Mental health

Anxiety, insomnia and irritability after war: what counts as a normal reaction and what is a reason to seek help

Almost everyone who has lived through an emergency feels psychological distress. It usually eases over time, but in a minority it becomes a disorder. How to tell the difference, according to the WHO and the US National Center for PTSD.

Neuro Hub editorial teamOctober 27, 20262 min read

In brief

Sadness, anxiety, sleep problems, fatigue and irritability after a crisis are a common reaction that usually eases over time.
If symptoms last longer than a month, are very upsetting or interfere with daily life, it is worth seeing a doctor or psychologist.
Support from loved ones, psychological first aid and evidence-based psychological interventions help.

A normal reaction to abnormal events

According to the WHO, almost everyone affected by an emergency experiences psychological distress, and it usually eases over time. Common signs include sadness, hopelessness, anxiety, sleep problems, fatigue, irritability, anger and physical aches. A minority of people develop a condition that needs treatment, such as depression or PTSD.

The WHO gives an estimate: among people who have experienced war or conflict in the past 10 years, depression, anxiety, PTSD, bipolar disorder or schizophrenia occur in 22%. In 13% these conditions are mild, in 9% moderate or severe.

What PTSD looks like

The National Center for PTSD of the US Department of Veterans Affairs identifies four groups of symptoms, and a diagnosis requires signs from each:

reliving the event (intrusive memories, nightmares);
avoiding things that remind you of the event;
more negative thoughts and feelings than before the event;
constant tension and alertness (feeling “on edge”).

Symptoms usually start soon after the event, but may appear months or even years later, and can come and go. Most people start to feel better after a few weeks, and stress reactions often fade on their own.

When to see a specialist

The National Center for PTSD advises seeing a doctor or mental health professional if symptoms last longer than a month, are very upsetting or disrupt daily life. Only a mental health professional can diagnose PTSD. There is nothing to be ashamed of: needing help after what you have been through is normal.

What helps, according to WHO recommendations

Community support and self-help: talking with loved ones, social connections.
Psychological first aid: emotional and practical support for a person in acute distress, given by trained workers.
Evidence-based psychological interventions for prolonged distress; they are delivered by specialists or trained community workers under supervision.
Clinical care in health facilities for priority conditions.

Where to get help in Ukraine

7333 — “Lifeline Ukraine”, 24 hours a day, free and anonymous: suicide prevention and mental health support;
0 800 100 102 — the line of the National Psychological Association, daily from 10:00 to 20:00;
0 800 33 20 29 — the crisis line of the Ukrainian Veterans Fund, 24 hours a day.

The numbers are taken from the Cabinet of Ministers’ page about the “Ty yak?” (“Are you okay?”) programme (June 2023); please check that they are still valid before calling. If you have thoughts of suicide or are in immediate danger, call 103 or 112.

Sources

This material is for information only and does not replace consultation with a doctor or psychologist. Self-medication can be harmful to your health.