong anxiety, he was afraid to fall asleep. After talking with a psychologist, it became easier,” explains Olena Beda. Most of our patients in the Kirovohrad region have symptoms related to anxiety or depression. “We work with children individually: we play, draw, help overcome fears, various negative emotions, etc. connected with what they experienced,” explains Svitlana Alekseenko, a psychologist at “Doctors without Borders”. Group psychological session, Kirovohrad region, 2023, author – Yulia Trofimova/ “Doctors without Borders” Group psychological sessions can be a support not only for forced migrants, but also for the community they live in. During such sessions, psychologists and social workers talk about the benefits of psychological care. This creates a more supportive environment and a wider understanding of the need to support mental health. Psychological first aid for traumatic events Missile strikes continue to threaten lives civilian population and lead to human casualties even far from the front line.This physical threat also affects the mental state of the population throughout the country. For people facing the consequences of shelling, psychological first aid is essential. It supports their ability to cope with symptoms such as shock, panic attacks, changes in appetite and sleep patterns, and withdrawal from daily activities. In the frontline regions – Zaporizhia, Dnipropetrovsk, Donetsk and Kherson regions – Doctors Without Borders teams respond to the acute psychological needs of people who have suffered from rocket attacks. For example, in March 2023, our psychologists worked at the site of a rocket attack on a residential area in Zaporizhzhia. Lyudmila Dyomina, resident of Zaporizhzhia, 2023, author – Yuliya Trofimova / “Doctors Without Borders” When teams of mobile clinics of “Doctors without Borders” arrive at the site of a rocket attack, the first thing they do is identify those who are in a difficult mental state. Timely and correct help can shorten the recovery time of a person after such a traumatic event. “The main thing here is to help a person come to his senses, to establish contact with him, to understand that he sees you, hears you, that he generally understands where he is now,” explains Inna Potapenko, a psychologist of Doctors Without Borders, “We always paid attention to those who sit and remain silent, because it was clear to us that this is a state of stupor from which a person must be brought out.” Mutual support and specialized assistance For some patients, one or two psychological sessions are not enough. Long-term and specialized care is needed to reduce the likelihood of developing mental disorders, prevent further development of symptoms, and restore a person’s ability to maintain relationships and avoid isolation. “Moral violence was sometimes more difficult than physical violence,” explains 52-year-old Andriy Verbych, who faced ill-treatment and torture while in captivity by the Russian armed forces. Andriy Verbych, a resident of Kyiv region, faced ill-treatment and torture while in captivity by the Russian armed forces, 2023, author – Nadiya Voloboyeva/Doctors Without Borders “They turn on propaganda in the cell, so that you cannot hear each other. If you think only about it, there is a feeling that you are losing your common sense.” In Gostomel, residents who have experienced violence and trauma often feel excluded from their community and become isolated. A combination of group and individual mental health activities can support a sense of self-identity and belonging to a community. “A person, a person, is not only a negative experience. It is much broader and much more,” explains the psychologist of “Doctors Without Borders” Maryana Kvyatkovska, “sometimes the person himself forgets about it. He lives with this trauma, memories. Life for them is divided on “before” and “after”, and they feel themselves in this vacuum.” Mental health is a key challenge for the Ukrainian health care system Despite the fact that the Ukrainian health care system is implementing initiatives aimed at improving mental well-being, the war has had a devastating effect on people’s mental health. The more residents are exposed to various traumatic events, the more likely they are to develop mental health problems. Green Grove, Mykolaiv Oblast, 2023, author – Yulia Trofimova/ “Doctors Without Borders” The lack of psychologists and consultants in rural areas, the stigma associated with mental health, and the reality of hostilities make it difficult for people to receive help. Without timely and appropriate psychological support, problems can develop into long-term post-traumatic stress disorders, anxiety and depression and significantly affect a person’s quality of life. Linda Nyholm, communications officer of Doctors Without Borders, specially for UP. Life Publications in the “View” section are not editorial articles and reflect exclusively the author’s point of view

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