Ukraine: Overcoming PTSD with evidence-based treatments
Post-traumatic stress disorder (PTSD) can occur after any life-threatening event. A person may experience anxiety, trouble sleeping, mood changes, difficulty controlling emotions, or constant tension. It's as if their body has returned to the place where the event happened .
During the last three years of the war in Ukraine, I worked with Médecins Sans Frontières, providing mental health care in the northeast of the country, as well as among IDPs and veterans.
The war affected everyone in one way or another: some witnessed violence, some left their homes and communities, some lost a loved one. Ukrainian veterans return home with invisible wounds of war, such as traumatic brain injuries sustained in combat or post-traumatic stress disorder.
Most people find ways to cope and recover from traumatic events without special treatment, but some cannot. This can lead to feelings of hopelessness and helplessness, as if they will have to live with PTSD for the rest of their lives. Everyone should know that there are effective treatments available and people can recover by learning to manage their symptoms if they have the right tools.
The PTSD Experience of American Veterans
Previously, I worked as a chaplain, rehabilitation therapist, and care manager at the Veterans Administration Medical Center in Nashville, Tennessee. We learned a lot about treating PTSD after military men and women began returning home from the wars in Afghanistan and Iraq in the early 2000s.
This has led to state funding for research into the mental health consequences of war, including PTSD, depression, and traumatic brain injury, and the development of evidence-based treatments that have proven effective for many people.
"Médecins Sans Frontières (MSF) is working to introduce evidence-based PTSD treatment in Ukraine through a specialized clinic at the Psychological Support Center. The center is located in Vinnytsia and serves military veterans and IDPs in the region and beyond .
One of the therapies we help implement is called Eye Movement Desensitization and Reprocessing/Trauma Reprocessing (EMDR). It is a way to help patients process their traumatic memories so that they are stored differently in their brains.
Psychologists ask patients to recall and recount the details of their traumatic experience while providing a sensory stimulus, such as moving a finger for the patient to follow with their eyes. The goal is to form new neural connections that transform the way traumatic memories are stored, leading to a reduction in trauma-related symptoms. These traumatic memories become more like typical memories, causing less emotional distress.
I remember when I first studied EMDR in 2005, it seemed strange to me that eye movements could have anything to do with memories. But the research continued, and the EMDR technique turned out to be very effective. People usually need about 12 sessions, but this can vary depending on the severity of the trauma.
In Ukraine, we also use narrative exposure therapy and trauma-focused cognitive processing therapy to help clients understand and change the way they experience traumatic memories. They learn how their current emotional reactions are related to past events, how to calm their nervous system and how their body reacts.
Another thing that really matters is the relationship between therapist and patient. I am honored to be a curator and mentor of a wonderful team of Ukrainian psychologists at Doctors Without Borders. They put their whole heart into this work and do an incredible job .
Continued success in the treatment of PTSD
We regularly examine each patient to track changes in PTSD symptoms, and we find steady improvement in problems such as nightmares and sleep problems. However, there are still many challenges. Alcohol dependence is widespread among people with PTSD in Ukraine. There is also a stigma attached to mental illness here, just as there is in the US and other countries where I have worked.
We have found that when one person has a positive experience with treatment, they come back and tell their family and friends about it, and more and more people seek help. We see this among veterans as well .
Today, the Médecins Sans Frontières Psychological Support Center in Vinnytsia treats about 100 patients a month, and we hope to continue this work in the coming years, as well as to conduct trainings for similar programs across the country. By sharing knowledge and improving care for people with PTSD, I am immensely proud of this work and my colleagues.