of ukraine and thank you to our armed forces of ukraine for protecting us, i say goodbye to you and wish you a quiet and peaceful and restful night on the air of our espresso news channel and the euro program espresso for ukrainian refugees in europe co-broadcast with the atp channel radio svoboda programs time-time of the voice of america including public television journalists, news broadcasts, bbc news ukraine and franz 24, as well as the broadcast of the information marathon, united news, together, we are strength, glory to ukraine , their values, loyalty, courage and strength, their elements land air and sea their goals victory victory and

victory happy day of the naval forces of the armed forces of ukraine the simplest became the most important smile look call voice любовь победит всё hug well eternity just really wanted to hug her words that in memory forever was a second together more expensive than all the treasures of the world to be honest, i really want to tell him when i know how to

love you when we are alive and let's talk about the good things, how inspiring the morning coffee is, but even in black and white there will be a color one about the random joy and inspiration of the moment that even in difficult times there is something to live for, happiness is in the little things, life will win, 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, however, the war can make its corrections in case the broadcast signal is lost, watch espresso on the satellite now espresso has 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 espresso broadcast will soon stop using the old parameters. ukrainian view thank you for watching, congratulations, i am iryna koval and this is a program about health during the war. the war in our country continues every day. air raids are launched in various cities. every day , civilians are killed. children, military doctors, volunteers and journalists. people are under occupation and are

hiding in basements. yes in bomb shelters we see a lot of grief and even those who seem to have held on at the beginning and were strong now feel mental exhaustion and i will tell you that this is absolutely normal because we all feel the consequences wars, everything that happens has a negative effect on our and your mental health. you have probably heard such an abbreviation as ptsd more than once. it is post-traumatic stress disorder. today we will discuss what it is. how does it manifest itself and does it really threaten everyone, and most importantly, what about it to do in today's conditions, every person needs to know about it first of all in order to timely diagnose and provide psychological and medical help, preventing the dangerous development of ptsd - this is the reaction of the psyche to a strong

stress or injuries, according to statistics, women suffer from ptsd more often than men, and by the way, not only war can provoke the appearance of ptsd in a person, it can be accidents, it can be disasters, natural disasters, violence, a negative experience of childbirth, the death of a loved one, but not every stress can lead to the appearance of ptsr well , let's go into detail and start with the plot of anna linkova, more and more people are now complaining about anxiety, insomnia, irritability, and panic attacks. but this does not mean that you already have post-traumatic stress disorder, because those who they really have it, they are unlikely to be able to cope on their own and need the help of specialists. why is it important not to postpone a visit to the doctor for later

? kyiv, where in the first days of the war the rashies broke in. a girl hid in the shelter of one of the universities for almost two weeks. there was no sunlight, no fresh air, only eerie sounds and fear. the battles were going on. tanks were running saboteurs and in parallel the battle was going on on dumbo near the sea of ​​kyiv, at one point it seemed to us that water was starting to flow, but it was a vibration from the furious battle that was taking place outside, the neighbor said that the sky was simply red from the shelling, two weeks later the girl and her family left to relatives in the west of ukraine, however,

russian rockets are flying there, and so after sleepless nights, katya will leave here where it is safe to go abroad. the flight of a plane or a helicopter throws me into the cold while it flies, i just wait to see if it will fly further or not and inside everything goes down about most of her symptoms katya is not ready to talk to anya on camera or with a specialist reluctance to talk about experiences is a very common manifestation of post-traumatic stress disorder says a psychologist who works abroad with refugees from the occupied territories, i am a manifestation of avoidance, that is, people generally do not want to talk about what they experienced, how they passed, hmm, how they left ukraine and the psychological consequences - this is only the beginning, a month passes, uh, there are already

some physical symptoms, that is, people feel bad, they feel broken, when we conduct a diagnosis, we see that in terms of health, your son is fine. this is also a manifestation of post-traumatic stress disorder when crossing a state road at the border, refugees undergo a medical examination and often turn to a psychologist themselves, but internally displaced persons who have left hell for relatively safe regions rarely show such a desire and withdraw into themselves. and this is in perspective no longer ambulatory treatment, but inpatient treatment, inpatient departments, all overloads. taking care of your psychological health is not just a whim or a trend, it is a duty to your body, and especially now in the conditions of war, you need to listen to yourself and if you notice symptoms, contact a specialist, this is

an increased irritability is a sleep disturbance, if sleep is both insomnia and nightmares, it is not motivated aggression, not speech, therefore it is anger, it is depression, it is generalized anxiety and fears, according to a psychiatrist, one should not hope that the problem will go away in time without consulting a doctor with such symptoms can not only ease the psychological state of the patient, but also prevent more serious complications when at first we are talking about insomnia, irritability, which is quite well treatable, then more serious mental disorders join, such as severe depression, suicides and probably the most terrible thing is that there are suicides, they already are, so about 8%

of men and 20% of women who have experienced traumatic events have tsn, so here are the statistics made public the ministry of health of ukraine if nothing is done, it can end in the destruction of work relationships, health or even life, just now in the story they talked about the suicidal consequences of ptsd, it is possible to overcome or learn to manage it if you recognize the symptoms, diagnose and undergo treatment. so, the symptoms that indicate that that you need help are constant thoughts about a traumatic event, they arise involuntarily, you can dream or appear as flashbacks of life in full combat readiness, or a person has obsessive thoughts about one's own safety conscious avoidance of mention of the trauma panic attacks are such as a feeling of intense fear shallow breathing dizziness nausea rapid heartbeat and pain

behind the sternum emotional emptiness detachment from loved ones and loss of interest in once-loved things mistrust and troubles in everyday life can still be alcohol abuse, cigarettes and drugs, problems in relationships, sleep disorders , attentiveness, and tsr has such physical manifestations as constipation, indigestion, muscle hypertonicity you know, tachycardia, it can be chronic pain, headaches, diarrhea, or a feeling of tightness and heartburn behind the sternum, cramps and pain in the lower back. and finally , we already talked about suicidal thoughts, if they arise, tell your loved ones about it and seek help, and the first person to turn to is your family doctor, are there many appeals now with complaints about the symptoms of post-traumatic stress disorder and how family

doctors act in such cases? department of family medicine, therapy, cardiology and neurology, zaporizhia state medical university , iryna voloshina, mrs. iryna, i greet you. good afternoon, iryna, thank you for the invitation a-a. i know that ptsd develops when a person leaves a stressful situation and finds himself in such seemingly safe conditions . patients often present with ptsd symptoms, and are we talking about the threat of an increase in such cases in the future after the end of the war? i would say an epidemic or can you say even a pandemic in ukraine of mental disorders and diseases. and again, these are official data - they are forecasts of the world health organization , because war is a global risk factor for

the development of any mental disorder, so there will definitely only be an increase in appeals - an increase and statistical indicators, but i would say that what we see as statistics is only the tip of the iceberg, because in reality, well, i don't know if 20-30%, in my opinion, is still much more than our population now. uh ptsr of one or another degree of expressiveness and when you listed and the psychologist listed the symptoms and when they said that it is a state of constant readiness, i looked around and looked. and there is a suitcase next to me, and here, that is, and i think that i am also not alone, and in this that the state is still constantly ready it is fully present in every resident of ukraine, no matter where he is. and ms. iryna, tell me, are there any cases among your patients where a person who has experienced stress during the occupation , for example, has already evacuated abroad and already

sought help from there, because we know very there are many stories that are now being told and they are already known to the whole world, they are being told that in european countries it is not so easy for ukrainians to get medical help right away, it is necessary to go through the bureaucracy of these procedures, so do our citizens who are abroad turn to you and actually turn to you for advice what to do and according to the algorithm, how to act in this or that country, because indeed countries, even the eu, they are very different in their systems of providing medical care , and for example, those people to whom the state already for example, there poland, germany or france have provided such at least temporary insurance where the insurance policy they can without hindrance go to 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 there is a language barrier here a serious obstacle to that, i know now a lot of our people abroad. they are looking for russian-speaking or ukrainian-speaking doctors, of course russian-speaking doctors, there are simply statistically more of them rather, the emphasis is on them, that they are simply easier to find , but they are looking for language understanding, because when we talk about mental disorders , in particular ptsd panic attacks, as one of the options for e- testers, then language understanding so that there is no language barrier is extremely important in ukraine, i can also to say i am now the head of a direct mobile brigade in the de-occupied territories of kyiv oblast. and what we see is that we have actually consulted more than 1,000 patients in a month. this is completely.

need delegation not only to a psychologist, but even to a psychiatrist before hospitalization , and here what you showed in the story, i can say that there are places, and what they said that inpatients may be overflowing, this is not entirely true now, if a person needs hospitalization, he can even without referral of family the doctor should contact the psychiatrist directly, which is located in the polyclinic near the hospital. or , it is possible to go to the reception department of the hospital itself , and no one will refuse help to ms. iryna, as do you diagnose ptsd because, well, when we talk about the fact that people can turn to and simply call to get a legal or online consultation or simply diagnose ptsd in general, for example, without any personal contact, i mean when we communicate with a person who is near here you know. the question is, after all, to what extent the

patient will find this definition precisely in the word petesr. yes, for example, we have the icpc-2 classification, which is what we use in the primary lanka , and we have such a clause there, an acute reaction to stress or a reaction to stress or simply stress stress disorder anxiety disorder that is, we indicate the symptom, the main symptom, what the person is presenting with, i.e. if a person presents with a panic attack, this is how we write the reason for the presentation, panic attack, that's all, that's why let's say post-traumatic stress disorder it would be better if this diagnosis was already made by a specialist such as a clinical psychologist or a psychiatrist, if the doctor delegates a family doctor, the family doctor does not have such a task, namely to make such a diagnosis we carry out a hard differential diagnosis based on symptoms and if we see that the symptom is a manifestation of one of the manifestations of ptsd, we record it and give appropriate recommendations on what to do next for the person and

what these recommendations might be. can you make any appointments on your own, or can we make a family doctor? first, he can conduct a certain diagnosis. well, for example, there are questionnaires to determine what is a stress disorder and anxiety disorder and depressive disorder, the diagnosis takes from one to five minutes, and this can be done by sitting the patient either at the computer or by sending him a link to the a-a questionnaire so that he passes it and then simply shows the number of points or in the presence of a doctor if there are such questionnaires printed out, any method can be used to confirm the reason for the application, and here the question regarding the recommendation, i will immediately say what should not be done. neither the patient nor the doctors are the first priority, definitely not

you need to start with heavy psychotropic drugs , and there is such a drug of the band odessa group of foams. in general, this is such a serious enough group of drugs, and in each of the ptsr instructions it is written that do not start, do not prescribe groups without gasoline for zapinov in ptsd, because it can be very serious harm and in general, any drug treatment should be treated extremely as appropriate, it should already be done as one of the very next steps, that is, i started thank you for contacting us and for the advice for your consultation. iryna voloshina, professor of the department of family medicine, therapy of cardiology and neurology of the zaporizhia state medical university, and there are several treatment protocols for ptsd, and none of them are exhaustive 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 just now and with us on communications doctor psychiatrist psychotherapist candidate of medical sciences associate professor svitlana netrusova mrs. svitlana i am glad to see and hear you today i congratulate you good day iryna i am also very glad to see and hear you and all our listeners and i am very glad to have the opportunity to help with some advice and knowledge to share what those who suffer from psr or who are only in this traumatic situation and may be at risk of developing psr should know ms. svitlana. please tell me how many patients you currently have with psr.

to develop post-traumatic stress disorder and this is what i have for you, in fact, for you, uh, so many questions today, so let's be more concise and give such clearer answers. so, according to your estimates, are we expecting a massive increase in the number of ukrainians with such a diagnosis, and if so, when should we predict this beginning, because we talked at the beginning of the program about the fact that the ptsr was already developing when everything was over. but we know that there are people who, for example, have now gone abroad, so and for them, maybe it's over, maybe not, so when is this beginning supposed to happen. when will everything begin? i want to say that traumatic

stress first occurs - it's when, up to two days ago, a person experienced some traumatic situation there, or bombs were falling, or they were hiding in basements, or they lost someone close to them or they left and shot them in the back, that is, up to two days - this is traumatic stress, acute stress disorder from two days to four weeks . a psychotraumatic event took place and i want to tell you that it can be very long, it can even continue for months and even years if it is not treated, this post-traumatic stress disorder, in principle, the war is still going on now, and post-traumatic stress disorder people can suffer from the disorder during the war, not only when it ends in four weeks after they survived the

bombing there, before in four weeks when they survived and and further not necessarily in four weeks, you can, well, no, not earlier than after 4 weeks to four weeks, this is an acute stress disorder, in this case, this is a post-traumatic stress disorder, if it is not treated, if it is not dealt with, seriously, it can lead to certain very serious disorders. if there is a possibility, i i will tell you what these are the main clinical manifestations and it is necessary to contact specialists of psychologists, psychiatrists and psychotherapists in order to help yourself, and if a 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 this condition, if we are already talking about post-traumatic stress disorder, then it is necessary to contact to a psychiatrist, because this is the specialist who deals with the treatment of this development of ms. svitlana. however, i understand that not all people who have experienced this stressful event develop tsn, or are there any criteria for these there are people, and the most vulnerable contingent is the children of women, 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 are experiencing a stress disorder and a stress factor together with her, then it is easier to bear together all in all, it is these experiences, as well as certain characteristic features of a person, a certain heredity, which, in

quotation marks, ensures the occurrence of certain neurotic disorders, including post-traumatic stress disorder, there are certain people who are anxious people, who are people who, er, more er, how do they perceive all negative factors more seriously than other people, people behave differently and people experience differently and then give e- if the answer to this negative factor is the same for ms. svitlana 's post-traumatic stress disorder. for example, one's psycho-emotional state, and probably in this there are more expectations for one's environment, what behavior of a person should attract attention and give a signal that she already needs the help of a specialist well, if we are talking about post-traumatic stress disorder

, then a very important issue is not only sleep disturbance, the appearance of anxiety, excessive internal restlessness eh there eh irritation of increased certain vegetative manifestations that can cause increased anxiety or anxiety - this is an increase in pulse and pressure and eh 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 repeatedly told about it in my channel to you. i also tell about somatic manifestations of anxiety, but the main such symptom of post-traumatic stress stressorosis has such flashbacks, it is such a symptom and manifestation of er when they occur in people er who experienced some

certain stressful factor and they develop a stress er post-traumatic disorder, that is, it such sudden memories of these traumatic events and the person experiences them as vividly as if he now experienced it all again and these flashbacks trigger certain triggers such external stimuli irritants that can arise, for example, in some life situations, manifest themselves. for example , if people, for example, hear how and the helicopter is flying , they can perceive it as a trigger and they can have this flashback, a symptom of post-traumatic stress disorder, when they vividly remember all the events they experienced and which traumatized them greatly was it the bombing

was it the loss of loved ones or will it be ms. svitlana and what should be what should be ms. svitlana what should be during this behavior because look, for example, today in lviv there was a very strong thunder and people wrote even in social networks, the fact that they woke up from the fact that they thought that rockets were already flying there. so it is something exploding and it lasted for quite such a long time, so what was a person supposed to do? is it just some kind of list or did a person still have to cry somehow there to be nervous because we all understand that we are in such a 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 that this can lead to a flashback - well, to such stressful situations those of these people who have experienced certain stressful factors and that, this can be, for example

, increased anxiety in the evening, there can be, uh, in the trees, some kind of person sees a silhouette and thinks that it is some kind of person, some uh, man who wants to, who can bring danger to this it can happen to a person for example, when not only the rumble of an airplane or a plane or a helicopter or er these wants to scream, you have to scream, if she wants to kill something, somehow find dishes, find something or plates or something that does not hit so that you can hit safely and in this way physically show