Provider Guide to Addressing Veterans' Reactions to Current Events in Ukraine - PTSD: National Center for PTSD
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Provider Guide to Addressing Veterans' Reactions to Current Events in Ukraine

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Provider Guide to Addressing Veterans' Reactions to Current Events in Ukraine

Veterans may experience a range of challenging emotions related to the invasion of Ukraine. Events there can be a powerful reminder of Veterans' own military experiences.

Common Reactions

Some common reactions include frustration, sadness, helplessness and grief. Veterans may also feel angry or betrayed. They might question why the invasion is happening now and wonder how it will end. They may worry that the invasion in Ukraine could lead to another world-wide conflict of that they may be called back to service. Reactions can also be experienced as more general upset that they do not necessarily attribute to events in Ukraine.

Those with mental health conditions like depression, anxiety or posttraumatic stress disorder (PTSD) may experience increases in symptoms. Some may cope through avoidant strategies like drinking more, using substances or isolating. Veterans may also experience more military and homecoming memories and more trouble sleeping. Some may become preoccupied with danger or feel like they need to prepare for the worst. In response, they may become overly protective, vigilant or guarded so that they can avoid being shocked by, or unprepared, for what may happen in the future.

Feeling distress is a normal reaction to negative events, especially ones that feel personal. However, for some Veterans, these reactions may be overwhelming, continue for an extended period, or negatively affect functioning to the extent that intervention is indicated. Below are strategies to understand Veterans' reactions and help them through this challenging time.

Check In with Veterans

It is helpful to ask questions to recognize what each Veteran is thinking and feeling. Veterans may differ in their reactions—some feeling angry, some feeling sad, even some feeling relieved—so start from a place of no assumptions about what the Veteran is thinking or feeling.

  • Begin the conversation broadly: "There has been much media coverage and national conversation on what is happening in Ukraine. Would you like to spend some time today on your reactions to what is happening?"
  • Normalize reactions to events in Ukraine and begin a conversation focused on emotional reactions: "Many people have been experiencing strong feelings about the invasion of Ukraine. I wanted to check in and see how you have been doing during these very stressful times. How have you been feeling?"
  • As a way to begin the conversation, you can ask if the Veteran is engaging in these conversations elsewhere and about their support system (or lack thereof): "Have you been having conversations about your reaction to the invasion of Ukraine with others? In what ways have the conversations been helpful? Are there ways in which the conversations have been less helpful"
  • Another option is to tie the discussion in with the Veteran's treatment: "The news about the invasion of Ukraine can impact mental health in many ways. I'm wondering if you noticed changes in how you are feeling? Is this something you want to spend time working on today"

This interaction with you may be the Veteran's first or only opportunity to express thoughts and emotions. Give them (and yourself) room to reflect on their reactions. Take your time with the conversation, allow the Veteran to add to their narrative. Allow the Veteran the opportunity to experience emotions. Reflect back to the Veteran what you hear to make sure you understand their reaction. The Veteran's reaction may change over time, so consider checking in over multiple appointments.

Respond to Veterans' Needs

Help Veterans Identify and Challenge Unhelpful Cognitions

Ask Veterans what upsetting thoughts they are having related to the invasion in Ukraine. It can be valuable to help Veteran recognize and reframe any unhelpful cognitions. What is happening in Ukraine is terrible but often thoughts can be restructured to be more balanced and less catastrophic. For example, they may be thinking, "The invasion in Ukraine is going to lead to World War III," or, "No one is safe." Providers can have a collaborative discussion to help Veterans come to less extreme and less painful conclusions. For example, asking, "What are world leaders saying about support for Ukraine?" or, "How safe are you here?" The ultimate goal is for the Veteran to come up with a more balanced, less distressing thought such as, "Although countries allied with Ukraine are offering support, they are saying they will not fight Russia; leaders do not want a world war," or, "My family is currently safe in the United States."

Some Veterans may find meaning by supporting Ukrainian refugees. Veterans can look for opportunities to volunteer or make a donation. As more Ukranians make their way to the U.S., there may be opportunities to host families as well.

Encourage Veterans to Engage in Activities They Find Meaningful

Encouraging Veterans to engage in activities they find meaningful can help them focus on their lives in the present and can help to reduce distress. Explore what matters most to Veterans across the many domains in which they function, which may include as an individual, a family member, a parent or a community member. Once Veterans identify important values, providers can help them set realistic short- and long-term goals consistent with these values and help them plan concrete activities to work toward these goals. These activities will not change the past or the things the Veteran cannot control, but they can help the Veteran feel like life is meaningful and reduce distress.

Some Veterans may find meaning by supporting Ukrainian refugees. Veterans can look for opportunities to volunteer or make a donation. As more Ukranians make their way to the U.S., there may be opportunities to host families as well.

Encourage Positive Coping

It is important to assess the Veterans' coping strategies (adaptive and maladaptive), current resources and supports, and ongoing stressors. How might existing strategies be applied in this current situation? Are they as helpful in times of crisis? Are there ways they could be adapted to meet current needs? Social support, including spending time with people who understand what the Veteran is going through, can be particularly important in buffering stress. Make a plan with the Veteran about how to put their positive coping strategies into action to help them manage their negative reactions. Teach the Veteran a positive coming skill or share a coping self-help mobile app.

Conclusion

The invasion of Ukraine may serve as a traumatic reminder for many Veterans and service members of their own military experiences. Veterans will differ in their reactions and needs, and these may change over time. Asking questions, listening and responding to the individual needs of each Veteran will help them through this challenging time. Providers are further encouraged to be aware of their own reactions to world events. Take time and space to process and reach out to colleagues, friends and family for support as needed.

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PTSD Information Voice Mail: (802) 296-6300
Email: ncptsd@va.gov
Also see: VA Mental Health