Author’s note: I wrote this essay in Russian in 2019, shortly before the world as we knew it began to fall apart—first with the Covid pandemic, then, most abruptly, with the full-scale Russian invasion of Ukraine, which opened a Pandora’s box of militarism and violence. Back then, my intention was not to diagnose society but, on the contrary, to find a way out of a certain diagnosis that seemed to be so omnipresent: to reflect on a rather personal experience of depression from a broader perspective, approaching mental suffering as a social fact. Now, in 2026, when the essay has finally been translated into English, some of its points seem dated, while others have become even more pronounced. It is as if, during the pandemic, with its disciplinary practices of self-isolation, history briefly froze before accelerating again toward the extremes of war. Our mental states and disorders change accordingly, and the dynamics of these changes vary worldwide, but the structure of the clinical triangle, described in this essay—a psychic geometry of identification with the symptom—remains the same.
If depression was perhaps the paradigmatic diagnosis of the 2010s, today its place seems increasingly occupied by ADHD and, more broadly, neurodivergence. Experiences as common as distraction, procrastination, forgetfulness, fluctuating productivity, and difficulty organizing time are increasingly translated into a diagnostic vocabulary. A diagnosis thus functions not only as a medical category but also as a language of self-description, offering an explanation for why one finds it difficult to live and work in the way one is expected to.
Meanwhile, the old state of collective depression reveals its long-term effects in the new world of war. There is no direct connection between politics and psychic life, but if the metaphor of mental disorder can still be applied to a society, then now, looking back from 2026, I can only say that Russia was sick long before the invasion of Ukraine. Coming out from its latent state in 2010s, when it was covered up by Putin’s “stability,” and gradually moving towards its terminal stage, Russian depression culminated in a suicide in 2022. The beginning of the war against Ukraine was the collective suicide of Russian society. We are dead now.
It is hard to speak from the perspective of the dead, but it still makes sense. Why? Because, thinking globally, we are facing the rise of fascism—but not everywhere, and not everywhere to the same degree. Yes, in Russia one can no longer simply go out and reclaim the city, although things like solidarity become all the more valuable when the possibilities of acting together have been blocked by the repressive state apparatus. But recipes that have already expired in one place may still work elsewhere. After all, it is never too late to break the clinical triangle.
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I check my social networks and almost every day find posts by people suffering from depression. Some comment that they are also sick, while advising: walking in the park, jogging, alcohol, sex, a beach vacation, psychotherapy, medication. It’s easy to hurt those who are depressed with a random word. Expressions of solidarity, pep-talk attempts, or well-intentioned advice could get interpreted as devaluing the experience of mental suffering shared by the author. Leave me alone, you don’t get it.
Every era seems to recognize itself in a particular form of mental illness. In Freud’s time, it was hysteria; after Freud, it was neuroses and psychoses, then starting in the second half of the twentieth century, schizophrenia became a popular diagnosis. Deleuze and Guattari succeeded in capturing its essence: Schizophrenia is not an illness but the psychic reality of the capitalist mode of production. Everything flows. Capitalism is a flow of delirium; in order to fit into it and not go mad, one has to, in a sense, get ahead of it; a schizophrenic person is ahead of the game.
Schizophrenia was also widespread in the late Soviet Union. This diagnosis was often used in psychiatry, including punitive psychiatry. It was very easy to get labelled a schizophrenic, but this mental illness also received a paradoxical nonconformist recognition. Against the backdrop of a horrifically normative, officious Era of Stagnation, one could at least be a little bit weird, freaky, eccentric, or offbeat. There was something punk and, at the same time, highly spiritual about the schizophrenic youth of the 1980s, “in a room with a white ceiling, with a right to hope.”
After the fall of the USSR, it became common to hide psychic pain, as well as every other expression of weakness. In the nineties, the time of my youth, one had to be or seem strong, cool, tough, and resilient. That thuggish, scumbag era couldn’t stand the freaks; we were learning to elbow our way in. In the early Putin years, a wave of positivity hit us. Smile, everything will be great, just wonderful! I worked part-time as a model scout at an agency at the time. At a casting session, they checked the girls’ teeth first. Remember how the cover models had huge smiles then? Nowadays nobody is smiling; modern models wear a proud frown.
During the positivity wave of the 2000s, sadness was commonly treated with yoga and meditation. Russians started going to Goa to dance to trance and find themselves. Downshifting became a way to reject career ambition in favor of personal comfort and living in a warm country with cheap infrastructure. This generation—roughly the parents of those who are now aged sixteen to twenty—is criticized by Alexander Gorchilin in the movie Acid. The boy in the movie grows up and doesn’t know what to do; he just wastes his life. Meanwhile, the mom dedicates herself to self-improvement in warmer climates: We don’t care for other people’s problems, don’t ruin our karma. The same generation is depicted in Andrey Zvyagintsev’s film Loveless: Each parent is self-absorbed, living in their comfort zone while their children simply disappear.
It’s not that there was no depression during the positivity wave—quite the opposite. Today’s epidemic of depressive disorders speaks to how it was there but in a state of displacement. Positivity was the writing on the wall (in red), and the new generation easily recognizes the hypocrisy. Why smile if everything is understood? Why make all this extra effort with the body to cover up the soul? Why try passing off black as white? We don’t want to smile, not even on Insta, we are coming out of complex asanas, letting ourselves go—and it kicks in right away.
Today everyone knows that depression is a serious and dangerous disease—even your boss at work has to understand that. You have the right to take a day off. Along with the medicalization of depression, it’s also getting commercialized. The psychotherapist and the medications form an arrangement, which contains the inner world of the person who considers themself a patient—and here already we are picking an identity from a list of diagnoses. I have this particular disorder specified by X, my psychotherapist is Y, my medication is Z. The clinical worldview consists of triangles: In one corner is the therapist, in another the medication, and in the third the subject as a patient. Nothing else exists in this world, only symptoms and effects—both side effects and those that are expected. And it may appear that everything is functioning, but something here is off.
What exactly is off was explained by Mark Fisher in 2009: Medications cure the effects but not the causes. We know enough about the brain chemistry of depression to interfere with it using pills, but we would rather not ask what caused this particular chemistry in the first place. The medicalization and commercialization of mental illness depoliticize it. What we tend to consider our individual unhappiness is, in fact, our common misery. But that is the hardest thing to admit, because when depressed, a person is, in a way, locked up in their “I.” We fail to love. Another word for that is alienation. Leave me alone, I don’t need your advice; my suffering is not comparable to yours. Meanwhile, even the calls for not devaluing our depressive experience are formulated in market terms: They imply that experience has a price and can be devalued, just like any commodity.
Foucault referred to the medicalization of mental illness as “psychiatric power.” Today, in contrast to the anti-psychiatry movement that started in the sixties and seventies, we are completely at the mercy of this power. Foucault’s Madness and Civilization is a book that should get a sequel. Previously, the treatment was forced; now we dutifully go see the therapist of our own volition and with something close to pride announce that our bipolar disorder is in the depressive phase. Why do we do that? Because we have to identify with something, but with what? With a job we don’t like? With a homeland that tortures us? Instead, I identify myself with my self, with my pain, with my diagnosis, in this way trying to create a closed-loop tautological structure: A=A, meaning I=I.
Overcoming depression on an individual level is only possible by breaking this closed-loop structure of identity: to forget oneself, to come out and greet what is external, to allow oneself to be taken over by something much more significant and interesting than myself. “I” is not even an object but an empty category—there is nothing interesting in there; everything of interest begins with the Other. A bite of bread, a breath of air—all of it is bigger and more important than “I.”
However, there’s also the social level, and there depression is similar to mutual responsibility: Sure, we may crawl out of ourselves individually, or simply get stabilized while remaining patients and not leaving our clinical triangle (therapist-medication-patient)—but depression remains as the general backdrop. It is structurally embedded. Our very ancient brain simply refuses to play by the rules of a system with which it has not so much existential as ontological disagreements. Kafka in The Metamorphosis finds the best image for that: Gregor Samsa wakes up in his bed as a gigantic insect—and that’s the way to escape from work. Therapists and medication could have made him go where he does not want to go, but when the chemical treatment’s effect decreases, he will wake up again on his round back with a multitude of tiny, sticky legs.
The further we retreat into our selves and our individuality, walling ourselves off from what is external, avoiding love, camaraderie, and solidarity, giving something to others only on the condition of receiving it in return, the more we will get bogged down in a depressive reality, a world of alienated individuals, which is splitting up into clinical triangles again and again.
Genuine therapy is a radicalization of our dissent into collective action: not some hypocritical, forced socialization imposed from above, or from somewhere on the side, but going out into the street, or down to the underground (when going out is not possible anymore), fighting for the city, for the forest, for other people that are in trouble. It is an experience of going beyond oneself, an experience which is impossible to devalue because it is not individual but communal, and as such it is invaluable. A shared joy, easily translated into any language, because we managed—or at least we tried.
Translated from the Russian by Maria Melititskaya
