Ticking time bomb

How the war in Ukraine is causing a mental health crisis in Russia

An unprecedented mental health crisis is looming in Russia as soldiers returning from Ukraine exhibit increasingly obvious signs of Post Traumatic Stress Disorder (PTSD). In many cases, those who make it out of Ukraine alive are bringing the war home with them, often forcing their families to endure violent behaviour, flashbacks, and heightened levels of drug and alcohol abuse.

Bittersweet reunion

On a chilly day in March 2023, Anastasia woke up in her apartment before dawn. She was eager to be reunited with her husband Ildar, who had spent the last three months serving in the Russian military in Ukraine. With balloons and Russian flags in hand, Anastasia took a taxi to the bus station, scanning every bus that came in until she finally saw him.

Anastasia ran into his arms to embrace him and the pair went home, where their two young daughters were still fast asleep. When they awoke, the girls initially appeared confused by the man in the military uniform standing before them, though once they understood that he was their father, they wouldn’t let him out of their sight for the rest of the day.

However, Ildar’s family soon learned that the war had changed him. He had constant nightmares and reacted aggressively when he heard fireworks, thunder, or the anti-hail rockets used over nearby farmland. Misunderstandings with Anastasia, would suddenly flare up into arguments and he would start yelling, struggling to remind himself that she was not an enemy on the battlefield.

“It got lodged in my mind that if someone is an enemy, you just have to neutralise them,” Ildar said. “That’s why I try to avoid confrontational situations… I still don’t know how I might react.”

In these situations, Ildar would step outside to smoke or visit a neighbour. Then, only after he had calmed down, would he come back and apologise for his disproportionate reaction.

“My younger daughter would get scared, but the older one understood,” Anastasia said. “He would go to another room so the kids would witness as little as possible. At most, he would curse or break something. He didn’t attack us.”

Misunderstandings with Anastasia, would suddenly flare up into arguments and he would start yelling, struggling to remind himself that she was not an enemy on the battlefield.

Ildar’s aggressive behaviour is not uncommon among Russian soldiers returning from the war in Ukraine having lived in a state of constant tension for months. Yevgenia Lazareva, a clinical psychologist who works with returning soldiers, said that it was quite typical for those who had suffered near-death experiences, trauma, and violence to “behave inappropriately”.

“They might have night terrors, intrusive memories, or sudden reactions that seem unusual to their loved ones,” she said. “This can also lead to dependence on psychoactive substances.”

Anticipating a growing demand for trained specialists, Lazareva told Novaya Europe that many of her colleagues were training to treat war trauma and PTSD, and added that she hoped the government would step up its efforts to address the coming mental health crisis “because every state should be invested in having a healthy population”.

“PTSD can last for years,” she said. “It affects both the person struggling with PTSD and their family.”

Recently, when a stranger almost hit his car, Ildar became so upset that he considered physically attacking him. He and the other driver were screaming at each other, and Ildar couldn’t calm himself down.

“I had a knife in my car. It occurred to me that I could stab the man,” he said. “But I realised that if I went through with it, my life would be over. Somehow, I stopped, turned away from him, got back into my car, and drove on.”

Walking on eggshells

Bahrom returned from Ukraine in May 2023, after spending six months at the front. Originally from Tajikistan, Bahrom had enlisted in the Russian military to gain access to a scheme that fast-tracks Russian citizenship for foreign nationals who serve in the army. Upon his return to Russia, not only did Bahrom find his citizenship application stalled, he also struggled to readjust to civilian life.

Once, when he and his wife Shabona went out with friends, Bahrom became angry with her for looking at her phone. As Shabona tried to leave, Bahrom hit her repeatedly.

“Right after hitting me, he snapped out of it and started apologising profusely. He spent several days begging for forgiveness on his knees, and we haven’t had any major fights since,” Shabona said. “But for me, that was a turning point, a red flag that this was the new normal for him.”

Once, when he and his wife Shabona went out with friends, Bahrom became angry with her for looking at her phone. As Shabona tried to leave, Bahrom hit her repeatedly.

According to Shabona, her husband’s psychological state was upended by the war. He would twitch in his sleep and would often withdraw from others. He wouldn’t eat anything for a week at a time, only drinking and sleeping, refusing to talk.

“Always having to walk on eggshells is very unpleasant, wondering what kind of mood he’s in or how he will wake up feeling,” Shabona said. “I tried to get him to explain what was happening, but I soon came to realise that, in such moments, it was better not to approach him at all… He eventually calms down and returns to himself after a few days.”

Shabona said the Bahrom would pack up his things as if he were shipping out to the front on the slightest pretext, adding that many of his friends had subsequently gone back to fight in Ukraine.

“He went once and came back unharmed.” Shabona said. “Tempting fate for the second time is really not worth it.”

Shabona said she doubted Bahrom’s psychological injuries would ever heal, and admitted that she soon became exhausted in her attempts to help him recover. In February, she divorced Bahrom, and within two months he had re-enlisted.

Stuck in the past

Vadim was recruited by the Wagner Group to fight in Ukraine, but after suffering a bullet-wound to the hand had spent eight months in a hospital on the Black Sea. He returned home for long-term rehabilitation in January 2023 only to discover that he couldn’t stop thinking about the war, and started regularly blogging about his experiences.

His memories were so intense that he sometimes had trouble remembering that he was no longer in active combat. Like Ildar, Vadim was triggered when he heard certain loud noises. Once, during a sudden flashback on the street, he started operating an imaginary grenade launcher on his shoulder.

“About 150 metres from me, a truck appeared, and I thought it was a target. I raised my hands, raised the imagined grenade launcher, and fired it, adjusting for the wind,” Vadim said with a laugh. “It would be funny were it not so sad.”

Vadim also soon noticed his lack of empathy toward others. He resented the people he saw “scoffing” their meals at shopping mall food courts, people who “chose between cheese and sweet-and-sour sauce, while others ate rations in the trenches,” he said. He also harboured resentment to men who worked out at the gym for fun.

“Here, if a guy weighs 100 kilograms with six-pack abs, it’s cool. But in a combat situation, you just look at him and wonder how you will possibly carry him if he gets injured,” Vadim said.

He hardly reacted when he heard about tragedy and misfortune in the news. “My wife always asks me why I’m so indifferent,” Vadim said. “But, what’s the issue? Unless someone loses their arms or legs, unless someone dies, why worry?”

Vadim has promised his family that he won’t return to the Wagner Group, but admitted that he had nevertheless considered re-enlisting.

“We had a conversation about a possible fresh wave of mobilisation,” he said. “My wife didn’t like to hear me say it, but if a draft notice comes, I will go.”

Helpless

The Russian government provides limited resources for the psychological rehabilitation of veterans and for mental health care in general. In April 2023 — more than a year after the war began — Putin established the Defenders of the Fatherland State Fund to support Russian veterans of the war in Ukraine and the families of those killed in action, which included some funding to pay for psychological support.

According to the Sverdlovsk branch of the state fund, psychologists have been working with Ukraine veterans and have been able to achieve “very positive” results, despite having no specialised training in the treatment of PTSD.

For many demobilised combatants, therapy and mental health remain taboo subjects, and most veterans tend to shy away from treatment even when it’s available.

But such centres, which tend to be located in regional capitals, are simply too far away to be of much use to those living further afield. The Sverdlovsk branch told Novaya Europe that online sessions were not currently available, saying only that in some cases therapy could be conducted over the phone. When asked what advice they might give a veteran living outside the regional capital, they suggested looking for a local psychologist able to offer in-person sessions, but they were unable to provide a list of specialists based in the region's smaller towns.

Vadim, who went to therapy before the regional centres were set up as part of the mental health support services provided by the Wagner Group, has been seeing a psychologist once a week for months, and said it’s made him feel far better. But for many demobilised combatants, therapy and mental health remain taboo subjects, and most veterans tend to shy away from treatment even when it’s available.

When Shabona asked Bahrom if he would be prepared to see a therapist, he said no and insisted that everything was fine. Similarly, Ildar hasn’t pursued therapy either, says that he doesn’t know of anyone specialising in treating veterans with PTSD, and that he worries about the stigma associated with seeing a psychologist. While Ildar did at least say that he would go to therapy as a last resort if his mental health significantly deteriorated, he said that in the meantime he’s found comfort listening to pop music about the “special military operation,” and in being with his family.

Many soldiers, unable to cope through other means, turn to alcohol. Ildar, Vadim, and Bahrom all reported widespread alcoholism among the soldiers they knew. Shabona said she’s never seen some of Bahrom’s friends sober, and that their drinking often ended in violence. “They drink and beat their wives to a pulp. The wives suffer, but they still keep it all a secret as if they have the perfect family. It’s terrible.”

In April, Novaya Gazeta Europe recorded a rise in violent crimes committed by soldiers returning from the war, and the number of criminal sentences handed down to military personnel in Russia has increased sevenfold since the start of the war, despite the fact that many veterans now get far lighter sentences as courts recognise their military service in Ukraine as mitigating circumstances.

Ukraine veterans committing domestic abuse, which has for some time already been decriminalised in Russia, now enjoy virtual impunity, even if the case goes to court. In October 2022, a Wagner mercenary found guilty of beating his ex-wife beyond recognition and breaking both her eye sockets, was fined just 5,000 rubles (€50) after he presented the court with the medals he was awarded for his military service in Ukraine.