EDUARD K. CANNOT remember the exact chain of events that led him to approach a Ukrainian military checkpoint and shout, “Putin is my president.” The fashion designer says he remembers a growing state of panic as war raged outside his home in northern Kyiv. Even when shells weren’t exploding nearby, he wept uncontrollably at the news he saw on his phone. He became obsessed with the Russians, the forces of evil advancing from the other side of the forest. Perhaps he was looking for them when he left his house, in slippers and pajamas, for the Ukrainian positions inside the woods. Instead, he remembers saying he was looking for Katya Chilly – a new-age Eurovision contestant from Ukraine – before announcing his allegiance to the Russian president. He was bullied for his troubles.
That afternoon, Eduard K. was admitted to one of Kyiv’s psychiatric hospitals. Yaroslav Zakharov, the doctor who first saw him, said his illness was far from unique in a country traumatized by five months of fighting. The war has affected every Ukrainian in one way or another, and the stress amplifies the problems present among the most vulnerable. Under normal circumstances, the psyche functions like a digestive system, says the doctor; he is able to adapt and process extreme experiences. The protracted war changes that. The expectation of suffering weakens the nervous system. “People like to control things, and war doesn’t let you do that,” he says. The Ukrainian Ministry of Health predicts that the war will leave between 3 and 4 million people in need of pharmacological interventions and another 15 million in need of psychological support.
Dr. Zakharov’s department was a hive of activity when The Economist happened at the end of July. A soldier had just been admitted after an incident in which he had pointed guns at a colleague on the front line. The entire second floor of the building had been taken over by the military, the doctor revealed, with new admissions increasing amid hostilities in the disputed Donbass region in eastern Ukraine.
The most intense strain on resources, however, came during the Battle of Kyiv in March, when the hospital remained open despite missiles flying over and landing nearby. Doctors discharged all but the most dangerous patients and allocated their meager resources as best they could. There were many tragic incidents. One of the freed men, who had a history of mental illness, hanged himself after discovering his home near Kyiv had been ransacked by Russian soldiers. His wife is currently receiving treatment.
Eduard K. says that many patients admitted to his side came directly from Bucha or Irpin, suburbs of Kyiv where the Russian occupation forces committed terrible atrocities. The men were of all ages and walks of life, he said, from young to old, and friendly. A group of patients got it into their heads that Eduard K. was God. “They presented themselves one by one: it is the Archangel Michael, and so and so is the Archangel Gabriel”, he says.
Some were too traumatized to speak, but brought offerings to Eduard instead: apples, weird tea bags, coffee, socks. At the end of her first day in the service, her bedside table was overflowing with unsolicited gifts. A young patient brought him coins of a kopek. He had obviously witnessed Russian atrocities near his home in Bucha, although he was never able to say exactly what.
The Ukrainian government has sent mental health specialists to some of the worst affected cities. Nataliya Zaretska, a psychologist, has been working in Bucha for three months, helping civilians overcome the trauma of the occupation. She expected her program to end after six months, but demand was so high that she opened a new mental health center in the city. Ms Zaretska says the spectrum of mental illness is wide. She works with soldiers who have returned after being tortured in captivity and locals who have been prisoners in their own homes.
The Alice in Wonderland nature of Vladimir Putin’s invasion – the false claims of Ukrainian Nazism, the “liberation” of Russian-speaking Ukrainians, the “high-precision” missiles that end up killing civilians in shopping malls – makes recovery complicated for many people. . There are few things as dangerous to mental health as the feeling of betrayal and delusion, says Olena Nahorna, a colleague of Ms Zaretska now embedded with Ukrainian troops in the Donbass. Those who understood early on that Russia was the enemy were better able to deal with the horrors of war, she argues. Those who thought they were friends found it more difficult. “Many Ukrainians saw a neighbour, albeit an eccentric one, in Moscow. It was a personal tragedy when this eccentric friend burst into their home and started killing them.
Ms. Nahorna identifies a potential benefit of war: the national unity forged by the shared experience of trauma. Eduard K., now freed from Mr. Zakharov’s care, says the extreme nature of his experience has given him new clarity in life. “I realize that I might be dead, that different soldiers might have shot me, and that’s a big kick in the back.” His doctor agrees, but warns it is too early to know the full extent of his and Ukraine’s trauma. Mr. Putin, he says, has dropped a ticking time bomb on the psyche of every Ukrainian.
Barely holding back tears, the doctor reveals that his own rage drove him to try to enlist. He was persuaded against this by a veteran patient now in Donbass. “She told me that I had to take care of myself, that everyone would need me when the war was over.” She was right. ■
