“One day he hit me so hard that he broke my cheekbone.”

It all started when I was 17. I fell in love - as it turned out much later, with a manipulator and sociopath. Our toxic, as it is now fashionable to say, relationship lasted nine years. Over the years, I had two abortions, we tried to break up countless times - the reason was his infidelity, spree, even beatings. One day he hit me so hard that he broke my cheekbone. I left, but came back - I don’t know why.

That's how we lived. I latently understood that this was unhealthy and not healthy, and at some point I decided to turn to a psychologist.

This was my first experience, I went to the appointment in full confidence that they would help me.

But at the reception, this lady (I can’t call her a doctor), having learned that I work in a sex shop, immediately switched to “you”, then advised me to change jobs, “drove” over my mother and, as a cherry on the cake, stated that men like me only want to “fuck and throw away.”

“I decided that everything was to blame for my laziness, stupidity and worthlessness”

I no longer tried to go to psychologists. I just ran away - to another city, to Kyiv. For a year and a half I felt very good - every awakening brought happiness, even when outside the window the revolutionaries began to seize the prosecutor's office. Then I had to return - to St. Petersburg and to my evil genius. We began to live together - already calmly, with classic borscht and movies on weekends. I was a freelancer, I didn’t need a job. To friends too - during the “emigration” the circle of friends narrowed from the size of the equator to three people who started families. The ground was slowly disappearing from under my feet, and I almost didn’t notice it - I wasn’t upset that in February of this year he finally left, we broke up. And I wasn’t happy. It seems like I stopped feeling emotions altogether.

My average day began to be spent in bed. I woke up, turned on the TV and ordered food to take home. Not because I wanted to eat - I didn’t feel hungry. I simply stuffed everything into myself (twice as much as usual) under the pictures flashing on the screen - their meaning did not reach me, nor did the taste of the food. There were tumbleweeds of dust flying around the house - I didn’t care. It was as if I was being crushed by a concrete slab, I physically couldn’t get up - well, except to go to the toilet, and only when it was really hot.

From time to time, friends still dragged me to some parties, concerts - I agreed and went, but there was no effect. Nothing made me happy, although I used to like both music and company.

Of course, I tried to find the reason, and, as it seemed to me, I found it: I decided that everything was to blame for my laziness, weakness of will, stupidity, uselessness, and the list goes on. Here it is - a trap cleverly set by depression. You convince yourself of your own worthlessness, which makes you lose the last remnants of the will to live. There is no point in getting off the couch anymore.

By the end of the summer, my memory and attention began to fail: I could not even concentrate on washing one plate. I wasn’t scared - this is also an emotion, and I no longer had them. But my friend was scared - after seeing how I lived, she did not tell me that I needed to “get ready and go for a walk” and give other “useful” advice. She also took a course of antidepressants, so she simply sent me to a psychiatrist.

“I was ashamed: a young healthy girl turned into a vegetable”

In the psychoneurological department, the very first question from the doctor put me into a stupor. “What do you even care about”? Never mind! It was very embarrassing to describe my condition - a young healthy girl turned into a vegetable. And then we started talking about Kyiv, about my damned man - and I burst into tears. I talked about familiar things for an hour and a half, choking on tears. At the end of the conversation, the doctor said: “Well, what can I tell you?” “Go to work and don’t give people brains,” I mentally continued for him. And she turned out to be wrong. I was sent to a day hospital in psychiatric hospital named after Skvortsov-Stepanov with a diagnosis of adaptation disorder.

For two months I went there as if for work: electric sleep, antidepressants, different types psychotherapy. The effect appeared immediately, but not from the treatment: being among real crazy people invigorated me, of course. An unforgettable feeling when you sit in line for fluorography among comrades in straitjackets, and then on rounds you listen to stories like “everything is fine today, the voices have disappeared.”

“During art therapy, I realized that I didn’t just need support. I can strangle this support.”

After a couple of weeks, the therapy began to take effect. I was struck by the body-oriented one: it’s amazing how performing, at first glance, idiotic tasks like “imagine that you are a grain” or “image a dog” can open your eyes to own models behavior. I realized that it was with great difficulty that I began to make contact, and that I was simply hiding “in the house” from solving problems. During art therapy they asked me to mold myself in the form of a plant - I sculpted a bindweed, and then it turned out that I not only need constant support and support, but I can strangle this support - good version, actually explains a lot.

There were also individual sessions with a psychotherapist. Thanks to this magical woman: having started to work through my suffering on the subject of a forced move and a nine-year love epic, she eventually unearthed a huge number of things that had always prevented me from living. Thanks to her, I learned to say “no”, not to create illusions, to appreciate and listen to myself. After classes, I no longer wanted to bury myself in a blanket; I began to want to do something. The concrete slab has disappeared. I realized that for two years now I haven’t woken up not only in a good, but in a normal mood, without self-hatred! And suddenly she began to smile inside and out. Once a passer-by even said: “Girl, you are so happy, stay like that always.” But nothing special happened, I just became myself again.

I sat in the living room with my stunned parents, social worker and a nurse. I just found out that I have a mental disorder.

Just a week ago I was at a professional training. But I had to go home because I was overcome with anxiety and became increasingly depressed. For several days I wandered aimlessly around my parents' house.

Like most people, I tried to get rid of sad thoughts as quickly as possible. But this time I couldn't do anything about this terrible depression. I couldn't concentrate even on primitive television series. I listened to the songs and didn't understand what they were about. I thought I was going crazy. I was watching TV, but I saw something of myself: God, the devil, my boss and colleagues. Such hallucinations are one of the signs of psychosis, which develops as a result of deep depression. It was as if I had fallen out of reality.

The diagnosis of psychosis changed my life. I used to think that “mentally ill person” was the same as “psychopath.” I was sure that all mentally ill people are aggressive and antisocial. But on by example I learned that mental disorder is a perception of reality different from the perception of others, which is often accompanied by hallucinations.

When they told me that I had psychosis, I thought that I was now a danger to society, and I became even more scared. “I may have already done something terrible, but I don’t remember it,” I thought then.

One of my neighbors believed that he was the devil, and another said that he would save the world from evil

I spent ten days in a mental hospital. All the patients and nurses were the heroes of a fantastic story that arose in my sick brain. Nurses seemed like messengers to me evil forces, and my stay in the hospital was a punishment for my sins. One of my neighbors believed that he was the devil, and another said that he would save the world from evil.

A few days later, they found therapy for me, and I was able to return to reality. I started listening to doctors and reading articles about psychosis. I learned that many patients, like me, believe that mental illness is accompanied by psychopathic manifestations. Journalists and writers use the words “mentally ill” and “psychopath” thoughtlessly. And people who are far from medicine perceive them as synonyms.” For example, maniacs like Freddy Krueger are called mentally ill.

After the psychiatric hospital, my life changed. I went back to work. I am one of the lucky few who love my job. But my life today is completely different from my old life. People who have experienced deep depression often lose faith in themselves and in a happy future. In my hallucinations, I kept seeing a prison with monster nurses. And it seemed to me that it would be like this forever.

Mentally ill people are not dangerous, and the tolerant attitude of others contributes to rapid recovery

After treatment, I was surprised to discover that everything I saw was not really happening. It was as if my brain was mocking me. I was the hero of a thriller and lived episode after episode. Thankfully this terrible movie is over. I left the hospital and began to lead a happy life, which just recently seemed unattainable. After my illness, I began to appreciate my life and the opportunities it gives me.

I'm lucky. I have not had a relapse of the disease since 2014. But for many people they happen regularly. And the misuse and perception of medical terms in society makes these people feel ashamed of their illness. Due to the feeling of guilt that the patient experiences, treatment becomes more complicated and delayed.

I appeal to people to understand and remember that “mentally ill” does not mean “psychopathic, violent, cruel and dangerous.” Mental disorder - internal state when a person perceives reality in a distorted form. I call on the media public figures and simply tell caring people that mentally ill people are not dangerous, and the tolerant attitude of others contributes to a quick recovery.

A series of articles about how I was in a mental hospital, what the rules were there, how I managed to seduce the psychologist there, and what came of it all.

IN last episode We settled on the fact that they took me to my room. I didn’t know anything about the psychiatric hospital then, but now, having all the experience behind me, I think it makes sense to devote a certain amount of text to certain general information about her, so that the reader can understand my further thoughts and actions more clearly. I apologize for the deviation from the main line of the story, but I believe that in this case it is completely justified.

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About the department

Here we need to say a few words about interior decoration and equipment of the department. In general, my department was exemplary. Officially, it seems to be no different from the others, but in reality there are two important nuances:

1. One of the functions of this department is the image component. They bring commissions there, they take beautiful photos, they give him a lot of publicity, etc. Hence the renovation (subjectively terrible, but many people like it), a gym, a relaxation room with a large TV, flowers, carpets and other elements of poor people's show-offs.

I think it's time to comment on the quality of the photographs. It's simple: taking photographs in a psychiatric hospital is strictly prohibited. That's why all the photos are taken very quickly, while no one sees. And there’s no time for a good trick: they didn’t burn it, and that’s fine;)

The ostentatious nature of all this is especially annoying: we have a gym, but no one in their right mind would use it, because you can only wash twice a week. Why can you only wash twice a week? But because the department (or the entire psychiatric hospital, opinions vary here) saves water. Saves water so that you can install some useless TV or a new exercise machine that does not fit into any training scheme. Because you can brag about them, but not so much about clean patients.

Moreover, in the evening, when all life in the department ends (at 17:00), and the most convenient time for training comes, it is closed, because it is not supposed to.

And also, if you really work out there (most people go there either to talk or have privacy with a representative of the opposite sex), a dissatisfied sister-hostess will come and kick you out under the pretext that you are “working out too intensely and might overstrain yourself.” Some of the simulators do not work, and no one even tries to fix them.

Carpets and flowers have their own separate joke. The fact is that they cannot be placed in the department (violation of the rules fire safety). Therefore, regularly there is a madhouse going on in the madhouse - they gather the sick and force them to hide flowers and carpets throughout the psychiatric hospital (yes, you can’t go outside the ward, but you can :)). And then - in the same emergency mode, everyone together, staff and patients, pull them back out. Occupational therapy:)

2. Contingent. They try to hire the most flexible and “adequate” (I think it’s clear why the quotes are there, right?) psychopaths into this department. So that the property is not spoiled and good statistics are given.

There are three types of wards in the department:

1. Regular An eight- or ten-bed ward divided into two blocks. It has no doors (in general, the lack of doors and personal space is one of the most traumatic factors in a psychiatric hospital). In the block, respectively, there are 4 or 5 beds, one wardrobe (enough in summer, not so much in winter), and there is a bedside table next to each bed. There are two such chambers. Initially, I was put in exactly this kind of place.

2. "Average ward". It is considered more prestigious, and everyone tries to get there. There are also four beds, bedside tables, a wardrobe. But there are two important differences: there is a sink (which is convenient in the morning and in the evening, you can stand in a much shorter line for washing ) and TV. The latter is a very dubious factor, because there is a possibility that one of the three neighbors will turn out to be an ardent fan of some Malysheva and other TV nonsense, and will have to endure it: the staff in conflicts about TV always stands on the side of the “TV viewers” ​​(if only they don’t try to watch it after lights out, they’re strict about that). And there’s also a door. True, with glass, so there’s still no privacy, but at least it’s something. I also lay in such a room, but I really got a feel for its features I couldn’t: the sink didn’t work (for show, oh), and I agreed about the TV with my neighbor, and it was turned off (the TV, although the neighbor was given the choice of which of the two I would turn off.) There is only one such ward.

3. VIP chambers increased comfort. There are doors, there is a sink, double rooms. The luckiest people live there alone, but this happens rarely (or for extra money). I also lay in one of these, and I can say that the show, bitch, was here in all its glory. The rooms are, of course, VIP, but there is no ventilation there. The windows cannot be opened (there are simply no handles, plus the staff makes sure that patients do not find/make replacements for them), so the doors have to be kept open constantly because of the stuffiness.

The VIP room looks something like this:

View from the other side:

The same sink that allows you to avoid long lines in the morning, before meals and in the evening before bed:

Start of stay

So, they pointed me to my bed, explained how to use the closet (you can’t put things on top of the closet, you can’t use the shelf to store bags) and the nightstand (it’s forbidden to store food or drinks, things must be folded in a certain way) and left me to settle in. After changing my clothes, I tried to sleep (let me remind you that by the time I arrived at the madhouse, I had already been without sleep for more than a day). Not so! It turned out that it was time for dinner, and whether I wanted it or not, I needed to join him. I protested in every possible way, tried to explain that I was scared, that I would rather sit without food, but the most that I managed to get (that day, as it turned out later, was a very good shift) was permission to come to the dining room after everyone will disperse.

The dining room is an offshoot of the corridor in which the tables are located. Four patients sit at each table:

In my case, there was no one there except a nurse, who carefully showed me where to sit and placed a bowl. All the dishes in the madhouse are metal. So that it cannot be broken and cut with fragments of yourself or your fellow sufferers. Moreover, it is made of a fairly light and soft alloy. Of course, you can hit such a plate or mug, but it’s pointless, it’s better with your fist. That's what it was done for. There are no forks in the madhouse. Even plastic ones are banned and taken away.

Officially, there is no knife either, but in fact there is one. The algorithm is this: if you need to cut something off, for example, sausage (more about where sausage comes from in a mental hospital below), you go to the nurse, ask for a knife, cut it off under her supervision, and then return the device.

So, they put me a bowl of food and politely but persistently ordered (I can’t find another word) to eat.

About food

I think it’s worth saying a few words separately about madhouse food. Those who were in prison or the army (although this is debatable, it depends on the part) will probably not be surprised, but others may be interested. In general, food in this wonderful institution is described by two tags: " Cabbage" And " Saving".

Let's start with the first one. Cabbage. It’s everywhere, in all possible forms: cabbage “with meat” (the quotation marks are appropriate, I’ll explain a little later), “soup” with cabbage, sauerkraut (a pretty good thing, by the way), cabbage in the air. Oh yes, that smell! In winter it’s nothing, but in summer it’s just terrible. If you are unlucky enough to lie in the wards on the catering unit side (and I was unlucky), then the nauseating smell of rotten sauerkraut will haunt you for days on end. If you had the imprudence to go to a mental hospital with long thick hair (yes, that’s exactly what happened), then you simply will not have a chance to hide from him. Literally everything is impregnated with it: clothes, hair, furniture, bed, skin. Let me remind you that you can only wash twice a week.

By the way, the washing process itself is also quite interesting. Officially, washing is carried out twice a week: on Monday there is a “shower”, on Thursday there is a “bath day”. They differ from each other in that during the “bath day” you are given an extra towel. 15 minutes per person are given for washing and washing. This is not enough, especially in the summer, when a lot of things accumulate that need to be washed (simply because in the summer the department is terribly stuffy, you sweat a lot, and if you don’t want to be associated at the level of smells with a village latrine, sets of clothes should at least be changed once a day). Washing is done manually: in the shower room there is, in fact, a shower (which you can use) and a bath (which you cannot use). A basin is placed in the bathtub, in which washing is carried out. The door to the shower room does not close; moreover, it is embedded clear glass, so you have the pleasure of listening in the smoking room or on a walk comparative analysis own ass (I only got to discuss this part of the body) performed by the female population of the department. On the other hand, lovers of female nudity can easily satisfy their passion twice a week. In fairness, it should be noted that in other departments it is even worse - there they generally undress everyone and line up in the corridor. They also like to shorten the standard 15-minute washing period. It looks like this: you come in, lather up, stand, for example, shaving (dangerous razors are confiscated, safety razors are taken and stored at the nurse’s station, but before going to the shower you can borrow them, as well as nail clippers), your sister-hostess comes to you and in a commanding voice orders you to get out right now, because there are a lot of people, and in general you need to save water. You can resist, but you shouldn’t: you can be labeled as “aggressive” and fed/injected with such a hellish dose of antipsychotics that you will regret that you were even born. Therefore, diplomacy, pressure on pity and other emphatically peaceful strategies are used. The sister-hostess responds to this by bringing in another naked patient and ordering them to wash together, since you are so smart :) Since there is only one shower, it is technically impossible to organize the process without introducing elements of sodomy into it, so you have to quickly get out of the shower, as you go, wipe off the soap with a towel and curse everything in the world: you couldn’t wash yourself today.

A small clarification: when I went to the psychiatric hospital for the second time, I experienced such a decline in volition that, in principle, I no longer cared about how clean I was, and I began to relate to these issues much more simply. This is what life-giving aminazine does.

Anyway, let's get back to cabbage. You have about five minutes while you wash, when you don’t feel it: you washed off the smell, took off your clothes, the buzz. It was cabbage that became my main motive when deciding to shave my head. Less hair means less cabbage smell haunts you. In food, cabbage is, to put it mildly, boring. I’m actually surprised why they serve tea and compote without cabbage, what a savings it will be :)

Second important aspect- this is saving. If you read the menu (which is posted in the dining room every day), you might think that you have died and gone to culinary heaven: here you are " vegetable stew with meat", and "meat soup", and "stuffed cabbage rolls" and a bunch of other interesting foods. In reality, as usual, in reality everything is not as it really is. For example, in "porridge with meat" you can, with desire to find traces of chicken skin. And if you are very careful and rummage through several plates, you may be lucky and find one fiber similar to muscle. But, oddly enough, bone fragments are quite often found in this food. That is, apparently , animal raw materials still have some, albeit indirect, relation to what is happening in the catering department.

By the way, the degree of influence of this very raw material on the final product is well illustrated following example: three vegetarians and one believer (during Lent) ate our hospital “meat” dishes, and did not consider this any violation of their gastronomic-ethical-religious principles.

But I came across the most masterpiece not in the meat, but in the dairy sector of our diet. This is so beautiful that it’s hard to wrap my head around it, just think about it: milk soup... without milk. And like this! The soup is milky, but since milk is expensive, we won’t add it. This creation looks like this: huge boiled pasta (I wonder if large pasta is cheaper than small ones due to fewer movements of the cutting machine?) floating in a paste that is formed from the water in which they were boiled. And so that cunning patients do not eat it with meat or sausage (they can be obtained in the wild; below I will describe the mechanics of this action), the paste is made slightly sweet. A disgusting dish, I tell you.

When you walk around the territory of a psychiatric hospital and see very expensive cars parked (I, for example, will never be able to afford one in my life), all sorts of crazy thoughts involuntarily come to mind about the existence of some kind of, if not connection, then at least correlation between the cost of this fleet and the amount of meat / milk and other excesses on the plate of an individual psycho... But we, keeping in mind all sorts of libel laws, will not develop these potentially dangerous thoughts...

Let's return to something more pleasant: sausage. Sausage (as well as meat, fish, fruits, cookies and other excesses) can be found in psychiatric hospitals. The first and universal source of such grace is sendings from the world of normal people. Everything is simple here: either they send/bring something to you during a date, and you eat it, or they bring it to someone, and he shares it out of the kindness of his heart. This method, as far as I know, works in all departments, in some the prohibitions on the list of transferred products are stricter, in some the frequency of parcels is limited, but, in general, this method is quite popular and is accessible to any crazy person.

The second option is to buy small things like coffee/cigarettes/matches through the medical staff. It is practiced only in acute departments and forced conditions, i.e. where the regime is really tough. It is not accessible to everyone, but only to those who are able to build adequate social connections with tired, low-paid staff who, frankly, treat the contingent with some degree of contempt. However, the phenomenon does occur and deserves to be included in this list.

The third option is available only to a select few, those who ended up in our exemplary department. It is implemented very simply: while walking, you can go to the store (it’s about 500 meters from the psychiatric hospital) and buy everything you need there. The most interesting thing is that when returning from a walk, there is either no inspection or it is minimal. I personally brought in yogurt, a plastic fork, and a razor (it’s almost impossible to bring all these items in upon admission). Officially you can’t go to the store (because it’s outside the territory of the madhouse), but in fact the staff turns a blind eye.

There is also a fourth option, when people from other, more strict branches order us some small purchases, after which the transfer of inventory items, as a rule, in the catering unit or while performing work. Again, this is not available to everyone, but it is practiced by some.

Since the staff understands that food in a psychiatric hospital, to put it mildly, is not able to provide the proper balance of nutrients, and in terms of taste it is completely beyond any discussion, in general, purchasing food from outside is approved. A special refrigerator was even purchased and installed for this purpose. The scheme is this: you bring food to the department, go to the post, hand it over, they give you a bag signed with your name, you put the food there, after which it is taken to the refrigerator.

The refrigerator is in the dining room, but it is locked. It is opened three times a day: during breakfast, lunch and dinner. Thus, if your financial capabilities allow you, and you are in our exemplary department, you may not interfere with hospital food at all. Personally, I didn’t indulge much, I ate what they gave me in the psychiatric hospital, and I kept coffee in the refrigerator (not allowed, but for some it’s possible) and some cheap sweets. Since the caloric content of food is quite low, and dinner ends around seven in the evening, closer to lights out people begin to feel bouts of gluttony :) And the refrigerator with a transparent door in which your food lies attracts the inhabitants of the psychiatric hospital.

When I had an aquarium as a child, I observed similar behavior in fish: towards the end of the break between feedings (about eight hours for my inhabitants), the fish begin to cut circles around the empty feeder. There is nothing there, this activity does not saturate, does not speed up the appearance of the next soldering, but they still all gather there. And psychos behave exactly the same way. Visual ethology of a person, what :)

Naturally, such a dietary pattern gives rise to various kinds of informal relationships designed to somehow soften what is happening (you want to eat!). Some of the patients hide food in the rooms or pockets, and the staff, in turn, conduct regular searches (there are mice in the department, and the staff do not want them to be further attracted by the food hidden by the patients). Someone manages to negotiate with the staff to open the refrigerator after hours. Sometimes it works. Sometimes the staff themselves offer to open the refrigerator in exchange for doing some work: clearing the snow, cleaning the compartment, moving some heavy objects.

The most exciting days during my stay were the days when snow fell (several monthly norms, the psychiatric hospital was completely covered), and the staff formed sonder teams to clear it. If you fit in, awesome bonuses were available to you: in the morning, before everyone got up, they opened the refrigerator, the smoking room, and even put on a Potter. You could drink coffee in the morning, that little sip of freedom that you always dream about. Smokers enjoyed the combination of coffee + cigarette. Then everyone walked together, cleared the snow (the amount of work, by the way, was quite ridiculous, many didn’t even have time to get tired), after which - the second round of hot tea. It was very cool.

About the daily routine

So, after describing the crazy food, let's move on to the main branch of the story (I hope the reader can withstand my numerous slips). So I ate and went to the ward. Since I really wanted to sleep, and I was alone in the room, no one bothered me, and I passed out until the morning. Around seven I was woken up, and my first full day behind the fence began.

Here we should make another digression and tell you a little about the daily routine in the psychiatric hospital. Generally speaking, there is an official routine that fully regulates this aspect for both staff and patients. It looks like this:

Naturally, to real life he has a very indirect relationship, and both psychos and those who are supposed to treat them ignore him;)

The first thing I must say is that patients do not have any organized hell (see point 2). On the contrary, everyone experiences their personal hell alone, and, it should be noted, for most it lasts much longer than the stated 30 minutes. This is an intimate process, as a rule, the person living it is not particularly eager to join society (or is simply not able to join it): someone is writhing from neuroleptics (this is when a muscle cramps in the body, usually in the neck area, you it hurts, you are literally twisted into the letter “zyu”, but you can’t do anything about it, and they don’t give you a proofreader because you’ve done something wrong), someone is struggling with hallucinations (one of my colleagues was “fucked” during attacks for his dreams”, right in the department), someone suffers from difficulty urinating (this is when it seems that your bladder is about to burst, but you just can’t empty it, it just doesn’t flow, although you just want to pee terribly, and you you pray at least to simply and openly piss yourself), some are burdened with the existential reality of meaninglessness, in general, everyone has something to do.

In reality, the schedule looks something like this (the times indicated are approximate, since certain fluctuations within 20-30 minutes are acceptable):

6:30 - Get up;
07:15 - close the smoking room;
08:00 - we take out the trash, go get breakfast, take the barrels, sometimes we clean the smoking room;
08:20 - breakfast;
09:00 - round;
10:00 - first dose of pills, start of physiotherapy. After taking the pills, take a smoke break;
11:00 - 13:00 walk. If it is Monday or Thursday, then somewhere in the same period of time you need to wash;
14:00 - lunch;
14:45 - second dose of pills, after - a smoke break;
15:00-16:00 - sleepy hour. For some, art therapy or work in a psychological group may be carried out at this time;
16:00-17:00 - second walk;
18:20 - dinner;
19:00 - cleaning the department after dinner (we wash the dining room, vacuum the carpets, sometimes scrub the exercise room and rest room);
19:30 - informal smoke break (sometimes there may not be one);
20:45 - third dose of pills, smoke break;
22:00 - lights out;

To be continued...

Disclaimer: especially for Comrade Major and his colleagues from law enforcement agencies and other similar organizations: the text is fiction, fantasy, a figment of the imagination. All names, locations, events and characters- are fictitious, and the use of the pronoun “I” and the pseudo-documentary style of presentation is nothing more than artistic device. The pictures were drawn... no, not in pirated Photoshop, but in a licensed GNU volume of GIMP. Any coincidences with reality are accidental. And in general, do not confuse the author and the lyrical hero.

Head physician of the Samara Regional Psychiatric Hospital Mikhail Shafer told the DG correspondent about friendship with patients, meeting with two Lenins, why patients run away and return, when obsession helps write a book, is it possible to give a razor to a crazy person, who are the old-time patients, and is it possible to improve life after discharge.

Mikhail Solomonovich, last year open doors You said that 10 years ago, various types of psychiatric disorders were observed in every seventh Russian, and today – in every fourth. Is the number of mentally ill people increasing so quickly?

- Exists official statistics. She says that traditionally 1-2% of the world's population is mentally ill. One in every hundred people may suffer from schizophrenia. If we take our region, the statistics are the same - about 2% of the population suffers from schizophrenia. This figure has not increased for several years. However, it is necessary to clarify here: the statistics include those who asked for help. And among them there may be people with a chronic mental illness, or those suffering from insomnia, anxiety or weakened memory. At the beginning of this year, there were just over 52 thousand residents of the Samara region. But this figure is disingenuous. After all, we must understand that there is a big difference between people who seek help and people who have a disorder but do not seek help.

- How many potentially mentally ill people are there in Samara then?

— According to various studies, up to 30% of people seeking help at a regular clinic show signs of a mental disorder. That is, they are not mentally ill, but in fact, when presenting somatic complaints to the doctor, they do not realize that the cause of their suffering is a mental disorder. It is clear that a person will not go to a psychiatrist, but rather go to a clinic. These people do not see their problems: they blame everything on their physical condition, but in fact they are nervously or mentally ill.

- How to determine that you are mentally ill?

— A clear sign is inappropriate behavior.

I was just on the subway to see you, and a man was sitting opposite me, talking to himself in a whisper. Or just thinking out loud. Does it mean he is mentally ill?

— There is a term for this: “presumption of mental health.” A priori, we are all mentally healthy... until proven otherwise. Therefore, when we talk about signs of a mental disorder, we mean a change in a person’s behavior that is noticeable to others. Let's take your example of a person who was talking to himself - this seems to be objective signs of hallucinations. Or maybe you just didn’t notice the earphone in his ear. Here we need to prove it.

- What other mental illnesses do people have that are difficult to recognize on their own?

- Delusional disorder. The man says that he is being watched, that he is being irradiated with rays, that someone is breaking into his apartment, that he is special, and in this world he must fulfill a mission, and that is why he is connected either with the devil or with God.

Or, let's say, arrhythmic syndrome - insomnia. It may be forced when a student is preparing for an exam, or security officers are preparing for an operation and are taking phenamine [a strong stimulant nervous system – approx. auto]. And there is insomnia associated with mental illness - as with bipolar disorder. The person is in a manic state. He doesn't need sleep at all.

When a person has mania, he feels good. Elevated mood, accelerated physical activity, accelerated thinking. A person can eat a lot and still lose weight. This state is very pleasant. Moreover, it can also be productive. Here we had one scientist, he was in a state of mania, and he wrote an entire book in the hospital.

The problem is that the main symptom of a mental disorder is a weakening of critical abilities. A person cannot determine the painful nature of his condition.

In all previous interviews, you indicate that the most popular diagnosis among hospital patients is schizophrenia. It would be interesting to know - what is the rarest diagnosis given to a hospital patient?

— Patients with neurosyphilis were quite rare [the causative agent of syphilis penetrates into nerve tissue – approx. auto ]. A maximum of 10-12 people pass through each year. This disease is difficult to diagnose. And it does not appear immediately. Approximately only 10-15 years after the body is infected directly with syphilis.

While I was preparing for the interview, I noticed that many experts associated the unstable social status in a country with an increase in the number of mentally ill people. Do you think insanity and the unstable environment around you are connected?

— These two concepts are very difficult to connect with each other. Let's say in concentration camps there were no mental disorders. People in such a terrible atmosphere gathered and mobilized themselves for life. Difficult living conditions always presuppose the resistance of consciousness to them.

Of course, stress can provoke mental illness. For example, during the crisis year of 1998 in Russia, the number of suicides increased sharply. But we cannot say that the madness occurred due to the deteriorating economic situation in the country.

Let's rewind time at least 10 years ago. It's 1989. No crisis. Everything is relatively good in the country. And then Kashpirovsky’s sessions begin, and a lot of people experience an exacerbation of mental disorders. Television programs that were supposed to help, in a number of cases provoked and revealed mental illnesses that had previously been mild and unnoticeable.

Since an outbreak of mental illness can be caused by almost anything, how much trust can patients then have? For example, do they shave themselves? Are their knives and forks dull?

— Some people are physically unable to shave on their own. We have special barbers for this. However, the majority of patients are not in an acute condition. As usual, shaving occurs: the staff on duty gathers patients, sits them in front of a mirror, distributes the machines and makes sure that they do not cut themselves.

Regarding cutlery and knives, we, of course, do not give them to patients. But you are allowed to use forks and spoons. The dishes are glass. But we do not give patients matches or lighters. We do not allow smoking in the department. Some patients do not have free access - either with staff or with relatives. And there are patients who can freely walk around the territory and even go beyond its borders.

- Are there frequent escape attempts?

“Just recently, a patient who was undergoing compulsory treatment left us. They brought him to us after he committed the murder. His sister was sure that he came to us by mistake. They say he is completely healthy. I note that Lately His condition was stable, but the court did not terminate the proceedings. Therefore, we could not release it.

Several times the sister tried to take the patient out without permission. We stopped these attempts. But the court once again refused to discharge the patient. And the very next day, his sister tricked him into taking him out. Of course, we have already informed the law enforcement agencies. We will look for him and bring him back.

There are cases when patients run away because they simply weren’t talked to. For example, we have a patient who ran away very often before. But when one of the heads of the department promised him that every year for a day the patient would be able to travel outside the perimeter, visit his mother’s grave, meet his sister, the escapes immediately stopped.

There are cases of escape, but they are extremely rare.

- Some patients return on their own. Why do they choose to live in a hospital rather than in freedom?

“Sometimes they come back on their own.” Sometimes a psychiatric team comes. Sometimes - police officers. When they do it themselves - most often due to the fact that they do not find shelter for themselves. It happens that a sick person will run away, get drunk, spend the night in not the best surroundings, and then return. Because he knows for sure that here he will be washed, fed, and placed in a warm place.

- Before the interview, I also looked into the regional library, into the local history department. There I came across Hardin's medical report for 1913. He pointed out that one of the main problems of the hospital was overcrowding and extreme cramped conditions. Today, while walking around the hospital grounds, I got into a conversation with one employee, he also said that the patients are now “lying on top of each other.” It turns out that the problem has existed for more than 100 years?

- Indeed, the problem persists. There is still not enough space for patients. But we are now trying to solve this. And I can tell you that today is not the worst of times. When I first came to work here in 1978 and read the hospital reports, it indicated that 20-30 people were accommodated on the floor. Now this is no longer the case.

- Are there, so to speak, old-timers in the hospital? Why have they been lying here for so long?

“We have patients who have been on treatment for 15, 20 and even 30 years. For the most part, these are those who were still being treated in psychiatric hospital No. 2. There was one like this in Gavrilova Polyana. In 1993, the hospital burned down, and most of the patients were transferred to us.

There were patients with chronic illness. Their consciousness was greatly altered. Their passports either burned or disappeared during the fire. It is quite difficult to reconstruct the history of such a patient. We conditionally know his first and patronymic names, since there are no documents confirming this.

I remember how I participated in the evacuation of patients from Gavrilova Polyana. It was spring, there was a flood on the Volga. And a whole steamship with sick people came from Gavrilova Polyana. I accept them and try to establish their identity. One says to me: “I am Lenin.” Another one repeats after him: “I am Lenin too.” And until we figured out everyone’s personal history, there were two Lenins in the hospital.

Now there are a maximum of ten unnamed patients left. We call them what they called themselves. Of course, no one calls themselves Lenin anymore. Losing your memory completely is very rare. This only happens in Mexican TV series. Patients even with severe forms of mental disorders give their first, last, and sometimes even patronymic names.

Another thing is that the patient can call different names. We have medical records where two names are indicated at once. The patient changes them for delusional reasons, as if hiding from someone.

For patients who have completed the full course of treatment, can we say that they are completely healthy, or do they then come for preventative care for several more years?

— In psychiatry there is no concept of “full course of treatment.” You cannot cure a patient by giving him 10 injections of one drug and 20 injections of another. Many mental disorders require lifelong treatment. It's not a matter of course treatment, but long-term treatment. Now there are “prolongs” - drugs that can be taken once every two weeks, once a month or even once every four months. And all this time the person is in a normal state.

But we also have a certain repetition. Some patients have a relapse. By various reasons: refusal of treatment, non-compliance with treatment regimen, alcoholism or social troubles. And sometimes there is a spontaneous deterioration for no apparent reason.

- What awaits a person after being discharged from a psychiatric hospital? What can he become?

— Mathematicians who were involved in computer science were treated here. Very smart people. Had an attack. We cured them. They have now returned to teaching and research work. Or there was a case when a young man was admitted who fell ill for the first time, and the disease progressed so malignantly that after 3-4 years he became completely retarded.

Definitely about the future former patient You can't talk about a psychiatric hospital. If a person has a family, support, social status, education, then the possibility of adaptation is much greater. For example, we have a boy undergoing treatment who is very seriously ill. But his relatives help him, and we effective drug we write it out for him. And, despite the illness, the boy graduated from university and is now getting a job.

Hi all. I'm Olga. In November, I was lucky enough to become a patient at a neuropsychiatric hospital. Let me tell you, the joke about “happiness is the right choice of antidepressants” is absolutely true!
Here's one day from mine happy life in a mental hospital. 12/14/2012 All photos were taken with a phone. Who will allow me to use a camera there?

2) We make up the crib like in a pioneer camp

3) Woke up, cleaned the appendages..... (c)

4) Time moves towards breakfast.

5) you have 5 minutes to comb your hair, put on your makeup and all that..

6) For breakfast, a casserole made from yesterday’s pasta and cottage cheese. Plus imitation sausage. Doesn't excite.

7) Fortunately, I have my mother’s little hotels. I lay out sandwiches and coffee on the nightstand.

8) By the way, tumboka:

• Thermal mug
• The book "Jihad. Terrorists are not born" - recommended to me school teacher eldest son.
• Electronic book (how would I survive without it?)
• A bottle of holy water (take the tablets). It’s not that I’m deeply religious, it’s just a fad here. Everyone ran and I ran, what...
• Homemade audio system - two dessert cups and a roll of toilet paper, decorated using the decoupage technique :)

8) Morning dose of happiness.

9) Time moves slowly. And it's time for me to get some needles.

10) About twenty needles are in my hands and on my ears. They harmonize everything very much, they say.

11) Time control:

12) You can read for half an hour. Today this is the “House in Which...” Next to our establishment is a temple, and behind it is a boarding school for “special” children. I imagine that this is that HOUSE..

13) The next item will be a massage. On this magical machine you can do anything with me, I’ll just say thank you. :) Did you notice the blue jar on the table? She's amazing in action!

14) Time

15) I’m going to a group psychotherapy session. Today we are talking about the upcoming holidays. Everyone's soul becomes warmer.

16) It’s already noon. We're having lunch!

17) Lunch wow. Potatoes, fish, salad, tea.

18) After lunch and before quiet time we have time for auto-training and relaxation. I'm the first, I have time to take the best place. Ka-a-if!

19) Every other day, instead of relaxation, we have art therapy. We make cacti from papier-mâché.. I made my audio system there. A very wonderful activity...

20) I had a great night’s sleep during the relaxation session, so in quiet times I’m as alert as a crab! I sit down to work. I'm writing a script for a tablet toy.

21) Creative afternoon tea. Chocolate, chocolate, chocolate - full of endorphins. :)

22) Quiet hour ended at four. I spent an hour doing yoga with my cellmates:

23) Dinner time

24) the curd pudding is delicious, the buckwheat is thrown away. Compote is also good. Some dried fruits in it.

25)Evening dose of happiness. It was also during the day, but I forgot to take it off.

26) And take a walk. It's fine outside. I turn on phone music and throw the phone into the hood. The headphones are lost.
On a walk you can walk around the hospital...

27)...And you can (carefully) go outside the perimeter and walk to the store, to the temple, as far as your legs will take you. The main thing is to return on time.

28) There is a place for nicotine addicts:

29) I return around six:

30) Today is Women’s Day in my heart. We must hurry.

31) Made it!

32) Tomorrow I have DISCHARGE! I'm packing my things. As an advertisement, here is a photo of the game "Imagenarium". It's a nice thing in our establishment!

33) Time, why are you so slow?