‘Nation under stress’: Doctors say mental health is top priority in Ukraine

Since the start of the war in Ukraine, more than 3 million refugees have fled – by bus, train, car and on foot – to neighboring countries. Some have destinations in mind, while others have no plan. But as these displaced citizens navigate different but equally impossible conditions, doctors in countries bordering Ukraine say there is a common thread: mental health is the most commonly reported medical condition.

ABC News interviewed doctors from the United States and Europe who traveled to the border to volunteer. According to these doctors, among the millions of refugees, acute stress disorder has been reported as a common illness.

“Acute stress disorder is basically a fight-or-flight reaction that lasts from a few days to a month and involves being exposed to a threat to your life or limb and not being able to stop thinking about it” , Dr. Craig Katz, a clinical professor of psychiatry, medical education, systems design and global health at Mount Sinai’s Icahn School of Medicine, told ABC News.

In cases where people are in fight-or-flight mode, “they are very likely to have trouble sleeping, be extremely anxious, and not have much of an appetite as they have to focus on surviving.” , Katz said.

Russia launched its all-out invasion of Ukraine on February 24, exposing its citizens to death and destruction, as well as the disruption of basic needs.

“It’s clearly a nation under strain,” Dr. Dan Schnorr, an emergency physician with Doctors Without Borders, told ABC News. “Every child of [Ukraine] is now experiencing multiple adverse childhood events, and this is one of countless casualties that will reverberate through generations.”

“It is a real humanitarian crisis. People leave with only what they can carry. Families are separated. Trying to find a way to do it,” says Dr. Preethi Pirlamarla, cardiologist and director of heart failure at Mount Sinai, Queens.

Research suggests that direct exposure to traumatic events, such as the war in Ukraine, can have lasting effects, including PTSD, anxiety, depression, and relapse from alcohol abuse. According to the American Psychiatric Association, the prevalence of acute stress disorder ranges from 13% to 50% depending on the type of event they are exposed to, and about half of people with acute stress disorder develop PTSD.

According to Katz, the risk of developing lasting effects of acute stress disorder increases with the extent of exposure to a traumatic event, previous trauma that was not previously well treated, history of psychiatric disorders and lack of social support.

Alternatively, being spiritual, having social support, realistic optimism, being cognitively flexible, and having a sense of purpose can all help mitigate the effects of acute stress.

“Psychological first aid is a way to heal people’s mental scratches and bruises so they don’t become festering wounds,” Katz said. “You make sure people feel safe, make sure they have meals to eat, you mostly make sure they – as much as you can – they are with loved ones or have some kind of communication that has support.”

In Palanca, the border post to Moldova, psychosocial clinics have been set up to identify people with mental disorders and mitigate the effects of this trauma.

“It’s more about listening and giving a shoulder to cry on,” said Dr Axel Adolfo, an emergency physician working with Doctors Without Borders. “It’s about having someone waiting for them there with their arms fully open… They just want to let go of the two to three weeks they’ve been in fear or doubt and can feel they’re close. of [safety].”

The challenge now becomes to help integrate these populations into neighboring societies.

“People always say mental health is a good idea, but they need to start planning now,” Katz said.

Refugees are at risk of developing lasting mental health effects. Ultimately, according to Katz, screening will be important in identifying who might need to be connected with a psychiatrist.

For now, though, “it’s about being here and saying, ‘The whole world is watching, and we’re here to help, and it’s okay to cry,'” Adolfo said.

Nicholas P. Kondoleon, MD, is an internal medicine resident at the Cleveland Clinic and a contributor to the ABC News Medical Unit.

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