Depression down days

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. 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

Depression: more than a bad mood

What is depression? Many people will say that this is a newfangled word for lazy people and idlers - they say, do not touch me, I feel bad! In fact, clinical depression is a serious condition that requires diagnosis and timely treatment. Today we will talk about the signs of depression, treatment methods and, most importantly, about the stereotypes and fears that this condition has acquired.

We all have sometimes "bad days" - cloudy weather, fatigue, problems at work or conflicts with loved ones. .. When you are sad for a day or two, and then everything falls into place again, this is not depression. You can talk about the suspicion of a disease when emotional depression persists for weeks or even months, without signs of improvement. Many people think that depression is a trivial condition, a fake and contrived disease. But this is not true, because depression is a real disease with real symptoms and treatments. Depression is not an indicator of “weakness”, it is not something that can be dealt with if you just “pull yourself together”. But the good news is that once you have been diagnosed with depression by a doctor, the condition is highly treatable and most patients are able to fully recover and enjoy life again. nine0003

What are the signs of depression?

Depression can manifest differently in different patients.

Emotional symptoms - feelings of hopelessness, sadness, melancholy, loss of interest in favorite activities, tearfulness. Many people with depression also suffer from increased anxiety.

The disease may also present with physical symptoms such as insomnia, fatigue, various types of pain, lack of appetite and decreased libido. nine0003

Symptoms may vary in intensity. In the "mild" version, depression can be manifested by feelings of anxiety and bad mood, and "severe" forms of the disease can lead to suicidal states, when a person loses the desire to live.

When should you see a doctor?

If you think you have depression, don't put off seeing your GP. Our doctors speak Russian and have all the necessary qualifications for the diagnosis and medical treatment of depression. If required, we will also find a psychotherapist for you. The sooner you seek help, the sooner you can begin your journey to recovery. Do not be ashamed to seek help, depression is not a sign of weakness of character, but a disease that requires attention and treatment. nine0003

Causes of depression

Sometimes depression is triggered by some significant event in a person's life - the loss of a loved one, dismissal from work, divorce or even the birth of a child. Other risk factors are alcohol or drug abuse, loneliness, or long-term health problems (such as chronic heart disease or cancer). Some people also have a genetic predisposition to depressive disorders, but often depression appears for no apparent reason. nine0003

Depression affects one in ten people in the UK and can affect men and women, young and old alike. Studies have shown that about 4% of children aged 5 to 16 suffer from anxiety or depression.

Depression treatment

Depression is usually treated with a combination of three methods - the introduction of a healthy lifestyle, psychotherapy and medication. For each patient, a treatment plan is drawn up individually, based on the severity of the condition and the personal characteristics of the person. nine0003

If you suspect depression, don't be afraid to seek help. Our general practitioners will conduct a detailed diagnosis for you and help you choose a treatment, while maintaining your complete confidentiality.

6 ways to start your day with depression

There are days when you can't wait to get out of bed in the morning in anticipation of new interesting events. But more often you still want to soak up in bed longer. However, for people suffering from depression, getting up in the morning is difficult not because they want to soak up the bed a little longer. nine0003


  • 1. Start the morning with a mantra of gratitude
  • 2. Select only one target per day
  • 3. Agree on plans for the morning
  • 4. Communicate with pets
  • 5. Ask for help
  • 6. Don't blame yourself for bad days

Apathy, lethargy, lack of energy, a feeling that there is not enough strength even for the smallest task and horror at how much they have to do, physical and emotional heaviness and the inability to tear your head off the pillow - this is not a complete list of morning sensations and experiences of a person with depression. nine0003

According to WHO statistics, more than 300,000,000 people worldwide suffer from depression. According to 2017 data, the number of people with depression in Ukraine was about 6%. This is the leading position among European countries. And this number is increasing every year. According to the Ministry of Health, depression is the most common form of mental disorders in Ukraine.

This can be explained by prolonged hostilities in the east of the country, a huge number of internally displaced persons, restrictive measures in connection with COVID-19and the lack of a government program to support people's mental health.

There are many reasons, but the essence remains the same. The difficulty of getting up in the morning is due to a deficiency of serotonin, dopamine and norepinephrine - neurotransmitters that regulate mood, sleep, appetite, energy, memory and focus levels. If the levels of serotonin, dopamine and norepinephrine are imbalanced, a person feels tired throughout the day.

In order to help people with depression and make it easier for them to get up in the morning, there are effective methods: nine0003

1. Start the morning with a mantra of gratitude.

It is difficult for a person in a state of depression to find joy and reason for gratitude in anything. After all, apathy, lack of interest and inability to enjoy the usual things are just included in the list of symptoms of this disease. But as hard as it is, trying to remember things to be thankful for can really help bring you back to life. You can start your morning by asking, “What is there in my life that I can be grateful for? Why get out of bed in the morning? It can be a favorite job, children, pets, or even indoor flowers or a flower bed under the window. nine0003

You can thank life for a roof over your head and get out of bed in order to put your house in order, or perhaps a meeting with a loved one is planned. It is enough to find at least one reason, cheer up and get out of bed for her sake.

2. Select only one target per day.

Having a long list of things to do can make you reluctant to get out of bed, causing you to think that it's impossible to redo these things anyway, it's pointless to even try. You can change tactics: instead of a long list of tasks, give yourself one goal per day. Doing one thing is not so difficult, and the very thought of freedom after doing it can be encouraging. nine0003

The main thing is that the goal must be realistically achievable. Even if it seems that you hardly have enough strength even for a walk in the park, let the goal of the day be a walk. Sometimes depression can be associated with a difficult life situation that needs to be addressed: a difficult task at work or a protracted conflict with a loved one. If a difficult life situation is at least partially fueling a depressive state, it makes sense to set a goal for yourself with an indication of the timing for its implementation. The deadlines can be flexible so as not to increase the anxiety of the deadline, but they should be. nine0003

3. Agree on plans for the morning.

People often find meaning in relationships with other people or shared hobbies. A depressed person may feel isolated and lonely. In this case, making plans with another person can be a good incentive to start the day: arranging to meet someone for breakfast, coffee, or a morning walk will not only help you get out of bed, but also strengthen your relationship with the other person. If the agreement only irritates or burdens, another motivation should be used. nine0003

4. Communicate with pets.

Pet owners know the benefits of having a pet in the family: companionship, unconditional love, affection and joy. Research has shown that having pets creates a sense of stability and security, and the need to care for them is an additional therapy for people with mental disorders. Communication with animals reduces fear and anxiety, increases the level of oxytocin in the blood. It is not uncommon for people with depression to keep pets as a distraction from their condition. A pet in the house will not allow you to stay in bed all day demanding food and attention, and keeping the pet alive and healthy will be motivating enough to get out of bed. nine0003

5. Call for help.

The first thing a person with depression needs to learn is that you don't have to deal with it on your own. A doctor can prescribe antidepressants to help relieve the condition, while adding therapy and therapies such as yoga, meditation, or acupuncture will help to gradually eliminate symptoms of depression, regulate mood, and cope with the disease much faster and more effectively. It is important to avoid alcohol and other central nervous system stimulants, as these substances can increase symptoms of depression. nine0003

6. Don't blame yourself for bad days.

People suffering from depression are more prone to self-criticism than anyone else. It should be borne in mind that during a period of depression there can be both progress and a rollback, when a person does not find the strength and incentives to get out of bed.

Learn more