ContentsThe most common psychological issues linked to warHow these issues show up and what symptoms to watch forWhen it’s time to seek helpKey differences between those in combat zones and those in safer areasHow to manage anxiety and stress during wartimeThe long-term impact of war on Ukrainians’ mental healthBack in 2022, the World Health Organization reported that around 25% of Ukraine’s population was at risk of mental health conditions like anxiety, depression, and PTSD. And according to the National Institute for Strategic Studies, by the end of the war, nearly half of all Ukrainians may need psychological support.Psychologist, Gestalt therapist, and Mental Support for Media expert Yulia Krasnikhina spoke with Espreso about the key mental health challenges Ukrainians face due to war and how to manage them.The most common psychological issues linked to warKrasnikhina explains that long-term war means not just constant danger, but ongoing psychological and physical pressure, like sleep problems and psychosomatic symptoms. War drains both emotional and physical resources.“What we’re seeing now are the effects of long-term stress, uncertainty, loss, and no chance to fully ‘exhale.’ People are stuck in survival mode, functioning on autopilot, emotionally numb, or, on the flip side, overwhelmed by anxiety, irritability, panic attacks, media fatigue, and insomnia. In one way, this shows how the mind adapts to danger. But it’s also exhausting, and over time can lead to burnout, apathy, depression, or breakdowns in relationships,” says Krasnikhina.So, what mental health issues are most common among Ukrainians right now, according to psychologists? These include:Chronic anxiety – about loved ones, safety, the future. People often stay tense, struggle to focus, can’t feel joy, and delay making decisions.PTSD and trauma responses – seen in soldiers, civilians, and anyone who’s been through shelling, lost their home, or lost someone close.Survivor’s guilt – especially in people who fled or stayed in safer areas. They feel torn: “I’m alive, others aren’t” or “I have it easier here, it’s worse there.”Relationship issues – emotional distance, detachment, and conflict between those on the front line and those in the rear or abroad.War fatigue – when people go numb, shut down emotionally, stop reacting to news and pain. Everything starts to feel the same, so they tune out to protect themselves.Psychosomatic symptoms – physical pain without a medical cause, issues with the heart, stomach, or immune system. These are all tied to chronic stress, along with sleep and appetite problems.“Even so, we also see powerful examples of psychological resilience – solidarity, support, and deep emotional growth. Ukrainians are adapting, reaching out for help more often, and starting to value the things that truly matter – relationships, life, and freedom,” the psychologist adds.How these issues show up and what symptoms to watch forThe psychological effects of war vary from person to person, depending on their experience, nervous system, support system, environment, and circumstances. But the most common reactions include acute or chronic stress, anxiety, and in more severe cases, post-traumatic stress disorder (PTSD).Signs of stress and anxiety:A constant sense of anxiety, even without a clear threatPhysical tension, muscle spasms, headaches, or other body symptomsTrouble sleeping, difficulty falling asleep, frequent waking, nightmaresIrritability, mood swings, tearfulness, or emotional “numbness” where motivation disappearsDifficulty concentrating, forgetfulness, memory issuesHypervigilance or sensitivity to noise (e.g. jumping at loud sounds, even in safe areas)Avoiding news or war-related conversations or, on the flip side, a compulsive need to follow every update“A typical sign shows up in a person’s behavior, others notice something different. For instance, someone who used to be talkative goes quiet, or vice versa. Overworking or refusing to work at all can also point to stress and anxiety,” says the psychotherapist.Signs of PTSD:PTSD often develops after extreme trauma, like shelling, combat, loss, or witnessing violence. But this diagnosis can only be made by a psychiatrist!Warning signs that shouldn’t be ignored:Intrusive memories or flashbacks, reliving the trauma over and overNightmares and persistent nighttime anxietyEmotional numbness, disinterest in life, pulling away from others, shutting downSudden outbursts of anger, panic, or fear with no obvious cause, disproportionate reactions to triggersGuilt, even when it's irrational (like “I survived, others didn’t”)Withdrawing from people, places, or topics connected to the traumaSelf-harming thoughts or behaviors – signs someone may have lost their sense of purposeWhen it’s time to seek help“The main thing is not to wait for it to ‘pass on its own.’ Even deep trauma can be worked through with support, therapy (or medication when needed). This isn’t ‘weakness’, it’s a natural response to unnatural circumstances,” says Yulia Krasnikhina.She stresses that you should pay attention:If symptoms persist for weeks and interfere with work, relationships, or everyday lifeIf someone stops eating, sleeping, or expresses a wish not to liveIf they’re struggling to adjust after war, evacuation, or lossIf friends or family notice that the person has shut down, avoids everything, or, on the contrary, is constantly on edge, aggressive, or not acting like themselvesKey differences between those in combat zones and those in safer areasWar affects everyone, no matter where they are. But the type and depth of that impact vary, says Yulia Krasnikhina. Broadly, these effects fall into two categories: acute trauma and long-term stress.People in or near active war zones face immediate threats – danger to life, destruction, injury, death. These experiences often lead to:PTSD or acute stress reactions (numbness, panic, stupor);Flashbacks, nightmares, intrusive memories;A shattered sense of safety – at home, in public, even in their own bodies;Loss of loved ones, homes, social roles – deepening helplessness;Emotional burnout – “just surviving” becomes the only goal.“Often, when they move to safer places, these people are the least likely to ask for help,” says Krasnikhina. “They’re stuck in survival mode: ‘I don’t have time to feel – I have to act.’ But this is exactly what causes deep psychological trauma.”For those in safer regions or abroad:They live in constant low-level anxiety, often with guilt – “I’m not there” or “I have it easier. Their struggles are different but still serious:Emotional burnout from the news, worry, and contact with loved ones in danger;A constant feeling of helplessness, wanting to help but not knowing how;Survivor’s guilt – especially for those who’ve left the country;Separation from family, the stress of adapting to new environments;“Invisible” stress – life looks fine on the outside, but inside, there’s guilt, shame, and emotional numbness.“War wounds people differently. Someone on the front line and someone far from it, both can carry deep emotional trauma, just in different forms. So don’t compare pain,” says the psychotherapist. “Recognize your own experience. Don’t dismiss it. Don’t be afraid to seek help. Every reaction matters. We’re all going through collective trauma, and only by accepting what we feel can we stay human, compassionate, and strong.”How to manage anxiety and stress during wartimeLiving under war means living with chronic stress. You can’t eliminate it, but you can learn how to manage your state and find ways to stay grounded, says Yulia Krasnikhina.Here are some tools that help:1. Breathing: your emergency aidTry the “4-7-8” technique: inhale for 4 seconds, hold your breath for 7, exhale slowly for 8. Repeat 4–5 times.Longer exhalations help calm anxiety and stabilize your nervous system.2. GroundingUse the “5-4-3-2-1” method: name 5 things you see, 4 you hear, 3 you can touch, 2 you smell, 1 you taste.This helps bring your focus back to the present moment during anxiety or panic.3. Movement and body-based practicesWalk, move, stretch, dance, any physical activity releases happy hormones and eases tension.Touch also helps: hugs, warmth, self-massage, or wrapping up in a blanket can make you feel safer.4. Information hygieneLimit news exposure by setting “news windows” – for example, 15 minutes twice a day.Turn off auto-scroll and stick to trusted sources.5. Relying on the usual and "small life"Don’t be afraid of routine – even basic things like waking up, eating, washing your face, and having coffee can build confidence.Create your own “warm rituals”: a cup of tea, your favorite music, a book, sports, prayer, or a daily list of “what good did I do today.”Talk more with people who make you feel safe and calm.Psychologist Yulia Krasnikhina says there are also specific tips for parents who want to support their children’s mental health during the war.“You don’t need to be perfect parents – just be ‘good enough’ and present,” she says.So, parents should keep in mind:Your own state: A stable adult is a child’s biggest resource. If a parent doesn’t ignore fear but can recognize and manage it, the child senses that.Calm honesty: Children pick up when something’s wrong. It’s better to explain things simply than stay silent or scare them. For example: “Yes, it’s worrying now, we hear a siren, but we’re together, we know what to do. We’re safe.”Let kids express emotions: Play, drawing, talking, or reading stories helps. Don’t dismiss fear. Instead of saying “don’t be afraid,” say: “Are you scared? I’m with you. We’re together. This will pass,” says the psychotherapist.Familiar rhythm and simple joys: Kids need a routine – sleep, meals, play – to feel grounded. Even in tough conditions, let them play, laugh, and dream. Childhood should stay childhood.Symbols of safety: A favorite toy, blanket, “peace box,” or positive drawings – anything that makes them feel safe – can help.“And most importantly: ask for help. Don’t be ashamed – whether it’s for yourself or your child. Psychological support is care, not weakness,” the psychologist says.The long-term impact of war on Ukrainians’ mental healthYulia Krasnikhina, a psychologist at Mental Support for Media, stresses that war isn’t only about the front lines and weapons.“It’s also a long, quiet fight for mental, social, and national health. We’re already seeing a generation shaped by loss, anxiety, and forced maturity. And yes, the effects will last,” she says.Even after the war ends, we’ll still be dealing with:PTSD, chronic stress, depression, burnoutAdaptation issues, especially for those returning from war or emigrationBroken families, relationship issues, lack of trust, aggression, isolationTraumatic narratives that will stay in the collective consciousness“Psychological ‘demining’ will be just as hard as clearing physical mines in Ukraine. But it’s possible. And most importantly, it has to start not ‘later,’ but now,” the psychotherapist says.What can be done today to reduce the impact?Psychological education needs to reach every home. People must understand that emotions aren’t weakness – they’re signals. Anxiety, trauma, and adaptation should be discussed openly, without judgment. Emotional literacy should be taught in schools, at home, and at work. Then, psychological support will feel normal and accessible – no shame, whether online or in person. This way, everyone can get help: soldiers, civilians, kids, the elderly. More trained professionals are needed to provide that help. Then, in schools, kids will get emotional support, not just academics. Veterans will receive care, not be left alone. There should be spaces for families to connect and heal.The expert adds that trauma should also be processed through culture. Art, film, music, and honest conversations help people face pain instead of hiding it. Memory becomes part of healing – not just a scar.“We can’t erase the experience of war. But we can give it meaning – through solidarity, a new culture of care, and shared memory. We can turn pain into experience, not by glorifying trauma, but by acknowledging it. We can rethink who we are – as people, as a nation. You don’t have to carry that ‘explosive’ inside. When these ‘mines’ are seen, felt, and lived through – they stop being a threat. They become something that transforms instead of destroys. So yes, this ‘demining of the soul’ won’t happen in a year or even a generation. But the more support, presence, and honesty there is – the fewer inner wounds we’ll carry,” Krasnikhina concludes.