Psychological state and mental health during the war are extremely important. Many people suffer from exhaustion, devastation, fatigue, anxiety and panic. Psychologists have formulated useful tips on how to master yourself in critical conditions, how to help the loved ones and look after your mental health in such critical conditions.

During the war, our body works at the maximum capacity. Stress hormones, which task is to mobilize the body in a critical situation, also have their “expiration date”. You may observe strong mood swings from anxiety, anger, a rush of optimism to complete devastation and exhaustion. It is important to realize that these are perfectly natural states that substitute each other from time to time. You can and should work with each of them.

Panic is an attack of severe fear, anxiety and feelings of inner tension. Panic paralyzes a person or, conversely, pushes a person to reckless actions. During the panic, the opposite reactions are observed: one wants to run, the other – on the contrary, to hide in the corner. It is important to remember that this is the state in which the enemy wants to see us, because it makes us the most vulnerable, so it is necessary to take measures to restore a normal mental state.

Acute panic attacks and anxiety are usually followed by feeling of apathy. Such periods may be short, but they also need to be worked out with. It is important to remember that apathy is a natural “chemical” setback after a surge of stress hormones.

In critical situations, relationships with loved ones are severely tested. Try to maintain relationships and help your loved ones, because it increases your ability to survive and resist, as well as gives meaning to your actions.

If someone close to you is experiencing excessive destabilizing anxiety or panic attacks, take the following steps:

Under normal circumstances, a person has time to understand the feeling of guilt and deal with it properly, i. e. to identify possible mistakes, correct them and understand how to avoid them in the future. In critical conditions, it is quite difficult to deal with guilt, and it can have a very negative impact on a person’s psychological state, depress him or her and paralyze the activities.

Toxic guilt is very difficult to overcome. If you need help – turn to specialists, take care of yourself.

If you have decided to see a psychotherapist, it is important to find not only someone you can trust, but also a qualified professional with the appropriate credentials.

You can start with the following steps:

Ask for recommendations from people you trust. Remember: psychologists do not disclose what happens during therapy.

When searching online, visit specialists’ websites and social media pages. Read what they write in posts and articles, and consider sending them a few questions. This will help you understand whether their values and approach are compatible with your own.

During the first consultation, ask the psychotherapist:

• whether they have relevant education and certification — ask to see their diploma and inquire about additional training or professional development. If you have doubts about the diploma’s authenticity, you can verify it in the state education registry (you will need the diploma details);
• whether the specialist undergoes personal therapy — this is important to ensure the therapist does not project their own issues onto the client;
• whether the specialist has a supervisor they can consult for professional guidance. A supervisor is a specialist who, after obtaining a therapist’s qualification and gaining extensive practice, undertakes several additional years of study to receive this qualification. A supervisor or supervision group helps address difficulties that may arise during therapy;
• whether the specialist has practical therapeutic experience and how many years they have been practicing;
• whether the specialist has experience working with your specific issue, as it may fall outside their area of expertise;
• what therapeutic method they use — the specialist should clearly explain how they will work with you and what you can expect from therapy. Do not forget to ask about possible risks;
• whether the psychotherapist belongs to professional associations of psychologists, such as the National Psychological Association or the Ukrainian Union of Psychotherapists — this helps you understand the specialist’s standing within the professional community.

When should you stop therapy and find another specialist?

• The specialist is connected with you in everyday life (work, relationships, friendship, or family) and did not decline the consultation.
• The first meeting was unstructured and you did not come away understanding how you would work on the problem.
• The person does not have the appropriate education and is only studying or practicing alternative “healing” methods.
• You hear promises about quick results with little effort. Effective therapy is complex, long-term, and sometimes emotionally demanding work on yourself.
• You hear phrases about “right” or “wrong” feelings. All feelings are valid and deserve acknowledgment.
• You feel the psychologist is trying to change you according to their own values or is manipulating you. A specialist should help you understand yourself, not reshape who you are.
• You feel uncomfortable after several sessions. For therapy to be effective, the client must trust the specialist.
• There is no clear structure or consistency in addressing your problem, and the therapist cannot explain why.
• The specialist does not follow the ethical code for psychologists.

How to understand that psychotherapy is helping

• You begin to understand your own problem.
• You have formulated a clear goal related to the problem and are working on it.
• You have resolved the problem or learned how to live with it (if the situation cannot be changed).
• Your relationships with other people have improved.
• Your self-esteem has improved and you feel more confident.
• Your overall wellbeing has improved.
• You take responsibility for your actions without excessive self-blame.
• You understand your own emotions better.
• You are beginning to form goals and personal aspirations.

Even if you are unsure which specialist to choose, a psychotherapist is often a good starting point. A qualified professional will help you clarify your situation and point you in the right direction.

Psychiatrist

• has a higher medical education
• works with mental disorders, psychiatric illnesses, and addictions
• can prescribe medication
• can refer patients for medical examinations

Psychotherapist

• has a higher medical or humanities education
• works with mental and behavioral disorders
• does not prescribe medication
• uses psychotherapeutic methods

Psychologist

• holds a higher education degree in psychology (not a medical professional)
• works with behavioral and cognitive processes, psychological and interpersonal issues, and stress
• does not prescribe medication

Medical psychologist

• has a higher medical education
• works with mental health prevention among at-risk groups, psychodiagnostics, and psychological rehabilitation
• can prescribe medication

The material was prepared with the assistance of Dmytro Vakulenko, medical psychologist and Olena Lazarenko, psychologist, psychotherapist, and accredited therapist of the National Association of Gestalt Therapists of Ukraine (NAGTU). 

With the support of the National Psychological Association (NPA), volunteer psychologists created the psychological support center “How Are You?” (Yak Ty?) for people affected by recent events and experiencing ongoing stress, worry, and anxiety. Support is free and available at any time of day. To receive psychological assistance, fill out the online form.

“Tell Me” (Rozkazhy Meni) is a free online platform for psychological consultations. The platform’s team helps anyone who needs emotional support, guidance, or counseling in response to the rapid changes currently affecting the economy, society, and everyday life. You can request help through the initiative’s website.

The International Committee of the Red Cross (ICRC) has opened a free hotline for support: 0-800-300-155.

“UkrYednist” is a website providing free psychological support from the Ukrainian Union of Psychotherapists. The team will match you with a specialist based on the issues you indicate. There is also an option to join free online support groups.

Telegram chatbots for psychological support for Ukrainians

Friend. First Aid (Drug. Persha Dopomoha) — a bot created with the support of UNICEF, based on modern protocols and evidence-based research.

Words Help (Slova Dopomahayut) — a bot that explains different emotional states and suggests ways to help yourself when consulting a psychologist is not possible. It also provides advice on how to support someone who may need psychological help. Created by the Mental Health Center of the National University of Kyiv-Mohyla Academy (NaUKMA) and the CyberFI Faculty of Informatics at NaUKMA.

The material was prepared with the assistance of: Orest Oliinyk, psychologist, Valeriia Palii, psychologist, President of the National Psychological Association (NPA), the official website of the Ministry of Health of Ukraine.

If thoughts of suicide or urges to harm yourself appear

This is a reason to seek help immediately. If you are in immediate danger, call 112 or 103.

You can also contact the Lifeline Ukraine Suicide Prevention Hotline: 7333 (available 24/7).

If you need emotional support and to speak with a counselor, the national hotline “La Strada–Ukraine” is available: 116 123 or 0 800 500 335 (24/7, free of charge).

Remember: during an acute crisis it is important not to be alone — ask someone to stay with you or call a trusted person.

Writing down memories, such as keeping a diary, can be an effective self-help technique for trauma. Psychologists recommend recording your thoughts and feelings on paper to cope with stress, anxiety and the effects of traumatic events. This process allows a person to express their emotions, analyse what they have experienced and begin the journey to healing. A detailed description of the traumatic experience is used in trauma-focused therapy.

Keeping a diary:

• improves mental and physical health
• helps to cope with stress and anxiety
• organises thoughts  
• allows you to express feelings, reflections, and describe negative emotions
• reduce hyper-arousal, which will make it easier for you to remember later
• understand and accept the traumatic event as part of your life, but don’t let it control it
• to “work through the wound” through description – this leads to healing and reduced vulnerability.

Records of wartime experiences are also an important testament to historical events. This can help future generations better understand the events of the present. It will also make it harder for Russians to manipulate the facts of the past in the future, because you are keeping real evidence. 

You can either record your traumatic experience in a personal diary or use special tools. For example, the Svidok.org platform.

• In this case, recording your memories will not only ease your psychological state, but will also help human rights activists and journalists document the horrors of war. 
• If you wish, you can choose not to share your testimony on the platform with others. Or you can write your memories anonymously. 
• The developers of Svidok.org emphasise that the data in your war diary is protected and anonymous.

Practical tips for keeping a diary:

• Start with short notes about daily events, impressions, reflections on the news.
• Make keeping a diary a regular practice.
• Write down not only the bad, but also the good things that happened to you. 
• If you find it difficult to start writing, try answering questions: ‘What is the most memorable event of this month?’, “How do you cope with stress?”, “What inspires you?”, etc.
• When you feel ready to share your traumatic experience, try writing it down in a free format. Start with where the event happened, under what circumstances. Write about what happened and how it affected you.

Safe diary keeping

If you are under occupation or in potentially dangerous regions, your testimony may pose a threat if found by the occupiers. 

Safety comes first! Therefore:

• don’t store diary notes in the phone, which can be searched;
• if you write your memories in a paper diary, don’t keep it in a visible place;
• hide it securely or burn it in case of danger;
• remember to clear your browser history if you use online platforms to record your testimony.

Prepared based on the recommendations of psychologist Kateryna Pavlyshyn, NGO “Women’s Power of Ukraine”