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Clinical severe depression


SAMHSA’s National Helpline | SAMHSA

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  • SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

    Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Last Updated: 08/30/2022

SAMHSA Behavioral Health Treatment Services Locator

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Welcome to the Behavioral Health Treatment Services Locator, a confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.

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The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

Severe depression - causes, symptoms, signs, treatment

Major depression is a serious disorder of a person's mental state. It can occur for many reasons, and is characterized by a depressed state, a sense of worthlessness, an all-consuming melancholy, a pessimistic and decadent mood. Depression spares no one - it can overtake any person, regardless of their gender, age, material and social status. nine0011

Severe depression causes

Severe depression usually occurs for two reasons: psychological and physiological.

For psychological reasons, depression can develop as a result of stress or any traumatic situation. This may be the death of someone close or relatives, physical or moral violence, a terrible catastrophe, in which a person became a participant, and many others. Usually, after two months, the depression can go away, but without proper help, it drags on and severe depression can develop. nine0011

A number of seemingly insignificant unpleasant life situations that have been present in a person’s life for a long time can become a source of constant stress. Lack of material resources; work that does not bring joy; forced living with unpleasant people; deterioration in the quality of life due to any chronic disease - all this can be attributed to a constant stressful situation.

Severe depression can develop due to frustration - a condition in which a person constantly feels that his desires are unfulfilled. nine0011

Existential crisis - can simultaneously act as both a cause and a manifestation of depression. It is expressed in the loss of life goals, a sense of the meaninglessness of existence, an imbalance of harmony.

The physiological causes of depression have completely different roots. Alcohol and drug use, menopause, cerebrovascular accidents, severe overwork, chronic diseases, lack of proper nutrition - these are just a small list of physiological disorders that can lead to severe depression. An important fact is that depression rarely develops for any one reason, often several factors lead to this at once. And successful treatment is possible only if all the causes of this mental disorder are taken into account. nine0011

Severe depression symptoms

The fact that a person is in severe depression is determined by the following symptoms: depressed mood, decreased efficiency and activity, constant feeling of fatigue, inability to concentrate on anything, constant self-flagellation and guilt, low self-esteem, thoughts of suicide, a gloomy and hopeless look on your future, insomnia or, conversely, severe drowsiness, loss of appetite.

The clinical picture of severe depression is as follows: a person experiences a persistent feeling of melancholy every day; his mood is depressive; there are signs of psychomotor retardation; he cannot concentrate his attention on anything; decreased sex drive; in the morning the patient feels tired and overwhelmed because he cannot sleep well at night. Signs of severe depression also include a feeling of suffocation and discomfort in the chest, complete apathy, pessimistic views about one's future (a person always expects misfortune to happen), lack of will, inability to make any decisions, constant drowsiness and a feeling of laziness. nine0011

Signs of severe depression

If a person does not have the strength and desire to do something, if he cannot force himself to do anything, and at the same time is constantly in a bad, depressed mood, then this indicates signs of a depressive state. The manifestations of depression also include constant laziness, under which apathy disguises itself. The fact is that during severe depression, the human brain begins to work differently - its biochemical processes change, which leads to the appearance of laziness. There are three main brain transmitters that are responsible for a person's mood, energy and performance - these are dopamine, norepinephrine and serotonin. And when their work is disrupted, complete apathy sets in and there is a lack of energy to engage in any activity. In such cases, it is necessary to start treatment with special preparations on time, otherwise the person simply does not want to get out of bed in the morning and completely lose interest in life. The consequences of severe depression can be very serious and negative for the patient - a constant feeling of fear and anxiety develops, eventually acquiring manic forms. nine0011

The course of severe depression in pregnant women deserves special attention. Since it often causes miscarriage. Therefore, at the slightest sign of a depressive state, a woman needs to seek help from a specialist.

Severe depression and suicide

Severe depression is dangerous because the patient completely loses the instinct of self-preservation. The lingering feeling of longing, as well as the constant pain that torments the soul, makes him think about suicide. An all-consuming sense of guilt, a feeling that he deserves punishment, a desire to free his loved ones, often push a person to commit suicide. According to statistics, 15% of people with mental disorders of unknown etymology become victims of suicide. nine0011

At the beginning of the disease, the person is so weak, exhausted by severe depression, that he is not able to take any steps in order to take his own life. But as soon as this condition goes away, the patient may make an attempt to lay hands on himself. He will think over the suicide plan in detail, develop it, and try to create a deceptive impression that he is better, without leaving the thought of committing suicide.

The most common cases of suicide are among single people with a history of somatic diseases, and people who have had suicide cases in their family. nine0011

What should a person do if he has all the signs of severe depression? The answer to this question is one - immediate appeal for help. If depression is not treated, it will become chronic, and this is already fraught with very dangerous consequences.

Severe depression treatment

How to start treatment for severe depression? Of course, with a visit to a psychologist or psychotherapist. Consultations with these doctors, as well as individual and family psychotherapy sessions, will help to identify the primary source of the disorder, to determine the main causes of the depressive state. Many methods of psychotherapy are used to treat severe depression - this is classical psychoanalysis, psychodrama, existential therapy, cognitive-behavioral therapy, and body-oriented therapy. nine0011

In some cases, when a patient has a severe neurotic form with disturbances in the work of the vegetovascular system, an additional examination by a neurologist is necessary. It will help to exclude the presence of neuroinfection, TBI, intoxication, or disorders of the vascular system. To exclude the onset of early menopause, a woman should visit an endocrinologist and a gynecologist.

For the medical treatment of severe depression, various drugs of the SSRI group (Paxil, Reksetin, Prozac, Cipralex, Pram, Zoloft), tranquilizers (Alprazolam, Relanium, Nitrazepam, Diazepam) and antidepressants (Venlaxor, Mirzaten, Coaxil) of the new generation are used. nine0011

But the most important thing in the treatment of severe depression is the desire of the person himself to get rid of his disorder. At the same time, it is important to realize that this process is long and laborious, and will require a lot of patience and strength from the patient.

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Signs of severe depression | SKKSPB №1

Depression is also characterized by sleep disorders, which are noted by approximately 80% of patients. As a rule, these are early awakenings with the inability to fall asleep, lack of a sense of sleep, difficulty falling asleep. These disorders, as well as restless sleep with unpleasant dreams, are often the very first symptoms of incipient depression.

If the depression is shallow, it is sometimes difficult to recognize it. This is due to the fact that people are ashamed to tell others about their problems, to admit to “weaknesses”. Quite often, especially in Russia, depressive states are masked by alcohol abuse. In addition, often patients suffering from depression, in order to "shake themselves up", "throw into all serious things", are fond of gambling or extreme sports, leave to serve on a contract in "hot spots". Surrounding people, relatives who do not have psychiatric knowledge, often accuse them of debauchery, drunkenness, riotous lifestyle, parasitism. Meanwhile, this behavior is a kind of “cry for help”, an attempt to fill the spiritual emptiness brought by depression with new acquaintances and impressions. nine0011

Depressive conditions can occur in shallow forms that are easily treatable, but at least a third of depressions are more severe. Such depressions are characterized by:

– ideas of guilt, sometimes reaching the degree of delirium; unshakable conviction of their sinfulness, low value (patients consider themselves great sinners, believe that because of them all relatives and Humanity will perish, that they are “moral freaks” from birth, supposedly deprived of the foundations of morality and a sense of empathy for other people, that they do not places on earth. They find in their past numerous "confirmations" of what has been said, they believe that the doctor and other patients are aware of these sins and express contempt and indignation with their facial expressions and gestures, but in words they "hide, deny the obvious." This must be remembered both to the patients themselves and to their loved ones, in order to prevent an impending threat in time: remove all firearms, piercing and cutting objects, ropes, strong drugs and poisonous household liquids, close windows or shutters, do not let the patient go anywhere alone. persistent character and not amenable to dissuasion, it is urgent to seek advice from a neuropsychiatric institution or call a psychiatrist at home:

- mood swings during the day: in typical cases, the patient, upon waking up, immediately feels longing. Sometimes, even before full awakening, through a dream he experiences a painful premonition of a heavy coming morning. In the evening, the state of health improves somewhat;

- a person may experience a feeling of unmotivated hostility towards relatives, friends, constant internal dissatisfaction and irritation, which makes him unbearable for the family;

- in some people suffering from depression, constant doubts, fear for the health and well-being of loved ones, obsessive, that is, arising against their will, ideas about the misfortunes and troubles of family members come to the fore. nine0011

In the next article we will talk about how depression can manifest itself through somatic symptoms.

Material prepared by Stavropol Psychiatric Hospital based on information from the National Center for Mental Health ( http://www.

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