Managing the psychological effects of war in Ukraine
Oct 10, 2023 | By: Olivia Giovetti
In honor of World Mental Health Day, we are sharing a story from Concern’s work to address the psychological effects of war in eastern Ukraine. A version of this story originally ran in the Irish Daily Mail in March 2023 and is reprinted with permission.
Content Advisory: This story contains descriptions of war.
The 45th wedding anniversary is traditionally regarded as the sapphire anniversary; a gemstone associated with peace and prosperity. For Olek and Veronika*, their own 45th anniversary, which they marked this past February, should have been a celebration of as much. It had been hard won.
They initially met and fell in love in the eastern Ukrainian city of Zaporizhzhia. They’re back here now, but not by choice — or under circumstances that they could have ever imagined. They tell me this as we sit together in the basement of a university building that has, in the last year, been repurposed as a community center to meet the needs of some of the millions of Ukrainians displaced by war. Olek and Veronika started coming to this building to attend a weekly support group for senior citizens, supported by Concern and run by local Ukrainian partner organization, Posmishka.
Whatever comforts they may have found in returning to a familiar place with happy memories have been obliterated by the traumas of the first year of war, and the uncertainty of what lies ahead.
Finding love (and a ram) in a fraught generation
The pair originally lived in Zaporizhzhia. Veronika (now 65) drove a tram; Olek (now 70) was a driver for an orphanage. “A difficult place to work. Most people couldn’t stay there for a long period of time, but my husband worked there for many years,” says Veronika, patting her husband’s hand with pride.
Despite running into each other from time to time, Olek — who has soulful eyes, but a reserved expression — had seen Veronika a few times, but was too shy to approach her. It was at the wedding of mutual friends that he was finally able to break the ice, with the help of a ram. Tasked with receiving the bride and groom’s gifts, the two were baffled when one guest brought the animal.
“We were standing together saying, ‘Why would you bring this huge ram to a wedding?!’” Veronika recalls. Another guest at the wedding saw the pair laughing and said, “You will get married next!” In February of 1978, they did just that. They moved to the city of Polohy, had two children, and built a life together.
All of this happened against a chaotic historical backdrop. When Olek and Veronika were born, the Holomodor famine of the 1930s and the ravages of World War II were fresh scars for their parents. They were raising a young family of their own when the Soviet Union collapsed and Ukraine gained independence, setting off nearly a decade of cataclysmic inflation. They entered the new millennium in an era of political instability and corruption. In context, while the last year has brought unimaginable and visceral horror to the doorsteps of millions, it’s also only the latest salvo for a fraught generation.
Historical and personal trauma
Many have had personal traumas to contend with in this time as well. In 2007, Veronika sustained several injuries in an accident, including a broken jaw and multiple arm fractures. Some doctors didn’t expect her to survive. Others expected she would be paralyzed for at least five years.
“But I told them it would not be like that,” says Veronika, a steely glint in her eye. She found a post-trauma clinic in Kharkiv, roughly six hours away by car, that she visited twice a year, and learned how to walk again.
In that time, however, Olek also had a series of strokes that forced Veronika to put her own recovery on hold to help her husband. Now in the early stages of dementia, Olek doesn’t speak throughout our nearly hourlong conversation, but in hearing his wife recount this part of their story and remembering that time, he begins to quietly cry from a sense of guilt.
Ultimately, the couple saw the experience as their chance to regain their lives and their health. “The doctors at the rehabilitation center said to me, ‘Your time on earth is not over. You are still needed here,’” Veronika says.
“The doctors at the rehabilitation center said to me, ‘Your time on earth is not over. You are still needed here.’”
“Nobody believed this was really happening”
As they approached their 45th anniversary, Olek and Veronika should have been in a place where they could bask in the rich life they built together. They ought to be enjoying country life at their dacha, going to book club meetings at their community center in Polohy, or seeing their four grandsons. Back home, Veronika volunteered with the local Veterans Affairs center and danced in a local troupe for women over 50 called the “Fayni Pany” (a playful translation of “Nice Ladies”). She pauses here to linger over photos from past performances, wearing powder blue chiffon for “Kyiv Waltz” or the traditional embroidered vyshyvanka for International Women’s Day. She has a contented smile in each of the pictures.
I look for traces of that smile while sitting across from her, but the psychological and emotional effects of the last year are like another person sitting in the room with us. “We didn’t believe it at first,” says Veronika of the February 24 invasion. “Nobody believed this was really happening.”
Nor did they think it would move so quickly at first, only to lapse into protracted violence. On March 3, Russian forces reached Polohy.
As the couple watched tanks roll down their street, they also worried about the knock-on effects of the invasion: Olek’s health problems returned, and they were unable to get his medications. Without them, his legs swelled — making the frequent trips up and down the stairs to their local bomb shelter even more difficult. His dementia was also starting to progress, and doctors warned that he could die.
As Russian forces went door-to-door, performing what Veronika euphemistically calls a “cleansing” of their neighborhood, she begged her husband to stay in bed. “But he couldn’t do that,” she says, her voice starting to break.
“At one point, I looked out my window and saw a Russian soldier pointing a gun directly towards me,” she adds. “He said, ‘Don’t say a word, or I’ll shoot.’ I was so scared, I couldn’t move.” Eventually, the soldier left.
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As she tells me all of this, Veronika looks from time to time at Lilia, the psychologist who works with Posmishka, the Ukrainian-based NGO leading their support group. Lilia nods, supportively.
Veronika adds she doesn’t think she would be able to tell this story without the help she and Olek have found in this group. With 20 years’ experience as a psychologist, Lilia has been able to adapt her expertise to the current needs in eastern Ukraine. While the conflict may dip in and out of international headlines, she notes that millions are still living in a constant state of stress, the psychological vicissitudes of war.
“The main challenge now is that people haven’t adjusted to the circumstances that they’re now facing,” she explains. “Even after a year.”
This remains one of the under-documented effects of conflict, but one that can carry significant impacts. The World Health Organization estimates that, over the last decade, one out of every five people who have experienced war or other forms of armed conflict, will face depression, anxiety, PTSD, bipolar disorder, or schizophrenia. Applying this to Ukraine would leave an estimated 9.6 million in need of psychosocial support.
Essential infrastructure
While Zaporizhzhia is safer than many areas of eastern Ukraine, it’s still close to the frontlines. Air raid sirens are a daily reality. In February 2023, the city had seen damage from the last five months of missile attacks, and more in the intervening seven months. For pensioners like Veronika and Olek, the country’s inflation rates have left them unable to afford even the basics. In the last year, they’ve watched the life they built together erode at a horrifying pace.
And while the material needs are undeniable, Lilia adds that the mental toll so much uncertainty and need takes on a person cannot be ignored. Without being able to end the airstrikes or fix the economy, she says two of the best tools for Ukrainians across the country are awareness and self-regulation. “We cannot completely eliminate this state of high anxiety, but over time we can learn to physiologically handle it.”
Even when the war ends, Lilia adds, the path towards psychological recovery will continue. But — like water, roads, and electricity — it’s an essential infrastructure.
“They can’t say ‘I need help’”
Veronika and Olek’s experience with Posmishka hasn’t solved everything. But it’s provided some much needed community amid the chaos. Veronika recalls not only the practical techniques they’ve learned — psychological as well as some physiotherapy exercises for Oleks legs — but the emotional relief from joining this group. “We were met with very friendly faces here.”
The couple consider themselves lucky, as well: They were able to ask for help, one of the biggest barriers that Posmishka sees in reaching more Ukrainians with psychosocial first aid. “I think there are still many people who need this, but are very shy. They can’t come and say, ‘I need help,’” Veronika adds.
These are indeed three small but very difficult words to say, but they’ve become an essential step for the couple to move back towards peace and prosperity. Veronika is emphatic: “We needed this.”