We are currently in the third year of the full-scale invasion of Ukraine. For many participants of the war it is a one-way ticket; others return home, but to another life. Post-traumatic stress disorder (PTSD) acquired on the frontline becomes an invisible but no less destructive side of the conflict. This inner fight, which happens in the soldiers’ minds, often goes beyond the struggle of just one person and breaks in upon family life. People who return from the front line bring trauma, which changes not only their lives but also the lives of their families, friends, and society in general. They return to a civil society that has an atmosphere of fear and violence in the air, which makes it difficult to restore normal human relationships. Against this background, one of the most serious and widespread problems for society is ex-combatants’ PTSD, which can manifest itself in the form of aggressive behavior and aggravate the problem of violence. However, just like many other problems, Russian authorities do their best to ignore this one as well.
What is PTSD and why is it dangerous?
In 1952, the American Psychiatric Association (APA) published the first Directory of Mental Disorders (DSM-I), which included a category “gross stress reaction” for people who experienced traumatic events in their lives. However, it was assumed that reactions to trauma go away quickly, and if the symptoms persisted for six months or more, new diagnostics were required. Despite evidence confirming the link between trauma and psychological disorders, in DSM-II (published in 1968, amid the fervor of the Vietnam War) this diagnosis was replaced by “adjustment reaction to adult life,” which did not include PTSD.
It was not until 1980 that the APA added PTSD to the new DSM-III volume. The concept of PTSD brought a historically important understanding that trauma is evoked by an external event and is not an innate characteristic of a person. In the first version of DSM-III, a traumatic event was described as catastrophic stress beyond regular human experience.
Another important discovery was made at that time: 7 out of 100 veterans have PTSD. It was also found out that the rate of PTSD is significantly higher in regions where a military conflict is ongoing or has just ended.
What do people with PTSD experience? For them, a traumatic event remains a core and recurring experience that can suddenly evoke rage, panic, terror, fear, sorrow, shame, or despair. The hyperexcitability that accompanies PTSD can be so intense that it sometimes looks like paranoia, and outbursts of irritation and anger can manifest themselves in the form of aggressive behavior. The body and mind of people experiencing PTSD are always ready to act and are always in “fight or flight” mode. These symptoms reveal themselves in the form of intrusive images, nightmares, and vivid flashbacks; they can haunt a person for years, decades, or even for the rest of their lives if they are not provided with adequate support.
How are PTSD and domestic violence connected?
According to the World Health Organization, people with PTSD are three times more likely to behave aggressively compared to people without the disorder. PTSD and other psychological traumas people acquired at the frontline accompany them in peaceful life, which often turns into aggression toward those closest to them.
This situation is aggravated by the fact that in an armed conflict violence becomes not only a part of military strategy, but also a life norm for soldiers. Every week news about physical assaults, fights, and murders committed by those who came back from the war in Ukraine appear in the media. Here are just a few examples for September 2024: “A previously convicted war veteran who stabbed two women to death was detained in Sakhalin”; “An ex-fighter of private military company ‘Wagner,’ who was recruited in a penal colony, was accused of beating his pregnant girlfriend to death”; “A war participant was detained on the charges of murder of a 11-year-old girl.”
Given the variety of violence, the fact that such news appears every week is concerning. And these are only the cases that have been reported to the media — a great number of them remain private. According to research by Verstka, in the two-and-a-half years since the start of the full-scale invasion of Ukraine, no fewer than 242 civilians in Russia have died and 227 have been severely injured as a result of crimes committed by combatants of the war. The majority of victims are relatives or acquaintances of these military men; and the majority of the crimes are of a domestic nature and occur against the background of alcohol consumption.
However, not all acts of violence are committed by people with psychological problems. Even though PTSD may contribute to aggressive behavior, the majority of people with psychological problems are not inclined to violence. Experts in this field state that poor mental health by itself is not a reliable indicator of a propensity toward aggression. More often, behavior is defined by socioeconomic factors (unemployment level, poverty, lack of access to education, etc.), substance use, and cultural attitudes. Nevertheless, it is important to keep in mind that people with PTSD are at risk, which is why the problem should not be ignored.
What happens in families to which deeply traumatized people return? Under conditions of war, violence becomes a norm, justified at the state level: the authorities explain the full-scale invasion of Ukraine as necessary to protect national interest and guarantee the state’s own security. Official media and state channels often emphasize that violence is a way to resolve the conflict, and the participants of war are considered heroes. In nearly every propaganda TV show presented by Vladimir Solovyov one can hear that, under certain circumstances, aggression and violence are justified as a way of dealing with external and internal threats. Sergey Shoigu, the Russian Federation’s Security Council secretary, justifies aggression in the following way: “We do not have a right to be weak. If we are weak, then the same thing will happen to us that happened in Syria, Libya, Yugoslavia, and many many other countries.” On 60 Minutes, a show on Channel One, it is often repeated that the time for humanism has gone and in these war conditions, determination and readiness for physical action is indispensable.
In this sense the state’s consistent unwillingness to adopt a law on the prevention of domestic violence, and the lack of support to the victims may also be seen as continuation of this rhetoric and legitimation of aggression. Meanwhile, participation in the war with Ukraine is considered a mitigating circumstance for those accused of domestic violence.
Apart from that, social infrastructure is deteriorating: funding for social programs is being reduced, NGOs and relief funds are being registered as foreign agents or undesirable organizations, which makes it difficult for them to operate. The law on “foreign agents” deprives many of them of international funding, which forces centers either to shut down or work with minimal resources from donations. Frequent inspections, bureaucratic barriers and fines are becoming an everyday reality, distracting employees from their main work — helping the victims. At the same time, state media often discredit such organizations, blaming them for the “destruction of traditional values.” Meanwhile, there is virtually no alternative support from the state. At the end of October 2024, T-bank disconnected the Prodolzhenie donation platform, which was used by the Siostry center to support victims of domestic violence. This led to the loss of 1,100 donors. In August of the same year, the Nuzhna Pomochsh fund announced its closure, citing as one reason having their fundraising and work with partners interrupted after the Ministry of Justice recognized it as a “foreign agent.” The fund was an important part of social infrastructure in Russia and supported other NGOs and social initiatives. Meanwhile, the number of socially vulnerable people is growing, an outflow of personnel in socially important spheres is apparent. Families in which violence takes place now find themselves in an even more vulnerable position.
State rhetoric puts emphasis on the necessity of raising birth rate for the sake of the Fatherland and creates an atmosphere in which women are considered a means to fulfill demographic goals, not as intrinsically valuable personalities with the right to their own bodies and reproductive health. Those who return from the frontline experience stress and trauma, and they may express their emotions through aggression and violence toward their close ones. Under such conditions aggressors often think that they have a right to their partner’s body as a reward for “protection of the country,” which means sexualized violence, within the family as well. In wartime conditions a woman’s submission is considered a “duty to their Fatherland”: a woman is literally forced to conform to expected patriarchal roles.
Women find themselves in situations with limited access to their own reproductive health. This can take the form of, among other things, a lack of information about contraception, limited access to abortion, absence of social support for mothers, or propaganda of motherhood as the main role of the woman. When violence is justified at the state level, it penetrates everyday life. Under such conditions when soldiers with PTSD come back home and continue to fight with inner demons, family becomes an arena for their battles.
What is the state’s position toward the PTSD problem?
The state pays minimal attention to the problem of PTSD in those who have returned from the war in Ukraine. Instead of concentrating on social support and rehabilitation, key priorities are military expenses and maintenance of the armament industry. In 2023 more than 5% of GDP in Russia was directed toward military needs — a sum that surpasses expenses on social politics (about 4% of GDP) and healthcare (4.9% of GDP) including aid for people with PTSD. According to calculations by website Vazhnye Istorii, in some regions every second ruble of welfare payments goes to participants of the war with Ukraine and families of the deceased, sometimes even more. For example, regions spend on average 13% of the welfare payments budget on one-time payments to new contract servicemen. In general, about a quarter of all welfare payments (23%) go to participants of the war.
Military expenses are reinforced by the mobilization of industries and labor for the military-industrial complex, the increase in state orders for armament products, and the involvement of a significant part of the economy into military processes. As a result, resources that could be used for solving social problems, including improving psychological help for veterans, are directed toward the continuation of warfare while many social problems stay in the background.
At the same time one cannot say that the state totally ignores the problem of veterans’ psychological health. In April 2023, Vladimir Putin signed a decree titled “On the creation of the ‘Defenders of Fatherland’ State Fund for supporting participants of the special military operation.” One of the fund’s purposes is the “organization of/and administration of care for combat veterans, who participated in the special military operation […] from February 24, 2024,” including “psychological-psychotherapeutic aid […] primary psychotherapeutic consultation with defining subsequent tactics of their monitoring and involvement of medical psychologists and other specialists for this purpose.” Who then organizes this aid? Among those in charge are: head of the fund Julia Shoigu (daughter of Sergey Shoigu), Chair of the fund Anna Tsiviliova (Putin’s first cousin once removed, as was discovered by the investigators of the Proyect media resource), Chair of the supervisory committee of the fund Sergey Kirienko (first deputy director of the Presidential Executive Office). The list of participants is interesting. One of the fund’s purposes is psychological help for those who returned from the war.
In the webinar on “Psychological help with PTSD,” Julia Shoigu speaks rather professionally about PTSD, its consequences, and how psychiatrists should work with such patients. Shoigu is one of the authors of instructional guidelines for PTSD diagnostics and therapy. Nevertheless, state initiatives such as the Defenders of Fatherland fund turn out to be ineffective and do not solve existing problems. Thus, provided resources turn out to be insufficient. The fund’s budget in 2023 amounted to 1.3 billion Rubles, which represents only a fraction of the necessary amount of financing for comprehensive rehabilitation of veterans. For example, in the USA 2.2–2.5 trillion dollars (about 2% of the whole military budget) is spent on veteran support, which covers a much larger number of people and offers various services. Whereas in Russia, as practice shows, the number of specialists in the sphere of psychological health does not correspond to the growing number of veterans who suffer from PTSD. Formal declarations of help for veterans look good on paper, but in reality the work turns out to be ineffective.
There is a combined result: the state is essentially brushing off its responsibility to provide aid to those who return from the war, promotes aggression and normalizes violence, whereas non-state funds are on the brink of closure. This creates a dangerous situation and leads to serious social consequences, which affect not only the veterans themselves but also their families, friends, and society as a whole.
What will the level of domestic violence be like in a lingering conflict?
Patriarchal official state rhetoric emphasizes the necessity of “tolerance” to soldiers, which puts more pressure on women, forces them to put up with violence and play a traditional gender role that involves smoothing out family conflicts at their own expense. This happened with the families of those who came back from Chechen wars. Researches show that wives and partners of the veterans who suffered from PTSD experienced higher levels of physical and emotional abuse. Moreover, women took the role of caregivers for their traumatized husbands, which often left them to deal alone with their aggressive behavior.
The situation is aggravated by alcohol and drug consumption. Data provided by the National Institute on Drug Abuse show that more than a quarter of veterans with PTSD experience addiction problems, which makes aggression even more destructive. Access to weapons also plays an important role, as in families where there is a gun the risk of domestic violence increases.
The cessation of military conflicts does not lead to the cessation of domestic violence; on the contrary, it increases it. The experience of war strengthens stiff masculine attitudes: force becomes the main value, expressing emotions is considered a weakness, and heroism takes the form of violence. At the same time, postwar societies often do not possess the necessary mechanisms and resources to support domestic violence victims. In most cases, the state that went through a military conflict focuses on rebuilding the infrastructure and economy, setting aside the problems of domestic violence and reintegration of the former participants of combat activity.
According to the United Nations, peace restitution programs and state reforms are often designed without taking women and children into account. Political leaders, the majority of whom are men, often ignore or underestimate the importance of addressing domestic violence when they design peace agreements and recovery strategies for the country. This type of violence in such societies may be overlooked by the legislature’s view, while in Russia it is decriminalized altogether.
Post-conflict societies often experience a return to traditional gender norms, which establish inequality and make women even more vulnerable to violence. Patriarchal structures reinforced during wartime continue to dominate many years after it, preventing effective protection of women, children, and elderly people. Although protecting survivors of domestic violence should be a key task of state politics in war and postwar societies, experts predict that even after military conflicts end, the level of violence in families may remain high for many years if the problem is ignored.
Positive examples of initiatives, which are still helping the victims (and they do exist, for instance, the Nasiliu.net center, Siostry, etc.) may create an impression of hope and confidence that changes will come, but it should not sugarcoat reality. The problem of domestic violence is too deep to be solved by individual efforts. It is important to speak the truth even if it is an unhappy one: despite the existence of funds and charity organizations in Russia, their effort is obviously not enough to solve the problem. Even though these organizations continue to help, each of them is a drop in the ocean that risks soon drying out from experiencing the lack of resources and the difficult situation in the country.
It is necessary to act now to help the victims of domestic violence during wartime. It is crucial to support existing initiatives as well as create crisis help services and centers, where not only victims but also perpetrators of violence can seek assistance. Only in this way will there be an opportunity to prevent subsequent cases of aggression and stop the cycle of violence. Working with perpetrators of violence may help them become conscious about their actions, change their behavior, and learn constructive ways to resolve conflicts. Not only does this protect the victims but it also encourages a safer and healthier environment for everyone in society. It is indispensable to change sociocultural stereotypes and fight toxic masculinity, which becomes more and more destructive in times of war. It is essential to provide affordable and quality PTSD treatment throughout the country, and not to continue criminal war against Ukraine.
“Essential” here means a question of life and death that requires urgent and decisive action.
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The creation of the article was supported by Rosa-Luxemburg-Stiftung.
