The conflict in Ukraine is escalating, and so is anxiety in and out of the country. So for this week’s Friday Sessions, we talked with disaster psychiatrist Craig L. Katz, M.D. His efforts around disaster psychiatry have included organizing the psychiatric response to 9/11 in New York City. He founded and directs Mount Sinai’s Program in Global Mental Health, is a professor of psychiatry at the Icahn School of Medicine, and spoke to us live, from a quiet spot in the ER at Mount Sinai Hospital.
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“It’s hard to know what the psychological aftermath will be,” Dr. Katz told Friday Sessions co-host Drew Ramsey, M.D. “We generally divide the psychological aftermath into acute, immediate, and long-term. Acute is days or weeks after the event, but you have to be able to define ‘after.’”
But from disasters he’s provided services for previously, it’s clear that it’s important to pay attention to mental health issues right now. “If issues continue,” he says, “you need to see if they’re coalescing into PTSD or major depression or relapses of alcohol use problems.”
He identified that other people are often your best defense in shoring up mental wellness in situations like the Ukranian conflict.
“Communities that are explicit about mental health being part of disaster and trauma recovery are really going to go a long way; we know from research that communities that are more cohesive do much better mental health-wise,” he said. “Even if you’re sweeping up your streets together.” Even in community-wide disasters, people often feel they’re the only ones it happened to. “Having people do things together opens up a back-door channel for people to talk about what one another is going through.”
Another approach: “The military uses something called battle buddies,” he said. People pair up to check on each other and how they’re doing…you can check in along a stress continuum—are you doing OK; do you have a little bit of distress, a moderate amount, a lot?”
Drs. Katz and Ramsey acknowledged that if you’re not involved in the conflict and you’re not directly helping someone who is, there can be a sense of helplessness or almost guilt.
You might wonder how you can enjoy your coffee or nature when others are suffering. “I often say the only thing worse than everyone running away from a disaster would be if everyone ran toward it,” Dr. Katz says. We need the rest of the world to go on. In the case of the war, people are fighting maybe for the kind of world many of us are living in. You have to maintain it—there has to be something they’re fighting for.” Which doesn’t mean you shouldn’t feel sad or anxious. That’s natural in the face of something terrible, he says. Of course, if your stress reactions are negatively affecting your life (your work, sleep, appetite, etc), pay attention to that and don’t be afraid to ask for help.
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