How to cope better with the psychological consequences of war, flight and displacement

 > Psychological counselling service for Ukrainian students at the University of Vienna:

Many people affected by war, flight and/or displacement suffer from the psychological consequences caused by their situation. These psychological strains can manifest in many different ways, including:

  • Massive anxiety and restlessness
  • Sleeping problems
  • Strong negative emotions (grief, helplessness, anger and aggressive tendencies, etc.)
  • Problems concentrating
  • Excessive brooding about the situation
  • Increased need for information and problematic media use
  • Need to see/find the family
  • Reactivation of previous traumas (caused by war or other trauma) and related symptoms, such as flashbacks, nightmares, etc.
  • Diminished performance
  • Anxiety about the future
  • Helplessness
  • Feelings of loneliness
  • Withdrawal from social life
  • Depression
  • Suicidal tendencies
  • Insensitivity
  • and more

How do I stay mentally stable ?

Hardly anyone remains completely unaffected and does not feel one or the other psychological reaction mentioned above. Some even experience several reactions simultaneously. In psychotraumatology, these initial reactions to situations that you overcame or that still persist are considered appropriate and normal, since we naturally react to experiences for which we have no coping strategy yet. War, flight and/or displacement are abnormal situations to which we react in a psychologically appropriate way, even if they 'only' affect us indirectly, for example, as relatives who are in a safe place. But be aware: These appropriate reactions can very quickly intensify, turning them into symptoms and posing a risk to your mental health.

The aim of the following considerations is to remain mentally stable for a longer period and to continue to be able to cope with everyday life. It does not help neither your family nor your friends who are still in Ukraine if you suffer too much mentally. They key word is mental hygiene. The exercises described below do not replace psychotherapy, but they can help you remain as mentally strong as possible.

In a first step, it helps to understand that you are in an exceptional situation that is deeply distressing. Not being able to sleep, feeling extremely restless, alternately experiencing grief, aggression or the feeling of helplessness, constantly thinking about the situation in Ukraine and continuously fearing the worst is not only very stressful but also confusing and also hinders you from keeping a cool head. All emotions mentioned above are signs of massive traumatic stress. It is helpful and useful to make yourself aware of this over and over again and to accept these emotions. This will help you develop strategies that support you in coping better with the situation.

Accepting negative emotions: Allow yourself to be sad, angry and helpless. Allow yourself to experience these emotions. Do not let the emotions overtake you, but consciously take time to experience them. Bottling up these emotions will only intensify them, which will increase the mental strain.

Feeling of being overwhelmed:
Do not overwhelm yourself with everyday chores and providing concrete help. Enduring and coping with your current situation is stressful enough. Allow yourself to take a short break regularly. This will also help you physically and keep you from tiring too much. The more tired you are, the more vulnerable to mental stress you are.

Anxiety, restlessness, sleeplessness: Sit down in a comfortable chair. Place your hand on your upper abdomen and breath in deeply. Feel your belly expand and breath out slowly. While doing so, silently count (at least) to 5. Repeat this exercise at least three times in a row. The controlled inhalation and exhalation calm you down and make you stronger. This exercise also helps if you are overwhelmed by negative emotions. Regular physical exercise outside, such as taking a short walk everyday, will also help reduce stress and restlessness. Focus your attention on your environment and not on your emotions. Consciously notice what is happening around you. If this is hard for you, say what you hear and see out loud. These exercises help you recover from the mental strain you experience and increase your mental stability and strength.

Need for information:
Information helps us because it allows us to develop a feeling of being able to control an uncontrollable situation. Therefore, obtaining information is important and helpful. However, receiving too much information can also lead to information overload and spur emotional reactions. In particular, when you see too many images showing very distressing scenes. Keep control of the amount of information you consume. For example, by specifying times of the day during which you follow social media or other news. Avoid information from dubious sources that contain many images. Images showing distressing, war-related scenes will intensify negative emotions and thus increase the risk of developing symptoms. Therefore, too much information does not help, but rather worsens your situation and can, for example, cause the images you saw to haunt you in nightmares.  

Negative thoughts: You can abandon thoughts that drain too much of your energy or that frighten you very much. Abandon them by telling yourself: "Drop it! Stop! Hold on!" in a loud inner voice. Clench your fist and think of something more pleasant or focus on your next task. Take a deep breath and focus on your surroundings. If the negative thoughts keep on racing, repeat this exercise. After a few days, you will have learnt to abandon your negative thoughts.  The more you practice, the easier this exercise will get.

Social belonging:
Traumatic events, such as those in Ukraine, can arouse feelings of powerlessness, isolation and loneliness, especially when a family cannot be together or when a part of the family is fleeing or still in Ukraine. Restlessness, deep brooding, despair, hopelessness and sleeping problems can intensify the feeling of being powerless and alone. People in this situation are at risk of losing touch with their social contacts and getting increasingly isolated. Try to consciously stay in touch with your contacts and maintain your relationships. Friendships ‘buffer’ (this is what we call social support in psychotraumatology) the risk of becoming mentally unstable. Visualising who you would like, for example, to call or talk to in order to feel better is often already enough. Try to keep in touch with and cultivate the contact with your family members. It is certainly helpful to define specific times at which you want to communicate with each other. Scheduling allows you and your loved ones to focus on everyday challenges, which is hard enough as it is. Some also ask themselves if it is good to talk about anything that moves you. For example, “is it okay to tell my parents/children/grandparents how worried I am” or “is it okay to cry or should I rather try to stay strong”. Any communication that remains authentic is good. You do not have to be strong for anybody. Strength can come (back) from the feeling of being connected and from experiencing social support. The only thing you should try to avoid is, for example, blaming someone else for staying/fleeing or the like. Accusations such as these lead to the opposite of social belonging: they result in isolation because it is often difficult to resolve the dispute.  Therefore, stay connected and be tolerant.

Death and grief: As hard as it is to write about death, it is necessary to reflect on this topic as it is one of the inevitable consequences of war. Losing a person you love or a friend is always painful, also in times of peace. Dealing with dying and death during war is even more difficult, because it shows the futility of war. In times of war, there is hardly ever the possibility to bid farewell in a peaceful and dignified manner. Often, you have no information about the death of a loved one for a long time, neither about the circumstances, nor about the date or place of death. We know from bereavement research that saying farewell in a peaceful and dignified way requires a concrete place at which you can be close to the deceased person once again to remember them and bid them farewell together with family and friends. If this is not possible, saying goodbye, which is so important from a psychological perspective, becomes more difficult and the grieving phase can last longer. We call this prolonged or complex grief. One way to compensate a little for the lack of a possibility to say goodbye is bidding farewell to the person you lost in a symbolic way. You can say goodbye in a symbolic way by thinking of a ritual that helps you say farewell. For example, you could hold a small ceremony together with friends in which you remember the person you all loved. You can do this at a place to which you can always return later. This way, you create a place of remembrance where you can grieve also from a distance. Religious persons may also find comfort in religion and religious rituals.

Unfortunately, grief also comes with the feeling of being exhausted and worn out. In addition to the tears and wailing over the loss of a loved one, grieving persons are very tired and might have the feeling that nothing and nobody can comfort them. This is an appropriate reaction that many bereaved persons experience. This first phase of grief takes time, but please note: Nobody can and should grieve permanently. Recreation is not only permitted, but absolutely essential. Allow yourself to do things that are good for you. The grieving process is more difficult when it is mixed with your feelings about the war. Therefore, it is even more important to allow yourself to take a break from time to time in order to remain mentally stable and to be able to cope with the difficult everyday chores.

For children, death is often incomprehensible as they do not have sufficient abilities to think in an abstract way. However, children feel grief and they understand that it is an exceptional situation. From a psychological perspective it is therefore necessary to talk about death and to share your grief with children. This helps to prevent that children, for example, believe that they are responsible for the death of a person. Children want to partake, so talk to them in a way appropriate for children – it is better for them to be able to partake in the grief and to be allowed to talk about it.

Depression: a persistent negative mood, lack of energy, decreasing concentration and focus, increased tendency to cry, reduced or increased need to sleep, lack of appetite or increased appetite as well as increased irritability can be warning signs of depression. War and flight make us despair but this despair feels ‘alive’ – you can feel it and remain active, even if you are (very) desperate from time to time. Depression, on the other hand, rather leads to emotional numbness – you feel paralysed, emotionally cold and hardly able to do anything. If you notice signs of depression, take them seriously and contact one of the counselling offices listed under the following link: Information for affected students (

Suicidal tendencies: Depression does not always but relatively often come with thoughts about the own death. Thoughts about suicide and death wishes are a sign of deep existential despair. These thoughts or wishes can subside, but they can also intensify. In any case, you should contact one of the counselling offices listed under the link below and get help. Thoughts about one’s own death as well as death wishes are nothing to be ashamed of – they simply pop up. Such thoughts are a clear warning sign and show that your mental resources are depleted and that you should seek help. Please take these warning signs seriously and get help by contacting the counselling offices listed under the following link: Information for affected students

Dealing with fear

Fear is one of the predominant emotions experienced by people who escaped war or who are fleeing. It is also a dominant emotion among people who are already safe or whose relatives are (still) in the war zone. 

Fear is a fundamentally useful and normal emotion that warns us of danger. Fear also helps us to avoid danger and thus helps us to navigate through life relatively safely. This is considered positive and healthy fear. Also during times of war or when fleeing war, fear is a normal and appropriate emotion. It mainly manifests through strong physical tension which shows, for example, through racing of the heart, increased perspiration, heightened acoustic perception or inner unrest. Shaking, difficulty in breathing, a tight chest or dizziness can also be signs of fear. You are basically on alert and scan your environment for risks on your inner radar. As a natural reaction to a perceived danger, we try to protect ourselves. For example, by taking shelter in a secure place (e.g. air-raid shelter) or by looking for help. Fear can also save our lives. At the same time, the emotion is also exhausting because our body is constantly on alert. War or flight require us to be on constant alert, which can lead to fear becoming a permanent feeling or taking a life of its own. We call this generalisation, which means that we do not only experience fear when we see actual danger, but also in cases that resemble a dangerous situation (for example, triggered by noises). Furthermore, the person affected might suffer panic attacks that are uncoupled from dangerous situations and occur seemingly suddenly and unexpectedly. The symptoms very much resemble the signs of the initial fear, but a panic attack usually lacks an apparent reason. It usually only lasts several minutes during which you feel as if in mortal danger. Taking refuge in shelters frequently can also lead to claustrophobia persisting for a longer time. For example, this can manifest in a fear of narrow spaces or crowds. Moreover, people affected are at a risk of developing specific phobias, that are a fear of individual things or situations that are not dangerous as such but are perceived as dangerous. To prevent these developments, it is crucial that you try to find some form of relaxation during dangerous situations. For example, you can try to relax using relaxation exercises (see anxiety, restlessness, sleeplessness) by practising inhaling and exhaling slowly or at least repeatedly reminding yourself of breathing (holding our breath, as is common when we experience fear, intensifies the emotion). So, use breathing as a remedy for fear.  

Social belonging also helps. For example, talking to someone when fear starts to creep up or hugging or be hugged by someone can be helpful and provide comfort. 

Pathological fear differs from helpful, vital fear: The following types of behaviour are signs of pathological fear: for example, persons affected spend more than half of the day thinking about their fears, move around less and less to prevent seemingly dangerous situations, become depressive due to the fear, think about suicide to overcome the fear or try to suppress the fear and prevent it from spreading by using alcohol, drugs or sedatives, or the family/relationship of the persons affected also already suffer due to this form of fear. If you experience one of the types of behaviour mentioned above, you should seek professional help, for example, by consulting a behavioural therapist. 

The forms of fear described above differ from the fear we experience when we worry about someone else or when we fear that somebody might be hurt or killed in war. These are major concerns revolving around loved ones who might be or are in danger. This is a normal and appropriate reaction, especially if you are safe while your loved ones are still in danger. However, this form of fear can also develop in a way that leads to a situation in which all thoughts and concerns revolve around the issue and take up a lot of time of everyday life. To stop the worrying thoughts from racing or at least slow them down, it helps to stay in touch and/or to keep yourself informed (see need for information). If your worries keep you awake day and night, you can try doing the breathing exercises and the exercise to abandon negative thoughts, or talk about your worries with a person you trust and who will listen to you. Please get professional help, if you do not have a person with who you want to share these emotions and thoughts. But before doing so, be aware that your worries and fears are appropriate during war and are considered normal reactions.

Finally safe – how can I help best?

Family members or friends of persons who managed to flee often ask themselves, for example, how to best deal with their family members and friends. Should I address the war or could this intensify the trauma? What do children need? Am I allowed to show my emotions or do I have to show strength and keep my emotions to myself? How can I best help to cope with traumatic events? How do I deal with the usual (family) conflict issues? 

Addressing traumatic events:

You cannot forget traumatic events, but you can change how you remember them. They can transform from a haunting memory characterised by an urge to remember, the feeling of reliving the traumatic situations, despair, anger, grief, strong tension connected with, for example, racing of the heart, shortness of breath and nausea (dealing with fear), to memories that you can talk about without experiencing these negative emotions. In a first phase, arriving refugees are initially relieved to be in safety. Some have the urge to talk about their experiences, while others avoid talking about them. People who want to talk about their experiences need someone who listens to them and who is willing to hear even about harrowing experiences. This way, they can partake in the anguish and offer some relief. But be aware: Listening to and sharing traumatic experiences can cause psychological stress also in the listener. Consider if you are ready and have enough strength to listen to the traumatic experiences. In any case, consider the following: When talking about war, flight, displacement and related traumatic events, take your time, take breaks and stop the person talking about their experiences if you notice that they suffer too much, cannot stop crying, retreat and/or appear apathetic. Take a break, have some tea or a glass of water or go for a short walk. Just say: “Come on, let’s take a short break. We both seem to be a little exhausted and it will do us good to relax a little.” Please do not pressure the person talking about their experiences to continue talking. Respect their limits. Also ask for a break if it is too much for you. An ‘overdose’ of talking and/or listening can intensify mental suffering. If you are not able to listen to the traumatic experiences, you can help the affected person by supporting them in getting professional help. For example, you can inform them about available offers and tell them that you believe that psychological/psychotherapeutic help would be very useful and appropriate (link to counselling offices).

Persons who seem to avoid talking about their experiences may have many different reasons: For example, they may not want to burden their environment or they fear being overwhelmed by negative emotions when talking about their experiences. Some are ashamed of what they experienced and also feel responsible somehow or even guilty. Shame and guilt are common emotions among persons affected by psychotraumatic reactions, as paradoxical as this may seem. Not talking about the events experienced is possible for a while but in the long run avoiding to talk about one’s experiences will worsen the mental condition. Avoidance prevents the person affected from overcoming the traumatic event which may result in traumatic memories surfacing in the form of, for example, images or the feeling of being in the traumatic situation again. In many people affected, the experience of being safe leads to a gain in confidence in themselves and in their environment. As a result, they are able to open up and to start talking about their experiences little by little. However, if they keep avoiding to talk about their experiences, relatives and friends can provide the affected person with information about professional support offers and tell them that they are worried. Make sure to communicate your worries in an ‘I message’. For example: “I am very worried about you because I have the impression that I cannot reach you emotionally any more. I have heard that this can be a sign of great psychological stress. I have some very useful information who you can contact if you need help.” Do not urge the person affected but emphasise your worries in a loving way. Link to counselling offers 

The behaviours described above provide support in coping with traumatic events. Talking about the events experienced, sharing your worries, developing coping strategies and planning the next steps together is social support lived in practice. Authentic interaction is the best safeguard against long-term psychological issues. However, get professional help yourself if you feel inhibited by inner factors (link to counselling offers). Even if you did not flee from the war zone yourself, this war may afflict you. A few hours of psychological counselling can help you find better coping strategies for yourself and your loved ones.

Traumatic experiences usually intensify already existing family conflicts because the fundamental confidence of the persons affected has been massively shattered. Situations of war usually affect all family members, even if they have experienced very different traumatic situations. This can result in an intensification of previous conflicts or it can lead to the family members moving closer together because family conflicts become less important. The latter is more common. You can take decisions in every dispute: You can either decide to avoid conflict issues to be able to better deal with more important challenges, or you can decide to stifle your emotions to ease the conflict situation. You can also decide to ease the conflict in a calm and objective manner. An argument is more of a hindrance in coping with the challenges at hand. 

Please consider the following when dealing with family members and friends who escaped war:

Drugs to facilitate sleeping or to relieve pain as well as psychoactive drugs should only be taken if prescribed by a medical specialist.

Alcohol should be used only moderately.

Making long-term future plans should be avoided. Planning for the near future is enough.

Children and adolescents benefit from regularity and familiarity in everyday life.

To ease the tension palpable among all those involved, please see the recommendations on “anxiety, restlessness, sleeplessness”, “negative thoughts” and “dealing with fear”.  They might help you to become calmer.

Do not urge arriving refuges to talk about their experiences and suffering, but listen to them if they start talking about it. 

Also do not press family members or friends who fled the war to go into therapy. However, if you feel that they need help, please provide information and offer to help them. Communicate this in an ‘I message’.

It is also okay to show emotions. Sharing your emotions enables growing stronger together, while hiding your emotions weakens you.

In case of conflicts, try to solve them in a calm and objective manner.

Talking about war with children

For most children, war is an incomprehensible concept. They are not able to comprehend why people are killed by other people, they cannot fathom the factors leading to a war and they cannot image what it means not to be safe any more.

Children who escaped war also have no or hardly any words to talk about their experiences and about how they are doing. Children who feel helpless or want to understand something usually turn to their family members. Their adult family members are also affected by war, traumatised and exhausted too and may occasionally feel helpless as well.

What you should consider when talking about war and flight with children

Prepare yourself: Parents can best prepare by trying to become aware of their own emotions and thoughts. We recommend talking about everything that moves you with a person you trust. This will help you keep your own emotions somewhat in check and to be sensitive towards the emotions of your child.

Starting the conversation: Ask your child what they know and what they would like to know. Ask about their emotions and thoughts. However, please do not expect that they know how they feel or what they think. Children’s emotions and thoughts about war, flight and exile differ from those of adults. Therefore, try to figure out what your child feels and thinks. Take their emotions seriously and do not question them. 

Clarify and inform: Once you figured out what your child has understood and what moves them, you can correct misunderstandings, for example, that war could also break out at a place of exile. Reassure your child that it is safe now. Too much unfiltered information unsettles children even more than it unsettles adults. Therefore, only share reliable information with your children and restrict their access to unfiltered information on social media. It is okay if you cannot answer a question with verified information. You cannot and do not have to know everything.

Provide a sense of safety: After many days on the run and the constant feeling of uncertainty and loss of control, children constantly need reassurance that they are safe. Children can also get a sense of safety by becoming aware of the many relief programmes that are implemented. Tell children what is being done to help those still in the war zone and to contribute to end the war. If children want to provide help themselves, tell them how they can best help. For example, by sending positive thoughts to family members who are still in the war zone. 

Children who unnoticeably listen in on conversations between adults might misunderstand information shared in these conversations or might not understand what they hear. Children then tend to complete what they heard so that they can interpret it. They conjecture something that causes stress, uncertainty or anxiety. Therefore, please check if your children are listening in or include them in the conversations of adults. 

Remain patient: Children need regular conversations to understand what happened. Therefore, take your time to talk about the war again and again. Traumatic stress can cause behavioural problems and/or problems concentrating. These are appropriate reactions to the experience of war and fleeing. The more inner safety the child regains, the easier these problems will resolve. Be patient. Try to be caring, loving and friendly as best as you can. 

Classifying reactions of children according to age

Pre-school and school age

Children feel helpless and are insecure. As a result, they are very anxious. This anxiety affects really many aspects of life. Due to their development, they are unable to clearly express their fears and to describe their emotions. Fear and helplessness mainly manifest in the loss of skills they previously mastered. For example, children find it difficult again to stay alone at kindergarten or school and do not want to let their parents leave. They seem to be very clingy and do not want to do anything, such as playing, on their own any more. Going to bed and sleeping alone is difficult or even impossible for many. Nightmares or jolting awake during night are also signs of fear and helplessness. Issues may also occur regarding language development or the development of personal hygiene. For example, children might begin to talk less or fall silent. Bed-wetting may also become an issue again. Some children may use play to re-enact traumatic situations to process them. These re-enactments often relate to individual situations being acted out over and over again, though the situations rarely have a ‘positive’ ending, i.e. the negative consequences of the traumatic situations are hardly changed through playing. 

Older school children

Children in this stage are very concerned about their own safety and the safety of others. They may develop feelings of shame and guilt regarding their own actions during the traumatic situations experienced. For example, because they wet themselves or cried in a situation of great fear. They are able to talk about the traumatic event and express their emotions. Children at this age may also suffer from problems falling asleep or sleeping through over night as well as from nightmares. In school, they might have problems concentrating or their performance might decrease. Furthermore, they may suffer from stomach ache and headache that are not caused by physical disorders. Some children may express their anxiety and helplessness by showing aggressive behaviour. 


Adolescents are not always aware of their emotional reactions to traumatic situations, i.e. they are not always able to see a connection between their behaviour, their emotions and their negative experiences. They may feel ‘abnormal’ and this feeling might intensify through the comparison with other adolescents as is typical at this age. They feel different and excluded and further withdraw from their social environment. They might express fantasies about revenge and vengeance when talking to other adolescents and are susceptible to extreme ideologies and to changing their ideals radically. In addition, they may develop a (strong) desire to go to war and might not accept arguments regarding their health. Other self-destructive and risky behaviours may occur as well (e.g. alcohol or drug consumption, self-harm, etc.) 


If children experience traumatic situations, the entire family and/or familiar attachment figures are affected. The emotional reactions of children and adolescents can differ greatly from those of their relatives and attachment figures. Therefore, it is very important for adults to become aware of their own emotional state to be able to perceive the emotions of children and adolescents. Understanding one’s own emotions and the emotions of children and adolescents is an essential step in overcoming traumatic reactions, since it is easier to support each other and to better cope with one's emotions. 

  • Emotional reactions and symptoms after surviving traumatic situations are normal. They are appropriate reactions to an abnormal situation .
  • Once you are out of danger, you should try to establish stability regarding your living conditions and to organise a regular daily routine for children and adolescents.
  • The initial emotional reactions and symptoms may even regress on their own in a safe environment. If this is not the case, you should seek professional psychological assistance (see information about psychological counselling offers ).
  • Allow children and adolescents as much contact as possible (if they wish).
  • Stay connected with other adults or make contact with relief organisations or communities (see information about social belonging ).
  • Protect children, adolescents and yourself from obtaining too much information on social media.
  • Establish your daily routine again that you followed at home, such as telling a bedtime story or eating together.
  • Reassure children and adolescents that you are going to stay together. This helps you and your children and adolescents to know that you are together even if everything is not alright again.

(Source: NCTSN: after a crisis helping young children heal.pdf (, adapted by Brigitte Lueger-Schuster)

Brigitte Lueger Schuster
Professor of Psychotraumatology at the Department of Clinical and Health Psychology at the  University of Vienna

Psychological assistance in crisis situations