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Recommendations to mitigate the impact of adverse mental health effects brought on by war

Nancy Burgoyne, Ph.D., ABPP
• March 08, 2022

The Family Institute at Northwestern University sends its support to all who are experiencing pain and suffering because of the war in Ukraine. We know that within the Ukrainian diaspora, many are agonizing over the fate of their friends, family, and their sovereign country. There is no overstating the impact.  To too many families around the world, this is a familiar feeling. Armed conflict is occurring in many parts of the world, including Libya, Mexico, Somalia, Syria, and Yemen. Closer to home, more than 21,000 people were killed due to violence in the United States in 2020 alone. As relationship-based mental health professionals we recognize that when those we love are threatened, the strain is immense. The American Psychiatric Association, in their Statement and Resources on the Mental Health Impact of the War in Ukraine, stated bluntly, “The war in Ukraine will have adverse mental health effects on individuals and communities around the world.” To mitigate the impact, we offer the following recommendations.  

Honor your experience by practicing self-compassion 

There is not a right way to feel. Your proximity to those directly impacted by the war, your general sensitivity, and your prior trauma history will influence your response in a variety of ways.  You may, for example, feel worried, sad, scared, overwhelmed, angry, helpless, grief-stricken, and/or horrified.  Or you may feel simply numb, or not currently in touch with feeling distressed. It is unhelpful to judge how you or others feel. 

Take a moment several times a day and pause to observe your own experience. Put words to how you feel. Once you have tuned into yourself, use self-talk to speak compassionately to yourself.  Compassion involves sensitivity to the experience of suffering.  In this case, direct it to yourself. The benefits of self-compassion are scientifically supported. So, don’t be shy, speak to yourself tenderly, as you would to a beloved friend; “I am hurting, and I am scared, and it’s okay to feel this way. I am human and I care, that’s healthy”.  Once you have taken a few moments to honor your experience, gently re-direct your attention to another activity. Re-direction may be quite difficult, that is to be expected.  It takes patience and practice to move away from strong feelings and you may not be able to ‘shake off’ some amount of residual distress. That’s okay. The more you create brief periods of time to honor your feelings, the easier it will eventually become to refocus on the activities in front of you. 

There is a confusing wrinkle in how some people cope that is worth anticipating.  Some people have a delayed reaction to stress. One way to think about this is that it is a strategy to cope with the demands of the crisis at hand. This can also occur within families, where members effectively ‘take turns’ so that not all members are subsumed at the same time. ‘Turn taking’ can occur within a brief period of time or extend out over months or years. Knowing this normalizes the experience of the person(s) who does not appear impacted in the present but will need support when they suffer later.  

Take action 

One of the most critical ways to positively improve your mental health is to take action. Inaction contributes to feelings of helplessness and powerlessness and may lead to a sense of despair.  Taking action that is within your abilities and congruent with your values is empowering, esteem building, and is connected to finding meaning in life, which is linked to resilience.  

There are many ways you may choose to act. While The Family Institute is not advocating for a particular type of action or a particular organization to align yourself with, this link leads to a list of verified resources and organizations providing humanitarian, military, and emergency response aid to Ukraine.  

We especially encourage you to consider action that connects you directly with like-minded others.  Social and emotional support is an important protective factor for health.  Interestingly, research suggests that providing social support may be even more important than receiving it. 

Manage media intake 

While staying informed is important, and a way to feel connected to what is happening in Ukraine, research shows that overexposure to media during a crisis is linked with worse mental and physical health down the line. “The greater the amount of exposure people have to media about a tragedy, the more likely they are to report distress,” says Roxane Cohen Silver, Ph.D., a professor of psychology who studies stress and coping at the University of California, Irvine. Her research has shown that repeated news exposure in the week following the 9/11 attacks predicted acute stress, prolonged symptoms of posttraumatic stress, and even physical health problems 2 to 3 years later (Psychological Science, Vol. 24, No. 9, 2013). She and her colleagues have found similar patterns around the Boston Marathon bombing, the Pulse nightclub shooting in Orlando, and the COVID-19 pandemic. 

When you do consume news, the American Psychological Association, in its coverage on how to handle the trauma of war from afar, advises that you seek news from credible sources. News on social media may be unreliable, politically motivated, or sensationalized. Avoid 24-hour news channels and instead access longer-form journalism or reliable print media that provide additional context for current events. 

Maintain structure 

It would not be surprising if you were losing sleep, have seen a change in your eating habits, are irritable, and/or struggle to concentrate or focus. When events that are extreme or out of the ordinary occur, we often are thrown off our usual routines and into patterns that are dysregulating.  This contributes to a sense of unease. Get back into your routine. It is not wrong to take care of yourself now or to enjoy things you usually enjoy. The war and aftermath will not be brief. Protect your energy. You will be better able to stay usefully engaged if you are not depleted. Employ whatever stress reduction strategies work for you. There is no universally effective stress reduction technique but maintaining daily routines and protecting your sleep are crucial. When there are responsibilities that you need to tackle, set priorities and work on simple problems first. This may reduce a sense of helplessness.   

Help children manage their distress 

Children look to their caregivers to help them feel safe. This remains true no matter your child's age. Talk to your children. Behavioral health care providers who work in trauma and recovery advise parents to use the news of the war in Ukraine as an opportunity to talk and listen to their children.  Ask your kids what they’ve heard about the situation, and what feelings it’s stirring in them. Help them name their emotions so they can better talk about them. Young children may communicate their fears through play or drawing. Elementary school children will often use a combination of play and talking to express themselves. Adolescents are more likely to communicate their feelings and fears verbally. Your children are likely to sense what you’re feeling about the tragedy in Ukraine, and that’s okay. Don't try to hide your distress from them; what we hide only invites their curiosity and triggers their fear. Help them understand that painful emotions—upset, sadness, anger, fear—make sense at a time like this. And give them assurance that your distress won’t prevent you from taking good care of them while you take care of yourself as well. Parents should acknowledge to children that bad things do happen, but also reassure children that the adults in their lives are doing everything they can to make their local environment — school, home, and neighborhood — safe for them. 

The recommendations above for adults apply to children as well. The predictability that comes from structure can be reassuring. This is another reason to re-establish your family’s routines. Children are even more vulnerable to the effects of media coverage than adults. Parents should monitor how much exposure a child has to news reports. Research has shown that some young children believe that the events are recurring each time they see a television replay of the news footage.  

The National Child Traumatic Stress Network offers these additional resources for children and families who need support: 

Most importantly, tune into opportunities to offer extra affection and attention — you are the best source of soothing for your child.  

Watch for changes in mood or behavior – yours or your children’s 

While changes in mood or behavior are understandable given the magnitude and impact of the crisis, changes that significantly negatively impact functioning that persists for more than a few weeks call for professional support. In children, a persistent change in the child's school performance, changes in relationships with peers and teachers, excessive worry, school refusal, sleeplessness, nightmares, headaches, stomach aches, or loss of interest in activities that the child used to enjoy are reasons to reach out for help. 

If you are concerned that your or your child's response to the war has become unmanageable, or if you would like more individualized guidance in how to best respond to the troubling times we face, the clinicians at The Family Institute are here to help. We respect our clients in the context of the events and relationships that impact their lives and understand that the Ukrainian community is in the midst of a truly devastating experience. We extend to you our support and our care. 

Nancy Burgoyne, Ph.D., ABPP

Chief Clinical Officer
Nancy Burgoyne, Ph.D., (she/her) is the chief clinical officer at The Family Institute at Northwestern University. She is a licensed clinical psychologist and a family therapist who abides by the scientist-practitioner model. She has more than 30 years of experience providing direct service to clients, and for more than 20 years, has supervised and served as a leader to her fellow clinicians. In Dr. Burgoyne's current leadership role, she created and oversees The Family Institute's continuous clinical quality improvement team. She led the integration of teletherapy into the practice, established the Clinical Practice Advisory Council, and leads the organization's effort to provide continuous learning opportunities for clinical staff in order to ensure high quality care. Dr. Burgoyne is a faculty member in the Master of Science in Marriage and Family Therapy program and has extensive experience developing graduate school level systemically oriented curricula. Dr. Burgoyne is committed to approaching her work with cultural humility and believes that every human being is worthy of compassionate witnessing.