Many recognize the physical hardships faced by those who have experienced war, but few understand the subtle psychological and emotional effects that accompany such experiences.
This article explores these hidden challenges and how those who have experienced war navigate their complex feelings and the lasting impact of it.
Common Psychological Effects of War
When examining the psychological impact of war, it’s crucial to understand that trauma manifests in diverse ways, deeply influenced by an individual’s role and experiences during the conflict. Research shows that military veterans often face unique psychological challenges compared to civilians. However, trauma doesn’t discriminate—civilians can be profoundly affected too, with rates varying based on factors like proximity to conflict and personal experiences.
Despite varying exposure levels, there’s a common thread that binds all those affected by war: the fundamental human response to extreme stress and danger. Whether soldier or civilian, the brain’s response to trauma involves similar neurological pathways.
According to research by Dr. Steve Sugden, MD, at the Huntsman Mental Health Institute (HMHI), three primary populations are susceptible to war-related psychological trauma:
- Civilians residing in conflict-affected areas
- Military personnel engaged in combat on both sides
- Individuals exposed to war-related content through various media channels
These groups can develop similar trauma profiles, with prevalent symptoms including:
- Post-Traumatic Stress Disorder (PTSD)
- Clinical depression
- Chronic anxiety
- Hypervigilance
So, as we can see, the psychological impact of war is not always confined to those directly involved in the frontline, but can affect individuals who may be far removed from the physical battleground.
The Global Psychological Impact of War
Today, violent conflicts are at their highest since World War II, affecting over 2 billion people globally. War-induced anxiety and uncertainty undermine global safety perceptions, demonstrating that mental health issues spread faster across borders than economic crises.
In Ukraine, where the full-scale Russian invasion enters its third year, feelings of loss, uncertainty about tomorrow, and constant threat of death have become integral parts of many people’s lives. Numerous Ukrainians grapple with profound grief and depression, their emotional difficulties compounded by unresolved loss and the inability of many to return home. These psychological consequences create a heavy burden that will be carried for a lifetime.
The weight of this burden often manifests in severe psychological conditions. According to the World Health Organization (WHO), one in five people (22%) who have experienced war in the last decade will face mental health disorders such as depression, anxiety, post-traumatic stress disorder (PTSD), bipolar disorder, or schizophrenia.
How War Reshapes Health: World Statistics
→ Effect on mental health
According to a comprehensive meta-analysis, the prevalence of war-related mental health disorders is widespread and alarming. Studies show that 28.9% of individuals who have lived through war experience depression, with rates varying between 3.2% and 79.6%, depending on the conflict.
Civilians tend to suffer higher rates of depression compared to military personnel. Similarly, 30.7% of those exposed to war report symptoms of anxiety, with civilians displaying a significantly higher prevalence (38.6%) than military personnel (16.2%). This stark difference can be attributed to the fact that civilians often find themselves unprepared for the chaos and unpredictability of war, while soldiers are trained to cope with high-stress situations, which can mitigate certain anxiety-related responses. The sense of helplessness civilians experience, compounded by the destruction of their homes and threats to their families, fuels their anxiety.
However, it’s essential to recognize that military personnel endure their own set of psychological challenges, distinct from those civilians face. Soldiers may report lower levels of anxiety, but their mental health struggles are far from negligible. They are more likely to suffer from conditions such as moral injury and survivor’s guilt, which complicate their psychological recovery. These feelings often stem from the traumatic experiences of combat, the loss of comrades, and the ethical dilemmas encountered in war.
While civilians and military personnel experience post-traumatic stress disorder (PTSD) at similar rates—25.7% and 21.3%, respectively—the emotional burdens for soldiers are shaped by their direct role in combat and the weight of responsibility, which can be just as debilitating, if not more so.
→ Effect on physical health
The psychological toll of war doesn’t just manifest in mental health issues—it also has profound effects on physical health.
Prolonged stress, particularly the type caused by war (distress), alters our neurobiology and weakens the body’s ability to cope. This distress activates the amygdala, our brain’s “panic button,” making us hyper-reactive to fear and anxiety-inducing stimuli. Constantly being in a state of high alert exhausts the body, leading to the suppression of functions like libido and the immune system. Over time, the depletion of dopamine, a key “happiness hormone,” results in apathy, depression, and emotional fatigue. During war, the cerebral cortex, responsible for regulating behavior and empathy, also suffers, making individuals less tolerant, less able to manage emotions, and more prone to conflict.
The impact of this stress response extends to chronic physical conditions. The persistent release of cortisol and adrenaline contributes to insulin resistance, raising the risk of diabetes. Simultaneously, stress-induced inflammation can damage arteries, raising the chances of heart disease, heart attacks, and strokes. War trauma also accelerates blood clotting, further increasing the risk of cardiovascular events.
In the context of the ongoing Russian terror in Ukraine, these health consequences have become particularly severe. The number of patients there with diabetes has increased by more than 20%, heart attacks by over 16% and strokes by more than 10%. The stress and disruption caused by the war have also led to an anticipated surge in neglected cancer cases, as many are unable to access medical care due to displacement, occupation or psychological paralysis. The chronic nature of these conditions, intertwined with mental health issues, creates a vicious cycle, where physical health deteriorates further as mental health worsens, making recovery even more challenging.
This complex connection of mental and physical health underscores the long-term impact of war on both civilians and military personnel. While the statistics may show different mental health outcomes for these groups, the underlying trauma and distress are universal, deeply affecting all who are exposed to the horrors of wars.
Unobvious Emotional Responses
The interplay between mental and physical health is just one part of the broader psychological landscape shaped by war. Beyond the more well-known conditions like PTSD, anxiety, and depression, those who have experienced horror and terror often face a range of less obvious emotional responses. These reactions, while less discussed, can be equally disruptive.
For instance, in peaceful environments, individuals may find everyday sounds or sights unexpectedly triggering, bringing flashbacks even when far from the war zone. Some may even experience a strange dissonance—feeling more secure during moments of chaos or unsettled by calm, as the absence of the adrenaline rush they’ve grown accustomed to leaves them feeling disconnected or even numb.
Guilt is another heavy burden for many refugees. For some, the simple act of living in a safe space can induce overwhelming feelings of guilt, especially when they are aware of friends, family, or fellow countrymen still enduring the war. They may struggle with feelings of unworthiness for being in safety, leading to inner conflict as they try to reconcile the normalcy of their new lives with the trauma they left behind. This guilt can manifest in subtle ways, such as difficulty enjoying life’s pleasures, or avoiding making new connections for fear of betraying those who remain in danger.
Accompanying the guilt many refugees feel is an intense, often irrational fear of danger and loss. Even in safe societies, individuals may remain on edge, haunted by intrusive thoughts about potential harm or the loss of loved ones still in war zones. This heightened state of alertness can lead to a cycle of anxiety, where the fear of dying or receiving bad news distorts their perception of reality, making it difficult to relax or feel secure. Mundane situations may trigger overwhelming feelings of vulnerability, reinforcing a deep-seated belief that safety is an illusion. In this state of emotional tension, they might also become overly protective or caring, driven by an instinct to preserve what they can in the face of uncertainty, further complicating their struggle to find peace.
In addition, many of those affected by war, particularly refugees, may also feel a strange pressure to ‘perform’ their trauma. When in safe spaces, they might feel a need to justify their suffering to those around them, ensuring that their pain is visible and acknowledged. In some cases, this need stems from frustration that others in more stable circumstances may trivialize their experiences or fail to comprehend the gravity of the ongoing war.
Personal Experience
These less obvious emotional responses are deeply felt by many who have lived through war – including myself. Each time when I leave Ukraine, I notice how the effects of the Russian invasion continue to shape my emotional reactions in some confusing ways.
For instance, whenever I hear a plane approaching closely, I feel a sense of unease. The rising sound makes me tense, as if preparing for something bad to happen, even if rationally I know it won’t. This stems from my experiences in Ukraine, where such sounds often preceded explosions. On my first night here, I even woke up startled by a plane, momentarily forgetting I was no longer in a war zone. So the simple noise of a plane feels like a trigger, taking me back to the war even though I’m thousands of kilometers away.
→ Adrenaline addiction
Another emotional response occurs when I’m back in Ukraine and hear air raid sirens or even distant explosions. Surprisingly, sometimes it makes me feel an odd sense of relief. It’s as if my body knows how to handle that kind of danger — the adrenaline kicks in, heightening my senses and providing clarity. The chaos like that feels familiar, something I understand. Here in Thessaloniki, where things are calm, I consciously feel happy and relieved to rest from constant threat and emotional stress. Yet, subconsciously, it feels like something is missing.
This emotional dissonance is hard to explain to those who haven’t experienced it. It’s not just about fear, it’s about how the body and mind adapt to survive. From the point of psychology, we can explain that constant stress caused by war provokes an adrenaline rush, which over time can create adrenaline addiction. That heightened state, where every sense is sharp and focused, becomes something the body craves. And so, when the adrenaline is absent, like here in Thessaloniki, you can feel uneasy.
Thus, safety, in a sense, can feel disorienting because it doesn’t come with the same rush of adrenaline that my body has learned to expect. I know I’m not alone in feeling this way — it’s a silent struggle that many people who have lived through war experience. While this struggle makes many feel strange, at least it’s not the worst thing to experience, so I will not complain.
→ Envy for normalcy
A different wave of dissonance emerges when I read the news about Ukraine from afar. In those moments, I feel grounded and reconnected with the reality I’ve lived through, yet I also feel a profound difference between myself and those around me.
The privilege of living normal lives—without the constant worry for the safety of family and friends—can feel unfairly frustrating sometimes. Not because I wish for anyone to feel the same way, of course not, not in the whole world. It comes instead from deep empathy for my fellow Ukrainians, from a sense of helplessness and constant pain for my nation. With all of this weighing on my heart, I feel it’s difficult for people to fully understand me and what it’s like to live with the ongoing awareness of war. This creates a sense of isolation, as my concerns are deeply tied to a reality they don’t share.
At times, I even feel envy, not for myself, but for our children, youth, the elderly. I wish our kids’ biggest problem was getting a bad grade at school, not thinking about how to get to the shelter during a missile attack. I want our young people to see their futures as vividly as those abroad, not wondering whether they will die on the frontline or in a random Russian strike.
With all my heart, I would want to read, “He was only 18 when he competed in the Olympics,” than “He was only 18 when he died defending our freedom.” I want to see Nika Kozhushko’s art thriving and Yaryna Bazylevych’s activist ideas implemented in her youth projects, instead of knowing that these flowers of the nation were killed by a Russian rocket. I want to see people from my school living their lives, not knowing that Pavlo Fostyk, the boy I played volleyball with in 6th grade, died at the age of 18 on the frontline defending our peace. There are many more names you don’t know, many more names that represent real people—the future of Ukraine—who are now just captured in casualty statistics.
I want all parents to live long, happy lives, not crying in cemeteries over their children’s graves. But I feel so helpless because everything I want, everything we want, can disappear in an instant, lost among the rubble. Our hopes, our lives, our very existence hang in the balance—dependent on whether someone in a neighboring state pulls the trigger or if military aid from our allies arrives in time.
So in the end, this is exactly where the jealousy comes from, and it is not for myself, but for my dear Ukrainian strangers who deserve so much better.
→ The pain of being overlooked
That isolation deepens even more when I see global attention shifting, making Ukraine’s ongoing struggle feel like an afterthought. Other issues dominate the headlines, while the brutal Russian aggression against my country seems to fade from people’s minds. Even if Ukraine isn’t fully forgotten, from what I see and hear, it feels this way. Watching the suffering of my home lose its urgency is painful. While I understand that many global issues vie for attention, it’s hard to accept that the world is moving on while the war is far from over for us.
It’s true that Ukraine still appears in the news, and some might argue our struggle hasn’t been forgotten. However, the scale of the devastation often feels underrepresented. Entire cities and regions have been reduced to rubble, with the total area of occupied and destroyed land by Russians equaling the size of Portugal. Our country is bleeding daily, experiencing death, abduction, torture, rape, ecocide, and the constant threat of nuclear disaster. Every day, lives are shattered. You go to bed unsure if you’ll wake up the next day, whether you are far from the frontline or right beside it. Yet, this unimaginable destruction is frequently reduced to just a few headlines in foreign media.
→ Boycotts and resistance
Beyond the physical war, we face other battles, like boycotting companies that continue doing business with Russia (because it directly funds the missiles that hit us) and combating Russian propaganda abroad, where their authorities try to erase our identity and discredit us.
While politicians offer weapons and financial aid, public support often feels limited, especially when we go out of our way to make a difference. It’s frustrating to see so few people outside Ukraine understand the importance of these boycotts or show solidarity in other efforts we make. Even a simple action like choosing not to buy certain products which are still present in Russia can contribute to saving lives in Ukraine.
→ The power of awareness
However, I realize that in many cases, it’s not people’s fault for not knowing the horrors of the war or what they can do to help. It’s the fault of biased or silent media. In fact, when I talk to foreigners about the war, I feel happy when they start to support Ukraine, express sympathy, and admit that their local media no longer covers the war. In those moments of deep conversation, I realize my frustration isn’t directed at them at all.
So, while we are grateful for the support we’ve received, we also need the world to remember that our fight is ongoing, and the scale of suffering and destruction is far greater than what is often portrayed. To make matters worse, the situation has deteriorated even further since the world’s initial focus on our plight.
This isn’t to say I expect everyone to fully understand, but what I hope for is that people remember: even when a war fades from the headlines, it hasn’t ended for those still living through it every day. The emotional and psychological toll continues long after the physical danger passes, shaping us in ways that are difficult to explain.
Offering Support
During or after a war, helping people can be different, but the most important thing is to be there for them and support them at least emotionally. Listening without judgment, showing compassion and patience are key components of support. Often, war survivors need a space where they can share their experiences or just be in silence. It is also important to offer concrete help: it can be providing basic needs, organizing a safe place, or simply offering support in what they need at the moment. Allow the person to determine what is most important to them.
When interacting with someone from a war zone, approach with sensitivity and respect. Allow them to share their experiences at their own pace, without pressure. Avoid probing questions that might trigger traumatic memories or demand explanations for wartime actions. Instead, maintain emotional boundaries and respect their autonomy.
If you’re genuinely interested in their experience, use open-ended questions that give them control over how much they share. For instance, ask “How do you feel about that?” or “What are your thoughts on this?” rather than requesting specific details about events. This approach allows them to express themselves comfortably, sharing only what they’re ready to discuss.
To sum-up
Mental health is essential for overall well-being, yet preserving it becomes incredibly challenging during times of war. The ongoing conflict disrupts the lives of millions, leading to a wide range of negative psychological effects such as anxiety, depression, trauma, and a constant sense of insecurity. For those directly affected by war, maintaining mental stability often seems impossible amidst the chaos and devastation.
As individuals not living in war zones, it’s crucial to foster awareness and empathy toward those enduring such hardships. By understanding the emotional and mental toll of war, we can offer meaningful support, whether through raising awareness, providing resources, or simply showing compassion to those who need it most. In doing so, we can play a small but important role in helping to mitigate the long-lasting effects of conflict on mental health.
