Anxiety, panic attacks, insomnia, fatigue, apathy – all of this has become a familiar backdrop to life, even for those who have never been diagnosed. And more and more often, Ukrainians are trying to cope on their own – with sedatives, advice from friends, and short ‘breaks’ that do not cure, but only delay the moment of seeking help.

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The silent pandemic

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According to the results of the study «Conscious Choice» conducted by the organisation ZDOROVI, Ukrainians – and even doctors – recognise that the mental health of the population has deteriorated sharply in recent years. Doctors record symptoms of anxiety or depression in every second patient, and panic attacks, psychosomatic disorders or post-traumatic symptoms in every fifth patient. According to WHO estimates, about 46% of Ukrainians report a deterioration in their health, often associated with sleep disorders and mental health problems.

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Despite this, people are reluctant to seek professional help. Often, this is due to a lack of access or funds. But even more often, it is due to shame and fear. Ukrainians fear being labelled «mentally ill» and resort to self-medication, buying psychotropic drugs without a prescription or following «advice from the internet».

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This is a typical scenario of pharmacological dependence, a new epidemic, when a person tries to control the symptoms but does not address the root cause – trauma, anxiety, stress.

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The Ukrainian context: strength and vulnerability at the same time

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Ukrainians are used to holding on. «Let's hold on» has become almost a national slogan. But it is precisely this ability to endure that often prevents them from allowing themselves to be vulnerable. According to the study «How are you?» (fourth wave, December 2024 – January 2025), only 17% of Ukrainians have consulted psychologists or psychotherapists (in 2022, this figure was about 7%).

The problem is exacerbated by a lack of trust in the system: access to specialists is limited, there is a shortage of psychologists at the primary level, and cultural stigma remains strong even among medical professionals. As part of the Conscious Choice programme, Ukrainians cite the following reasons for self-medication:

- fear of being judged at work or among friends;

- belief that «it will pass on its own»;

- disbelief in the effectiveness of help;

- lack of basic knowledge about mental health.

These are not isolated cases — they reflect the social trauma that the country is collectively experiencing.

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Medical workers – among the most vulnerable

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Mental exhaustion has affected not only patients. Ukrainian medics, who have been working under constant stress since the first days of the war, have found themselves at risk. They are the ones who help others, but often do not have time to help themselves. Over the past two years, several initiatives aimed at supporting medical workers have emerged in Ukraine.

In particular, ZDOROVI implemented the programmes «Doctor. Reboot» and «Medicine for Doctors», in which hundreds of medical professionals underwent group and individual consultations with psychologists.  The goal is not just to «relieve tension», but to provide tools for self-regulation and recovery. Because a sustainable healthcare system is impossible if those who save others burn out in it.

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Restore trust

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The war has forced Ukrainians to learn to live in extreme conditions. But survival does not equal health. A return to «normality» is only possible when mental health becomes part of basic care – just like vaccination or treatment for chronic diseases.

This process has already begun: civil society organisations are running training programmes, international partners are supporting local initiatives, and doctors are increasingly talking about the importance of recovery.

Most importantly, the language is changing: from «I have to hold on’ to «I have the right to help». ZDOROVI's advocacy programme «Conscious Choice» aims to show that mental health is not a private matter, but an element of national security.

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«After the war ends, mental health will become a key topic in national reconstruction – just like infrastructure or the economy. We must learn to take care of ourselves and each other, without feeling ashamed of it», – notes Natalia Tulinova, founder and CEO of ZDOROVI.

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After all, anxiety, apathy and exhaustion affect not only quality of life, but also the economy, defence capabilities and social cohesion.