Ukrainians’ mental and emotional health is remarkably resilient, but special attention is needed for those who have experienced the full-scale war’s worst impacts, according to experts who spoke to Kyiv Post.
Some 80 percent of Ukrainians have not experienced Post-Traumatic Stress Disorder (PTSD) during the course of the full-scale war against them. This is the counterintuitive key finding from research conducted on the initiative of Dr. Dmytro Martsenkovskyi, an assistant professor of psychiatry at the Bogomolets National Medical University.
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Additionally, the 20 percent who have been impacted are in line with the average rate of PTSD in a war-impacted society.
A recent analysis of adult survivors of war from 1989 to 2019 across countries found the average global rate of PTSD in a war-impacted society is 26 percent. Rates of PTSD are considerably higher in war-affected populations than populations unaffected by war, where the average is around 10 percent or less.
The study by Marstenkovskyi and academic colleagues from Western universities was based on a representative sample of 2,050 adult Ukrainians.
Ukrainians’ relative strength in the face of adversity is shown by another of Marstenkovskyi’s studies where 90 percent of participants reported being exposed to a traumatic event, including air raid sirens (99 percent), sheltering underground (72 percent), witnessing infrastructure destruction (64 percent), and hearing gunfire (52 percent).
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“Even though Ukrainians have been exposed to very high ‘doses’ of abnormal trauma during the full-scale war, their emotional and psychological response is encouragingly ‘normal,’” Dr. Marstenkovskyi, who is also a clinician at Kyiv’s largest children’s hospital, told Kyiv Post. “Most Ukrainians have found it within themselves to deal with and manage traumatic events, and to be able to live productive lives in very difficult circumstances.”
“When it comes to PTSD and Complex PTSD, what we are seeing in Ukrainian society is, to some degree, what we expect to see in a war-impacted society,” he continued. “It’s important, however, that we appropriately triage people with PTSD-related symptoms and tailor care to their needs through right treatments at the right time.”
Among those most exposed to trauma are Ukrainian servicepeople who have been wounded in combat and Ukrainian civilians injured by Russian shelling and bombing. The Superhumans Center in Lviv has provided more than 600 prosthetic devices to individuals who have lost limbs to amputation. Around a third of their patients have returned to active military service.
Svitlana Kutsenko is Superhumans’ head psychologist and well placed to comment about PTSD in Ukraine.
“Yes, we are facing a huge collective trauma – war trauma. But Ukrainians have already proved to be a super-resilient nation,” Kutsenko said. “Under constant missile attacks, we build innovative medical centers that make even our international partners jealous. We open new businesses, continue business operations in the cities close to the front line, pay taxes, give birth to our children in the shelters, continue the learning process at schools and universities with chronic sleep deprivation, save lives of our people and so on. People with PTSD don’t do that.”
While they accept inherent resilience in most of their patients, Kutsenko and her colleagues at Superhumans work hard for patients to receive the appropriate emotional and psychological support needed for recovery.
“A lost limb will never grow again; a wounded face will never look the same as before the injury; psychotrauma and painful memories will remain with a person until the end of life,” she said. “Amputees don’t expect their leg or hand to grow back. They just learn to live with prosthetics and find new ways of doing things they used to do before the injury.”
“It’s the same with psychotrauma,” Kutsenko added. “One is never the same person having experienced heavy injury and physical and moral pain. One needs to learn to live with it, deal with painful memories, integrate this experience into one’s identity, and own a new body image and new personality traits.”
Kutsenko elaborated on the process: “Rehabilitation (both physical and mental) helps recovery. Literally step by step in some cases, a person learns to live with prosthetics and a new body image. He or she develops new skills, learn that falling is okay, and learn how to get up and move on… So losing a limb may go both ways – to PTSD or to post-traumatic growth. It depends how much support you get from others and how much you believe that your life is worth living.”
When asked if Ukraine’s government could introduce a policy to improve PTSD management, Kutsenko is very clear in her answer.
“The biggest one is to win the war. This is the only national policy personally I am interested in,” Kutsenko said.
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