Ukraine War's Hidden Toll: Two Million Casualties and a Nation's Mental Health Crisis

Two million. That's the estimated number of Ukrainian and Russian soldiers killed, wounded, or missing since Russia's full-scale invasion began nearly three years ago. Behind this staggering figure are families like that of Anastasiya Buchkouska, a 20-year-old student who now visits her father's grave in western Ukraine.

Brushing snow from his headstone at Lychakiv Cemetery in Lviv, she reflects: "Trauma doesn't define us. We're defined by how we overcome trauma, how we fight in these circumstances, how we support each other."

When Hope Turns to Grief

Buchkouska's father was called up almost immediately after Russia launched its invasion on February 24, 2022. A former military serviceman, he was sent to the front lines with minimal preparation. Contact with his family became sporadic—brief messages and fleeting signs of life until September 2022, when everything went silent.

For seven months, he remained officially listed as missing. Buchkouska held onto hope while fearing the worst. When confirmation of his death finally came, she said she had little choice but to "deal with it." This was war, after all.

Her uncle died around the same time. She focused on caring for her inconsolable grandmother, inventing conversation topics and small activities to provide distraction. In quiet moments, she broke down but reminded herself not to "overthink things."

A Cemetery Running Out of Space

Lychakiv Cemetery, where Buchkouska's father lies buried, tells its own story of the war's toll. The surge in deaths in early 2022 forced authorities to expand beyond the cemetery's original boundaries. That additional space is now itself running out of room.

Precise casualty figures remain difficult to verify, but according to the Center for Strategic and International Studies, nearly two million Ukrainian and Russian soldiers are estimated to have been killed, wounded, or gone missing since the invasion began.

Russia alone is estimated to have suffered almost 1.2 million casualties, including at least 325,000 deaths—losses exceeding those of any major power since World War II. Ukraine's military casualties are estimated between 500,000 and 600,000.

The UN Human Rights Monitoring Mission confirmed that 2,514 civilians were killed and 12,142 injured in Ukraine in 2025 alone.

Living in 'Complete Uncertainty'

Beyond the battlefield casualties lies a deeper crisis. Sabine Freizer Gune, UN Women's representative in Ukraine, said in late 2025 that "pretty much everybody" in the country "has some mental health issue."

Kseniia Voznitsyna, a neurologist who founded Ukraine's first mental health rehabilitation center for veterans, explains the psychological burden: "Living during a war means living in complete uncertainty. We cannot plan not only our day, but also the next few hours."

Oleksandra Matviichuk of the Nobel Peace Prize-winning Center for Civil Liberties describes the constant fear: "There is no safe place in Ukraine where you can hide from Russian missiles."

People in eastern Ukraine and major cities like Kyiv, Kharkiv, and Odesa are regularly awakened by mass strikes. During winter months, Russian forces often target infrastructure, leaving millions without electricity, heat, or reliable water supply.

The Economics of Trauma

The war's psychological impact extends beyond immediate safety concerns. Voznitsyna points to fundamental uncertainties about the future: "How the economy will hold up remains uncertain. Whether people will have jobs with decent pay—these are open questions."

The combination of physical destruction, economic disruption, and psychological trauma creates a complex web of challenges that will outlast any ceasefire. Many Ukrainians live with amputations and psychological wounds that will require years of rehabilitation.

Resilience Under Fire

Despite the overwhelming circumstances, Buchkouska's words at her father's grave reflect a resilience forged under pressure. "If the war ends, we will all be happy," she said matter-of-factly, "but we cannot do anything about the people who died, we cannot make them come back to life."

Her eyes showed faint signs of tears, but her voice remained steady. "Now, more than ever, we feel acutely what it means to be human."