sleepy nights, katya went to a place where it is safe abroad and although the danger for the girl of the past, the anxiety has not disappeared, every sharp sound, every flight of a plane or helicopter throws me into the cold when he flies, i just wait to see if he will fly further or not and inside, everything falls about the majority of her symptoms katya is not ready to talk to anya on camera anya with a specialist reluctance to talk about what she experienced is a very common manifestation of post-traumatic stress disorder, says a psychologist who works abroad with by refugees from the occupied territories of avoidance, i.e. people generally do not want to talk about what they lived through, how they passed, hmm, how they left ukraine and the psychological consequences - this is only the beginning , a month passes uh-uh, there are already some physical and symptoms, that is, people feel they feel bad

, they feel broken when we carry out a diagnosis, we see that everything is healthy as if it is fine . this is also a manifestation of post-traumatic stress disorder when crossing the state border, refugees undergo a medical examination and often turn to psychologist, but the internal displacement of persons who have left hell to relatively safe regions rarely show such a desire and withdraw into themselves. and this in the long run threatens not outpatient treatment, but inpatient inpatient departments, all overloads. taking care of one's psychological health is not just a wishful thinking or the trend 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 increased discipline, this is a sleep disorder, if a dream

both insomnia and nightmares are unmotivated aggression, not speech, that's why she's angry, it's depression, it's generalized anxiety and fears, according to a psychiatrist, you shouldn't hope that the problem will go away in time, not consulting a doctor with such symptoms can not only alleviate the patient's psychological state, 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 are added, such as severe depression, suicides, and probably the most terrible thing is that with this is suicide, they already are, so about 8% of men and 20% of women who have experienced traumatic events have ptsd, here are the statistics published

by the ministry of health of ukraine. in the story, they talked about the suicidal consequences of ptsd, you can overcome it or learn to manage it if you recognize the symptoms, diagnose and undergo treatment, so the symptoms that indicate that you need help are constant thoughts about a traumatic event, they occur involuntarily, you can dream or manifest as flashbacks of life in full combat readiness, or a person has obsessive thoughts about his own safety, conscious avoidance of mentions of trauma, panic attacks, these are such as a feeling of strong fear, shallow breathing, dizziness, nausea, palpitations and pain in the sternum, emotional emptiness, detachment from loved ones and loss of interest in once-loved

things, mistrust and troubles in everyday life, there may also be abuse of alcohol, cigarettes and drugs, problems in relationships, sleep disturbances , attentiveness, and tsn has such physical manifestations as constipation, indigestion, muscle hypertonicity , 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. talked about suicidal thoughts, if they arise, tell your loved ones about it and ask for help, and the first person to turn to is the family doctor, so are there many complaints about the symptoms of post-traumatic stress disorder and how family doctors act in such cases, we will find out by contacting us, family doctor, professor of the department of family medicine, therapy, cardiology and

neurology of zaporizhzhya state medical university , iryna voloshina, mrs. iryna, i greet you good afternoon, iryna, thank you for the invitation a-a i know that ptsr is already developing when a person comes out of a stressful situation and finds himself in such seemingly safe conditions. do patients now often present with symptoms of ptsd and are we talking about the threat of an increase in such cases in the future after the end of the war is clearly predicted. i would say an epidemic or 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 -what kind of mental disorder, therefore, there will definitely only be an increase in appeals -

an increase in 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 i know that 20-30%, in my opinion, much more of our population now have ptsd of one degree or another, and when you listed and the psychologist listed the symptoms , and when they said that it was a state of constant readiness, i looked around and looked. i have a suitcase next to me, and that is, and i think that i am also not alone in this, that the state of constant readiness is present in every resident of ukraine , regardless of whether it has been under it. stress during the occupation, for example, she was already evacuated abroad and already sought help from there, because we know

a lot of stories that are now being told and they are already known to the whole world. procedures, so do our citizens who are abroad turn to you and actually turn to you for advice on what to do and for an algorithm on how to act in one or another country, because indeed countries, even the eu, they are very differ in the systems of providing medical care , and for example, those people to whom the state already hmm, for example, poland, germany or france have provided such at least temporary insurance where the insurance policy, they can freely contact the nearest family doctor and he will already provide the first advice or already for the definition of such serious the indicators will be delegated to a specialist, and of course the language barrier is a

serious obstacle, so i know a lot of our people abroad. they are looking for russian-speaking or ukrainian-speaking doctors, of course there are simply statistically more russian speakers, so the emphasis is on them because they are simply easier to find , but they are looking for linguistic understanding, because when we talk about mental disorders , in particular ptsd panic attacks, as one of the options for e-mail, then there is a linguistic understanding so that there is no language barrier extremely important in ukraine, i can also say that i am now directly in charge of the mobile brigade of 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. 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 story, i can say there are places, and what they said that inpatients are overflowing, maybe this is not completely true now if a person needs hospitalization, he can go directly to a psychiatrist, even without a referral from a family doctor, which is located in a polyclinic near the hospital, or possibly to the reception department of the hospital itself and no one will refuse the help of mrs. iryna, how do you diagnose ptsd, because, well, when we talk about the fact that people can turn to and simply call to get a consultation or an online consultation, or simply diagnose ptsd in general, for example, without any personal contact. pay attention when we communicate with a person who is nearby, you know. the question is, after all, how important will this definition be to the patient, precisely in the word petesr? yes, for example, we have the

icpc-2 classification, which we use at the primary link and we have such a clause there, acute reaction to stress or reaction to stress or simply stress, stress disorder, anxiety disorder. that is, we indicate the symptom, the main symptom, what the person complained about, that is, if a person complains of a panic attack, we write the reason for the complaint, panic attack. that's why, let's say, post-traumatic stress disorder. i would say that it would be better if this diagnosis were already made by a specialist such as a clinical psychologist or psychiatrist, if the doctor delegates a family doctor to a family doctor there is such a task, namely, to make such a strict differential diagnosis, we conduct it symptomatically 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 can be. is this

recommendation after all again, you should contact a psychiatrist or a special psychologist . it takes from one to five minutes to determine whether a stress disorder or an anxiety disorder or a depressive disorder is diagnosed, and this can be done by sitting the patient either at the computer or by sending or mollink to the questionnaire so that he passes only then simply show the number of points or in the presence the doctor already has, if such questionnaires are printed out , any method can be used in order to confirm, after all, the reason for the application, and here the question regarding the recommendation, i will immediately say that there is no need to do neither the patient nor the doctors first of all, you definitely do not need to start with heavy psychotropic drugs, and there is such a drug of the group of benzopines, and it is generally such

a serious enough group of drugs, and in each of the instructions for ptsd it is written that do not start, do not prescribe groups of benzopines for ptsd, because you can very seriously harm and in general, any drug treatment should be treated very carefully, this should already be done as one of the very next steps, that is, don't i want to thank you, i want to thank you, we will talk about treatment and drugs later and i thank you to those of you who were in touch with us and for your advice, we were contacted by iryna voloshina , professor of the co-department of family medicine , cardiology and neurology therapy of the zaporizhia state medical university, and there are several treatment protocols for ptsd and none of them are 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 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 need to know and may be at risk of developing psr mrs. svitlana please tell me how many patients you currently have with psr well, i want to to say that i don't have so many patients that

i can make a percentage sample of my own, uh, that means experience, i mean from my practical activities. but if we take a general sample , then up to 30% of the general population may suffer from post-traumatic stress disorder. and those people who experienced violence or had er were participants in those traumas of such an event just now a traumatic event with er war there is no need to talk about violence against women or about other moments there is a fire or something else or something else we have a war and this big, so very powerful, such a psychotraumatic factor, which can lead to the occurrence of post-traumatic stress disorder. and it is precisely in such people who experience such a stressful, powerful factor that up to 30% of people can develop post-traumatic stress disorder, but

i have you in fact, in fact, i actually have so many questions for you today, so let 's be more concise and give such clearer answers. so, look at your estimates, whether we are in for a massive increase at all 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 ptsd was already developing when everything was over, but we know that there are people who, for example, have now gone abroad and they might have ended , maybe not, so when is this beginning supposed to happen. 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,

whether 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. event 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 is basically a war now continues 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 you can well no well no sooner than after 4 weeks to four weeks it's acute stress disorder it's going to happen in this case it's post stress dramatic disorder if it's not treated if it 's not dealt with seriously it can er lead to of 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 does not have the right to make a diagnosis, only a psychologist has the right to make a diagnosis - a psychiatrist is the only specialist who 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 talking 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. however, i understand that not all people who have experienced this stressful event develop ptsd, or are there any criteria for these people? the vulnerable contingent is the woman's children, as well as it 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 this together with her stress disorder and a stress factor are then easier to bear together, uh, all together. these are these experiences , as well as certain characteristic pe-heredity, which, well , in quotation marks, ensures the occurrence of certain neurotic disorders, which includes post-traumatic

stress disorder, there are certain people who are anxious people, who are people which er more er how they perceive all negative factors more seriously more traumatic than other people, people behave differently and people experience differently and then give er if the answer to this negative factor this also applies to ms. svitlana's post-traumatic stress disorder. then, since you see that every person is an individual, let's talk about how not to miss this symptom , because a person cannot always correctly assess , for example, his psycho-emotional state, and probably in this there are more expectations for his environment, what is the behavior of a person should attract attention and give this signal that she already needs the help of a specialist. well, if we are talking about post-traumatic stress disorder, then it is a very important question not only sleep disturbance, the appearance of anxiety, excessive

internal restlessness, e-e, e-e, irritation of increased certain autonomic manifestations that can cause increased anxiety or anxiety - this is an increase in pulse and increased pressure, and e-e, diarrhea 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 told about it and on my channel to you, i also tell about somatic manifestations of anxiety, but the main such a symptom of post-traumatic stress is such flashbacks, this is a symptom of such manifestations when they occur in people who have experienced a certain stressful factor and they develop a

stress disorder post-traumatic disorder, that is, these are such -e 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 - be, for example, er, manifest in some life situations, for example if people, for example, hear a helicopter 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 that they experienced and which were very traumatic. was it a bombing? was it the loss of loved ones of people or will it be ms. svitlana and 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 that they woke up from the fact that they thought that rockets were already flying there, so that something was exploding and it lasted for quite such a long time, so what was a person supposed to do ? we all understand that we are in such a situation, if we can say 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 a stressful state of us in those in these people who survived certain factors and that, it can be, for example , heightened anxiety in the evening, it can be, er, in the trees, some kind of

person sees a silhouette and thinks that it is some kind of person, 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 er these er it could even be the same thunder, let me tell you, well, i always said that if a person wants to experience this reaction and he wants to cry, he should cry if he wants to shout must shout if she wants to kill something, some dishes, find something or plates or something that does not beat so that it is possible to beat safely and in this way physically er-e manifest to release steam so-called that is in this in this case eh i understand that thunder we are not

can cancel and we can't cancel some fireworks if the people next to us want to celebrate their birthday even though it's wrong . can remind, it will be a flashback and will start this flashback and a person will remember so vividly and experience these feelings as if they were. to talk more about the treatment of ptsd, and there are already ongoing discussions about the legalization of medical cannabis in ukraine and the use of medicines based on it for the treatment of people with ptsd .

to use medical cannabis preparations 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 what do you think this treatment should be and does the medical channel have the right to be present here with i want to tell you that before a person has yet consulted a specialist and she is worried about all this, she must take all the sedatives that just sit there, relieve anxiety, reduce and calm down and i really respect uh, the interview of my previous uh was very good i mean, the professor who spoke very nicely about the family doctor's ptr, but i may not agree with her. well,

i have my own opinion on this, as you said. to which we all know and have no more than a month, you can take it and there is nothing wrong with it. if a person takes it and calms down, if he can overcome his anxiety and calm down thanks to taking this drug, which belongs to the class tran says that these are not scary drugs at all, they are not psychotic drugs at all, aren’t they releptics or antipsychotics, that is, i don’t understand why everyone is 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 herbal drugs on the basis of whether there are pregabalin, certain anti-anxiety drugs, whether there is buspirone from specialimin or any other drugs, it does not matter, all the drugs that calm down , they relax, what about cannabis? my opinion is the following for a short period of time, it is possible

and it is possible to take it but if it is a long-term reception, it is still organic brain damage and my colleague called me and asked me to express my opinion about the role of svitlana, will you stand aside because it is impossible, our children will be stupid as they will accept yes and let me talk about this topic with you next time, because unfortunately for a short period it is possible, well, this does not apply to the long-term, it will harm you, i want to thank you very much ms. svetlana for your advice and for this consultation that you gave today provided to our viewers, so we were contacted by a doctor, 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 have been in the combat zone for a long time, because a serviceman has to use weapons

to eliminate the enemy, you see with your own eyes the death of fellow citizens and the civilian population from shelling networks, and this is morally very difficult and leaves its mark. therefore, many military personnel have symptoms 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, the percentage of soldiers who witnessed the death of their comrades or the civilian population or saw the bodies of the dead, symptoms of ptsd also develop in approximately 12-20% of servicemen who suffered combat trauma but did not seek psychological help for the development of ptsd and other

negative psychological states are also affected by the environment, so the question of how society and other people should treat military personnel who have experienced a difficult combat experience and are currently in touch with us is the executive director of veteran hub, military psychologist artem denisov and veteran veteran hap - this is such a space . where they support chi combat veterans and their family members and work with them free of charge, psychologists, lawyers, and employment specialists, including experts of the hub, deal with military personnel from petester, mr. artem, i congratulate you good afternoon, mr. artem, the hostilities in our country have been going on since 2014, and during this time, your hub has probably encountered this huge problem more than once as a veteran veteran. how did you help the military to cope, including their families? well, first of all i would like to point out that we started

working in the format of the veterinary organization in 2018, but before that we worked in various projects of the sister organization and so on. if we talk about the ptsr in particular, well, don’t look here. the question is that it occurs exclusively in the military, yes . is but we asked you, mr. artem, we talked about different categories of people today, we want to talk with you specifically about the military, go there.