Depression always feeling tired

SAMHSA’s National Helpline | SAMHSA

Your browser is not supported

Switch to Chrome, Edge, Firefox or Safari

Main page content

  • 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.

  • Suggested Resources

    What Is Substance Abuse Treatment? A Booklet for Families
    Created for family members of people with alcohol abuse or drug abuse problems. Answers questions about substance abuse, its symptoms, different types of treatment, and recovery. Addresses concerns of children of parents with substance use/abuse problems.

    It's Not Your Fault (NACoA) (PDF | 12 KB)
    Assures teens with parents who abuse alcohol or drugs that, "It's not your fault!" and that they are not alone. Encourages teens to seek emotional support from other adults, school counselors, and youth support groups such as Alateen, and provides a resource list.

    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
    Aids family members in coping with the aftermath of a relative's suicide attempt. Describes the emergency department treatment process, lists questions to ask about follow-up treatment, and describes how to reduce risk and ensure safety at home.

    Family Therapy Can Help: For People in Recovery From Mental Illness or Addiction
    Explores the role of family therapy in recovery from mental illness or substance abuse. Explains how family therapy sessions are run and who conducts them, describes a typical session, and provides information on its effectiveness in recovery.

    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

Alcohol, Tobacco, and Other Drugs

Your browser is not supported

Switch to Chrome, Edge, Firefox or Safari

Misusing alcohol, tobacco, and other drugs can have both immediate and long-term health effects.

The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. NSDUH estimates allow researchers, clinicians, policymakers, and the general public to better understand and improve the nation’s behavioral health. These reports and detailed tables present estimates from the 2021 National Survey on Drug Use and Health (NSDUH).



  • Among the 133.1 million current alcohol users aged 12 or older in 2021, 60.0 million people (or 45.1%) were past month binge drinkers. The percentage of people who were past month binge drinkers was highest among young adults aged 18 to 25 (29.2% or 9.8 million people), followed by adults aged 26 or older (22.4% or 49.3 million people), then by adolescents aged 12 to 17 (3.8% or 995,000 people). (2021 NSDUH)
  • Among people aged 12 to 20 in 2021, 15.1% (or 5.9 million people) were past month alcohol users. Estimates of binge alcohol use and heavy alcohol use in the past month among underage people were 8.3% (or 3.2 million people) and 1.6% (or 613,000 people), respectively. (2021 NSDUH)
  • In 2020, 50.0% of people aged 12 or older (or 138.5 million people) used alcohol in the past month (i.e., current alcohol users) (2020 NSDUH)
  • Among the 138.5 million people who were current alcohol users, 61.6 million people (or 44.4%) were classified as binge drinkers and 17.7 million people (28.8% of current binge drinkers and 12.8% of current alcohol users) were classified as heavy drinkers (2020 NSDUH)
  • The percentage of people who were past month binge alcohol users was highest among young adults aged 18 to 25 (31. 4%) compared with 22.9% of adults aged 26 or older and 4.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Excessive alcohol use can increase a person’s risk of stroke, liver cirrhosis, alcoholic hepatitis, cancer, and other serious health conditions
  • Excessive alcohol use can also lead to risk-taking behavior, including driving while impaired. The Centers for Disease Control and Prevention reports that 29 people in the United States die in motor vehicle crashes that involve an alcohol-impaired driver daily


  • STOP Underage Drinking interagency portal - Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Interagency Coordinating Committee on the Prevention of Underage Drinking
  • Talk. They Hear You.
  • Underage Drinking: Myths vs. Facts
  • Talking with your College-Bound Young Adult About Alcohol

Relevant links:

  • National Association of State Alcohol and Drug Abuse Directors
  • Department of Transportation Office of Drug & Alcohol Policy & Compliance
  • Alcohol Policy Information Systems Database (APIS)
  • National Institute on Alcohol Abuse and Alcoholism



  • In 2020, 20. 7% of people aged 12 or older (or 57.3 million people) used nicotine products (i.e., used tobacco products or vaped nicotine) in the past month (2020 NSDUH)
  • Among past month users of nicotine products, nearly two thirds of adolescents aged 12 to 17 (63.1%) vaped nicotine but did not use tobacco products. In contrast, 88.9% of past month nicotine product users aged 26 or older used only tobacco products (2020 NSDUH)
  • Tobacco use is the leading cause of preventable death, often leading to lung cancer, respiratory disorders, heart disease, stroke, and other serious illnesses. The CDC reports that cigarette smoking causes more than 480,000 deaths each year in the United States
  • The CDC’s Office on Smoking and Health reports that more than 16 million Americans are living with a disease caused by smoking cigarettes

Electronic cigarette (e-cigarette) use data:

  • In 2021, 13.2 million people aged 12 or older (or 4.7%) used an e-cigarette or other vaping device to vape nicotine in the past month. The percentage of people who vaped nicotine was highest among young adults aged 18 to 25 (14.1% or 4.7 million people), followed by adolescents aged 12 to 17 (5.2% or 1.4 million people), then by adults aged 26 or older (3.2% or 7.1 million people).
  • Among people aged 12 to 20 in 2021, 11.0% (or 4.3 million people) used tobacco products or used an e-cigarette or other vaping device to vape nicotine in the past month. Among people in this age group, 8.1% (or 3.1 million people) vaped nicotine, 5.4% (or 2.1 million people) used tobacco products, and 3.4% (or 1.3 million people) smoked cigarettes in the past month. (2021 NSDUH)
  • Data from the Centers for Disease Control and Prevention’s 2020 National Youth Tobacco Survey. Among both middle and high school students, current use of e-cigarettes declined from 2019 to 2020, reversing previous trends and returning current e-cigarette use to levels similar to those observed in 2018
  • E-cigarettes are not safe for youth, young adults, or pregnant women, especially because they contain nicotine and other chemicals


  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program


  • Truth Initiative
  • FDA Center for Tobacco Products
  • CDC Office on Smoking and Health
  • National Institute on Drug Abuse: Tobacco, Nicotine, and E-Cigarettes
  • National Institute on Drug Abuse: E-Cigarettes



  • Among people aged 12 or older in 2021, 3. 3% (or 9.2 million people) misused opioids (heroin or prescription pain relievers) in the past year. Among the 9.2 million people who misused opioids in the past year, 8.7 million people misused prescription pain relievers compared with 1.1 million people who used heroin. These numbers include 574,000 people who both misused prescription pain relievers and used heroin in the past year. (2021 NSDUH)
  • Among people aged 12 or older in 2020, 3.4% (or 9.5 million people) misused opioids in the past year. Among the 9.5 million people who misused opioids in the past year, 9.3 million people misused prescription pain relievers and 902,000 people used heroin (2020 NSDUH)
  • According to the Centers for Disease Control and Prevention’s Understanding the Epidemic, an average of 128 Americans die every day from an opioid overdose


  • Medication-Assisted Treatment
  • Opioid Overdose Prevention Toolkit
  • TIP 63: Medications for Opioid Use Disorder
  • Use of Medication-Assisted Treatment for Opioid Use Disorder in Criminal Justice Settings
  • Opioid Use Disorder and Pregnancy
  • Clinical Guidance for Treating Pregnant and Parenting Women With Opioid Use Disorder and Their Infants
  • The Facts about Buprenorphine for Treatment of Opioid Addiction
  • Pregnancy Planning for Women Being Treated for Opioid Use Disorder
  • Tips for Teens: Opioids
  • Rural Opioid Technical Assistance Grants
  • Tribal Opioid Response Grants
  • Provider’s Clinical Support System - Medication Assisted Treatment Grant Program


  • National Institute on Drug Abuse: Opioids
  • National Institute on Drug Abuse: Heroin
  • HHS Prevent Opioid Abuse
  • Community Anti-Drug Coalitions of America
  • Addiction Technology Transfer Center (ATTC) Network
  • Prevention Technology Transfer Center (PTTC) Network



  • In 2021, marijuana was the most commonly used illicit drug, with 18. 7% of people aged 12 or older (or 52.5 million people) using it in the past year. The percentage was highest among young adults aged 18 to 25 (35.4% or 11.8 million people), followed by adults aged 26 or older (17.2% or 37.9 million people), then by adolescents aged 12 to 17 (10.5% or 2.7 million people).
  • The percentage of people who used marijuana in the past year was highest among young adults aged 18 to 25 (34.5%) compared with 16.3% of adults aged 26 or older and 10.1% of adolescents aged 12 to 17 (2020 NSDUH)
  • Marijuana can impair judgment and distort perception in the short term and can lead to memory impairment in the long term
  • Marijuana can have significant health effects on youth and pregnant women.


  • Know the Risks of Marijuana
  • Marijuana and Pregnancy
  • Tips for Teens: Marijuana

Relevant links:

  • National Institute on Drug Abuse: Marijuana
  • Addiction Technology Transfer Centers on Marijuana
  • CDC Marijuana and Public Health

Emerging Trends in Substance Misuse:

  • Methamphetamine—In 2019, NSDUH data show that approximately 2 million people used methamphetamine in the past year. Approximately 1 million people had a methamphetamine use disorder, which was higher than the percentage in 2016, but similar to the percentages in 2015 and 2018. The National Institute on Drug Abuse Data shows that overdose death rates involving methamphetamine have quadrupled from 2011 to 2017. Frequent meth use is associated with mood disturbances, hallucinations, and paranoia.
  • Cocaine—In 2019, NSDUH data show an estimated 5.5 million people aged 12 or older were past users of cocaine, including about 778,000 users of crack. The CDC reports that overdose deaths involving have increased by one-third from 2016 to 2017. In the short term, cocaine use can result in increased blood pressure, restlessness, and irritability. In the long term, severe medical complications of cocaine use include heart attacks, seizures, and abdominal pain.
  • Kratom—In 2019, NSDUH data show that about 825,000 people had used Kratom in the past month. Kratom is a tropical plant that grows naturally in Southeast Asia with leaves that can have psychotropic effects by affecting opioid brain receptors. It is currently unregulated and has risk of abuse and dependence. The National Institute on Drug Abuse reports that health effects of Kratom can include nausea, itching, seizures, and hallucinations.


  • Tips for Teens: Methamphetamine
  • Tips for Teens: Cocaine
  • National Institute on Drug Abuse

More SAMHSA publications on substance use prevention and treatment.

Last Updated: 01/05/2023

How to get rid of chronic fatigue and depression? Treatment of depression in the Central Medical Health Center "Alliance"

The frantic pace of city life, the desire for material well-being and climbing the career ladder at the cost of rest and favorite activities turn into chronic fatigue and depression.

Chronic fatigue, depression is a reason to seek help from a psychotherapist.

Exhausting everyday affairs do not bring a sense of satisfaction and lead to depression; in a depressed mood, a person copes with things even worse. There is a non-disappearing fatigue, in the fight against which neither weekends nor vacations help. A person not only cannot continue things as before, the nervous system is exhausted, a mental disorder begins. nine0003

It is impossible to rely on chance in such a situation - the disease will not go away on its own. To defeat them in time, seek help from an experienced specialist.

How does the disorder manifest itself?

Fatigue and constant lethargy are some of the signs of depression. With constant depression and fatigue, a person feels lethargy and indifference to everything, cannot concentrate, and has no strength for anything.

Symptoms of the disorder include: nine0003

  • weakness, which even after rest and sleep is not replaced by activity;
  • pain that covers the whole body, discomfort;
  • poor sleep, slow falling asleep and frequent awakenings, not feeling sleepy in the morning and daytime sleepiness;
  • increased anxiety;
  • frequent colds.

In the case of depression, a person is tormented by rapid fatigue, a negative vision of the future, and a constantly lowered mood. nine0003


Stress, overload and overstrain deplete the nervous system, it disrupts the exchange of neurotransmitters - for example, serotonin (the hormone of joy, pleasure). By itself, it recovers for a long time, you can speed up recovery with the help of antidepressants and psychotherapy.

Lack of appetite, lack of response to external circumstances in the family, at work, in society can be added to the symptoms of a mental disorder. nine0003

Mild depression can hide several mental disorders at once (dysthymia, bipolar affective disorder, cyclothymia), their treatment is different. Therefore, for a diagnosis, you need to contact a competent psychotherapist.

How to get rid of fatigue and depression?

Without timely treatment, symptoms can seriously damage family relationships, affect professional activities and relationships with friends. nine0003

If depression and fatigue prevent you from living a full life, working and communicating with loved ones, do not put off making an appointment with a specialist!

A competent psychotherapist will tell you how to get rid of chronic fatigue and depression:

  • symptoms of depression, fatigue, sleep problems relieve drugs - antidepressants, sedatives;
  • psychological problems, psychotraumas, conflicts need to be resolved at sessions of individual psychotherapy; nine0020
  • You can control vegetative manifestations, control the body and resist stress with the help of biofeedback therapy.

With a timely visit to the doctor and strict adherence to the recommendations, the prognosis is favorable.

Chronic fatigue syndrome: signs and treatment

Spleen, apathy, depression - that's what many people call it.
Asthenic syndrome - doctors call it.

What is it? There is such a simple life hack: if symptoms of weakness and lethargy appear right in the morning, then you need to ask yourself when do you feel better in the morning or in the evening? If in the morning, then everything is ok. If in the evening? For example, you went to bed on time, and it’s very difficult to get up in the morning, you have to persuade yourself for a long, long time, while there may be sleep disturbances, you get up as if you didn’t rest, you feel overwhelmed in the morning and this lasts for a long time, then, of course, you need to suspect depression . And here the help of a specialist may be required, very often this condition is a mask of some kind of chronic disease. 9 should work here0070 is not just a psychologist, but a good practitioner who can see the condition that is masked by depression.

The second option

when the condition is not bad in the morning, but it worsens in the evening. I worked quite a bit and was exhausted, I have no more strength, I want to sleep again, and there is still a long day ahead. In such a situation, we must think about organic conditions, most often hormonal. There may, of course, be conditions such as anemia and dysfunction of the gastrointestinal tract, but more often endocrinology. A hormonal examination will allow you to dot the “and” and make adjustments. nine0074 The third option should include moments of depression and asthenia that occur after past illnesses. When the body struggled with something, it used up resources and is now exhausted. The end of winter-spring is a period when we often get sick, and the energy reserves in the body are replenished slowly, also because the products that we can find this season are depleted in vitamins and microelements that are necessary for energy processes.

If an asthenic condition has already arisen, then, of course, we will not achieve the desired effect by changing the diet alone. You definitely need vitamin supplements. nine0003

Consultation with specialist is required for selection.

Vitamins themselves are not a source of energy, but they activate numerous metabolic processes. Thanks to vitamins, food is properly digested and gives us strength. The metabolism works exactly the way it is supposed to work. The activity of hormonal glands, the cardiovascular, nervous system is regulated, they are involved in hematopoiesis. Vitamins are involved in all body processes, so the deficiency of each affects the deterioration of well-being. nine0066

So, vitamins and microelements - activators of energy processes: C, B1, H (biotin), folic acid, vitamin D, Copper, Chromium, Potassium, Magnesium, Iron, Iodine.

Let's see why and what vitamins we need. Why is it necessary in the spring, even if we eat right and include a lot of green and fresh foods in the diet. First of all, of course, vitamin C . He is responsible for immunity, for vitality, for a good mood. Increases the body's resistance to disease. Participates in the exchange of norepinephrine - this is the hormone of courage, thanks to which we kind of internally gather, mobilize, begin to think more clearly, make decisions faster and be effective. Effectively deal with stress. nine0003

The second most important vitamin in this respect is vitamin B1 . It helps the regeneration of the nervous system, which affects the emotional state. Participates in the Kreps cycle, this is the main energy station in the body, so it is essential.

Vitamin B7 (Biotin, Vitamin H, Coenzyme R) controls the absorption of nutrients and their conversion into energy. Eliminates the feeling of eternal fatigue even with prolonged exertion, relieves sleep problems and, along with thiamine, determines the human ability to concentrate and mental work. nine0003

B9 (folic acid), like vitamin C, promotes the production of norepinephrine, protects against stress, awakens optimism and gives us energy. Including sexy!

Vitamin D orchestrates the blood flow. How well he copes with his task depends on whether the cells are fully supplied with oxygen and cleared of decay products in a timely manner, as well as how quickly we can restore our strength after rest.

No less than vitamins, we need minerals:

Copper , the presence of which in the body directly affects metabolism, is involved in the formation of norepinephrine and serotonin.

Iron together with vitamin D is responsible for delivering oxygen to cells.

Selenium strengthens the nervous system and performs many other functions.

Potassium , the lack of which results in muscle weakness and heart rhythm disturbances. In order to avoid potassium deficiency, first of all, it is worth giving up fast food, which contains monosodium glutamate and salts, which are potassium antagonists. nine0003

Iodine saves us from chronic fatigue, shattered immunity and mental decline.

Chromium affects the functioning of the brain and the activity of the nervous system.

Magnesium is the "main power engineer" of cells, participates in more than 300 biochemical reactions and metabolic processes and along the way provides us with healthy sleep. Its deficiency is expressed in a feeling of permanent fatigue, lethargy and dizziness. nine0003

Additionally, we want to say that iron and iodine deficiency also causes a state of apathy and lethargy. Their prescription is recommended by doctors because there are certain restrictions.

If you take vitamins, eat well and properly, but nevertheless you are still covered in spring. There is an even more advanced level, we can test the genetics of vitamin metabolism . This is a simple and quick test, it is cheaper than constantly testing vitamin levels. nine0172 In genetics and metabolism of vitamins, there can be persistent vitamin-deficiency states, despite even taking medications. There may be features associated with the exchange of vitamins, genetic features in which a person needs higher adjustments than others. Vitamins are coenzymes of many metabolic processes. They are involved in the synthesis of substances-accelerators of metabolic processes. Without them, they are not produced; without them, genomic material cannot be read. We have certain genes that encode all metabolic processes, the synthesis of regulatory proteins, enzymes that ensure the regulation of all metabolic processes. Information from genes may or may not be read due to the fact that there is a deficiency of certain vitamins in the body at the moment. Activation and synthesis of hormones may not occur due to the lack of certain vitamins, there is no reading of genomic material that encode information about the activity of hormones, for example. Therefore, vitamin deficiency is the first thing to be eliminated. nine0172 This study opens the veil of chronic conditions: persistent anemia, persistent chronic fatigue syndromes, digestive disorders. Gives simple answers to what needs to be monitored, and correct only what is a stumbling block for each individual person. We would like our readers and patients to know that on a highly scientific level we can give a simple understanding of the processes, a simple answer to this question.

Learn more