The war in Ukraine is still ongoing but more and more people are organizing conferences and building platforms to address an important question: what comes after the war?
A lot of these efforts are concentrated around rebuilding the cities and infrastructure, but an issue I find equally important is what will happen to the country’s public health sector and the mental health of our generation after years of battling constant stress, which for many people will be combined with complex PTSD.
I became especially curious about this issue after writing my recent mini-series about people living through the winter of power, water, and heating outages. My interviewees admitted to feeling overwhelmed and worried about the influence of these extreme conditions on their children. In my effort to understand the consequences of power outage-related stress, I spoke to a Ukrainian psychologist, who specializes in trauma, Illya Poludonnyi, and checked the data on other countries that have been going through frequent outages in the past. Illya’s commentary below is given in the first person.
Illya Poludonnyi, a psychologist
“How are outages influencing people’s morale and mental health?”
I think morale stays strong. If anything, there is a higher drive to resist. However, mentally, people are extremely exhausted from a combination of frustration multiplied by the huge amount of necessary adaptation.
In order to imagine what life is like in Ukraine at the moment, one would have to do an experiment, in which someone is constantly turning off their lights, gadgets, elevators, internet, and phones at random. It is a complete chaos and for the average modern person, it leads to a massive frustration of needs. We are used to a certain living standard and when it gets taken away from us, the quality of life steeply declines. Every simple convenience, such as ordering things online, disappears and we start to understand just how much our life depends on electricity. It takes a lot of energy to adapt to the new reality. People have to fit in all the house chores, work responsibilities, and private matters into the two hours of electricity per day.
The biggest effect on the body is total exhaustion - physical, mental, and emotional. The process of adaptation adds a long to-do list on top of an already busy schedule. People are adapting as months go by, but most of my clients report their exhaustion: they sleep 15 hours a day, they have trouble concentrating or staying productive, and they become forgetful. These are all normal adaptive responses of the organism. Children are mirroring the stress and tension their parents are going through, which often spills out through sickness, tantrums, bad sleep, or deviant behaviour. My hypothesis is that people will keep getting better at adapting, we are already seeing it happen, but it will take some time.
However, when the war ends, and let’s hope that it will happen soon, the healthcare system will be overflooded by patients with depressive episodes. There is a price to pay for the constant “fight or flight” mode and the huge amounts of cortisol (the body's stress hormone) our bodies are releasing daily. It is similar to the cases of cancer survivors who had depressive episodes after they were cured. I recommend everyone try their hardest to manage their sleep and rest now, no matter how challenging it is in these extreme conditions".
A systematic review of the impact of power outages mentions the same big issues that Illya has pointed out - without power, people also lose light, temperature control, transport, access to clean water and sewage disposal, food storage, transport, means of communication, and a possibility to use life support devices. Taken together these factors have an enormous impact on mental health. Surveys of people living through the power shortages often report spiking rates of stress, anxiety, and PTSD flashbacks. Specific vulnerable groups such as pregnant women, children, the elderly and people with psychiatric or physical conditions are especially affected.
However, not all hope is lost. Experience from other countries that have been going through frequent power outages (like Puerto Rico, Finland and Sweden among others), show that picking good strategies for handling power outages helps to greatly reduce their negative psychological consequences. Governments are advised to provide clear public communication warnings about the possibility of power outages and how long they might last. People themselves are recommended to control their levels of preparedness, information seeking, and communication with others. If those strategies are followed, some people can even experience positive emotions related to the outages, as they can give a sense of “cosiness” through family closeness, which is also something that my interviewees commented on in previous articles in my series.
Darya, the mother I interviewed in part 1 of my series, said that her family felt closer than ever having to spend evenings talking to each other instead of using external entertainment. Karina, a business owner from part 2, noticed that the visitors to her restaurant found the evenings with candlelight very romantic. Of course, it feels wrong to romanticize hardship, however, trying to maintain a positive attitude, relaxing in time, and helping others is one of the best coping strategies, according to research. Parental warmth, availability, and involvement are also important protective factors, shielding children from the effects of war, and contributing to their future resilience.
More than a month has passed since my interviews, and by now outages in Ukraine are rare, as the country adapted to new energetic demands. Avangarden (Karina's private gallery and restaurant) has continued to thrive despite the hard times and still holds events almost daily, that are always full of visitors. Darya’s baby is growing every day, and Darya herself decided to become a psychologist. The government of Ukraine has also launched the National Program of Mental Health and Psychosocial Support, which has a special focus on teaching how to care about yourself and others in periods of stress.
It gives me hope that this was the last dark winter.