Ukrainian journalist Konstantin Ryzhenko has escaped the Russian-occupied Kherson region, moving between homes and changing phones to stay ahead. A known figure who drew the invader’s attention, he now grapples with an anxiety disorder after weeks of hiding. “I just had another panic attack after meeting with soldiers this afternoon. I fear what the future holds for me,” he wrote on social media. A panic attack is a sudden surge of intense fear that triggers physical reactions.
Against the backdrop of a war that has caused immense devastation, mental health concerns can feel secondary. But non governmental organizations working in Ukraine are reframing the issue, dedicating resources to people in need. Families endure days of bombardment in dark basements. Soldiers who witnessed a comrade die, or who lost a family member, or who did not have time to grieve, carry heavy emotional scars. Some even struggle with the violence they themselves inflicted on others in battle.
“Taking another person’s life is profoundly traumatic. We hear from fighters who have killed invading troops,” shared Paul Nilandis, founder of LifelineUkraine, a suicide prevention hotline that handles about 1,000 calls each month. He notes survivor guilt when a soldier loses a partner and wonders why he survived.
Volunteers with military experience work to earn callers’ trust, guiding them toward calmer states of mind and linking them with resources for ongoing emotional support.
Ryzhenko’s group is effectively the sole nationwide organization of its kind inside the besieged country. There are army-based psychologists, but they do not always reach every need, and some soldiers find the help insufficient or impractical. “In some cases, the guidance is to pray,” a Ukrainian journalist notes regarding the limitations inside frontline units.
The country has relief programs for children and soldiers, but there is no broad, long-term program for the wider population affected by the war. Requests for free psychological help are common, and private therapy remains expensive. With the economy strained by conflict, the middle class struggles to afford care.
Social stigma also plays a role. “It’s not culturally accepted for men to show feelings or cry,” one journalist points out.
Support for those under pressure extends to organizations like Doctors of the World, which have worked for months to provide psychosocial care in cities such as Kyiv, Kharkiv and Chernivtsi. Their mission is to aid displaced, refugee, or besieged populations by addressing emotional needs to prevent long-term harm.
Ricardo Ankaramental, a mental health coordinator in Ukraine for Doctors of the World and for the newspaper network, has witnessed the depth of psychological distress among people who are far from home. “The pain is intense,” he explains, as six months of war erode the sense of safety and stability. The hope of returning home fades and financial pressures mount.
Group interventions to strengthen community resilience
After half a year of conflict, resilience programs are evolving. Officials note that helplessness remains a constant stress for those outside their normal routines, a cumulative burden. People in reception centers and nearby provinces hold onto the belief that they will return soon, a belief that is increasingly difficult to sustain as time passes.
Interventions in border centers emphasize collective exercises to build resilience. The aim is to keep people active and adaptable, even as they have endured trauma and witnessed violence. Some individuals receive personalized attention once a need is identified.
When distress escalates to a disorder, specialists step in. Mental health care in Ukraine is not yet integrated into the first level of public health, and multidisciplinary teams in a broader system remain limited. Access to psychologists is scarce, and some areas lack sufficient specialized care.
Depression, aggression, fear…
What surfaces most often is a mix of depression, anxiety, post-traumatic stress, and behavioral changes among youths. There are increases in suicidal thoughts and risk behaviors among adolescents, along with heightened fear and anxiety in children, sometimes expressed through bedwetting or withdrawal from play and social interactions.
Psychologists urge caregivers to provide spaces for minors to vent anger, sadness, and disappointment within the family. While adults struggle to cope, they stress the importance of helping children express fears and maintain daily routines like sleep and meals.
For many young people who have witnessed violence, trauma can shape their social relationships for years. Early intervention is essential to prevent long-term consequences.
No mental health care
Experts from Doctors of the World acknowledge that the broader system does not currently cover all needs. In recent months, city-based psychologists have conducted thousands of consultations, both in person and online, and the country has launched an initial first-aid hotline for immediate support.
Therapies are offered in Ukraine, including in temporary bomb shelters where people take refuge from attacks. These spaces often include university basements, dormitories, or cultural centers where those who lost their homes reside. Although most patients are women, men benefit significantly from mental health and psychosocial support services.
Doctors of the World highlights the cultural stigma around expressing emotions. Mental health remains a taboo subject in rural areas, and much of the work focuses on education to normalize seeking help and accessing care.