During 1992–1994 life expectancy at birth in Russia dropped by 6.1 years for men and by 3.3 years for women. Very little individual-level evidence linking mortality experience with social conditions and behaviors is available. This article puts together evidence from analysis of routinely collected data on changes in Russian mortality. These data suggest that the mortality upsurge cannot be attributed to absolute deprivation, collapse of the health system or environmental pollution. Instead, psychological stress caused by the shock of an abrupt and severe economic transition is likely to have played a major role mediated in part by the adverse health effects of excessive alcohol consumption.