This is the third article in the series on mental health. This time we talked to Belarusian social activist R.P.: about punitive psychiatry in Belarus, misdiagnosis in Poland and hope for recovery.

R.P. – 33 years

My first experience of going to a psychoneurological dispensary was 3 years ago, in Belarus. I was diagnosed with acute psychosis. Acute psychosis is like an evil dream that does not go away, where reality is blurred by hallucinations and it is difficult to differentiate one thing from another.

That’s when I went to Novinki, to the psychiatric ward. The hospital turned out to be not as scary a place as I thought. They don’t inject everyone with haloperidol or electroshock. But, however, I had some cases that I would call extremely unprofessional, even criminal. Once a man in serious psychosis was put in my ward, he did not understand who he was and where he was. The man was of advanced age. He was fixed to the bed, as they say in such institutions, which means simply tied to the bed. In the night I heard moaning, and when I woke up I saw that the man’s limbs were blue, he looked bad and was delirious. I called the corpsman, he didn’t do anything, he said: “none of my business” and left. Afterwards, I offered the tied man a drink and loosened the knots. He agreed and thanked me.

Tying people to the bed is a standard procedure in Novinki, but I think it is a complete violation of patients’ rights. Even if you fix in case of the possibility of self-harm, it should not be until the hands and feet turn blue. The next day I was transferred to another ward, to a unit where there were people in recovery. As I walked down the hallway, I looked into the ex ward to see this man. He was weird, but you could see the humanity in him. He was always tied up and looked bad. On the second day I learned that he had died. Why? Was it Novinki fault? I believe it was. After all, he was simply not given water and tied to a bed for several days without moving at an advanced age. That’s criminal negligence, I believe. I also heard many stories of deaths, theft and rape there, but I am telling you what I personally encountered.

I was treated well, there were no violations. They even pretended not to notice that I had my cell phone with me, which is forbidden. I used it to set up a meeting room in my room, and patients came up to me with requests to call their loved ones. But in fact, it was very scary to look at people with such a diagnosis, their non-acceptance of their condition and their desperate attempts to prove otherwise were like trying to break a wall with a dandelion… And yet in everything they did, there was a deep acceptance of their disease and understanding of their condition. It was as if they knew what was happening to them, but they could neither accept it nor change it. And, to tell the truth, I want to believe, I know it – a dandelion breaks through the asphalt, it means that one day it will break through the wall, but you just have to wait. Meetings with loved ones… I don’t remember, I think they allow visits once a week and phone calls in the evenings, but I could be wrong.

The treatment is non-therapeutic, medication only. They take the acute attacks off and put you on maintenance neuroleptics. I am not an opponent of medications, I understand that they are like crutches, and mental illness is like a trauma where you cannot walk without crutches. The quality of medication, unlike in Europe, is terrible. In the hospital my legs twisted terribly, I couldn’t sleep at night, sometimes when there was a kinder shift I was given sleeping pills and painkillers. Sometimes I left the morning pills (sedatives) for the evening and drank a few at a time in the evening before going to bed to dull the pain.

So two weeks passed… I was not allowed to go outside, I saw a psychologist twice, she conducted a light test and that was the end of therapy, the rest of the time – pills, sleeping, twisting my legs. The food is meager: unlike European hospitals, it does not provide for a vegetarian diet, so we had to barter – exchange a cutlet for a salad, etc.

Once I was attacked by an orderly. He refused me a smoke break, as it is forbidden, but unofficially everyone smokes with the permission of “their majesties” the orderlies. I told him that if I did not smoke, I would tell the higher-ups that he came drunk to work and was sleeping on duty. In response, he attacked me, and after an imitation of a fight, he still allowed me to smoke, and from now on there were no conflicts.

During my stay in Novinki my psychosis disappeared… I came out of there without delirium and in a normal condition, only because of medication I gained 10 kilograms. Usually I weigh 65-67 kilograms. I weighed 75-80 kilograms after I came out, such as the side effects from Belmedpreparaty. I would not advise anyone to take Belarusian medicines, if you have a choice, choose imported ones. I was prescribed a horse dose of neuroleptics in pills and an injection. So I lost my job.

Going into the night to work, I realised I just wasn’t physically up to it. I couldn’t be multi-functional, multi-tasking at the same time, I was getting physically tired. One day in the middle of my shift I sat on a chair under the cameras and texted the director that I was on heavy pills and couldn’t do my job because of this condition. They understood me, paid me for the hours worked, accepted some of the work done, which in fact meant that they had to work without 100% layout, and let me go home. I never went to that job again. But I immediately found another one, where, after explanations, they did not pay attention to my stickiness and slowness. Before taking the pills, I was quite an active person.

One more thing: never mix alcohol with Belarusian pills. Once I decided to celebrate my discharge and bought a bottle of French dry wine, after which the ambulance came to me: my legs failed for 8 hours. It’s scary, I wouldn’t wish that on anyone.

Eventually I was able to prove that I was recovering and was left with only one injection, which was not as bad of a side effect as the pills I was taking. And I recovered over time…as I thought I would.

In 2021, I moved to Ukraine, to Kiev. This was my second attempt at moving to Ukraine. The first one in 2020, but due to my mental state I had to move back. The second attempt was more successful. I lived in Kiev for half a year. There I became registered in the psychoneurological dispensary, where I was given prescriptions and necessary injections. There were no problems with this, I provided a certificate with the diagnosis and appointments, and I was given the medicine by prescription. So I lived normally for six months.

There were three emigrations in my life. The first – Ukraine, unsuccessfully. The second – Ukraine, successfully, half a year. And Poland – the third, successful to this day: I came by chance, I had a chance to come for three months on a study programme. My plans were not to stay in Poland, but to return to Kiev. But three days after I arrived, Russia attacked Ukraine. And there was no turning back. Belarus is closed, even though I wasn’t caught once at the 2020 protests. I was not photographed anywhere, but I was caught before and quite often. I have a series of fines to pay, but I don’t owe anything to this “Belarusian” state and I’m not going to support it with my penny either. There is a war in Ukraine, therefore, the only option was to stay in Poland.

Three months passed, and I didn’t take the injection… Maybe that was the problem. And the psychosis happened again. I was horrified at what was happening and immediately paid for a psychotherapist and prescribed neuroleptics. A single visit to a psychiatrist in Poland costs 50$. I took the pills, but my condition worsened, I was losing touch with reality again. And once it came to the point that at the moment of an attack I behaved aggressively towards a person close to me and they called a brigade of paramedics on me… There I confessed my hallucinations and inability to cope independently and I was hospitalised for the second time, only in Poland.

In Poland I spent two weeks in a hospital. Treatment here is free, only if you pose a threat to your loved ones or yourself. It was not a very pleasant time. Except for the food: at least there’s a vegetarian menu there.

I don’t speak Polish or English. I couldn’t explain what was happening to me, what was bothering me. There is no one to talk to, you are in a foreign country in a closed institution. How long will you be here? Will they be able to help you? All these questions remained unanswered until I was discharged. The whole ward is Polish-speaking, and it’s as if you are in a birdhouse where all the nightingales and you are a sparrow – everyone sings in their own way, and you chirp alone about your own.

They’re doctors, no doubt, but how can they help you without talking to you? Much less diagnose you?

Two weeks passed like that… The treatment is the same as in Novinki – no therapy, only pills. Schedule: wake up – pills, lunch – pills, dinner – pills, the rest of the time sleep or look at the phone. Phones are allowed, unlike Novinki, as well as smoke breaks. The main difference from Belarusian Novinki is that there is no atmosphere of doom, everything is more positive, though lethargic. Music is playing, you can smoke, the orderlies do not steal provision, there is no non stop swearing and fewer people tied up. Otherwise, it’s the same.

Better quality pills, no side effects. But the most unpleasant thing is that they treat you for something and with what. After two weeks I was discharged, but with a new diagnosis – schizophrenia. Schizophrenia…. Without talking to me once, referring to what I said in a psychotic frenzy. I’m diagnosed with schizophrenia… Bye, driver’s licence, bye, normal job. Fu***ng hell, hello schizophrenia! How did they diagnose it? If all the questions were: How are you feeling? – Fine. – Good. Thank you.

So I came out of the Polish hospital, calmed down, but with a new diagnosis. I must admit that in some ways I was glad, despite the diagnosis: the medicine helped me, I started to feel better. But I had a new realisation that the mental fuck-up might be longer than I expected. Or if the doctors believe, there could be improvement in five years with no setbacks, though possibly sooner. It was hard to accept. Living with a diagnosis is like walking through a minefield, you never know when it’s gonna blow. And then, all is well, a great day comes along and… and everything that was, shatters into little pieces. I learnt a lot of practices to keep myself from slipping. Buddhist teachings about mindfulness helped a lot. Also nihilist teachings about denial. But you can’t get very far with the latter. So I left only the Buddhist ones.

In general, I am not a very good person… I have done a lot of bad things in my life and I think I deserve the diagnosis. After all, everything you do has a counteraction, and if you do a lot of bad things, it will all come back sooner or later. What you water the ground with, such fruit will grow.

At the moment, I only do regular injections of neuroleptics. In contrast to Belarus, here it is the latest generation drug, very cool, leaving you with no side effects. They give it to me for free, because I am registered at the hospital. I was also prescribed Xanax and Pregalabine, but I don’t take them, or I do, but very rarely. The rhythm of life seems to be restored, but the feeling of a minefield doesn’t go away, and you learn to live as a miner. To sense where a breakdown might happen, where there might be triggers, and to avoid those territories, or to enter, but prepared.

In truth, there are hard days and you get tired of the peculiarities of your psyche. And thoughts creep in about death, but with my diagnosis this is not news, even learned to approach it with a kind of philosophical note. Like, what is life without death and death without life. Only one thing is scary – that before death there is a chance to do a lot of stupid things. The diagnosis was revised and I was diagnosed with schizoaffective personality disorder. It did not become easier, and this assumption suggests that in addition to schizophrenia I have added at least bipolar disorder, with a predominant depressive phase. But with this diagnosis the chance of remission is higher. In Poland there is no modern treatment scheme for this disorder, but for schizophrenia there is, so the doctor persuaded me to be treated according to the new scheme and not to change the diagnosis in the papers for now. I hope it will work.