Not all wounds bleed: MSF reports surge in post-traumatic stress disorder in Ukraine

Médecins Sans Frontières (MSF) addresses the urgent need for psychological assistance among people affected by the war across various regions of Ukraine, focusing particularly on the most vulnerable groups: those still living near the frontline; individuals who are directly exposed to the war, such as the severely wounded and their family members as well as internally displaced people (IDPs; and people who have lost their families or loved ones.

In Vinnytsia, central Ukraine, MSF runs a psychological support centre dedicated to treating traumatic stress. At the centre, doctors, psychiatrist, psychologists, and health promoters work with people suffering from post-traumatic stress disorder (PTSD) linked to the war. To support recovery, the team provides both individual therapy sessions and group creative classes. The MSF team has seen a rise in the number of people seeking help for mental trauma in 2025.

In addition, MSF teams provide evidence-based treatments for war veterans, wounded or demobilized and back to civilian life, relatives and families, as well as for displaced people affected by the ongoing war. The center utilizes therapies such as Eye Movement Desensitization and Reprocessing (EMDR) to help patients process traumatic memories and alleviate symptoms of post-traumatic stress disorder (PTSD).

“The number of patients receiving active treatment for PTSD at our centre each month increased from 57 in January 2024 to 118 by the end of April 2025,” says Christine Mwongera, MSF medical coordinator. “We are witnessing a considerable need for mental health support, particularly among men in Ukraine. The proportion of male patients among newly admitted individuals has grown. Many are veterans — people who lived and worked in conflict areas and now face challenges adapting to a relatively safer environment and rebuilding social connections. We also observe that many patients require systematic, long-term treatment.”

Many men, in particular, feel stigmatised and are reluctant to seek help. Stigma surrounding mental health remains a significant barrier to care in Ukraine — especially for men — and is rooted in long-standing cultural and historical attitudes. It can be particularly difficult for loved ones to support those trying to adapt socially after returning from war-affected areas. Often, people suffering from PTSD believe they can manage on their own, without medical help. This often-invisible illness can severely reduce quality of life and increase risky behavior, turning daily routines into a cycle of trauma, isolation, and physical exhaustion, worsening chronic health conditions.

“I was sitting across from the therapist, and when he asked what was bothering me, I answered honestly: everything, including him,” says 27-year-old war veteran Oleksandr Zelenii. Seriously injured during a double explosion in Luhansk region, he now lives with a traumatic brain injury, sleep disorders, memory loss, and symptoms of PTSD including irritability, lack of motivation, and difficulty with social interactions. “After years of rehabilitation and consistent MSF psychological support, I feel more balanced and calmer. I’ve even applied for a new job, where I can work as a peer supporter — because I believe I’m ready to share my experience and help others on their recovery journey.”

Anatolii Sobkevych, a 34-year-old seriously wounded in 2023

Anatolii (34) and Antonina Sobkevych (32) live in the Vinnytsia region with their two daughters, aged 12 and 8. In 2023, Anatolii was seriously wounded — the nerves and artery in his right arm were severed. Despite intense pain, he refused amputation and fought to regain mobility. Throughout his recovery, Antonina stood by him, even as tensions arose due to Anatolii’s frustration over losing his independence.

“At the beginning, it was very difficult,” Antonina admits. As Anatolii felt himself slipping into depression, he decided to seek psychological support. The Veteran Hub referred him to Médecins Sans Frontières (MSF), where he began therapy with psychologist Tetiana.

Since then, he says he’s gradually finding balance: his mood has stabilised, his aggression has decreased, and he’s rediscovered small joys like reading and woodworking. Once introverted, Anatolii now feels more open to connecting with others and imagines a quieter, more purposeful life rooted in nature. With Antonina’s support, he believes that — despite the hardship — their relationship has grown even stronger.

Oleksandr Zelenyi, a 27-year-old seriously injured in 2022

Oleksandr Zelenyi, 27, was seriously injured in May 2022 in the Luhansk region during a double explosion. Since then, he has been living with a traumatic brain injury, along with sleep disturbances, memory loss, and other symptoms commonly linked to post-traumatic stress — including irritability, loss of motivation, and difficulties in social interaction.
​​
​Following several hospitalisations, Oleksandr was referred to the Médecins Sans Frontières (MSF) mental health centre in Vinnytsia, where he began therapy with psychologist Tetiana in January 2025.

“I remember being woken up by nurses at 7 a.m. in one of the clinics, just after I had been wounded, so I could attend a session with a psychotherapist at 8. I was frustrated—exhausted from a sleepless night, I had just started to doze off around 5 a.m. Being woken up felt overwhelming. I sat across from the psychotherapist, and when he asked what was bothering me, I told him honestly: everything, including him.
​​
​Now, after several years of rehabilitation and regular psychological support from Médecins Sans Frontières, I feel much stronger. So much so that I’ve even applied for a position with the organisation—because I believe I’m ready to share my experience and support others on their path to recovery,” shares Oleksandr.

He also says the sessions have helped him stabilise his mood, manage his emotional reactions more effectively, and begin readjusting to everyday life. He describes the MSF centre as a safe space and notes that he has regained some ability to communicate. While he still approaches relationships with caution, he is now considering becoming involved in peer support for other veterans.

Oleksii Lohanov, a 57-year-old veteran of multiple wars

Oleksii Lohanov (57), a veteran of several wars—from the Soviet-Afghan conflict in the 1980s to the current war—is at home in the Vinnytsia flat he shares with his wife, Natalia, their Labrador, Merlin, and their five cats, whom he considers to be ‘his best therapists’. The couple work together in the family printing business. Their two sons are currently at the front, while their daughter is studying.

Oleksii suffers from complex post-traumatic stress disorder as a result of the traumas accumulated over more than 40 years, along with serious physical and neurological after-effects: speech and motor difficulties, heart problems, cognitive fatigue, and more. He recalls that it was only several years after returning from Afghanistan that he began to feel a deep, diffuse, but persistent stress. At the time, there was no form of psychological support for those who had experienced life and work in war areas. He wasn’t even aware then that what he was feeling was the result of trauma. It was Natalia, his wife, who helped him adapt to a safe environment, he says.

Many of his fellow Afghanistan veterans have seen their families break up. Oleksii sees himself as an exception, thanks to his stable family situation. Natalia jokes that she has married Oleksii four times: the first during peacetime; the second upon his return from Afghanistan; the third after the war in Ukraine began in 2014; and the fourth now, as he has become a veteran of the large-scale invasion, having suffered severe trauma.

With the current war, old traumas have resurfaced. Six months ago, Oleksii felt the need for psychological support and turned to the Médecins Sans Frontières (MSF) centre in Vinnytsia, where he has been receiving therapy ever since.

“At the beginning of our sessions, Oleksii could barely walk and was also experiencing serious heart issues as a result of his injuries. Now, after a period of therapy, his condition has significantly improved—he’s sleeping much better and making real progress. In cases like his, we may not be able to achieve full recovery, but our focus is on restoring psychological resilience and improving quality of life. He’s now close to completing his therapy. We’ve had around 40 sessions together, meeting once a week.

In our work, I use a combination of trauma-focused approaches such as Brainspotting, EMDR, sensorimotor psychotherapy, and narrative therapy. About half of these methods are neurobiological—they don’t require the patient to speak in detail about the trauma, which can be re-traumatizing. This allows us to engage the body’s own healing processes. While traditional talk therapy often has limited effectiveness with trauma, these body-based methods can be much more supportive. Of course, if a patient wants to talk, we create space for that as well,” explains Liudmyla Honcharuk, psychotherapist at Médecins Sans Frontières.

His psychological state has now stabilised considerably, although the physical after-effects are irreversible. After decades of suffering in silence, he now wants to encourage others who may feel the same to seek psychological support.

“The main issue with mine-blast acoustic trauma, like the one I experienced, is the disruption of neural connections in the brain. That’s what causes most of the physical symptoms. My left arm has limited mobility, and when I’m tired or anxious, I sometimes lose the ability to speak entirely—or I stutter. My right leg can suddenly give out, and I might fall without warning. I also have severe blood pressure fluctuations.

The psychologist from Médecins Sans Frontières uses special therapeutic techniques to support my recovery—through music, targeted exercises, and other methods. The progress is slow, but very real.

A year ago, I could only focus for about an hour a day. Now, after six months of therapy with MSF, I can concentrate for two to two and a half hours a day. And I’ve learned not to rush—I understand that healing takes time”, - shared Oleksii.

Polina Bila, a 10-year-old displaced from Bakhmut

After the intensive shelling of Bakhmut, Donetsk region, Polina, her mother Hanna, her father, and her older brother Sviatoslav (13) were forced to evacuate the city on April 5, 2022. They spent three months in Poland before settling in this Vinnytsia displacement centre, where Tetiana, their grandmother, eventually joined them.

A few weeks ago, Polina suffered a serious accident during a cheerleading practice - her great passion - resulting in a compression fracture of the sixth vertebra. She underwent surgical stabilization and must remain bedridden for two months. Any return to sports will depend on medical evaluations and the lengthy rehabilitation that follows. Now unable to move, Polina is psychologically vulnerable both because of her injury and its consequences and because of her forced departure from Bakhmut due to the war in 2022. Through play (including this “magical healing cat”), music, and guided conversations, MSF Psychotherapist Liudmyla Honcharuk employs stress-reduction techniques and sensory exercises to provide Polina with psychological support.

"I think about my life in Bakhmut very often, and I feel sadness and anger” Polina confides, continuing to attend her former school’s classes online. She hopes to return to Bakhmut one day to cultivate a large orchard of lemon and tangerine trees and dreams of becoming a pastry chef, creating her own cakes and confections.

Hanna Bila, Polina's mother, displaced from Bakhmut

Since June 2022, Hanna Bila has been living in a former school converted into an internal displacement centre in Vinnytsia, along with her daughter Polina (10), her son Sviatoslav (13), her husband, and her mother Tetiana. The family fled Bakhmut, in the Donetsk region, during the bombardments at the start of the large-scale invasion.

An accountant for the Bakhmut City Council, Hanna now works remotely from Vinnytsia. Since 2024, she has been receiving psychological support from Médecins Sans Frontières (MSF) to help manage her war-related anxiety. She highlights the effectiveness of relaxation exercises, body-based stress-reduction techniques, and the safe space provided for expression. Although she already feels better, she acknowledges that she still needs ongoing support.

Hanna's husband was wounded in 2014 but is still not officially recognized as disabled. The process of obtaining this recognition is complicated, they shared. Their son Sviatoslav, deeply affected by the war, has seen several psychologists but now refuses to continue therapy despite his emotional fragility. Hanna’s mother Tetiana and daughter Polina also benefit from MSF’s support.

Danylo and Alisa Fostii, a 7-year-old and his mother forced to flee Kramatorsk

Danylo Fostii, age 7, was forced to flee Kramatorsk (Donetsk region) with his 48-year-old mother Alisa when the war intensified in 2022. Now settled in a temporary apartment in Vinnytsia, where he is enrolled in school, Danylo speaks of “always living out of suitcases,” the lack of a space of his own, and the absence of his father who remained in Kramatorsk. Alisa reports that she has observed in her son a deep sense of inferiority and signs of aggression. For this reason, they now both attend weekly psychological support sessions at the MSF centre in Vinnytsia—appointments that Danylo eagerly anticipates each Thursday, during which he expresses his emotions through drawing and games focused on identifying feelings, especially joy, his favourite emotion.

Alisa, meanwhile, suffers from chronic anxiety and panic attacks for which she has taken antidepressants; she receives ongoing psychological care from the MSF teams, whom she describes as compassionate and professional. In parallel, Danylo continues his extracurricular activities: he practices mental arithmetic (Soroban), which he hopes to teach in the future, plays in a chess club, and trains in taekwondo.

Andrii Panasiuk, mental health supervisor at the MSF centre in Vinnytsia

Andrii Panasiuk, mental health supervisor at the MSF centre in Vinnytsia, brings both professional and personal experience to his role. A veteran himself, he turned to the field of psychology at the age of 30, completing his studies and undertaking various therapeutic trainings. Since joining Médecins Sans Frontières in December 2023, he has been leading a growing team of psychologists — currently six, soon to be seven — with a focus on providing support to individuals affected by the war, many of whom are men.

Andrii highlights several common challenges among those seeking help: a reluctance to access psychological support, feelings of injustice, emotional distress, and persistent physical pain such as phantom limb sensations or the effects of injury. Many also struggle with substance use as a way to cope. He notes that stigma around mental health remains a significant barrier to care in Ukraine — particularly among men — rooted in longstanding historical attitudes.

With deep awareness of the psychological toll of the war and the heightened risk of suicide among those affected, Andrii emphasises the importance of creating safe, supportive spaces for healing. He adds that some of the most complex and emotionally difficult cases involve people who have experienced captivity, where trauma runs deep and recovery requires time, compassion, and specialist care.

Note to editors:

Since the beginning of the full-scale invasion of Ukraine, MSF has adapted its activities to respond to the new challenges of the war.

The main areas of work in 2025 include an MSF ambulance service to transport people with serious injuries from frontline to safer areas; mobile clinics providing medical consultations necessary medicines to people living in frontline areas; early rehabilitation for seriously injured patients in Cherkasy region; PTSD treatment of and psychological assistance in the Vinnytsia region; and donations of medicines.

In addition, our teams run mobile clinics in towns and villages in the Kherson, Donetsk, Mykolaiv, Dnipropetrovsk and Kharkiv regions. We provide primary healthcare, mental health counseling and psychoeducational services, as well as sexual and reproductive healthcare.