Kristina Shalashenko, a therapist who lives in Odessa, Ukraine, lives through a nightmare each day, wondering if or when Russia’s invasion will force her to flee her home. “It’s very scary. Everybody’s terrified and in shock,” she says through a translator. “The world [we’re] used to, it’s not there anymore.”
Thousands of miles away, Kero Lubkova, who was born in Odessa and now lives in Colorado, spends their days checking news sites and social media for updates. Lubkova doesn’t do it because the updates may influence their next move, but because they “cannot focus on anything else.”
Disturbing photos and videos fill the screens of people seeking updates across the world: damage to buildings and bodies after the shelling in cities like Kyiv and Kharkiv, people and pets huddled in shelters, and Ukrainian citizens tearfully calling their loved ones to say goodbye, just in case.
It’s a lot to process. “I definitely don’t think that anybody should ever be used to seeing things like this,” Lubkova says. “But that’s kind of what it came down to. If I want to know what’s happening in my country, I unfortunately have to see this with my own two eyes.”
People in Ukraine and around the world are watching the crisis unfold not only through traditional news sources, but also on social media via raw, personal TikTok videos, Instagram stories, and tweets. It’s not exactly the “first social media war,” as some have branded it; social media has been used to document other armed conflicts, such as the Syrian war that began in 2011. But the way wars are covered on social media has drastically changed over time. In 2011, TikTok didn’t exist and Instagram was a year old. As of Mar. 7, TikTok videos tagged with #ukrainewar have been viewed more than 600 million times, and almost 180,000 Instagram posts have used that hashtag.
That stream of information is powerful: it forces people to pay attention and gives them a window into the experiences of people in Ukraine. But tracking up-to-the-minute developments can come at a cost. Research suggests that news coverage of traumatic events can affect viewers’ mental health—and with footage and photos from Ukraine flooding social media and misinformation spreading rampantly, that has implications for public health.
“People want to educate, people want to inform, people want to bear witness,” says Jason Steinhauer, author of History, Disrupted: How Social Media and the World Wide Web Have Changed the Past. “The challenge is, it’s embedded within this [social media] ecosystem and architecture which, at its heart, is problematic.”
Roxane Cohen Silver, a professor of psychological science at the University of California, Irvine who researches media coverage and trauma, says the amount of media someone consumes and how graphic that content is influence its effects on mental health. Compared to people who viewed less, those who watched at least four hours of television coverage per day during the week following the September 11 attacks reported increased stress and symptoms of post-traumatic stress disorder (PTSD), and were at greater risk of developing health problems years later, Cohen Silver’s team found in a study published in 2013.
Read More: The Fight to Save Lives in Ukraine’s Largest Children’s Hospital
It’s impossible to equate the experience of living through war to that of watching it unfold on a screen. But Cohen Silver’s research does suggest that news coverage can have a strong impact on people who are not directly affected by a crisis. After the 2013 Boston Marathon bombing, consuming at least six hours of related news coverage each day was linked to higher acute stress than being at the finish line when the bombs went off.
It’s difficult to tease out how social media versus traditional news coverage affects mental health, since few people exclusively view one or the other, Cohen Silver says. But there are some crucial differences. At traditional media outlets, editors decide which content is too graphic to show, and often label disturbing images with warnings. But people “can take pictures and videos and immediately distribute that [on social media] without warning, potentially without thinking about it,” Cohen Silver says.
Social networks are also battlegrounds for spreading misinformation. “Russia has been waging a social media and misinformation war for the past 10 to 12 years,” Steinhauer says, and that has only escalated during its invasion of Ukraine. For example, Ukrainian officials warned that Russia would likely spread false information suggesting that Ukraine had surrendered, Reuters reported.
The technology and culture website Input also recently investigated Instagram pages that appear to feature “on-the-ground” posts from Ukrainian journalists, but are actually run by people thousands of miles away, including a 21-year-old man in the U.S.
Social media can be used productively during crises. Ukrainian President Volodymyr Zelenskyy has used it to speak directly to citizens and foster strength and solidarity among them. Social platforms have also helped Ukrainian people share their realities with the world (including people in Russia who, because of misinformation, don’t believe the war is happening), contact family members, and find resources and support as the crisis unfolds.
But the spread of fake news, and the constant possibility that online materials have been altered or stripped of crucial context, can affect mental health by chipping away at our senses of reality, says Mary “Masha” Mykhaylova, a licensed clinical social worker who lives in San Francisco and was born in Ukraine. “Holding in mind the possibility that you’re going to come across something that’s emotionally manipulative and untrue can have a psychological toll,” she says. One timely example is misinformation’s link to poorer mental health during the ongoing COVID-19 pandemic. A study published recently in JAMA Network Open, which examined mental health during the pandemic, found a link between reporting symptoms of depression and believing vaccine misinformation (though the researchers couldn’t determine if one was causing the other).
The Ukrainian crisis follows two years of almost non-stop bad news, and fake news, about the pandemic, along with countless stories about climate change, racism, inequality, and other emotionally weighty issues. Studies suggest that news coverage of the pandemic has contributed to mental distress—and adding yet another difficult topic to the mix can worsen those feelings, Cohen Silver says. Her research has also shown that people who are prone to anxiety are more likely to seek out crisis coverage, potentially “fuel[ing] a cycle of distress…from which it’s very difficult to extricate oneself.”
It can be useful for anxious people—and anyone, really—to turn off the screen and walk away. Based on her research, Cohen Silver says she has chosen to read about the conflict in Ukraine rather than viewing images or videos that could be psychologically damaging.
But for people like Mykhaylova who have personal ties to Ukraine, “abstaining from the news and social media doesn’t feel like an option,” despite the drawbacks, she says. “I feel more calm and less disoriented when I’m engaging with what’s going on, especially if it’s content made by Ukrainians. It can definitely be disturbing and enraging…but my reaction feels like a righteous response.”
Lubkova agrees, noting that—while seeing photos and videos from the war is difficult—it’s sometimes harder to stomach the idea that others don’t seem to care.
Still, Mykhaylova says it’s important to set limits on the amount of time spent watching the news and checking social media. That limit will vary from person to person, and maybe even from day to day, but staying informed shouldn’t come at the expense of sleep, food, or time outside, she says. Seeking therapy can help, too.
Steinhauer, the social-media author, says to remember that the compulsion to constantly refresh social media is, in part, “a byproduct of platforms and devices that have been purposefully built to be addictive.” More important than getting by-the-minute updates, he says, is staying engaged in the response to the crisis, whether that means donating money to organizations that are supporting Ukrainians, writing to representatives, or supporting people in your community who have ties to Ukraine. Those positive actions “could be a substitute for the doom-scrolling that the devices and the platforms draw us into, especially when there are these calamitous moments that require all of us to stand up and pay attention.”
Shalashenko, the therapist in Odessa, echoes that message. “I want the whole world to help us survive through this,” she says through a translator, “and stop this nightmare.”
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Write to Jamie Ducharme at jamie.ducharme@time.com