The Hidden Economic War: How PTSD Silently Devastates Ukrainian Families' Financial Future

Whilst the world watches Ukraine rebuild its shattered infrastructure—repairing bridges, clearing rubble, restoring power grids—another reconstruction project unfolds quietly in homes across the country. It's the financial rebuilding that families must undertake when PTSD moves in as an unwelcome guest, bringing with it invisible but crushing economic burdens that can persist for decades.

When we think about the cost of war, we typically picture the obvious expenses: military equipment, humanitarian aid, physical reconstruction. But Bosnia's experience reveals a hidden economic battlefield where PTSD wages a silent war against family finances, national productivity, and entire communities' ability to recover and thrive.

The True Price of Invisible Wounds

In Bosnia, researchers discovered something that should concern every Ukrainian family and policymaker: PTSD doesn't just cause emotional suffering—it creates a cascade of financial devastation that can last for generations.

The numbers are staggering. People with PTSD generated healthcare costs 63% higher than those without the condition. But that's just the beginning of the story. When formal healthcare systems couldn't meet the overwhelming need—as is often the case in post-war societies—families stepped in to fill the gap, often at enormous personal cost.

Imagine this reality: In Croatia, 61% of people with untreated PTSD relied on family members for care. These unpaid caregivers—mostly women—provided an average of 304 hours of support every three months. That's nearly the equivalent of two full-time jobs, unpaid, whilst trying to maintain their own employment and care for their own needs.

The financial burden was crushing. Even with limited access to formal healthcare, the average cost of caring for someone with untreated PTSD exceeded €1,100 every three months. In Croatia, informal care costs alone averaged €1,378 per person. These aren't just statistics—they represent families draining their savings, mothers leaving their jobs, and entire households sliding into poverty because of one person's invisible wounds.

When PTSD Comes to Work

The economic impact of PTSD extends far beyond healthcare costs. It follows veterans into job interviews, workplace interactions, and career advancement opportunities—often with devastating results.

In Bosnia, the employment statistics paint a stark picture of how trauma can derail professional lives. Only 28.6% of veterans with PTSD were employed, compared to 62.3% of veterans without PTSD. Nearly three times as many veterans with PTSD perceived their economic status as low compared to their peers without the condition.

Think about what this means for Ukrainian veterans. A soldier who served bravely on the front lines may find themselves unable to hold down a job not because they lack skills or determination, but because hypervigilance makes open offices feel dangerous, because sudden noises trigger flashbacks, or because insomnia leaves them too exhausted to function effectively.

The ripple effects are profound. When the primary breadwinner struggles with employment, entire families feel the impact. Children may have to leave school to work, spouses may have to take multiple jobs, and families may lose their homes or be unable to afford basic necessities.

The Caregiving Crisis

Perhaps the most overlooked aspect of PTSD's economic impact is the burden it places on family caregivers—predominantly women who find themselves navigating a role they never expected and for which they received no training.

In Bosnia, researchers found that over 83% of people with untreated PTSD still met the diagnostic criteria a decade after the war ended. Their family members had become their primary support system, providing everything from emotional comfort during flashbacks to practical assistance with daily tasks that trauma made overwhelming.

These caregivers faced impossible choices: continue working and leave their traumatised loved one without support, or leave their jobs to provide care and watch their family's financial situation deteriorate. Many chose a middle path that satisfied no one—trying to work part-time whilst providing intensive unpaid care, resulting in career stagnation, chronic stress, and their own health problems.

For Ukrainian families, this pattern is already beginning. Wives of veterans are leaving their jobs to support husbands with PTSD. Mothers are caring for traumatised sons whilst trying to maintain households. Adult children are becoming caregivers for parents whose war experiences have left them unable to function independently.

The Poverty Trap

PTSD creates what economists call a "poverty trap"—a self-reinforcing cycle where poor mental health leads to unemployment, unemployment worsens mental health, and families become increasingly unable to afford the very treatment that could break the cycle.

Veterans with PTSD in Bosnia were significantly more likely to experience chronic health conditions alongside their mental health struggles, creating additional barriers to employment and further increasing healthcare costs. Families found themselves choosing between basic necessities and medical care, often going without both.

The cruel irony is that untreated PTSD becomes more expensive over time, not less. Without proper intervention, symptoms tend to worsen, requiring more intensive care and creating greater barriers to employment. What might have been addressed with early, relatively affordable intervention becomes a lifelong burden that can impoverish entire families.

Beyond Individual Families: The National Cost

When PTSD affects a significant portion of the population—as it has in Bosnia, where roughly 26.5% of adult war survivors continue to struggle with the condition—the economic impact extends beyond individual families to affect entire nations.

Consider the labour force implications. If a quarter of Ukraine's war survivors develop chronic PTSD, that represents hundreds of thousands of people whose economic productivity may be significantly impaired. Some may be unable to work at all, whilst others may work below their potential or require accommodations that not all employers are willing to provide.

The healthcare system faces enormous strain. Bosnia's experience shows that people with PTSD use healthcare services far more frequently than those without, placing additional pressure on medical systems already stretched by war's physical casualties.

Tax revenues decline as employment drops, whilst government spending on healthcare and social services increases. The very resources needed for national reconstruction are diverted to addressing the long-term consequences of trauma.

The Gender Dimension

The economic impact of PTSD is deeply gendered. In Bosnia, as in many societies, women bore the primary responsibility for providing unpaid care to traumatised family members. This "invisible labour" had profound economic consequences that extended far beyond the immediate family.

Women left careers, reduced working hours, or turned down advancement opportunities to care for loved ones with PTSD. Many developed their own health problems from chronic stress and caregiver burnout, creating additional healthcare costs and further reducing their earning potential.

For Ukraine, where women have played unprecedented roles in the war effort—serving in combat, leading humanitarian efforts, maintaining communities whilst men fought—the risk of losing this progress to unpaid caregiving responsibilities is particularly concerning.

Breaking the Economic Cycle: A Path Forward

Understanding PTSD's economic impact isn't just about documenting the problem—it's about recognising that investing in mental health care is economic policy. Every pound spent on effective PTSD treatment can save multiple pounds in healthcare costs, lost productivity, and informal care expenses.

Early intervention is economically efficient. The Bosnian experience shows that untreated PTSD becomes exponentially more expensive over time. Providing accessible, evidence-based treatment when symptoms first appear costs far less than dealing with chronic, entrenched trauma.

Supporting caregivers supports the economy. Programmes that provide respite care, caregiver training, and financial support for families affected by PTSD aren't just humanitarian—they're economic investments that allow caregivers to maintain their own employment and productivity.

Employment support must include mental health considerations. Job training programmes for veterans need to address PTSD symptoms that might interfere with work. Employers need education about accommodating workers with mental health conditions. Career counselling should help people find roles that work with, rather than against, their mental health needs.

Community-based care reduces costs. Centralised, hospital-based mental health services are expensive and often inaccessible. Community-based programmes that provide support closer to home reduce travel costs, enable people to maintain community connections, and often achieve better outcomes at lower cost.

Hope in the Economics

Whilst the economic toll of PTSD is severe, Bosnia's experience also reveals something hopeful: some research suggests that overcoming trauma can lead to post-traumatic growth, developing new skills and resilience that can actually enhance productivity and earnings potential.

Veterans who receive effective treatment don't just recover—they often develop enhanced empathy, leadership skills, and perspective that make them valuable employees and community members. The key is ensuring they receive the support needed to transform their trauma into strength rather than letting it become a lifelong burden.

Our Economic Mission

At Viburnum Bridge Foundation, we understand that supporting veterans' mental health is not just a moral imperative—it's an economic necessity. When we help a veteran overcome PTSD, we're not just healing one person; we're potentially:

• Preventing a family from falling into poverty

• Enabling a caregiver to maintain their career

• Reducing long-term healthcare costs

• Keeping a skilled worker in the labour force

• Breaking a cycle that could affect the next generation

We recognise that effective mental health support is economic development. Every veteran we help return to productive employment contributes not just to their own family's financial stability, but to Ukraine's broader economic recovery.

Our programmes are designed with economic reality in mind. We provide support that enables veterans to work, helps families avoid the poverty trap of chronic PTSD, and builds community resilience that benefits everyone.

Building Ukraine's Economic Future

The war in Ukraine will end, but the economic consequences of trauma will persist for decades unless we act now. Bosnia's experience shows us both the devastating cost of neglecting mental health and the transformative power of comprehensive support.

By investing in mental health care today, Ukraine isn't just addressing individual suffering—it's protecting its economic future. Every veteran who receives effective treatment for PTSD, every family that avoids the poverty trap of chronic trauma, every caregiver who receives support to maintain their own career, represents a building block in Ukraine's post-war prosperity.

The choice is clear: we can learn from Bosnia's experience and invest in comprehensive mental health support now, or we can repeat their struggle and watch trauma silently devastate Ukraine's economic recovery for decades to come.

At Viburnum Bridge Foundation, we're committed to ensuring that Ukraine's heroes don't become casualties of an economic war they never knew they were fighting. Because when we heal trauma, we don't just heal individuals—we heal economies, communities, and futures.