The Morning Call

Battle to heal soldiers’ mental scars

PTSD emerging as a new enemy and expected to worsen

- By John Leicester

KYIV, Ukraine — Sleep plunges the soldier back into the horrors of Ukraine’s battlefiel­ds. He can hear bombs falling again and picture explosions. He imagines himself franticall­y running, trying to save himself and others. The nightmares are so vivid that he pleads with his doctor for help. “It will blow my mind,” he warns. “So do something.”

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

When peace eventually returns to Ukraine, many thousands of other soldiers are likely to come home like Miskow with a condition known as post-traumatic stress disorder, or PTSD. Psychologi­sts, veterans affairs officers and former combatants who have struggled with nightmares, distressin­g flashbacks and other PTSD symptoms are already working to head off a potential mental health crisis among soldiers and their families from the particular­ly gruesome, intense and grinding war.

Whether it’s increasing awareness and funding for mental health care or training counselors to help soldiers talk through psychologi­cal traumas, the goal is to prevent potentiall­y destructiv­e PTSD-related problems from taking root.

Ex-paratroope­r Sgt. Maksym Pasichnyk says civilian life was “very complex” for him after years of fighting pro-Russian forces in eastern Ukraine

and once Moscow then launched its full-blown invasion in February. His long exposure to combat, death and destructio­n left the 28-year-old with an array of PTSD symptoms. He fears many other servicemen and their families could likewise suffer.

“You have a din in your ears, you start vomiting, you come home and have constant shifts of blood pressure and you lash out at your family members, your kids, your wife,” he says.

“You constantly think that someone is watching you, you overthink, you abuse drugs and drink, you lose yourself,” he adds. “If you want to get help, you are interned in a psychiatri­c 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 combat at the start of the

invasion. His unit was inserted by helicopter at night to defend an airfield on Kyiv’s outskirts. The firefights and ensuing long slog back to the capital butchered his feet. The bleeding, bruising and bone fractures were so severe that he was discharged from further service.

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

“They look fine,” he says, “but they’re not.”

On Nov. 12, Pasichnyk went back to the damaged Hostomel air base where he fought, a return that again stirred flashbacks of the events he endured there. Setting off from the disembowel­ed remains of what before the battle had been the world’s biggest aircraft, he ran a half-marathon to raise awareness of PTSD

and to fund the treatment costs for 10 veterans with symptoms.

Pasichnyk says he worries not only about the risk of traumatize­d soldiers taking their own lives but also that they could turn guns on others and “might resort to terrorist acts.”

Speaking five months before the invasion, the veterans affairs minister, Yuliia Laputina, said there had already been “great demand” from military families for psychologi­cal support as a result of fighting since 2014 against Moscow-backed separatist­s in eastern Ukraine.

The minister, who has a doctorate in psychology, expressed concern that many are going back to “remote villages where there is no psychologi­st.”

“We must build a system where emergency psychologi­cal assistance will work in the most remote corners,”

she said.

Based on figures from previous conflicts, around 20% of troops exposed to intense fighting in Ukraine could develop PTSD, estimates British psychiatri­st Neil Greenberg, a professor of defense mental health at King’s College university in London who previously served as a Royal Navy medical officer for 23 years. He has also done online training for the Ukrainian military on managing traumatic events.

Unlike soldiers who fought in Afghanista­n or U.S. troops in the Vietnam war, Ukrainian soldiers are fighting in and for their homeland, with evident public support, a clear enemy and solid goals and justificat­ions. All that could help lessen the mental heath fallout for Ukrainian veterans, says Greenberg, who describes it as “a psychologi­cally good war for Ukraine.”

But a victory for Ukraine, returning soldiers being treated well afterward and reconstruc­tion will also play roles in determinin­g whether psychologi­cal illnesses cause “mass, mass casualties” among veterans “or just a large number,” Greenberg adds.

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

Omelchenko also does hands-on counseling with troops in the field and continues that work online when he is back in Kyiv, talking them through battlefiel­d traumas on video calls from his office. One recent call was with a frontline commander who was suffering from debilitati­ng panic attacks, after he’d seen a missile strike that severely injured three soldiers.

Russia’s heavy reliance on artillery bombardmen­ts is exacting a psychologi­cal toll on Ukrainian solders, Omelchenko says. He says social media are another psychologi­cal stress because they show soldiers that while they’re in trenches, loved ones and friends may be enjoying comparativ­ely normal lives.

“It’s really painful,” Omelchenko says. “Civilian life has a lot of good things which are not proper to show.”

On the other hand, Omelchenko says he is also fielding calls from families asking how best to deal with soldiers who are coming back changed from battle — taciturn, distant, on edge and in their own worlds. Omelchenko previously experience­d that himself with his grandfathe­r, who’d fought as a young teenager in World War II.

“My grandfathe­r never smiled,” Omelchenko says.

 ?? JOHN LEICESTER/AP ?? Calming sounds are played for soldiers at a clinic that treats veterans for PTSD on Nov. 21 in Kyiv, Ukraine. As the war with Russia grinds on, the stage is set for a potential mental health crisis among Ukraine’s soldiers and their families.
JOHN LEICESTER/AP Calming sounds are played for soldiers at a clinic that treats veterans for PTSD on Nov. 21 in Kyiv, Ukraine. As the war with Russia grinds on, the stage is set for a potential mental health crisis among Ukraine’s soldiers and their families.

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