Analysis of archival data showed that the war in Ukraine is taking place according to the same scenario as during the First and Second World Wars [25, 26]. The reaction of people to military events is regulated by different branches of the nervous system: sympathetic — it is responsible for “fight or flight” — and parasympathetic — “slow down and freeze”. Both systems are designed to keep a person in balance during stress and normalization.
However, during the war, the picture changes: stress rises, the balance in the brain is disturbed, and the parasympathetic system begins to dominate. It leads to changes in behaviour, “turning off” all emotions. This is necessary for a person to function effectively for survival.
During stress, a small structure of the limbic system of the brain is activated — the amygdale. It keeps adrenaline levels high and sends signals of potential threat. When an extreme threat is combined with helplessness, as happens during military operations, the brain can send signals to the body: “Stay still”. As a result, the heartbeat slows down, blood pressure, body temperature and intensity of movement decrease. In the conditions of war, such reactions can be instantaneous and temporary, and can last several days and weeks. Everything depends on the general mental state and strength of the traumatic event.
In addition, the amygdala sends signals to the hippocampus, the part of the brain responsible for storing memories, not to remember traumatic events. Therefore, Ukrainians now forget many important details, and sometimes we completely lose control over our thoughts.
The results of research by scientists from the medical school in Jerusalem show that during war, the reaction of the human psyche is different: from moderate and temporary stress, to severe mental injuries that have negative consequences for health, including depression, abuse of psychotropic substances and post-traumatic stress disorder (PTSD) [27, 28, 29, 30]. What's more, a study conducted by scientists from the United States proves that the traumatic events of war can have long-term effects on health and well-being [31, 32, 33].
The project of scientists from Ohio (USA) shows that most people who survived the war gradually adapt to the new reality, recover, and some in response to stressful circumstances and events feel uplifted, as if they have a “second breath” [34, 35]. This phenomenon is explained by Hubfall's theory, according to which trauma can lead to both loss and gain of important resources. So one might expect that exposure to war may lead to a deeper understanding of the value of life, which in turn may increase achievement and life satisfaction.
Even in those regions where there are no active hostilities, people find it difficult to accept the terrible events that have been taking place in Ukraine for almost two years.
In order to optimize the provision of psychological assistance to the population throughout Ukraine, psychological assistance hotlines were developed:
• International Committee of the Red Cross. Calls are free: 0-800-300-155.
• VartoZhyta call center: crisis counseling line. You can get psychological help at number 55-22 from 11:00 a.m. to 7:00 p.m. on weekdays.
• The National Psychological Association provides consultations over the phone or via video. The service is available to residents of all of Ukraine by calling 0 800 100 102.
• Lifeline Ukraine – 24-hour hotline. You can call 73-33 or write a message.
• Free psychological consultations on the Person in Trouble platform at the number 0 800 210 160. Within the project, teenagers, parents, and teachers can receive free psychological consultations in a group format.
Platforms for free psychological help during war: How are you?
Psychological support center, which was created by volunteer psychologists with the support of the National Psychological Association (NPA). Support can be requested free of charge at any time of the day. To receive psychological help, you need to fill out a questionnaire
Free online platform for psychological consultations – Tell me [36, 37]. If you feel anxious, have panic attacks, are close to depression or even on the verge, you can leave an application on this online platform.
Mental Help – an online platform created to provide free professional psychological help and support. The project involves a team of professional psychologists who work with Ukrainians free of charge. All meetings are confidential [38, 39].
To receive support, person must: go to the Mental Help website; choose a specialist; decide on the date and time of the consultation; specify personal information (PID, age, gender, e-mail, problem that worries you);click Schedule a meeting.
The details of the web conference will be provided to you after the meeting is confirmed. A session with a psychologist lasts 50 minutes.
At the initiative of the President and the Parliament of Ukraine, the majority of primary health care workers underwent training on the specifics of providing psychological assistance to patients with anxiety and depressive disorders.
Given today's realities, unfortunately, not all people have the opportunity to seek qualified help, so below are recommendations that will help reduce the level of adrenaline and cortisol, in order to avoid fatigue during the war, accelerate the exit from the plateau from distress, and prevent the development of PTSD or other destructive mental disorders.
Here are some of them:
• Set yourself only realistic goals, while dividing the solution of large tasks into several small stages. Do what you can and how you can. But even if you don't want to, you force yourself to take care of yourself and do routine housework.
• Avoid loneliness, do not refuse to communicate with people. Find someone to share your problems with and care for. It can be not only people, but also animals and/or plants.
• Join the volunteer movement.
• Choose a place and time where you can release negative emotions and negative energy, cry and cry without witnesses. Keep a diary of states, emotions and dreams. Physical activity of high intensity will save you from rage and anger.
• Control drinking water consumption. A dehydrated body stops resisting stress. Avoid alcohol, tonics, energy drinks, beverages and supplements containing caffeine and guarana, as well as amphetamines and any, even mild, drugs for a while until you have fully acclimatized and reached a plateau. Depending on your preference, drink green or black tea. Chamomile tea with lemon balm is suitable for everyone.
• Do not experiment with diet. Don't lose weight. Try to ensure that the diet is complete, varied and contains vitamins and Omega-3 fatty acids.
• Engage in light to moderate physical activity that does not require willpower. Both aerobic and anaerobic physical exercises reduce anxiety and stress, "burning" excess stress hormones, and after training guarantee the release of endorphins, dopamine, serotonin - hormones of pleasure and happiness. Training to exhaustion has a negative psychotropic effect, as it stimulates a powerful release of cortisol. The best types of physical activity for stress are swimming, aqua aerobics, dynamic yoga, and Nordic walking.
• If possible, regularly engage in self-training, breathing exercises with an emphasis on prolonged exhalation, mindfulness, meditation, static yoga. Breathing and strong muscle tension for 2-3 seconds will help relieve muscle tension. Passive relaxation to music, back and collarbone massage sessions, and aromatherapy relax the nervous system well. By the way, cuddling with a loved one or a pet increases the secretion of the love hormone - oxytocin, which lowers the level of cortisol.
• Don't hold yourself back from smiling or laughing. These emotions also help burn excess stress hormones. Singing, reciting poems, solving intellectual tasks/puzzles, computer games also help reduce stress and prevent overtiredness.
• Relieve severe anxiety attacks with ice water facials, warm water treatments for the entire body, and hot topical hand and foot baths.
• Massage of reflex points on the palms and fingers, which can be done using a massage "thorny" ball, spruce or pine cone, helps well.
• Make every effort to normalize sleep. Do not read the news or watch disturbing movies in the evening. Do not read, watch TV, laptop, smartphone in bed. Don't eat before bed, but don't stay hungry either. Go to bed and get up at the same time. Do not sleep with the TV/computer on. Take a walk in the fresh air before going to bed. If necessary, drink drugs that contribute to the normalization of sleep.
• Don't start your day by watching the news. Move the reading of reliable information from official sources to the time from 12:00 to 16:00 and critically evaluate all the news. Don't worry about things you can't control.
Quadro respiratory diaphragmatic gymnastics will help to cope with a panic attack, an episode of severe anxiety or fear. It is effective because deep rhythmic breathing with intense tension at the peak of the height of a deep breath (Valsalva reflex) stimulates the tone of the vagus nerve and the parasympathetic nervous system.
Respiratory diaphragmatic gymnastics Quadro [40].
During a panic attack, the following breathing exercises are performed while sitting on the floor, the legs are bent, the soles of the feet rest on the floor, the head is lowered:
• deep breath, "inflating" the stomach - 4 counts;
• breath holding with intense tension - 4 counts;
• full exhalation through the mouth, pulling in the stomach - 4 counts;
• pause with relaxation of the abdominal muscles - 4 counts.
Count quickly at first, but gradually slow down – “one, two, three, four”, “one, and two, and three, and four”, “one, one thousand two, one thousand three, one thousand four”. After performing breathing exercises, it is very useful to "ground yourself", for example, list 5 surrounding objects of the same colour, name the sounds and smells that are currently felt.
If stress has caused tremors in the limbs, head or body, then an effective way to stop the tremors is to perform even stronger vibrational movements. If there is someone around, ask for help to physically “shake” you and literally “de-stress”.
The following sequence of actions will help to get out of the stupor:it is necessary to bend a person's fingers, pressing them to the palms, without touching the thumbs; put your hand on his chest and adjust your breathing to his rhythm; quietly, slowly and clearly speak in his ear what can cause strong negative (!) emotions.