there may be abuse of alcohol, cigarettes and drugs, problems in relationships, sleep disturbances , attentiveness, and tsn has such physical manifestations as constipation, indigestion, muscle hypertonicity, or tachycardia, it could be chronic pain, headaches, diarrhea, or a feeling of tightness and burning behind the sternum, cramps and pain in in the lower back well, finally , we already talked about suicidal thoughts, if they arise, tell your loved ones about it and seek help, and the first person you need to see is your family doctor, so how much now appeals with complaints about symptoms of post-traumatic stress disorder and how family doctors act in such cases, we will find out and contact us from family doctor professor of the department of family medicine, therapy, cardiology and neurology of the zaporizhzhya state medical university iryna voloshina mrs. iryna i congratulate you good day

iryna thank you i know that ptsd develops when a person leaves a stressful situation and finds himself in such seemingly safe conditions. how often do patients now they refer to the 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 and they clearly predict i would say an epidemic or we can even say a pandemic in ukraine of mental disorders and diseases and this is again official data - this 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 in statistical indicators, but i would

said what we see as statistics, yes, this is only the tip of the iceberg, because in reality, ah, well, i don't know if 20-30%, in my opinion, is still much more than our population now, uh, they already have uh, ptsr, or a different degree of expressiveness, and when you listed and the psychologist listed the symptoms , and when they said that the state of constant alertness, 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 of constant alertness is fully present every resident of ukraine has never had one ap iryna, tell me if there are any cases among your patients where a person who experienced stress during the occupation , for example, has already evacuated abroad and has 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. in

european countries, it is not so easy for ukrainians to get medical help right away, they have to go through the bureaucracy of these procedures, so do our citizens who are abroad turn to you or actually turn to you for advice to do and according to the algorithm how to act in one or another country, because indeed countries, even the eu, they are very different in their systems of providing medical care and, for example, those people who are already covered by the state, 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 give the first advice or, for the determination of such serious indicators, will delegate to a specialist, and of course there is a language barrier here a serious obstacle, because i know a lot of our people abroad now. 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 say the treatment of mental disorders in particular, ptsr of panic attacks as one of the options of ptsr, here understanding the language so that there is no language barrier is extremely important in ukraine, i can also say i am now leading the direct e-mobile of the brigade of the de-occupied territories of kyiv region and what we see, we actually consulted more than 1,000 patients in a month, this is completely let's say that all are people, but very many of them also have symptoms that require delegation not only to a psychologist, but even to a psychiatrist before hospitalization , and here the what you showed in the plot, i can say that there are places, what you said is that inpatients are overcrowded,

it is possible that this is not entirely true now, if a person needs hospitalization, he can even without a referral from a family doctor go directly to a psychiatrist, 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 mrs. iryna . e or online consultation or just to diagnose ptsd in general e-e for example without any personal contact i mean when we communicate with a person who is nearby here you know the question is how the patient will find this definition precisely in the word petesr. yes, for example, we have the icpc-2 classification that 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 like this: panic attack. it is better for this diagnosis to be made by a specialist such as a clinical psychologist or a psychiatrist, if the doctor delegates to a family doctor, the family doctor does not have such a task to make such a strict differential diagnosis, we proceed according to symptoms and if we see that a symptom is a manifestation , one of the manifestations ptsr we record it and provide appropriate recommendations for what to do next for the person and what these recommendations might be

we can make some appointments on our own, but we can make a family doctor according to the first one can carry out a certain diagnosis. 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 computers or by sending him a link to a questionnaire so that he passes it, then simply shows the number of points or in the presence of a doctor, if such questionnaires are printed, any method can be used in order to confirm, after all, the reason for the appeal, and here the question regarding the recommendations, i will immediately say what should not be done, neither the patient nor the doctors , first of all, there is definitely no need to start with heavy psychotropic drugs, and here is such a drug of the benzinepin group and in general, this is 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 do very serious harm. and in general, any drug treatment should treat the blood with caution, it should already go as one of the very next steps, that is, i started i was contacted by iryna voloshina, professor of the department of family medicine , cardiology and neurology therapy of the zaporizhzhia state medical university, and there are several protocols for the treatment of ptsd, and none of them are exhaustive and universal, and should be selected for each person approach and medication 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 psychiatrist, psychotherapist, candidate of medical sciences, associate professor, svitlana netrusova, ms. svitlana rada i congratulate you and see and hear you today . good day, iryna. i am also very happy to see and hear you and all our listeners, and i am very happy to have the opportunity to help with my advice and my knowledge , to share what those who suffer from ptsr or who is in this traumatic situation and may be at risk of developing ptsr ms. svitlana please tell me how many patients you currently have with ptsr i don’t have a lot of patients that i can make a percentage sample of my own m means experience. i

mean 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. traumatizing events like this just a traumatizing event right 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 it is a big, very powerful, such a psychotraumatic factor that 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 actually have a lot of questions for you today

therefore, let's be more concise and give such clearer answers. look, according to your estimates, are we expecting a massive increase in the number of ukrainians with such a diagnosis ? it is already developing when everything is over. but we know that there are people who, for example, have gone abroad now, and for them it may be over, it is possible and no, so when should this beginning be? 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, or bombs fell, or they hid in basements, or they lost

someone close to them, or they drove out and shot them in the back, that is, up to two days - this is traumatic stress , acute stress movement for up to four weeks, and already under post-traumatic stress development , it is necessary to talk about it 54 weeks after the psychotraumatic event took place, and i want to tell you that it can be very long, it can be er even continue for months and even years if it is not treated this post-traumatic stress disorder, then 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 you can well no well not earlier than after 4 weeks to four weeks this is an acute stress disorder

moreover, in this case, this is a post-stress dramatic disorder if it is not treated, if it is not dealt with. seriously, it can lead to certain very serious disorders. if there is an opportunity, i will tell you what these are the main clinical manifestations and it is necessary to contact the specialists of psychologists and psychiatrists psychotherapists in order to help themselves, and if a psychologist is not a doctor, he does not have the right to make a diagnosis, only a psycho-psychiatrist has the right to make a diagnosis, only a single specialist has the right to make a diagnosis 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 about post-traumatic stress disorder, then it is necessary to contact a psychiatrist, because he is the specialist who deals with the treatment of this

development of ms. svitlana. but i i understand that not all people who have experienced this stressful event develop tsn, of course, i say 30% of these people develop it, and the most vulnerable contingent are women's children, and it also depends on what are the conditions of a person who has experienced a stressful situation? for example, if she is among those people who are experiencing a stress disorder and a stressful factor together with her, then it is easier to bear together. -e 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

who uh-uh more like them more seriously more other people perceive negative factors more traumatically, and other people behave differently, and people experience things differently, and then give an answer to this negative factor. this also applies to the post-traumatic stress development of ms. svitlana . - this is individuality, 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 kind of behavior a person has 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 issue not only sleep disturbance, the occurrence of anxiety, excessive inner restlessness, irritation of increased certain

autonomic manifestations that can cause increased anxiety or anxiety and increased pulse and increased pressure and er diarrhea can be flatulence, bloating, which can lead er people to specialists of a different profile , therapeutic cardiologists or gastroenterology although in fact it is increased anxiety, i have repeatedly told you about it on my my channel, i also tell you about somatic manifestations of anxiety, but the main such symptom of post-traumatic stress is such flashbacks, this is such a symptom of such manifestations uh when they occur in people uh who have experienced some kind of stressful factor and they develop post-traumatic stress disorder, that is, these are such

sudden memories of these traumatic events and a person experiences them as vividly as he does, as if he was now living it all again and these flashbacks are triggered certain triggers are such external stimuli irritants that can arise, for example, uh, in some life situations, manifest themselves, for example, uh, hmm, 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 of stress disorder when they vividly recall all the events that they experienced and that traumatized them greatly was it the bombing was it the loss of loved ones or will it be svitlana and what should be what should be ms. svitlana which should be during this behavior, because look, for example, today there was a very

strong thunder in lviv and people even wrote on social networks that they woke up because of it. they thought that rockets were already flying there, so that something was exploding and it went on for quite a long time time, what was a person supposed to do? it's just some kind of list, or a person was supposed to cry somehow , because we all understand that we are in such a case, if we say two words about these flashes, it can arise in connection, for example, with salutes that launch those people who don't understand that this can lead to a flashback - well , those people who have experienced certain stressful factors and those who have experienced certain stressful factors, and that can be, for example , increased anxiety in the evening, there can be, uh, in the trees, it's like seeing a person some kind of 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 roar of an airplane or an airplane or a helicopter or uh, these uh, it can be even the same the very thunder to tell well, i've always said that if a person wants to experience this reaction and wants to cry, you have to cry, if you want to scream, you have to scream, if you want to kill something, find some dishes , some plates or something that doesn't break so that you can hit safely and in this way physically uh-uh manifest to emit 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 some fireworks if the people next to us want to

celebrate their birthday even though it it's wrong but dear, such a noise, dear roar, dear sound, dear sight of blood or some red paint, it can remind a person of something he can't remind, it will be a trigger that will trigger this flashback and a person will remember so vividly and worry these feelings if as if they were now this minute at this moment because there remains i want so i listen to you there are literally three minutes left i want to talk with you more about treatment for tsn and already now there are ongoing conversations about the legalization of medical cannabis in ukraine and the use of medicines based on it 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 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? take all the sedatives that just sit down, relieve anxiety, reduce and calm down, and i really respect, uh, the interview of my previous uh, uh, i mean, the professor who said a lot about the ptr of the family doctor, but i may not agree with her. well, i have to this is my own opinion, 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 the whites, not on red prescriptions, but you can take it for no more than a month and there is nothing wrong with it. if a person takes it and calms down, if he can calm down, calm down his anxiety and calm down thanks to taking this drug, which belongs to the class, it is not a drug at all, it is not an antipsychotic drug at all releptics or antipsychotics, that is, i don't understand why everyone is so afraid, not 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 some basis or there are gabaline 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 that touch, as for cannabius, my opinion is as follows: for a short period

it can be possible and you can 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, how will they bathe, we will talk about this topic with you next time, because unfortunately it is possible for a short period, 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 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 are in the combat zone for a long time, because the military serviceman has to use weapons

to eliminate the enemy, you see with your own eyes the death of your comrades 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 acute reactions to combat stress or combat trauma , depressive reactions, anxiety disorder even after the first stay in the combat zone and it was 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 deaths of fellow citizens or civilians 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, the development of ptsd and other negative psychological

states is also influenced by the environment, so the issue of how society and the most different people should behave with military personnel who have gone through a difficult combat experience and are currently in touch with us, the executive director of veteran hub, military psychologist artem denisov and a veteran veteran of hap are such a space where chi combat veterans and members of their families are supported and psychologists, lawyers and employment specialists work with them free of charge , including experts of the hub also deal with military personnel from petester, mr. artem. i congratulate you . good day, mr. artem, so combat operations in our country have been going on since 2014, and during 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? well, first of all, i will note that we started

to work specifically in the format of a veterinarian organization in 2018, but before that they worked in various projects of sister organizations, and so on. if we talk about the ptsr in particular, well, look here, not the question is that it occurs exclusively in the military, well, eh, but simply yes, we talked about uh different today about different categories of people, we want to talk with you about the military medical diagnosis and the treatment itself the established diagnosis as a disorder should be dealt with by medical workers, medical specialists with the direct support of psychotherapeutic and other, but if we are talking about symptoms, because it is really

possible to work with this at stages even before a person develops the disorder itself, and before uh actually it will happen, you can work with those manifestations that a person experiences in his everyday life , it can also be sleep disorders, it can be various things related to chronic pain with alcohol abuse, including with you know with such a life when you are uh-uh sharp and uh-uh constant such uh-uh constant in essence readiness your body is constantly ready for uh-uh those factors that can arise and often may not arise it turns out that a person is all his own there in

further life in a conditionally peaceful state and experiences just as bodily as being in, for example, in the zone of hostilities, of course, now it is conditionally and until the beginning of a full-scale invasion. places in our country are all percentages, of course, it is safer somewhere, but to say that there is 100% now is like unfortunately, there is no, 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 with their words and actions not to drive a person with ptsd into an even greater psychological abyss, first of all, first of all , first of all, to have respect. well, for some reason, we are more or less used to other medical diagnoses

, and we show respect for people who have, for example, bronchial tubes and mental disorders but we still somehow, we treat it very cautiously, that is why, in principle, we should respect and give a person space so that he can experience it, if we speak for people who have been specifically diagnosed with this diagnosis , and it is possible without pressure. with respect for the boundaries of this person, we suggest seeking professional medical help i would not engage in self-medication in these matters. i would definitely seek help from specialists in the field of mental health, but i cannot say that our mental health field in our country is fully equipped and ready for those challenges that await us in the future, but all the

same there are specialists, they are becoming more and more, 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 or i want to thank you for today's inclusion. we realized that the topic here is so huge and we will still have something to talk about and we will definitely include you in the broadcasts. thank you. military psychologist artem denisov so 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, volunteer