Society
How Antidepressants Have Become a Lifeline in Russia
November 8, 2024
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Rustam Alexander
Melbourne University and author of Red Closet: The Hidden History of Gay Oppression in the USSR
Historian Rustam Alexander chronicles how Russians have gradually come to view psychological and psychiatric issues as socially acceptable topics. With the war in Ukraine dragging on, demand for antidepressants in Russia has jumped.
A poster explaining that depression is not "laziness and melancholy" and listing symptoms of depression like loss of interest in daily activities, sleep disturbances, problems with concentration, etc. Source: VK
Recent media reports indicate a growing number of Russians turning to antidepressants, with pharmacies running low on popular medications like Prozac. This trend is hardly surprising given the backdrop of the ongoing war in Ukraine, the experience of “partial mobilization” and the general uncertainty and anxiety about the future. The return of soldiers from Ukraine is expected to drive a further rise in antidepressant use, as many of them are likely to face serious psychological issues, including adjustment disorders, post-traumatic stress disorder and other related conditions.
According to a recent study conducted by Kontur Market, which offers management and automation solutions for small business, Moscow has had the highest increase in antidepressant use: in the first half of 2024, sales grew 18% versus the second half of 2023, from 109,062 to 128,609 units. St Petersburg ranked second for antidepressant sales growth, with a 17% increase (from 26,688 to 31,316 units). Sverdlovsk Region – where Ekaterinburg is located – came in third, posting a 14% rise in sales (from 28,607 to 32,653 units).
To understand that Russians are increasingly turning to antidepressants, one need not rely on statistics – simply Googling “antidepressanty v Rossii” (“antidepressants in Russia”) reveals a wealth of evidence pointing to the growing demand for these medications.
From Soviet wariness to post-Soviet normalization
During the Soviet era, the notion of mental illness, including conditions such as depression, anxiety and more severe disorders like schizophrenia, was heavily stigmatized. Soviet people typically avoided seeking psychiatric help, as a mental diagnosis was considered shameful and could severely impact their lives. For instance, individuals diagnosed with schizophrenia were often excluded for life from skilled positions. To make matters worse, Soviet psychiatry suffered due to its misuse by the authorities as a weapon against dissidents.
After the collapse of the USSR, many Russians still distrusted psychiatrists. Some popular journals even tried to raise people’s awareness about the virtues of psychiatry and reassure their readers that seeking help from a psychiatrist would not result in being locked up in a psychiatric asylum.
For example, in May 1997, the popular journal Ogonek wrote:
Most of us, even if we suspect we might be depressed, avoid going to a psychiatrist for fear of being labelled “abnormal” by our acquaintances. In contrast, in America, where people prioritize their mental health, a psychiatrist is often viewed as a family’s first ally. Our negative perception of psychiatry developed during a time when it was misused to suppress dissent. Under the new law “On Psychiatric Assistance and Guarantees of Citizens’ Rights in Its Provision,” a doctor cannot take any steps regarding your treatment without your consent. You are free to leave at any time; they have no right to detain you.
Things began to change in the 2000s. During this period, mental health and psychotherapy emerged as prominent topics on popular television shows. It’s important to note that the post-Soviet normalization of previously stigmatized issues was linked partly to the rise of TV entertainment. For instance, the topic of sex, which had remained relatively taboo, started to be demystified with the emergence of popular shows like Sex with Anfisa Chekhova and Elementary Sex, along with other talk shows where hosts and participants openly discussed their sex life.
Mental health issues began to be destigmatized in a similar fashion.
According to a recent study conducted by Kontur Market, which offers management and automation solutions for small business, Moscow has had the highest increase in antidepressant use: in the first half of 2024, sales grew 18% versus the second half of 2023, from 109,062 to 128,609 units. St Petersburg ranked second for antidepressant sales growth, with a 17% increase (from 26,688 to 31,316 units). Sverdlovsk Region – where Ekaterinburg is located – came in third, posting a 14% rise in sales (from 28,607 to 32,653 units).
To understand that Russians are increasingly turning to antidepressants, one need not rely on statistics – simply Googling “antidepressanty v Rossii” (“antidepressants in Russia”) reveals a wealth of evidence pointing to the growing demand for these medications.
From Soviet wariness to post-Soviet normalization
During the Soviet era, the notion of mental illness, including conditions such as depression, anxiety and more severe disorders like schizophrenia, was heavily stigmatized. Soviet people typically avoided seeking psychiatric help, as a mental diagnosis was considered shameful and could severely impact their lives. For instance, individuals diagnosed with schizophrenia were often excluded for life from skilled positions. To make matters worse, Soviet psychiatry suffered due to its misuse by the authorities as a weapon against dissidents.
After the collapse of the USSR, many Russians still distrusted psychiatrists. Some popular journals even tried to raise people’s awareness about the virtues of psychiatry and reassure their readers that seeking help from a psychiatrist would not result in being locked up in a psychiatric asylum.
For example, in May 1997, the popular journal Ogonek wrote:
Most of us, even if we suspect we might be depressed, avoid going to a psychiatrist for fear of being labelled “abnormal” by our acquaintances. In contrast, in America, where people prioritize their mental health, a psychiatrist is often viewed as a family’s first ally. Our negative perception of psychiatry developed during a time when it was misused to suppress dissent. Under the new law “On Psychiatric Assistance and Guarantees of Citizens’ Rights in Its Provision,” a doctor cannot take any steps regarding your treatment without your consent. You are free to leave at any time; they have no right to detain you.
Things began to change in the 2000s. During this period, mental health and psychotherapy emerged as prominent topics on popular television shows. It’s important to note that the post-Soviet normalization of previously stigmatized issues was linked partly to the rise of TV entertainment. For instance, the topic of sex, which had remained relatively taboo, started to be demystified with the emergence of popular shows like Sex with Anfisa Chekhova and Elementary Sex, along with other talk shows where hosts and participants openly discussed their sex life.
Mental health issues began to be destigmatized in a similar fashion.
“Inspired by the US talk show Dr Phil, where clinical psychologist Dr Phil McGraw offers advice to guests with relationship, addiction and mental health problems, Russian entertain television executives sought to create a similar program for a domestic audience.”
Dr Andrei Kurpatov and a patient on a TV show. Source: YouTube
In 2003, the channel TNT began to develop such a show. While searching for a host, the producers were introduced to psychotherapist Dr Andrei Kurpatov. He was initially excited about the idea and agreed to participate in the project. However, he soon withdrew, as he wanted to feature real people on the show, while the producers preferred actors.
Other connections brought Kurpatov to a less popular channel, Domashny, where he hosted a psychotherapeutic show No Problems, followed by We’ll Solve Everything with Dr Kurpatov from May to December 2005. The next year, he moved to Channel One, one of Russia’s two major state-controlled networks, where he began hosting the program Doctor Kurpatov.
While working on television, Kurpatov also authored a series of popular self-help books on anxiety, panic attacks, depression and other mental health disorders. Each of these books, featuring his well-known face on the cover, quickly became a bestseller. In them, Kurpatov explained the mechanisms of depression and anxiety, offered guidance and useful tips, and, most importantly, widely discussed the benefits of antidepressants – medications to which many Russians still had an aversion. As Kurpatov’s popularity and the sales of his books grew in the 2010s, so too did acceptance of mental health issues in Russian society.
With the rise of YouTube, discussions around mental health began to steadily proliferate. Psychiatrists from Moscow, St Petersburg and other cities – many of whom lacked the connections that Kurpatov had in the entertainment and publishing industries – started making their own educational videos on mental health topics. They gained followers, and viewers began sharing their experiences in the comments section about visiting psychiatrists and seeking help.
Psychological support as a familiar part of everyday life
Similarly, some Russians, like their counterparts in the West, began documenting their day-to-day experiences with antidepressants in video diaries. Those seeking medical assistance also turned to online forums, where they exchanged experiences with various antidepressants and offered each other support on the road to recovery. Furthermore, other media personalities promoting conversations about mental health, such as psychologist Mikhail Labkovsky, appeared on the horizon.
Gradually, younger generations of Russians, influenced by Western ideas and lifestyles that emphasize the importance of psychotherapy, began to see it not as a sign of weakness but as a valuable form of self-care.
Other connections brought Kurpatov to a less popular channel, Domashny, where he hosted a psychotherapeutic show No Problems, followed by We’ll Solve Everything with Dr Kurpatov from May to December 2005. The next year, he moved to Channel One, one of Russia’s two major state-controlled networks, where he began hosting the program Doctor Kurpatov.
While working on television, Kurpatov also authored a series of popular self-help books on anxiety, panic attacks, depression and other mental health disorders. Each of these books, featuring his well-known face on the cover, quickly became a bestseller. In them, Kurpatov explained the mechanisms of depression and anxiety, offered guidance and useful tips, and, most importantly, widely discussed the benefits of antidepressants – medications to which many Russians still had an aversion. As Kurpatov’s popularity and the sales of his books grew in the 2010s, so too did acceptance of mental health issues in Russian society.
With the rise of YouTube, discussions around mental health began to steadily proliferate. Psychiatrists from Moscow, St Petersburg and other cities – many of whom lacked the connections that Kurpatov had in the entertainment and publishing industries – started making their own educational videos on mental health topics. They gained followers, and viewers began sharing their experiences in the comments section about visiting psychiatrists and seeking help.
Psychological support as a familiar part of everyday life
Similarly, some Russians, like their counterparts in the West, began documenting their day-to-day experiences with antidepressants in video diaries. Those seeking medical assistance also turned to online forums, where they exchanged experiences with various antidepressants and offered each other support on the road to recovery. Furthermore, other media personalities promoting conversations about mental health, such as psychologist Mikhail Labkovsky, appeared on the horizon.
Gradually, younger generations of Russians, influenced by Western ideas and lifestyles that emphasize the importance of psychotherapy, began to see it not as a sign of weakness but as a valuable form of self-care.
“By the end of the 2010s, seeking therapy to enhance one’s quality of life and address personal challenges had become increasingly common among young Russians.”
Bloggers and celebrities who openly discussed their therapy experiences helped normalize the conversation. Some celebrities even launched their own shows on mental health on Instagram. Unsurprisingly, this growing awareness and acceptance of the mental health agenda existed primarily in larger cities, typically with higher wages, better living standards and more access to quality medical services. In more remote areas, meanwhile, mental health issues remained largely unrecognized, and discussions about psychotherapy and the use of antidepressants are still often stigmatized.
During the 2010s, attitudes toward antidepressants among younger Russians also began to shift, with medications like Zoloft, Prozac and Paxil and their cheaper Russian-made generics becoming popular buzzwords on Instagram, Telegram and YouTube. Still, the topic remains controversial, even to this day. A case in point is Bupropion, an atypical antidepressant and smoking cessation medication commonly prescribed in the West.
In the spring of 2019, several criminal cases were launched against Russians who ordered Bupropion from abroad, with some facing lengthy prison sentences of up to 20 years. As the accused later learned, Russian law enforcement had classified Bupropion as a “derivative of a narcotic substance” due to its resemblance to the banned drug Ephedrone, even though Bupropion does not appear on any official lists of prohibited substances. Russian psychiatrists have voiced concerns that this ambiguous legal status of the drug complicates their work and advocated for the legalization of Bupropion’s use, yet their appeals have largely gone unheard.
Still, by the early 2020s, Russian society had become mostly accepting of antidepressants. The apprehension surrounding their use has faded, especially in the context of the ongoing war in Ukraine. And this trend is likely to persist as the war drags on. As many Western cultural influences – ranging from the acceptance of LGBTQ+ rights and “child-free ideology” to various forms of pop culture – have been denounced and increasingly banned in Russia, it’s fortunate that this growing anti-Western sentiment has not extended to mental health treatments, particularly antidepressants, most of which are still imported. At least for the time being, Russians have something to cope with the anxiety and grief caused by the war.
During the 2010s, attitudes toward antidepressants among younger Russians also began to shift, with medications like Zoloft, Prozac and Paxil and their cheaper Russian-made generics becoming popular buzzwords on Instagram, Telegram and YouTube. Still, the topic remains controversial, even to this day. A case in point is Bupropion, an atypical antidepressant and smoking cessation medication commonly prescribed in the West.
In the spring of 2019, several criminal cases were launched against Russians who ordered Bupropion from abroad, with some facing lengthy prison sentences of up to 20 years. As the accused later learned, Russian law enforcement had classified Bupropion as a “derivative of a narcotic substance” due to its resemblance to the banned drug Ephedrone, even though Bupropion does not appear on any official lists of prohibited substances. Russian psychiatrists have voiced concerns that this ambiguous legal status of the drug complicates their work and advocated for the legalization of Bupropion’s use, yet their appeals have largely gone unheard.
Still, by the early 2020s, Russian society had become mostly accepting of antidepressants. The apprehension surrounding their use has faded, especially in the context of the ongoing war in Ukraine. And this trend is likely to persist as the war drags on. As many Western cultural influences – ranging from the acceptance of LGBTQ+ rights and “child-free ideology” to various forms of pop culture – have been denounced and increasingly banned in Russia, it’s fortunate that this growing anti-Western sentiment has not extended to mental health treatments, particularly antidepressants, most of which are still imported. At least for the time being, Russians have something to cope with the anxiety and grief caused by the war.
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