War Trauma in Ukraine

 

By Ruwan M Jayatunge M.D. (The former Medical Officer of Mental Health in the Sri Lanka Army and the author of PTSD Sri Lankan Experience / PTSD in the USSR

Russia’s attack on Ukraine has caused the largest humanitarian crisis in Europe since World War Two. Ongoing shelling, air attacks, and other acts of military violence have changed the psychological landscape of the Ukrainian people. Following the Russian invasion, the Ukrainian social fabric has been severely damaged. At present people are experiencing detrimental repercussions of combat trauma. Apart from widespread death and disability people experience combat-related violence, fear of death, displacement, loss of family members, property damage, and breakdown of supportive social networks. This armed conflict has caused a collective trauma in Ukraine.  

Ukrainian civil society has been degraded by the war and according to the UN reports more than 2.8 million refugees have fled since Russia began its invasion on 24 February 2022. People are displaced and many had to flee from Ukraine as refugees leaving behind their houses and other properties. The war is causing mass displacements. Many people lost property and livelihoods including their loved ones.  These issues can increase poor mental health among affected people.

High exposure to traumatic experiences has been prominent in women and children. The fleeing children have witnessed the gruesome events of the war and they are especially vulnerable to the effects of war trauma.  Exposure to war trauma has been associated with emotional disorders in children and increased the prevalence of other mental illnesses. They suffer a multitude of psychological problems and need immediate care.

The war has produced a range of emotional and behavioral stress reactions among the combatants as well as civilians. They are susceptible to developing common mental disorders due to their exposure to stressful experiences. Moreover, the war will have a long-lasting impact on mental health. The circumstance of war can produce combat-related PTSD (Post Traumatic Stress Disorder) and other trauma-related disorders among the victims with severe disruption in interpersonal and social functioning.

Research indicates a direct relationship between deployment and post-traumatic stress symptomology. The combatants have an elevated risk of suffering from PTSD and other mental health problems such as depression, generalized anxiety disorder and substance-related disorders.   these disorders can co-occur and create a condition known as “poly-trauma”. PTSD may develop in direct response to an exogenous, overwhelming traumatic battle event and the victims are affected by intrusive, avoidance, and arousal symptoms.

War adversely affects civilians and they are known as “collaterally damaged” victims. Direct exposure to life-threatening situations and violence can precipitate PTSD among civilians. In the Ukrainian conflict, many civilians witnessed air attacks, property destruction, displacement and some lost their family members. These events can potentially contribute to posttraumatic stress disorder and other mental health problems among civilians.

Many experts view PTSD as a universal and cross-culturally valid psychopathological response to a traumatic event such as war trauma. As a result of the Ukrainian war high prevalence of post-traumatic stress disorders (PTSD), depression, and anxiety will prevail among the victims.    This war will have elevated rates of PTSD and the mental trauma of the war can last for long years.  

The war represents a cause of mortality and morbidity in Ukrainian society and it is imperative to provide psychological first aid and psychosocial support for the war victims.  Ukraine needs immediate mental health treatment planning for the war victims. It’s essential to identify and treat posttraumatic conditions in the soldiers and civilians who were exposed to the conflict. They need ongoing, long-term mental health care.  Many clinicians indicate perspectives on improving the management of mental health, including increasing access to community resources and virtual care.  Mental health awareness-raising activities should be implemented and the war victims must have access to mental health and psychosocial support. The state should develop innovative mental health policies and practices to meet the urgent need of war victims.