A series of military conflicts in Eastern Europe has left millions of people with post-traumatic stress disorder, PTSD. LRT English partners at Hromadske International in Ukraine report about the long-term effects of ongoing, and forgotten, wars.
Picture the following situation: a seriously traumatised person is trying to behave as usual. The person walks in streets, uses public transport, talks to people and goes shopping – but all the while the wound continues to bleed.
Instead of rushing to see a doctor, the person is trying to get used to their circumstances, drown out the pain or adapt to it.
Millions of people are living this way. PTSD occurs in people who have faced something terrible, dangerous, terrifying; some extremely negative experiences that threatened their lives – like war.
People in parts of Eastern Europe have been subjected to a series of military conflicts – some are still ongoing. Millions of people were left with PTSD.
However, many do not even realise what exactly is happening to them. On top of that, they have no idea that professional help is available.
Belarusian 'Afghantsy' living and dying with PTSD
Some 30,000 Belarusians took part in the Soviet war in Afghanistan from 1979 to 1989, but only the physical injuries were treated in the aftermath. 'Afgantsy', as they are commonly referred to in the Russian-speaking countries, try to avoid talking about the war, although they often do not regret the experience. Euroradio spoke to some of them.
Belarusian veterans recall that many of them felt the same way, but there was little point in trying to convey their pain to others.
In the aftermath of the Afghanistan war, veterans suffered from a disorder that wasn’t even classified as one in the USSR. As a result, there were no doctors who could offer treatment.
Many of those who required help are no longer alive, whereas those who did manage to pull themselves through didn’t require it in the first place.
Afghan war veteran Anatoly Kozhukh recollects frequent nightmares featuring the bearded faces of Afghan forces. Kozhukh also speaks of prejudice he experienced in everyday life – even shop attendants would often ask what young people like himself went to Afghanistan for. The whole idea seemed very exotic to the rest of the population.
Another veteran Nikolai Garbuza remembers how the state turned away from Afghanistan veterans.
"We performed our duties there, defended our homeland. But they turned away from us after the war as if they didn’t send us there in the first place. It hurts," he says.
Despite this, he has some fond memories of Afghanistan and if it weren’t for hostilities, he would not even mind returning to see the city of Jalalabad and the mountains.
Alexandr Gemsky, who also took part in the war, thinks the state’s indifference was due to the disastrous state of the economy at the time. In his opinion, there were more important things to take care of in the early 1990s than veterans' mental health.
Memories of torn-off limbs and blown-open stomachs are still fresh in his mind, however. In any case, he believes it is too late to offer help now, as “80 percent of his comrades got divorced right away as if they had nothing in common [with their spouses]”.
This indicates that there was, undoubtedly, "something wrong with their minds", he adds.
Helpless: PTSD among veterans of the Transnistrian conflict
The 1992 Transnistrian war between Russian-backed breakaway forces and Moldova took the lives of around 1,000 people. Some 4,500 more were injured, but there were no attempts to count those who suffered psychological traumas.
They received no psychological aid, and many are still affected by PTSD which is getting more harder to treat with time. Many veterans admit to finding it harder to overcome psychological trauma. Hromadske's partner Ziarul de Garda investigated this issue.
For Anatoli Croitoru, it was the loss of comrades and friends to war that was the most painful experience. Others, like Victor Patrascu, say they were psychologically prepared to fight for and defend their homeland.
"The symptoms range from anxiety and sadness to mental illnesses and inability to focus on anything else," says psychiatrist Vadim Aftene. "Sadness, lament, isolation keep repeating. Compulsive ideas and sudden flashbacks of past experiences appear. Emotional emptiness, sleep disorders, nightmares. These symptoms exhaust a person mentally and somatically.”
Some Moldovans simply accept that they are “not Europeans”, so they don’t even expect to see personal psychologists, he adds. Thus former servicemen treat PTSD with alcohol or marijuana.
According to military expert and war veteran Andrei Covrig, "rehabilitation is done independently".
"For Moldovans, the psychologist is a glass of wine from your cellar," he says. "It is all done to relax and forget the past. For a brief period, it helps you to doze off, but in the long term, it makes things worse. Compulsive ideas, fears reappear around the clock. This person cannot lead a normal, quality life."
Covrig says that despite the temporary improvement, "it’s impossible to forget what has happened".
"And if you had a trauma or injury, you never forget it, you take it with you. If you saw your friend injured or killed, it can’t be forgotten," he adds.
Nagorno-Karabakh war veterans in Azerbaijan
The war in the Nagorno-Karabakh region between Armenia and Azerbaijan broke out in 1988. It is still ongoing.
“It is not customary to turn to psychotherapists. Even talking to your relatives about it is shameful. But we have to talk about this illness,” a veteran of the Karabakh conflict, Gasym, tells JAM News in Azerbaijan.
When he returned home in the 1980s, nobody could grasp what happened to him. He was treated for neurosis, but was eventually diagnosed with PTSD by a doctor he came across by chance.
Most Azerbaijani veterans, unlike Gasym, live with these symptoms – war nostalgia, depression, headaches, insomnia, suicidal thoughts, and aggression – ignorant of their diagnosis.
Elshad Rakhmanov spent four years in war and was injured. He lives with his mother in a one-room flat and works at a construction site.
"War dictates its own rules. You don’t distinguish among people: they’re all enemies. Whenever I tell people what I had to go through, they look at me as if I’m mad, as if I’m some monster," he says.
"You’d be having lunch with a comrade, you walk off 15 metres and return to see him killed. You literally just shared bread with him, it’s still in your mouth. You just discussed how you’d meet up in post-war life, but he is no more," he adds. "I left my soul there. So many years later I’m still there with those guys."
Rakhmanov has never visited a psychologist but did undergo a medical examination. He was diagnosed with a contusion. “I was prescribed something for my nerves. If I don’t take them for three days straight, I get wild,” said Rakhmanov.
He knows at least five fellow servicemen who have the same problems as he. They meet up once every three to five months.
"I didn’t go to war to get something from the state in return. I just want my fatherland to love me as much as I love it," he says, adding that his pension is 120 US dollars per month, so he can’t afford treatment.
Two factors come into play, according to psychologist Azad Isazade: the unpreparedness of the body and the intensity of the trauma. The latter can break even the strongest people, he says.
“Individual work is a must in order to filter through the hardest cases and treat them individually. Groups can attend light relaxation sessions, so that the person can drift away. So that he doesn’t enter society with that condition. The next stage is socio-psychological rehabilitation: we shouldn’t just provide them with jobs, but make them feel privileged as veterans,” says Isazade.
Nagorno-Karabakh war veterans in Armenia
On the other side of the barricade is an Armenian veteran of the same conflict – Aik Torosian. He was lucky to have been diagnosed correctly and was offered psychological help in time, although he did fight 20 years later. Hromadske partners JAM News spoke to him and other veterans.
Daniel Grigorian is still afraid of loud noises and bright light, even 25 years after the hostilities. Whenever he watches movies, he is often mentally transfered to the frontline of the early 1990s. He was 17 when the war broke out.
"We had no idea what a war was. We were teenagers, so we just thought it was a common occurrence. It was difficult to get used to it. Our fallen comrades remained in Shaumian [on the Azerbaijani side]. We wanted to return to fetch their bodies. This thought tortures me to this day," he says.
Daniel’s platoon returned home after the truce in 1994. He had to learn from scratch to live in peacetime again.
PTSD follows extremely negative emotional experiences. The affected develop a feeling of exposure that prevents them from returning to ordinary life.
Psychologist Karine Tatrian says that “it’s best to turn to a professional, because PTSD only gets worse with time”. The condition is also common among people who survived a life-threatening event such as an act of terror, torture or violence.
Torosian took part in the 2016 Nagorno-Karabakh clashes. For four straight days, full-on hostilities resumed for the first time since the 1994 truce. Torosian received an injury that was incompatible with military service and returned to civilian life.
"This situation is barely discussed in my family. But I still can’t forget it. It will remain with us forever. I no longer get as irritated by sounds. But it still has an effect on me. Especially now – I can’t stand it," he says.
Torosian received psychological help in a rehabilitation centre. Despite all his difficulties, he began his studies at a university. Now he wants to become a care worker to help those who need assistance.
Not just the soldiers
“We were unable to adapt, neither women nor men, and therefore it is difficult for us to communicate with children, with neighbours, and in society. We never spoke with psychologists. They didn’t explain anything to us,” Rukhsara Dzhumaeva, a military nurse, tells Meydan TV.
“During one of the battles, we had 96 people injured, dozens died and our tanker Balolgan went missing. We never learned of his fate. That’s the toughest thing for me,” she added.
“It took everything from us [...] apart from life, but I’d rather it had taken my life,” said Salim Salimov, a refugee from the Laschinsky district. “God forbid anyone goes through what we’ve been through. I wouldn’t wish this upon anyone. It’s like nothing else.”
Olya Zaporozhets, an associate professor in the School of Psychology & Counseling at Regent University in the United States, says that “people start to behave in an untypical way”. The symtptoms of PTSD are similar in everyone, she adds.
"If they used to be the life of the party, they become unrecognisable. They let themselves slide, take up drinking, can’t find employment. It’s these people that require therapy," she says, adding that "the symptoms and their intensity can be addressed".
But psychological traumas are seldom discussed, let alone treated in Azerbaijan. There isn't a single psychologist who specialises in PTSD in the whole of Azerbaijan, according to Meydan TV.
Civilians in Eastern Ukraine
Inna Dolia, a psychologist from the humanitarian mission Proliska, works with civilians at the frontline. "People aren’t easily convinced that they require psychological aid," she says.
According to a 2017 survey by International Alert, a UK-based NGO, around 32 percent of internally displaced people suffer from PTSD. Almost 22 percent of IDPs have depression and 17 percent have anxiety.
"People with mental disorders rarely turn to doctors due to stigma, prejudice, and the superstitious belief that a psychologist is someone who gets into your brain with a spoon," says Dolia.
But "everyone has their own history of trauma", she adds, as "people come in with nightmares, compulsive memories, traumatic experiences, insomnia, phobias, or basic mourning".
"When the person is in a danger zone, they mobilise. But this can’t be a long-term state, not for over five years. It’s very tough, but people have to [adapt]," says Dolia.
Yevhenia Sukhotska, a pensioner who lives near the frontline, has outlived both her son and granddaughter. The latter could not bear the burden of hostilities on top of her health problems.
Dolia has to find ways to comfort the woman. “It’s painful and tough at first, but it gets better,” she says.
The psychologist mentions that not everyone at the frontline requires psychological help. Only those who can’t bear it alone, but they still have to be ready to accept help.
Post-traumatic stress disorder is not exclusively triggered by war traumas. A repressive state regime – illegal detention, torture, extrajudicial executions, arson, public humiliation – can also cause or exacerbate PTSD, according to Dolia.
PTSD affects people from different countries who have survived a war with or without arms, those who volunteered for war, and those whose homes were destroyed by it.
Others continue to be hurt by their state. All these people require help.
This story was originally published by Hromadske International. It was edited for brevity by LRT English.
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