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Peace and PTSD: Ukraine is already working to heal the mental wounds of its soldiers

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The nightmares are so vivid and frightening that he begs his doctor for help. “It will take my breath away,” he warns. “Then do something.”

“Very, very, very stressful,” Witalij Miskow, 45, says of the night terrors he battles with tranquilizers and therapy at a mental health treatment center for soldiers on the outskirts of Ukraine’s capital, Kyiv. .

When peace finally returns to Ukraine, many thousands more soldiers will likely return home, like Miskow, with an illness known as post-traumatic stress disorder, or PTSD. Psychologists, veteran affairs officers and veterans who have struggled with nightmares, distressing flashbacks and other symptoms of PTSD are already working to avert a possible mental health crisis among soldiers and their wartime families especially horrifying, intense and overwhelming.

From raising awareness and funding for mental health care to training counselors to help soldiers talk about psychological trauma, the goal is to prevent the potentially destructive issues of PTSD, including suicides, domestic violence, alcoholism and drug addiction, to take root.

Former paratrooper sergeant. Maksym Pasichnyk says civilian life was ‘very complex’ for him after years of fighting pro-Russian forces in eastern Ukraine and once Moscow launched its full-scale invasion, now in its tenth month. His long exposure to combat, death and destruction has left the 28-year-old with an array of PTSD symptoms. He feared that many other service members and their families would suffer in the same way.

The repercussions come later. You have a debt in your ears, you start throwing up, you come home and have constant blood pressure changes and you go after your family members, your kids, your wife,” he says.

“You constantly think someone is watching you, you think too much, you abuse drugs and drink, you get lost,” he adds. “If you want to get help, you get admitted to a mental hospital, where they turn you into a vegetable. If you show flashes of anger, they give you tranquilizers and you just sit there.

Pasichnyk saw his last stand at the very start of the February 24 invasion. His unit was inserted by helicopter at night to defend an airfield on the outskirts of Kyiv. The exchange of fire and the long march that followed towards the capital slaughtered his feet. The bleeding, bruising and broken bones were so severe that he was removed from his post.

Outwardly, the muscular veteran looks like a picture of health. But physical integrity can hide the inner suffering of soldiers, warns Pasichnyk.

“They look good,” he said, “but they’re not.”

On November 12, Pasichnyk returned to the damaged Hostomel Air Base where he fought, a return which again prompted flashbacks of the events he endured there. Starting from the gutted remains of what, before the battle, was the largest plane in the world, he ran a half-marathon to raise awareness of PTSD and fund treatment costs for 10 veterans with symptoms.

Pasichnyk says he worries not only about the risk of traumatized soldiers committing suicide, but also that they might point guns at others and “may resort to terrorist acts.”

Ukrainian Ministry of Veterans Affairs spokeswoman Iulia Vorona said statistics on suicides and PTSD among veterans and their families are not made public during the war for security reasons.

But speaking five months before the invasion, Minister of Veterans Affairs Yuliia Laputina said there had already been “strong demand” from military families for psychological support following the fighting since 2014 against Moscow-backed separatists in eastern Ukraine.

The minister, who has a doctorate. In psychology, he said he was particularly concerned that many are returning to “remote villages where there is no psychologist”.

“We need to build a system where emergency psychological assistance will work in the most remote corners,” she said.

In a later interview this month with The Associated Press, one of his deputies, Eugen Kotyk, said the department was “actively working” on a suicide and alcohol risk reduction program.

Based on figures from previous conflicts, around 20% of soldiers exposed to intense combat in Ukraine could develop PTSD, estimates British psychiatrist Neil Greenberg, professor of defense mental health at King’s College London, who previously served as a Royal Navy physician for 23 years, including in Iraq and Afghanistan. Following the Russian invasion, he also undertook online training for the Ukrainian military on dealing with traumatic events.

Unlike soldiers who fought in Afghanistan or American troops in the Vietnam War, Ukrainian soldiers are fighting in and for their homeland, with clear public support, a clear enemy, and solid goals and justifications. All of this could help mitigate the fallout on the mental health of Ukrainian veterans, says Greenberg, who describes it as “a psychologically good war for Ukraine.”

But a victory for Ukraine, well-treated returning soldiers afterwards, and reconstruction will also play a role in determining whether psychological illnesses cause “massive casualties” among veterans “or just large numbers,” Greenberg adds. .

Anticipating that many will need help, Ukrainian psychologist Andrii Omelchenko is training volunteers – so far 300 and aiming for a total of 2,000 – to provide counseling to soldiers.

Omelchenko also gives practical advice to troops in the field and continues to work online when he is back in Kyiv, speaking to them about battlefield trauma in video calls from his 17th-floor office. A recent call was with a frontline commander who was suffering from debilitating panic attacks, after witnessing a missile strike that seriously injured three soldiers.

Russia’s heavy reliance on artillery bombardment takes a heavy psychological toll on Ukrainian soldiers, says Omelchenko. He says social media is another psychological stressor because it shows soldiers that while they’re in the trenches, their loved ones and friends can lead relatively normal lives.

“It’s really painful,” says Omelchenko. “Civilian life has a lot of good things that should not be shown.”

On the other hand, Omelchenko says he also answers calls from families asking how best to treat soldiers who return from battle changed – taciturn, aloof, nervous and in their own world. Omelchenko has already experienced this himself with his grandfather, who fought as a teenager in World War II.

“My grandfather never smiled,” says Omelchenko.

At the Forest Glade rehabilitation clinic outside Kyiv, Miskow continues his recovery. In addition to pharmaceuticals, the facility uses yoga, acupuncture, soothing sounds and other therapies on its 220 patients.

“I’m happy, I’m still alive,” says Miskow.

Yet he then cries as he recalls an artillery strike that killed several of his friends.

“I’m getting used to (these) feelings, but it’s still very, very difficult,” he says. “If you’re not there, you don’t understand anything at all, you won’t understand.”