‘I go to war in my sleep’ Russia is failing to provide PTSD support for soldiers returning from Ukraine. Psychiatrists expect disaster.

Report by Verstka. Abridged translation by Sam Breazeale.

Over the last year, thousands of Russian men have spent time on the battlefield in Ukraine and returned home. While there’s no official data on PTSD rates among these veterans, many of them are almost certainly suffering from the disorder and not getting effective treatment. Veterans with PTSD can have difficulty adapting to civilian life, and they’ve been found to have a heightened risk of engaging in harmful behaviors such as alcohol abuse and domestic violence. To gain insight into how these issues are playing out in Russia right now, journalists from the independent outlet Verstka spoke to a former Russian contract soldier, a former mercenary, and several psychologists who work with veterans and their families. Meduza is publishing an abridged version of their report.

‘The thing that helps most is cognac’

Dmitry (whose name was changed for security reasons) is a contract fighter from eastern Russia. He was first sent to fight in Ukraine in June. Initially, he said, he truly believed his mission was to “beat down the fascists.” Once he saw the reality on the ground and realized Russia was waging a war of aggression, however, he wrote a statement of refusal to fight.

He soon found himself in a “camp” for objectors in the occupied Ukrainian city of Brianka, where numerous soldiers have reported being held captive and abused. According to Dmitry, both Russian servicemen and Wagner Group mercenaries tried to intimidate him and his fellow soldiers into returning to the front by threatening and beating them.

Because the camp was close the combat zone, Dmitry also had shellfire to worry about. “One time, a HIMARS [strike] hit us. After that, I started jolting awake at night,” he says. “Ever since then, I’ve been going to war in my sleep. I wake up after I die in the dream, but then I spend another 5–10 seconds searching around for a grenade or a machine gun.”

After an injury in the camp sent Dmitry to the hospital, a psychiatrist wrote him a referral to an inpatient rehabilitation center. When Dmitry was sent back to the military base in his hometown, however, his commander there refused to let him seek treatment. Meanwhile, he and his wife had to start sleeping in different bedrooms; otherwise, his frequent nightmares would wake her up. Finally, he filed a complaint with the military prosecutor’s office, which prompted his commander to let him go to rehab.

At the rehab center, Dmitry was signed up for massages, physical therapy, various bath treatments, and an exercise regimen, all of which he found ineffective. After a masseuse pressed down hard on his injured arm, causing him to “see stars” from the pain, he stopped going to his massage appointments.

His experience with psychotherapy was no more helpful:

In the same session, Dmitry mentioned that in his nightmares, he’s fighting not against Ukrainian soldiers but against mercenaries. Before he left, the therapist asked him, “Wait, why are you fighting mercenaries?” Dmitry responded honestly: “I can’t dream about Ukrainian soldiers, because I never saw any.”

Dmitry said his nightmares continued the entire time he was at the rehab center — and continue to this day. So far, he’s only found two ways to suppress them:

‘Your brain can’t just discard those memories’

Evgenia Lazareva, a therapist who works with soldiers, told Verstka that about 20–30 percent of combat veterans return home with PTSD and require rehabilitation. One study of veterans from the Soviet–Afghan War and the Chechen Wars found that, on average, the more time a person spends in the combat zone, the greater the psychological effects will be, and the less adaptive his psyche becomes.

Russian lawmakers are currently considering opening special psychological rehabilitation centers for “special military operation participants.” Additionally, in December, State Duma deputies introduced a bill to provide free psychological support for all combat veterans.

But according to Lazareva, mental health specialists qualified to work with soldiers and veterans are in short supply in Russia, so having the government cover the cost of treatment is unlikely to solve the problem. In addition, she said, rehab services provided within military or government institutions are rarely effective, because servicemen fear their private information will be shared with their superiors.

“Therapy requires creating a safe setting, a situation that lets a person feel as if he can talk about anything at all,” she told Verstka. “I’d venture that it’s unlikely government services would be able to provide that kind of security.”

Even when high-quality mental health services are available, Lazareva said, veterans are often reluctant to seek it, whether due to shame or because of negative past experiences. As a result, she said, it’s common for people with PTSD to self-medicate.

‘I spent ten days in a stupor’

47-year-old Sergey grew up in Russia but spent several years living in Ukraine’s Zaporizhzhia region, and his wife had numerous Ukrainian relatives. Nonetheless, in March, he decided to join Russia’s 141st Special Motorized Regiment, also known as the “Kadyrovites,” to help “liberate Mariupol,” in his words.

For his first few weeks in Ukraine, Sergey had no cell service or Internet. When he finally managed to call home in April, he learned that his wife had filed for divorce; several of her family members had joined the Ukrainian military, and she decided she could no longer be married to a Russian soldier.

In May, Sergey’s deployment ended, and he returned to Russia. After attending a friend’s funeral, he tried to settle back into civilian life, but found himself haunted by insomnia and nightmares.

“Mariupol was a real meat grinder,” he said. “When I came back home, I spent 10 days in a stupor, drinking wine and cognac, because I couldn’t get to sleep. I wasn’t a heavy drinker before the war, but now it was a necessity.”

Eventually, he came to believe that the only way to cure his symptoms would be to return to Ukraine and experience combat again. Two weeks after returning home from his first deployment, he joined one of Russia’s private military companies (not Wagner Group). This time, he was stationed in Izium, where Ukraine was staging a successful counteroffensive. While he was there, he told Verstka, he saw one of his fellow mercenaries die by detonating a grenade on himself after mistaking other Russian fighters for Ukrainian ones. Sergey returned home in September.

Back at home, Sergey began experiencing constant feelings of panic and continued to have trouble sleeping. Though he initially vowed not to return to Ukraine for a third time, when he eventually got another call from a private military company, he agreed to go. He returned with a concussion in early December. He continues to struggle with symptoms of PTSD.

“To keep from overloading my nervous system with memories, I’ve deleted everybody who might remind me of the war, and I’m distracting myself however I can,” he said.

‘You go there as nice Vasily, and you come back as mean Vasily’

Even when soldiers with PTSD do decide to seek help mental health support, they sometimes find that specialists aren’t willing to see them.

“There are some specialists who don’t work with perpetrators of violence,” said psychologist Valery Vyatchanin. “So when a person signs up for a consultation, it’s important for him to check whether the specialist works with military service members. For example, a soldier might tell stories that, for me, simply as a human being, are unbearable, in which case I won’t be able to help him. After all, as a therapist, you need to be on your client’s side.”

According to therapist Evgeny Aleksandrov, Russia’s failure to ensure soldiers with PTSD get effective support is likely to cause a host of problems for the veterans themselves, their family members, and society as a whole.

“Maybe it’s kind-hearted Vasily who goes off to war, but it’s mean, alcoholic, destructive Vasily who comes back,” said Aleksandrov. “Is that family going to survive? There’s no guarantee. One wife recently asked me, ‘Am I obligated to endure this?’ That’s a family that’s unlikely to last.”

Aleksandrov said the large number of traumatized men who aren’t getting the help they need is likely to cause significant social unrest.

“These kinds of people will lose their jobs, because they’ll curse out their bosses and hit them,” he said. “They’ll lose their families, and they’ll lose their freedom, because if a police officer gets near them, they’ll punch him in the head. How many guys fell into crime after Afghanistan? If we don’t have a well-thought-out plan for rehabilitating soldiers, it will spell the end of civil society.”