For the most part, Russian markers of depression align with classic DSM-V symptoms. For example, Russians who feel depressed may suffer from sleeplessness, appetite disturbances, difficulty concentrating, and suicidal ideation (APA, 2013). Furthermore, like many Americans with depression, Russians often experience severely reduced moods during an episode (Hsieh, 2015).
However, there are some symptoms that seem relatively specific towards Russian culture. Many Russians living with depression tend to binge drink frequently to cope with mental distress (Hsieh, 2015). To add, Russians more considerably distrust others and avoid engaging with loved ones when depressed (Hsieh, 2015). Lastly, research suggests that the risk of depression in Russia positively correlates with material deprivation, being single, and reduced education (Bobak et al., 2006).
The concept of depression is relatively new in Russia. During the USSR period, the country was notable for severely abusing psychiatry (Brown 1989). Thus, plenty of Russians still fear mental disorders. A study conducted by psychologist Karine Nersessova indicates that Russians tend to view those with depression as 'weak-willed' and leading an 'immoral lifestyle'.
Additionally, Dietrich and colleagues (2004) found that Russians regularly attribute causes of depression—and other mental illnesses—to familial discord and problems with socializing. However, Turvey and colleagues (2012) found that, compared with U.S. participants, Russians are more likely to identify the cause of depression as "personal weakness".
Russians are less likely to seek professional help or turn to someone they trust when they feel depressed. Conversely, they are more likely to deal with psychological anguish on their own (Nersessova, 2019). That said, the chosen coping mechanisms for managing depression sometimes worsen symptoms rather than improve them. Such behaviors include heavy drinking and self-isolation.
Psychodynamic therapy, behavioral psychotherapy, and cognitive psychotherapy are common treatments in Russia. Psychodynamic therapy focuses on the inner psychological conflicts in an attempt to help the patient recognize the cause of their depression and resolve it constructively while behavioral psychotherapy focuses on addressing the problematic behaviors of the patient. Cognitive psychotherapy is a synthesis of the other two, and also focuses on breaking negative thought patterns.
In addition, there is a close focus on each patient's individual symptoms, attitude to life, and expectations due in part to the fact that Russian physicians have more time with patients than American physicians. (Simakova, 2003). However, many patients (~80%) suffering from Major Depressive Disorder (MDD) end up being treated by general practitioners rather than psychiatrists or therapists due to skepticism about the disorder (Simakova, 2003)
Though Russian psychiatric reviews have found antidepressants to be effective and essential, (Smulevich et al., 2015) many modern antidepressants are often not available due to cost, so physicians must treat patients without them or use older brands (Simakova, 2003)
There isn't an agreed upon Russian model due to depression only being recently recognized as a sickness (Simakova, 2003)
Counseling is a small field and much of it must be covered by general practitioners (Ivanov, 2016)
Therapists tend to focus on one strategy exclusively because of the limited scope and funding of counseling education programs (Ivanov, 2016)
General stigma surrounding mental illness remains quite high despite efforts to normalize it in the public eye (Ivanov, 2016)