Depression and apathy

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.

  • 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

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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. SAMHSA’s 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.



  • 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)
  • The 2019 National Survey on Drug Use and Health reports that 139.7 million Americans age 12 or older were past month alcohol users, 65.8 million people were binge drinkers in the past month, and 16 million were heavy drinkers in the past month
  • About 2.3 million adolescents aged 12 to 17 in 2019 drank alcohol in the past month, and 1.2 million of these adolescents binge drank in that period (2019 NSDUH)
  • Approximately 14.5 million people age 12 or older had an alcohol use disorder (2019 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)
  • Data from the 2019 NSDUH reports that 58.1 million people were current (i.e., past month) tobacco users. Specifically, 45.9 million people aged 12 or older in 2019 were past month cigarette smokers (2019 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:

  • 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 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)
  • An estimated 745,000 people had used heroin in the past year, based on 2019 NSDUH data
  • In 2019, there were 10.1 million people age 12 or older who misused opioids in the past year. The vast majority of people misused prescription pain relievers (2019 NSDUH)
  • An estimated 1.6 million people aged 12 or older had an opioid use disorder based on 2019 NSDUH data
  • Opioid use, specifically injection drug use, is a risk factor for contracting HIV, Hepatitis B, and Hepatitis C. The CDC reports that people who inject drugs accounted for 9 percent of HIV diagnoses in the United States in 2016
  • 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



  • 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)
  • 2019 NSDUH data indicates that 48.2 million Americans aged 12 or older, 17.5 percent of the population, used marijuana in the past year
  • Approximately 4.8 million people aged 12 or older in 2019 had a marijuana use disorder in the past year (2019 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: 04/27/2022

What is apathy and depression. Signs, tactics, prevention - clinic "Dobrobut"


Medical Library Dobrobut

Publication date: 2020-04-01

Apathy and depression - causes, treatment

Apathy and depression often go together. Apathy is considered a psychosomatic state, which is characterized by indifference, lack of interest in people and events. Depression is a more depressed mental state. Whether such disorders can be managed without treatment is a moot point. It is important to understand when temporary indifference associated with external causes becomes protracted and develops into depression.

Causes of depression and apathy

Often such disorders are confused with chronic fatigue syndrome, but they are distinguished not only by the course, but also by the causes of development. The causes of depression and apathy can be:

  • stressful situations - conflict at work or in the family, sudden disability, death of a loved one, etc.;
  • disorders of the endocrine system;
  • protracted chronic diseases that exhaust psychologically;
  • lack of sunlight, emotional burnout, beriberi, mental stress - especially often observed in students.

In some cases, a state of apathy and depression appears on the background of long-term use of contraceptive hormonal drugs, blood pressure lowering agents, steroids. The depression of psychosomatics is a side effect of these drugs, so they are taken only as prescribed by doctors for a certain time.

On the other hand, the causes of apathy and depression, as well as chronic fatigue, may be similar. However, only a specialist can make an accurate diagnosis, and if a person makes a verdict on his own and self-medicates, this can lead to serious consequences. Prolonged depression often provokes the appearance of suicidal thoughts.

Treatment of apathy and depression

Before dealing with depression and apathy, it is necessary to understand the causes of these conditions. If possible, you need to use your will to analyze your condition and understand what is needed to return to an active life. The danger lies in the fact that a person quickly sinks into an apathetic state, it seems to him that he can live without taking any action. Therefore, it is important that close people help the person psychologically, and if the violation in question drags on, then they bring him to a psychologist to find out how to overcome depression and apathy.

Most often, the described conditions are caused by severe stress. The chain "stress - apathy - depression" is fraught with the development of a serious condition. Answering the question about methods of dealing with depression and apathy, experts note the need to avoid stressful situations. For example, if there is a conflict at work, then it must be resolved or the job should be changed altogether. But doctors warn that this approach may not always work - for example, if a person has lost a loved one, then it is impossible to avoid stress. Therefore, you should immediately turn to specialists for psychological help.

It is not possible to get rid of apathy and depression quickly, it takes time and effort. With the onset of depression, setting yourself some grandiose goal, the path to which can be divided into several stages, will be effective. This should be a realistically achievable goal, and then it will be much easier to achieve what you want. It is worth keeping a diary of your achievements and carefully planning every day, noting what has already been done.

In severe cases, apathy and depression are treated with drugs. They are prescribed only by doctors - you need not only to know the daily dosage, but also the duration of therapy. Simultaneously with drug therapy, psychotherapy sessions are carried out.

Controlling one's psycho-emotional state will help to avoid disturbances. How to get rid of apathy and depression without hospitalization and taking medications can be found on the pages of our Dobrobut website.

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What is the feeling of apathy in a person. What to do if complete apathy for life

Most people know firsthand what apathy is. Frustration and fatigue are part of life, and the emergence of apathy is one of the reactions to stress. Traditionally, this concept is considered as a state that is manifested by the loss of interests, vitality and emotional responses. Each of us has periods of moral fatigue, depression and indifference to what is happening. All this negatively affects work, prevents you from maintaining personal relationships and enjoying life.

Apathy is a painful state of lethargy, indifference, lack of strength and motivation. There may be a loss of interest in hobbies and in things that previously seemed exciting and important.

Such signs are, of course, not uncommon. However, they should not be underestimated. You cannot be sure if you have apathy that this is a trifle that you should not pay attention to. In some situations, this condition not only reduces the quality of life, but can also be dangerous. For example, if a person is sick with a somatic disease, apathy will prevent him from gaining motivation for treatment. Also, apathy can be a symptom of a number of mental and neurological disorders.

Therefore, if you notice warning signs in yourself or a loved one, it is better not to ignore the problem, but try to figure it out.

Causes of apathy

All the reasons why apathy appears can be divided into two large groups: external and internal.

External causes are factors that act on the brain from the external environment or from other areas of the body. What causes apathy in such people:

  1. Severe stress - loss of a loved one, dismissal from work, man-made or natural disaster; can lead to the development of post-traumatic stress disorder.
  2. Emotional burnout - chronic stress, work with high responsibility, stressful lifestyle; high probability of developing neurasthenia, there may be reactive depression.
  3. Somatic diseases - diseases of organs that indirectly affect the brain; for example, atherosclerosis of the vessels that cause a stroke
  4. Endocrine disorders.
  5. Side effects of drugs: drugs that reduce blood pressure, sleeping pills, contraceptives.


Apathy can be a symptom of a number of mental and neurological disorders: depression, schizophrenia, Alzheimer's disease.

All of the above is not uncommon for a person who lives in a modern city. The emotional reaction in the form of situational apathy in these cases is a variant of the norm and passes along with the elimination of the stress factor.

Why does apathy set in for everything that happens when there are no external causes and reasons? Here, internal causes come to the fore. Apathy can be a symptom of a number of mental and neurological disorders: depression, schizophrenia, Alzheimer's disease.

Apathy in depression. Apathy can occur both in major depressive disorder and in dysthymia and masked depression. The latter is a type of depression, in which somatic complaints (pain in the spine, itching, respiratory failure) come to the fore in the absence of objective signs of the corresponding diseases. These are the so-called "masks" of depression, such conditions often cause difficulties in making a diagnosis.

Apathy in simple schizophrenia. This form of schizophrenia is characterized by slow progressive development and loss of natural mental functions. Emotional coldness, pathological indifference, thought disorders come to the fore. Delusions and hallucinations are not observed at all or almost, which is why the disease can go unnoticed for a long time. Without the intervention of a specialist, it leads to complete social isolation and disintegration of the individual.

Apathy in Alzheimer's disease. Alzheimer's disease is a neurodegenerative disease that primarily affects the frontal lobes. The occurrence of apathy is associated with the defeat of these particular parts of the brain, as well as with the development of dementia. Apathy develops in most patients with this disease.

What apathy looks like: symptoms and signs

Apathy deprives a person of interest in life, desires and motivation. The absence of these important incentives adversely affects behavior and performance. A low level of energy will interfere with both daily routine activities and taking on new challenges.


Over time, despite the actual deterioration of the condition, patients talk less and less about their problem, but go deeper into it.

Emotions are blunted, which is why everything that used to be of interest now does not give an emotional response. Bouts of apathy take away interest in almost all aspects of life. A person may be indifferent when long-awaited events occur, or when meeting new people. It is difficult to make an effort even to solve personal problems. The accumulated problems at work and in personal life only exacerbate the situation, because apathy is one of the ways the psyche isolates itself from a difficult situation and overstrain.

At first, when manifestations have not reached their maximum, people may express similar complaints: “I have some kind of apathy, I don’t want anything”, “I’m tired of everything, I can’t concentrate, I have no desire.” Over time, despite the actual deterioration of the condition, patients talk less and less about their problem, but go deeper into it. If your loved one complains to you about painful feelings, you should not ignore these words - the person may need help.

The main signs of apathy:

  • decrease or lack of aspirations and motivation;
  • changes in emotions and behavior: decreased interest in life, communication, old hobbies and new events, difficulty in performing current tasks, lethargy, lethargy, poor concentration, decreased mental functions, and more;
  • impact on quality of life: changes in behavior negatively affect professional success and personal life;
  • changes in behavior are not associated with the use of drugs and alcohol.

Clinically significant is the presence of these signs in a person for four weeks. Nevertheless, if you notice apathy in yourself or in your loved one, which lasts less, but causes significant discomfort and interferes with life, you should not postpone contacting a specialist. A professional will quickly help you understand the situation and understand whether it is just a bad mood, fatigue, or a condition that, in order to prevent complications, requires correction.

Diagnostic measures that can be carried out in a person with complaints of a feeling of apathy:

  1. Consultation of a psychiatrist-psychotherapist
  2. Pathopsychological research: helps in more depth
  3. to explore such mental functions as thinking, attention and memory. The method helps to detect disorders in the early stages and prevent the occurrence of severe manifestations
  4. Laboratory and instrumental methods to confirm
  5. diagnosis: Neurotest, Neurophysiological test system, EEG, CT, MRI of the brain (if organic pathology is suspected)
  6. Consultation of related specialists (neurologist)

How to cure apathy

Eliminating any mental problem takes time. If you or your loved one has signs of apathy, an experienced specialist will tell you how to help in this situation most quickly and effectively. It is necessary to establish and analyze the cause of this condition. It is up to her to choose the right combination of the following therapeutic approaches.

First of all, psychotherapy and pharmacotherapy will help.

Individual psychotherapy is one of the most effective methods. If the stressor cannot be eliminated, the doctor will help find a way to cope with it in a different way. During the sessions, patients learn to better understand the problem, fight fears and think positively. During the conversation, you will understand how to survive apathy and other painful feelings.

Pharmacotherapy. If the cause is a mental disorder or anxiety, then, depending on the problem, the doctor will prescribe the appropriate modern drugs. For example, mild tranquilizers are used that effectively relieve anxiety, or antidepressants that normalize mood have a positive effect on mental activity. Antipsychotics may be used.

Additional help:

  • family and friends support: if you want to know more exactly how to help a person with apathy, then a specialist will tell you how best to do it in your case
  • normalization of lifestyle, sufficient sleep, elimination of the stress factor: this item is important for apathy of any etiology
  • physiotherapy, massage, vitamin therapy, adaptogens: recovery of the body after difficult, exhausting periods (processing, past illnesses)

Remember that health is not limited to physical parameters.

Learn more