how to act in one or another country, because indeed the countries, even the eu, have very different systems of providing medical care, and for example, those people who the state already has, for example, poland , germany or france, have provided such at least temporary insurance and an insurance policy, they can without hindrance contact the nearest family doctor and he will already give the first advice or will delegate to a specialist for the determination of such serious indicators, and of course here the language barrier is a very serious obstacle, so i know now there are a lot of our people abroad. they are looking for russian-speaking or ukrainian-speaking doctors, of course, there are simply more russian-speaking doctors, so the emphasis is on them because they are simply easier to find, but they are looking for a linguistic understanding, because when we talk about the management of mental disorders, in particular, ptsd panic

attacks as one of the options of the ptsru, then understanding the language so that there is no language barrier is extremely important in ukraine, i can also say that i am currently leading the direction of the e-e mobile brigade in the de-occupied territory of kyiv region and what we see we in a month, they actually consulted more than a thousand patients, this is completely let's say that all are people, but very many of them also have signs that require delegation not only to a psychologist, but even to a psychiatrist before hospitalization , and here what you showed in the plot, i can say there are places what they said that inpatient hospitals may be overcrowded is not entirely true now. if a person needs hospitalization, he can go directly to a psychiatrist even without a referral from a family doctor. is located in a polyclinic near a hospital, or it is possible to the reception department of the station itself, and no one will refuse to help ms. iryna, how do you

diagnose ptsd because, well, when we talk about the fact that people can apply and simply call to get a consultation by phone or online consultation or just diagnose a traffic accident in general uh, for example, without any personal contact. i mean when we communicate with a person who is nearby . well, you know. the question is, after all, to what extent will this definition be fundamentally important to the patient ? words ptsr yes, for example, we have the icpc-2 classification that we use at the primary link and we have such an item there e acute reaction to stress or reaction to stress or just stress stress disorder anxiety disorder that is, we indicate the symptom, the main symptom, what she applied for a person, i.e. if a person presents with a panic attack, we write the reason for the visit panic attack that's all, that's why let's say it's

post -traumatic stress disorder e.e. clinical psychologist or psychiatrist, if the family doctor delegates a family doctor, the family doctor does not have such a task, that is, to issue such a strict differential diagnosis, we conduct it symptomatically, and if we see that there is a symptom, one of the symptoms of ptsd, we record it and provide the appropriate recommendations for what to do next for a person and what these recommendations can be. is this recommendation to contact a psychiatrist or a special psychologist again? can you make any appointments on your own or can we make a family doctor can conduct a certain diagnosis according to the first. well, for example, there are questionnaires for determining whether a stress disorder, anxiety disorder, or depressive disorder is diagnosed. it takes from one to five minutes, and this can be done

by sitting the patient down or at a computer or sent a mulink on a-a questionnaire so that he passed it, then simply showed the number of points or in the presence of a doctor already on if such questionnaires are printed, any method can be used to confirm the reason appeal and here is a question about the recommendation, i will immediately say what should not be done. neither the client nor the doctors should first of all definitely start with heavy psychotropic drugs, and there is such a drug of the group of benzinpines, and it is generally such a serious enough group of drugs, and in each of the instructions it is written don't start, don't prescribe groups of gasoline for zapings with ptsd, because it can cause serious harm. and in general, any medical treatment should be treated with caution. it should already be one of the following steps, i.e. started i want to thank you i want to

thank you we will talk about treatment and drugs later and i thank you for being in touch with us and for your advice and for your consultation i was in touch with us iryna voloshina, professor of the department of family medicine therapy of cardiology and neurology of the zaporizhzhia state medical university and there are several protocols for the treatment of ptsd and none of them is comprehensive and universal for each person, the approach and medication should be selected individually , but still taking into account the protocol and the circumstances of life and how psychiatrists treat ptsd and what are the features of this mental disorder, we will find out right now and contact us doctor psychiatrist psychotherapist candidate of medical sciences associate professor svitlana netrusova ms. svitlana it's nice to see

and hear you today i congratulate you good day iryna i'm also very happy to see you to see and hear all our listeners and i am very happy to have the opportunity to help with some advice and knowledge to share what those who suffer from pcr or who are in this traumatic situation and may have the risk that he will develop ptsd ms. svitlana please tell me how many patients you currently have with ptsd patients that i can make a percentage sample of my own uh-uh, um, that means experience. i mean from my practical activities. but if we take a general sample, then up to 30% of the general population can suffer from post-traumatic stress disorder. and for those people who have experienced violence or have been

involved in such traumatic events, such a traumatizing event is just now with the war. there is no need to talk about violence against women or other moments there is a fire or something else or something else, we have a war and this is a big, very powerful, psycho-traumatic factor that can lead to the emergence of post- traumatic stress disorder. - to develop post-traumatic stress disorder and this is what i am really talking about to you, uh, so today there are many questions, so let 's be more concise and give such clearer answers. look after yours estimates, are we expecting a massive increase in the

number of ukrainians with such a diagnosis? they have now left abroad, so it may be over for them, maybe not, so when should this start? when will everything begin? i want to say that traumatic stress first occurs - this is when, up to two days ago, a person experienced some traumatic situation there did the bombs fall or did they hide in the basements did they lose someone close to them or did they leave and shoot them in the back, that is, up to two days - this is traumatic stress, acute stress disorder from two days to four weeks . 54 weeks after the psychotraumatic

event happened and i want to tell you that uh it can uh be very long it can be uh even continue for months and even years if it is not treated these post-traumatic stress disorder, in principle, the war is still going on now, and people can suffer from post-traumatic stress disorder during the war, not only when it ends four weeks after they survived the bombing there, before after four weeks when they survived and further not necessarily after four weeks is possible, no, no, not earlier than 4 weeks to 4 weeks, this is acute stress disorder, in this case, this is post-traumatic stress disorder, if it is not treated, if it is not dealt with seriously, it can lead to certain very serious violations. if there is an opportunity, i will tell you what these are the main clinical manifestations and you must

definitely contact specialists of psychologists , psychiatrists, psychotherapists in order to help yourself, and if the psychologist is not a doctor, he has no right to make a diagnosis in only a psycho-psychiatrist has the right to make a diagnosis, only a single specialist legally has the right to make this diagnosis, and i want to say that if a psychologist at certain stages no longer helps people cope with with this condition, if we are talking about post-traumatic stress disorder, then it is necessary to consult a psychiatrist, because this is the specialist who deals with the treatment of this development of ms. svitlana . among these people, the most vulnerable contingent is the women's children, and

it also depends on the conditions in which a person who has experienced a stressful situation is in. for example, if she is among those people who experience a stress disorder together with her and that stress factor are then easier to bear together er all together these are these experiences and also certain characteristic features of a person, a certain er heredity which, well, in quotation marks , ensures the occurrence of certain neurotic disorders , which include post-traumatic stress disorder disorder there are certain people who are anxious people who are people who uh more people experience things in different ways and then give uh, if the answer is to this negative factor. this also

applies to ms. svitlana's post-traumatic stress disorder. then, since you see , each person is an individual, let's talk about how not to miss this symptom because a person cannot always correctly to evaluate, for example, one 's psycho-emotional state, and probably in this there are more hopes for her environment, what behavior of a person should attract attention and make it clear that she already needs the help of a specialist well, if we say about post-traumatic stress disorder, it is a very important issue, not only sleep disturbances, the occurrence of anxiety, excessive internal restlessness, er, there er, irritation of increased certain autonomic manifestations that can cause increased anxiety or anxiety, this is also increased pulse and increased pressure, and er, diarrhea there can be flatulence, bloating, which can lead people

to specialists of a different profile , therapeutic cardiologists or gastroenterology, although in fact it is increased anxiety, i have repeatedly i also told you about this on my my channel. i also talk about somatic manifestations of anxiety, but the main such symptom of post-traumatic stress disorder is such flashbacks. this is a symptom of the manifestation of when they occur in people who have experienced some kind of stress . a factor and they develop a stress, e.e. post-traumatic disorder, that is, these are such sudden memories of psycho-traumatic events, and a person experiences them as vividly as he did, as if he now experienced it all again, and these flashbacks trigger certain triggers, such external stimuli irritants that can arise - be, for example, uh,

manifest in some life situations. for example , if people, for example, hear a helicopter flying , they can perceive it as such. a trigger and they can have this flashback, such a symptom of post-traumatic stress disorder, when they vividly remember all those events they were worried and which traumatized them a lot was it the bombing was it the loss of loved ones or will it be ms. svitlana and what should be what should be eh ms. svitlana what should be during this behavior because look, for example, today there was a very strong thunder in lviv and people wrote even on social networks that they woke up because they thought that rockets were already flying there, so that something was exploding and it lasted for quite a long time, so what

was a person supposed to do? it's just some list or a person should have cried anyway because we all understand that we are in this case two words about these flashbacks that it can arise in connection, for example, with salutes that are launched by those people who do not understand what it can lead to to flashbeh - well, to such a stressful state we have those people who have experienced certain stressful factors, and it can be, for example , increased anxiety in the evening, there can be something in the trees, as if a person sees a silhouette and thinks that it is something a person is some kind of man who wants to who can bring danger to this person, it can be, for example, when not only the rumble of an airplane or a plane or a helicopter or uh these uh, it can

even be the same thunder that you are talking about about what if a person wants survive this reaction and she wants to cry you have to cry if she wants to scream you have to scream if she wants to kill something somehow dishes find something or plates or something that doesn't hit so that you can hit safely and in this way physically er-e show let off steam so-called, that is, in this, in this case, uh, i understand that thunder we ca n't cancel and we can't cancel any fireworks if the people next to us want to celebrate their birthday, even though it's wrong but dear, such uh noise, dear rumble any sound, any sight of blood or some kind of red paint, it can remind a person of something

he can't remind, it will be a trigram that will trigger this flashback and a person will remember so vividly and experience these feelings as if they were now this a minute at this moment, but if there is any left, i want to, i listen to you , there are literally three minutes left, and i want to talk with you more about the treatment of ptsd, and there are already ongoing discussions about the legalization of medical cannabis in ukraine and the use of medications for on its basis for the treatment of people with ptsd and you know it's no secret for you that it is a common practice in the world to use drugs from medical cannabis precisely for the treatment of such disorders, they do not cause addiction or dependence, so i want to ask you what is your opinion and here is how what do you think this treatment should be and does the medical channel have the right to be present here? i want to tell you that before a person has consulted a

specialist and he is experiencing all this, he should take all the sedatives that just sit there they relieve anxiety, reduce and calm down, and i really respect, uh, the interview of my previous uh, uh, i mean, the professor who spoke very well about the ptr of the family doctor, but i may not agree with her, well, i have my own opinion on this, as you said i have a lot of e-e protocols, but they are all different. that is, i cannot say that tranquilizers are a group of tranquilizers to which belongs our well-known gidazepam, which everyone knows and everyone can buy on white, not on red prescriptions, but take it for no more than a month you can take it and there is nothing terrible about it. if a person takes it and calms down, if he can calm down his anxiety and calm down thanks to taking this drug, which belongs to the class,

it is not scary drugs at all, not drugs of the antipsychotic series, are there releptics or antipsychotics, that is, i do not understand why is everyone so afraid of psychiatrists, everyone else is afraid of these drugs, but the truth is that you need no more than a month, or other drugs on a plant-based basis , or there are pregabalins, certain anti-anxiety drugs or there is buspirone from spitomin or some other drugs, it doesn’t matter, all the drugs that calm down, they relax, what does it matter about cannabis? my opinion is as follows: for a short period, it may be possible and you can take it. i asked you to express your opinion about the role of svitlana, will you stand aside, because it is impossible, our children will be stupid, how will they accept this

topic, we will talk with you next time, because on sorry for a short period, you can, well, this does not apply to the long term, it will harm you, thank you. i want to thank you very much, ms. svitlana, for your advice and for this consultation that you gave to our viewers today, so we were contacted by a psychiatrist, psychotherapist, candidate of medical sciences associate professor - svitlana netrusova, and most often cases of post-traumatic stress disorder are observed in military personnel who are in the combat zone for a long time, because a military serviceman has to use weapons to eliminate the enemy, see with your own eyes the death of fellow citizens and the civilian population from the range of shelling and this is morally very difficult and leaves its mark. therefore, many servicemen have symptoms of depression, anxiety or an acute reaction to combat stress or combat trauma

, depressive reactions, anxiety disorder even after the first stay in the combat zone, and it has been established that from 20 to 40% of soldiers need psychological help, symptoms of acute trauma are found in 680 soldiers, percent of soldiers who were eyewitnesses to the death of their comrades or a civilian population or saw the bodies of the dead, symptoms of ptsd also develop in approximately 12-20% of servicemen who suffered a combat injury but did not seek psychological help. with military personnel who have gone through a difficult combat experience and are now in touch with us, the executive director of veteran hub, military psychologist artem denisov and veteran veteran hap - this is

a space where veterans of combat operations are supported do psychologists, lawyers, and employment specialists work with them free of charge , including hub specialists, they also deal with military personnel from petester, mr. artem. i congratulate you . good day, mr. artem, so the hostilities in our country have been going on since 2014 and for this time, your hub has probably faced this huge problem more than once as a pt-ser of veterans. how did you help the military to cope, including their families? in 2018, before that, we worked in various projects of sister organizations and so on. if we talk about ptsr in particular, well, don’t look here. the question

is that it occurs exclusively in the military. well, uh, but that’s just how we talked about uh different today about different categories of people, we want to talk specifically about the military er-e go there you have probably already said everything er-e actually the main story is that as you have probably already talked about it ptsr - this is a medical diagnosis and the treatment itself e- e established diagnosis as a disorder should be dealt with by medical workers, medical specialists with the direct support of psychotherapeutic and others, but if we are talking about symptoms, then it is really possible to work with it at stages even before the person develops the disorder itself. and before it actually happens, it is possible to work with it these are the manifestations that a person experiences in his everyday life

. these can also be sleep disorders. these can be various things related to chronic pain, alcohol abuse, including, you know, with such a life when you sharply and er permanently like this your body is in constant readiness for those factors that may arise and often may not arise . it turns out that a person is in a conditionally peaceful state for the rest of his life and experiences the same bodily for example, being in a war zone, of course, now it is conditional and until the beginning of a full-scale

invasion . but to say that it is 100% now is like unfortunately, there is no such thing, and this also affects the development of the symptoms of similar stories, mr. artem, what can you advise those around you on how they should behave so that their words and actions do not drive a person with ptsd into an even greater psychological abyss before everything is, first of all, to have respect. well, for some reason, we are more or less used to other medical diagnoses, and we show respect to people, such as brothers, but to mental disorders. but we are still somehow very cautious about that basically have respect and give the person space so that he

can experience it if we are talking about people who have been specifically diagnosed with this diagnosis. that is possible without pressure. with respect for the borders of this person, suggest seeking professional medical help. in these matters, i would definitely seek help from specialists in the field of mental health, but i cannot say that now our field of mental health in our country is fully equipped and ready for the challenges that await us in the future, but all the same, there are specialists, there are more and more of them, and this is a good trend, so if a person really wants to support another person who has a similar disease, then the only thing he can do is advise, encourage to seek medical help

, but i also want to thank you for today inclusion we understood that the topic here is so huge and we still have a lot to talk about and we will definitely include you in the broadcast. now you need to be socially active and not be alone with your problems do not refuse the support of friends and relatives plan and think about what you will do after the war do volunteering help others do not give up physical activities give free rein to emotions in this way look for example at the team and we tried to give you today as comprehensive information as possible, it remains to emphasize once again that it is very important to consult a doctor in time to

establish a diagnosis and start treatment in order to do not allow the disease to develop, but i want this problem to pass by you and your loved ones. i am iryna koval. take care. events are the most important events that are happening right now and affect our lives . and invitations, experts soberly assess the events, analyze them by modeling our near future every saturday at 1:00 p.m. with a repeat at 10:00 p.m. studio event with anton borkovsky nayspresso february 24 date what

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so that our ukraine prospers, hide i love ukraine i was born here and i want to live here we work with faith in ukraine, it is very important in this difficult time to be aware of what is happening, we tell the news and help to understand the events, but the war can make its own corrections in case the broadcast signal is lost, see espresso on the satellite, espresso has now become available on two satellites at once. viewers who watch our channel on the astra satellite should readjust the tuner to the new parameters, because the old parameters will soon stop broadcasting espresso, the ukrainian view. thank you for watching .