War in Ukraine Breaks More Than Buildings

The destructive effects of Russia’s war on Ukraine are easy to see: ruined buildings, damaged infrastructure, blackouts, displacement, injury, and death. Yet Ukrainians are often described as a resilient people who carry on under conditions most would find unbearable.

In April 2024, the Institute for Behavioral Studies at American University Kyiv, together with the research laboratory Rating Lab, conducted a cross-sectional survey among adults living in different Ukrainian regions, excluding the territories temporarily occupied by Russia. The study examined respondents’ stress levels and attitudes to professional psychological help, the barriers to seeking support, and the ways people try to cope on their own.

The study found that Ukrainians’ determination comes at the cost of operating well beyond their limits. Coping resources are depleted, professional help is out of reach for those who need it most, and the gap between recognised psychological need and care received is widest among the most stressed. This is the picture that many narratives of resilience tend to obscure.

Stress amid prolonged war

The results of the study show that Ukrainians have a high overall stress burden. Of the 1,323 respondents, almost 70 per cent fell into the ‘moderate stress’ range, and another quarter reached the ‘high stress’ threshold. Stress, then, is not limited to a small vulnerable group. Amid the prolonged war, it has become a condition of everyday life.

Those who lived more hardships because of the war reported higher stress, but the type of hardship also matters. The greatest stress was found not among people who had experienced shelling or violence but among those who had been through prolonged deprivation: hunger, a lack of drinking water, extended periods of cold at home, or a loss of housing. Chronic material hardship can be as psychologically damaging as direct exposure to danger.

In terms of who carries the heaviest burden, people’s financial situation was the strongest dividing line: those who could not meet basic needs reported substantially higher stress levels than those who were relatively comfortable. This gap held regardless of where in Ukraine people lived. Women and unemployed people were also more stressed.

Coping without professional support

When professional help is out of reach, people rely on what they have at hand. Among those with lower stress levels, the most common strategies were talking to family or close friends, working or studying, doing physical activity, taking care of the household, and spending time with children. These simple routines provide structure, connections, and a sense of control. In the high-stress group, however, most of these strategies were reported less often. Alcohol use, by contrast, was more than twice as common: one in five respondents with high stress reported using drink to cope, compared with less than one in ten among those with low stress levels.

This evidence does not suggest that highly stressed people have stopped trying. It points to something more troubling: severe stress gradually dismantles the everyday resources people rely on to manage it. Exhausted people find it harder to maintain routines, stay socially connected, or remain physically active, even though these options are feasible and can help.

Why those in need do not always seek help

The most striking finding is the gap between recognising a need for psychological support and actually receiving it. Among the highest-stress respondents, 88 per cent said they needed help, while 62 per cent did not get it. The people suffering the most were also the least likely to get support.

The data reveal more than a simple access problem. Higher stress made people more likely to intend to seek help, but among those who had acknowledged needing help, higher stress did not make them more likely to follow through. Recognising the need and acting on it are two different things, and the gap between them grows where pressure is greatest. This finding can be seen as a sign of depletion: when people are exhausted and overwhelmed, the steps involved in finding and contacting a psychologist, which would be manageable under normal circumstances, become genuinely difficult to take.

The barriers reported by those with unmet needs reflect this situation. Cost was the most frequently cited obstacle (71 per cent), but almost as common was the belief that psychological help would not actually work: 67 per cent admitted that there are problems a psychologist cannot solve. Navigating the system was also a major hurdle: nearly two-thirds reported that finding and contacting a provider was a complicated process. In the high-stress group, every reported barrier was higher than in the broader sample, indicating that those with the greatest need also face the most obstacles.

Implications for psychosocial support in Ukraine

Since February 2022, the number of mental health and psychosocial support initiatives in Ukraine has grown substantially. The study findings suggest this is necessary but not sufficient.

The core problem is not that people are unaware that psychological help exists. Among the highest-stress respondents, 88 per cent recognised they needed support. The bottleneck is in the gap between acknowledging the need and being able to act on it. Expanding services and raising awareness will have only a limited impact if that gap is not directly addressed.

The findings point to two distinct problems that require different responses. The first is practical: the costs and complexity of finding a provider, making contact, and managing the process are prohibitive for people who are already depleted. For this group, the priorities are affordability, simplified access, and proactive outreach that reduces the effort required to initiate help. The second problem is harder: two-thirds of those with unmet needs doubted that psychological help would work for them at all. This is a trust and credibility problem, and it will not be solved by making services easier to find.

Both problems are most acute among those with the highest stress: the same people face the greatest deprivation, the fewest coping resources, and the most barriers. Reaching them requires services designed around the reality of what severe and prolonged stress does to people’s capacity to seek help.

Dr Volodymyr Vakhitov is an economist and the director of the Institute for Behavioral Studies at American University Kyiv.

Dr Natalia Tsybuliak is an associate professor at Berdyansk State Pedagogical University.

Natalia Zaika is a deputy director at the Institute for Behavioral Studies at American University Kyiv.

All authors are or were fellows at the Ukraine Research Network@ZOiS, funded by the German Federal Ministry of Research, Technology and Space.