Stressed by what's going on in Ukraine? How to cope – and help – Michigan Medicine

Key steps can protect your mental health while allowing you to make a human connection from a distance or in your community.
Disturbing. Inspiring. Gut-wrenching. Faith-restoring. Anxiety-provoking.
The news and social media posts from Ukraine and neighboring countries are all of the above, and more.
And that has many people feeling distressed, even from thousands of miles away.
That’s especially true for people with a personal or ancestral connection to Ukraine or other nearby countries – or to other conflict zones where refugees have fled their homes in recent years but haven’t received as much attention. Reports of racial discrimination against refugees of color at some border crossings has compounded the trauma too.
And younger people, who don’t have direct memories of the Cold War, may also be especially on edge about the potential implications of this conflict.
No matter what your heritage or age, the new Ukraine-related stress comes just as our nation comes down from a dizzying height on the two-year roller coaster ride of COVID-19. Many people still have unprocessed anxiety, grief and loss.
So, with all this going on, what can you do?
Two experts from Michigan Medicine – psychiatrist Michelle Riba, M.D., M.S., and internal medicine physician Michele Heisler, M.D., M.P.A., –  offer some tips and advice. Heisler is also medical director of Physicians for Human Rights, an international health and human rights organization.
It can be hard to look away from the news about Ukraine, with such compelling images and video, so much happening and so many ways to get news.
But, says Riba, it’s important to pull yourself away. Remind yourself that you don’t have to know everything that’s going on, and set time limits for yourself to consume news from reputable sources. Turn off app notifications.
“Veterans, especially those with diagnosed or undiagnosed post-traumatic stress disorder, may especially be triggered by these scenes,” she said. “If you have young children around, it’s important to share what’s going on in terms they can understand, but shield them from seeing too much on a TV that happens to be on while they’re near. If they see the same footage played repeatedly, they may think the events are happening over and over again, which we saw with 9/11 and other major events.”
If you know a person in their tween, teen or young adult years, odds are they have TikTok, Instagram, Snapchat, YouTube, Twitter or Facebook accounts, or are in group chats. If so, they are likely seeing a steady stream of graphic, first-hand videos, images and memes from Ukraine and nearby nations.
If you’re on social media yourself, you’re probably seeing the same.
Some of these posts may be especially distressing or gory – and some accounts may be deliberately spreading false information. The raw nature of the images, with no filtering for grisly content, can mean unexpectedly seeing things you would rather not see and can’t ‘unsee.’
Talk to young people about how repeated exposure to this kind of content can be distressing, overwhelming or numbing, and how information from crisis zones can often be inaccurate or incomplete.
Use the settings on each platform to mute certain topics or accounts, or to set time limits for this kind of screen time. Encourage them to follow accounts run by news and humanitarian organizations, which rely on experienced journalists and editors who verify their information before publishing it.
Years of research has shown that getting a good amount of sleep, on a regular schedule, can help keep mood and anxiety levels within healthy levels. So can physical activity, whether it’s pulse-raising exercise or sports, yoga or just a nice long walk.
Creative activities, such as hobbies, crafts, writing or home improvement, can provide an outlet and distraction. And don’t forget the power of meditation, attending faith-based gatherings and services, listening to soothing music, and taking quiet time to read a book or write in a journal.
Eating healthy meals on a regular schedule, avoiding over-use of alcohol and other substances, and making time to connect virtually or in person with people you enjoy spending time with are all important right now, says Riba. Check in with others to see how they’re doing, and share what you’re feeling now too.
These steps are especially important in light of ongoing COVID-related stress, Riba said. “It’s a marathon, and we’ve already been through a lot.”
People who are immunocompromised or have children under age 5 who can’t yet be vaccinated against COVID-19 may still have a high level of pandemic-related stress, so it’s especially important to reach out and support them – or to seek support if you’re one of them.
If you have an existing diagnosis of depression, anxiety or PTSD, or you’re concerned that you may have symptoms of these, it’s important to reach out to your health care provider or therapist to express what you’re feeling right now. They may have advice for other steps you could take.
Vicarious trauma is very real,” Heisler noted. “Watching this unfold is traumatic, and so is the sense of unfairness of being safe ourselves while others suffer. Take care of yourself.”
Riba recommends resources offered by the American Psychiatric Association and American Psychological Association, as well as advice for parents about helping children handle news related to disaster and traumatic situations from the American Academy of Child and Adolescent Psychiatrists.
Seeing everyday people experience sudden upheaval in Ukraine could also be the prompt you need to take action that could protect you and your family if a disaster strikes closer to home. Exerting control over the unknown in this way is a healthy coping mechanism, Riba notes.
The ready.gov website has lots of ideas for making sure you have the supplies and documents you’d need if you had to leave home suddenly because of a flood, tornado, earthquake or wildfire, or even if you had to shelter in place due to a power outage, blizzard or nuclear incident.
Heisler, whose work with PHR has taken her to many crisis zones, remarks that amid all the horrific news and images, she’s finding inspiration and hopes others can too.
“It’s heartening to see the response – even places that haven’t welcomed refugees are opening their arms,” Heisler said. “I’ve been inspired by the global outpouring, and the courage of Ukrainians, and it’s important to reflect on the humanity we’re seeing and allow it to expand our own hearts. We’re all human beings.”
Remembering to look for the good, not just dwell on the bad, can reaffirm our faith in humanity and sustain us.
Helping others can help you feel better, too. If you have the means to give even a few dollars, this is a good time to consider donating to support those who are working on the ground in Ukraine and neighboring countries to feed, house and provide medical care for those fleeing conflict, including people from other countries who were living in Ukraine, who have now also become refugees feeling the violence.
The rapid rise of this crisis, and the likely long-term impact as hundreds of thousands of people are displaced, mean the need is immediate and won’t go away anytime soon.
Be sure your dollars are going to a good cause by focusing them on established organizations such as UNICEF, the UN High Commissioner for Refugees,  Save the Children, Doctors Without Borders, the International Rescue Committee, the International Committee of the Red Cross, World Central Kitchen and CARE.
If you’re a member of a faith community that has a presence in Ukraine, there may be ways to give through that organization.
Beware individual crowdfunding sites and independent fundraising efforts that appeal for your dollars – they have less accountability for how they spend their funds and could even be scams.
If your heritage includes ties to countries that have had their own refugee crises recently, you may be feeling like those problems are getting overshadowed by the attention on Ukraine. But international aid agencies haven’t forgotten. And the more resources those agencies have, the more they can keep aid flowing to people everywhere who need help.
Your financial support could also fund the work that many organizations, including Physicians for Human Rights, do to document the impacts of crisis on individuals and societies. Such work can even help bring perpetrators to justice in international criminal courts.
While it remains to be seen whether refugees from Ukraine will be resettled in the United States, there are already refugees and asylum-seekers from Afghanistan and other nations in the country who need your help.
If people who suffer a major trauma such as fleeing a war zone get support for themselves and their family in their new homes, it can reduce their chance of PTSD and other issues down the road.
Each state has one or more charitable organizations, many of them faith-based, that coordinate resettlement for these individuals and families seeking refuge. These organizations likely could use donations of food, toiletries, clothing, shoes, furniture, household goods and skilled assistance right now.
For example, here’s Michigan’s page listing organizations that are helping refugees. And here’s a page that links to the refugee resettlement organizations for other states. 
“We’ve been in the midst of an era of refugee crises, and I hope the Ukraine crisis makes us all think about the suffering of other people who have to flee persecution, and how we can help,” said Heisler. “This is the most ‘wired’ conflict that we’ve ever experienced as a global connected society, and now that your heart is going out in this situation, think about other situations that have sent people fleeing from their homeland.”
If you’re a health care or legal professional, you can even get trained in how to conduct formal impartial examinations of refugees and asylum seekers, to create trustworthy records of their injuries or mental health symptoms that are important to their potential path to a new life. University of Michigan medical and law students also take part in this effort through the U-M Asylum Collaborative.
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