No matter how the war in Ukraine ends, hundreds of thousands of Russian fighters will live in the grip of post-traumatic stress disorder (PTSD) for the rest of their lives. Depression, suicides, alcoholism and violence are some of the consequences of the same evil that marked the United States after the Vietnam War. Russian Deputy Defense Minister Anna Tsivileva has stated that this type of illness already affects 20% of Russian veterans returning from the Ukrainian front. Clinical studies ensure that the numbers affected by this disorder are between 25% and 50% in all conflicts. Unlike the United States, Russia does not yet have an extensive aid network to support former military personnel throughout their lives, despite the fact that the invasion of Ukraine has been its deadliest confrontation since World War II.
The Russian Government hides statistics that could measure the social problem it will face in the coming decades. According to the World Health Organization (WHO), Russia ranked ninth in the world for suicides in 2019, with 25.1 deaths per 100,000 inhabitants – 44 among men. But this data predates the years of pandemic and the current conflict in the neighboring country.
“Any war leads to suicide. Absolutely anyone. Without a doubt, we will have enormous problems,” reflects Colonel Andrei Demurenko in a quiet cafe in the center of Moscow. “Both on the Ukrainian side and on ours there will be a large number of people outside of normality, people who will have no control over themselves, who will not be able to work, nor have a partner or children. Your life will be completely different after fighting. I know it well.”
Demurenko, 68, has enormous military experience. He was a commander in the international peacekeeping forces in Bosnia (1992-1995) and last year joined Russian troops as first deputy commander of the Wolf volunteer brigade., directed by a Serbian soldier. Due to his experience and the language, the colonel had de facto under his orders about 1,800 men to protect one flank of the Wagner mercenary group in the Battle of Bakhmut. He arrived in March 2023 and was wounded in the head by artillery during a reconnaissance mission in May. He suffered a bruise and skull fractures, and his hands still shake. He wants to return to Ukraine, but the doctors won’t let him.
“I have met many who marched at the front. Volunteer and mobilized brigades. They said they were ready to die, but I told them that that’s not the worst. If you die, that’s it. The most complicated thing is that you don’t know how difficult it is to return to normal life,” says Demurenko.
Mental health
Post-traumatic stress disorder was internationally recognized as a mental health problem in 1980 thanks to Vietnam War veterans. The US authorities today spend billions of dollars to support them and have a network of 120 centers to care for their ex-combatants, but even so, some 30,000 of them committed suicide between 2001 and 2019, four times more than all those who died in combat in Afghanistan. and Iraq. And the actual number of suicides could even be three times higher, according to a study by the University of Alabama.
Russia does not have these means despite the fact that current recruitment brochures guarantee psychological care for the soldier. However, steps are being taken to reverse this lack of assistance. Last year, Russian President Vladimir Putin approved the creation of the Defenders of the Fatherland fund. with an endowment of 1.8 billion rubles (about 180 million euros) that not only includes psychological support, but all types of medical, social and labor help – education and training in new jobs – for veterans and their families.
Among other measures, Moscow announced in 2023 the creation of a program limited to the “detection” and “prevention” of PTSD at the front, which would consist of temporary “basic treatment” in the rear before returning to combat. Furthermore, it was originally focused on officers, although it was finally decided to expand to all personnel. For its part, the Higher School of Economics and the Center for Psychological Assistance of the Ministry of Emergencies, directed by the daughter of former Defense Minister Sergei Shoigu, last year advanced a one-week training program for psychiatrists focused on PTSD.
“The Russian Ministry of Defense did not initially pay enough attention to PTSD and focused mainly on physical injuries,” says Ruslan Pukhov, director of the Center for Analysis of Strategies and Technologies (CAST), by telephone, “but over time it has understood the importance of solving this problem.” “He Ukraine syndrome It will be a much bigger phenomenon than the Chechnya syndrome (1994-1996 and 1999) or that of Afghanistan (1979-1989). In magnitude it will be comparable to vietnam syndrome in the United States and will last for many years,” he says.
Hundreds of thousands of Russians will one day return from the war. Vladimir Putin estimated in December 2023 that 617,000 fighters were currently fighting on the Russian side. To them should be added those who have died or been injured, but the Kremlin does not reveal the magnitude of the drama. A US intelligence leak released by The Economist raised the number of Russian casualties in June of this year to between 462,000 and 728,000 dead and wounded.
“The war in Yugoslavia was a low-intensity conflict,” notes Demurenko, “the war in Ukraine is completely different, it is very cruel. Large masses of people collide at close range with small-caliber weapons and artillery fires all the time. “You are surrounded by tanks and drones.”
The colonel illustrates the horror of all wars with an anecdote from 30 years ago. In Bosnia he saw hundreds of young soldiers collecting pine cones in a park. After taking them to the building where they were treated, their caregivers would scatter them on the floor again so that they could catch them the next day and keep their minds busy.
Demurenko describes the current conflict, which has frightened even Serbian volunteers: “On television it seems that there is a normal war, that everything is clean, the trenches are full of boards and there is a field kitchen and sleeping bags. “Don’t believe it.” According to him, the soldiers survive in liquid mud, their stomachs suffer from eating the same canned food every day and they do not rotate. “We only carry water to drink. To wash ourselves we resort to puddles; There may even be urine.”
Couples of friends have breakfast quietly in the cafeteria. Nearby there is a terrace where hundreds of young people danced, drank and flirted this summer. It is another planet compared to the barbarism that can only be sensed in Moscow from the videos leaked to the internet. Soldiers who commit suicide with the barrel of the gun in their mouths in front of the drone that records them; troops who have caught a sniper—the most hated enemy—and decapitated him.
“There is no mercy or pity for enemies,” says Demurenko. “After that you can’t continue being normal. And there are worse things. When you are forced to kill someone at point blank range; when suddenly your partner is killed with a shot in the head, or an explosion rips off his leg and he stops,” he says before citing another example that came to him from reliable sources: a convict promised his commander 10 Ukrainian ears . “He handed them over and then asked for a pardon for having gone to war.”
The invasion of Ukraine has divided Russian society between those who have gone to war and those who have stayed home. In addition, salaries are equalizing due to the country’s inflationary spiral. “The veteran who has lost his mind will see tomorrow the one who stood idly by (…) and will ask ‘what’s wrong with us?’ There will be problems,” he warns.
The return to routine will be another shock for veterans if they are not reinstated. “Money and country have been a secondary reason for enlisting,” says the colonel. “Many have gone for recognition, to think that they have not lived their lives in vain and did not remain a gray man from a small town who did nothing in life.”
A difficult return to reality
Psychiatrist Pau Pérez-Sales, director of the SIRA Center for Attention to Victims of Torture, highlights in a telephone conversation that PTSD “is the body’s biological response to all this horror, but it is not all that war leaves behind.” “There is a much deeper, more existential part,” says the expert. “Sertraline and paroxetine [dos antidepresivos] They give you a certain calm, but self-questioning — questions like ‘what did I do with my life’ or ‘why did I kill that person’ — no drug will take that away from you.”
The psychiatrist worked for decades in Latin America and sees a possible simile there with Russia. “In Honduras and El Salvador the rise in crime after the peace agreements was spectacular. “Many people from the guerrillas and the army suddenly lost their jobs and turned to common crime.”
Irene de la Vega, a specialist at the Spanish Society of Clinical Psychology-ANPIR, explains by phone that PTSD “is different for each person, but almost all psychological therapies include exposure to stimuli that may trigger traumatic memories.” The objective, according to the expert, is to “reprocess that experience to integrate it into memory and so that it remains as a bad memory that is not always present, and not as a memory that you are experiencing over and over again.”
The use of medications can be a complement to therapy, but this is the first line of combat against the disorder. Symptoms include loss of self-control, which can lead to violent behavior, and dissociation. “As if you were in a dream, in a movie. You see putting toothpaste on the brush as an absurd act,” adds Irene.