Depression triggered by an event
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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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.
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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
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how depression occurs - T&P
Depression is a disease known since antiquity. People suffering from it have always had a hard life - not only because of their own longing, but also because of society's attitude to the problem: if earlier the patient was suspected of being possessed by the devil, then in our times depression is often considered a manifestation of laziness and weakness. Scientists, fortunately, think differently and, moreover, successfully treat this disease. T&P explains how real depression differs from the usual blues and what to do if someone close to you suffers from it.nine0003
“Depression” is a relatively new term, having appeared only in the 19th century. However, the disease itself has existed for more than a millennium. She is mentioned in ancient texts from Mesopotamia, Babylon, Egypt and China. In those days, the cause of depression (as well as other mental disorders) was considered to be the possession of a person by demons. Treatment, respectively, were exorcism sessions: patients were beaten, tied, starved.
In Ancient Greece at the time of Hippocrates, healers, following the legendary doctor himself, were sure that melancholy (as depression used to be called) is caused by an excess of "black bile" - one of the main body fluids. Hippocrates recommended the use of bloodletting, baths, exercise, and diet to treat this condition. nine0007
The next important step forward was taken in the time of Plato: the philosophers of that time came to the conclusion that childhood experiences and problems in the family can be the cause of mental illness. However, it was not possible to advance further than this thought in those days - after another half a millennium, the dark ages came, which did not promise anything good for the mentally ill.
St. Augustine, who lived at the very beginning of the dark ages, declared that despondency and depression are the punishment for sins, and the symptoms of severe clinical depression are signs of demonic possession (yes, yes, again). They treated "demons" in much the same way as in ancient times - with the help of punishments with which the sick had to atone for their sins. But even the gradual decrease in the influence of the church by the 17th-18th centuries did not bring anything good to those suffering from depression: the era of reason and rationalism explained the disease "progressively" - as a lack of self-discipline and indulgence of laziness. However, this does not mean at all that medicine also condoned “laziness” - depression was treated with torture designed to distract patients from pernicious lack of concentration. nine0007
By the middle of the 19th century, hysteria was in vogue in Europe - it was used to explain many diseases in women, from depression to sexual dysfunction. The popularity of hysteria has led to the emergence of a huge variety of methods for its treatment - from hypnosis and water procedures to quite medieval practices like cauterizing the skin with acid to distract the patient from the disease. In the 20th century, depression began to appear more and more often as a separate diagnosis in medical practice, but even today the attitude towards it is ambivalent - the myth that it is not a disease at all, but a lack of motivation, connivance and laziness, is still alive. nine0007
What is depression
Today, depression is called anything, up to endless sadness about the absence of your favorite tea in a cafe. Doctors, however, have their own opinion on this matter. Depression in its classic form (also called clinical depression or major depressive disorder) has four main symptoms, and none of them are at all like what people normally feel when separated from their favorite drink.
1) Decreased mood. This is not just sadness, but a feeling of longing and hopelessness, felt literally physically. In the event that depression is caused by events in the outside world (then it is called reactive), it is impossible in principle to distract yourself from oppressive thoughts, despite all the cheerful advice of friends to “not get hung up”. If depression is endogenous (that is, caused not by external factors or other diseases) and there would seem to be no reasons for sadness, then life simply ceases to please entirely, completely. nine0007
2) Impaired cognitive function - in other words, problems with thinking. Firstly, thoughts become very slow and clumsy, and secondly, it is noticeably harder to think of them than before - they either scatter or get confused, and it is impossible to put them together. And finally, thirdly, thoughts always revolve around one thing. Either around the cause of reactive depression, or, with endogenous depression, around one's own sins, shortcomings, mistakes, flaws in character. One way or another, quite often depressed people come to the conclusion that it is they who are to blame for all their (and sometimes others') troubles, and it will not get better, which means that life no longer has any meaning. That is why depression is so dangerous risk of suicide. nine0007
3) Motor retardation. It becomes as difficult to move as it is to think, even one expression often freezes on the face - according to acquaintances, people with depression seem to age for several years at once.
4) Disorders in the work of various body systems. Symptoms of depression also include loss of appetite, insomnia, weight loss (even if there are no problems with appetite), general weakness and constant fatigue, disorders in the gastrointestinal tract, decreased libido and menstrual irregularities in women. nine0007
In addition to clinical, "major" depression, there is also "minor" - when the patient has at least two of the listed symptoms, but their number or severity does not reach full-fledged clinical depression. It happens that such a condition stretches for several years - in this case, the doctor diagnoses "dysthymic depression". It is often caused by some traumatic event in the past, already half forgotten, but still oppressive.
Diagnosing depression correctly is not always easy, because in addition to “textbook-like” cases, there are also patients who do not have any characteristic signs of depression at all, for example, there is no depression and sadness. But instead of it (or some other symptom), other disorders are added. Such depressions are called atypical. Simple atypical depressions include those in which grouchiness comes together (the term "grouchy depression" really exists in medical reference books), anger, a tendency to be ironic, cry, etc. But if, in addition to the characteristic features of depression, the patient also has hallucinations or delusions , doctors talk about complex atypical depression (it is also called psychotic). nine0007
And, finally, in addition to unipolar depression, when the patient's mood is more or less consistently bad or not at all, there is also bipolar disorder (formerly called manic-depressive psychosis), in which periods of depression are replaced by episodes of impressive spiritual uplift.
If we talk about exogenous depressions, then the reasons for their appearance (at least first-order reasons) include all kinds of traumatic events that happened to the patient, various diseases (primarily neurological, such as epilepsy and dementia, and endocrine, for example, diabetes), traumatic brain injury, taking certain medications, lack of sunlight, severe stress. nine0007
The situation is more complicated with endogenous, “causeless” depressions. There is no unambiguous answer to the question of what goes wrong at the moment when a person starts to get depressed. But there are hypotheses in this regard. The leading one today is the monoamine theory. According to her, depression begins due to a deficiency in the body of two substances - serotonin and (or) norepinephrine (they just belong to monoamines). The first of them, among other things, is responsible for the feeling of joy, the second is called the “mediator of wakefulness”, it is actively produced during stress reactions and in situations when you need to get together and act. nine0007
The problem may be not only in the actual lack of these substances, but also in violations of their transmission from neuron to neuron. The development of Prozac and some other popular antidepressants is based on this theory - their job is to increase the amount of monoamines or correct problems with their transmission. However, not everything is smooth here. Critics of the monoamine theory say that if the state of depression depended only on the level of serotonin, then antidepressants would help immediately after taking, and not after a monthly course of treatment, as it actually happens. In addition, studies suggest that when serotonin levels decrease, not everyone starts depression. From these premises, a separate "stress theory" has grown. According to her, the action of antidepressants is not at all due to their effect on the level of serotonin in the body, but to the stimulation of neurogenesis - the birth of new nerve cells. These processes in certain areas of the brain go on throughout life, and stress can disrupt them. A couple of weeks of taking antidepressants corrects the situation, and depression is thus defeated. The "stress theory" today is no longer considered an explanation for the origin of depression, but as a hypothesis about the mechanism of the work of some antidepressants, it is taken quite seriously. nine0007
Pill of happiness
Of course, the conversation about the treatment of depression should begin with a story about antidepressants. They are divided into two large groups - stimulating and sedative. The former are used when symptoms of lethargy and fatigue predominate, the latter - with depression accompanied by anxiety. Selecting the right antidepressant is a difficult task, given the type of depression, its severity, the patient's perceived response to the particular drug, and the potential for mania in patients with bipolar disorder. Incorrect selection of the drug can result not only in aggravation of the condition, but also in suicide - stimulating antidepressants can give the patient just the strength that he lacked to end his hateful life. Actually, that is why it is better not to conduct personal experiments with these drugs. nine0007
Often patients with depression are advised to undergo a course of psychotherapy - however, soul-saving conversations mainly show their effectiveness in reactive depressions. Endogenous, they treat, according to research, about the same as placebo.
In general, the range of remedies recommended for mild forms of depression is quite wide: physical activity, light therapy, acupuncture, hypnosis, meditation, art therapy, and so on. Most of these methods have no evidence base at all, some (these include physical activity and light therapy) have it. Unfortunately, with severe endogenous depression, all this does not work. However, there are treatments for such cases. nine0007
Electroconvulsive therapy shows the best results (significantly better than antidepressants, for example). This is not at all a continuation of the centuries-old history of treating depression with torture: the patient is given pain relief and a drug to relax the muscles, after which, with the help of an electric current, he is subjected to controlled convulsions. As a result, chemical changes occur in the brain that lead to improved mood and well-being. After about 5-10 sessions, 90% of patients show significant improvement (antidepressants help in about 60% of cases). nine0007
Depression is one of the most common mental illnesses. According to WHO statistics, more than 350 million people suffer from it in the world. So, it is very likely that someone you know may have this disorder. It is with them that you can show all your delicacy and sensitivity, because the correct treatment of a depressed patient is very important.
The very first rule is not to be ashamed of being a reinsurer. If someone talks about plans to commit suicide, it is better to first call the emergency psychiatric service, and only then figure out if it was a beautiful phrase or an expression of intent. nine0007
Depressed people are rarely good conversationalists—few can be when life seems unbearable. Therefore, when communicating with someone in depression, you should not take too harsh answers or their complete absence personally - this is only a consequence of the disease. There is no need to reduce the conversation to platitudes like "everyone goes through this" and "I understand how you feel." Firstly, your own feelings are always perceived as unique, and secondly, you really most likely have no idea what exactly a person is going through at the moment. It can be much more helpful to admit that you do not know how your friend or relative is feeling right now and are ready to listen to him if he wants to tell you about it. nine0007
Depressed people often feel lonely and isolated from others, and therefore the words that they are not alone, that you are ready to support them and help them, can be very helpful. But to say how hard it is for you because of their poor health is not worth it - the feeling of guilt will only grow, and the person most likely will not be able to correct the situation with all their desire.
No need to try to help feigned optimism - most likely, "cheerleading" will only aggravate the condition. Trying to "order" to come to your senses and pull yourself together is another great way to ruin communication a little more than completely, as well as unprofessional advice on treating depression, regardless of what Wikipedia says about these specific recommendations. Just letting your loved one know that you are here and ready to help him is the best medicine you can offer. nine0007
reasons, how to understand that you have depression, how long it lasts, is it possible to get out of it on your own
Please explain in simple terms what depression is. For example, how long can it last? How can I tell if I or someone close to me has depression?
Is it possible to cope with depression without the help of a specialist? Can depression go away on its own?
Are there any official data for the world and Russia, how many people are in a state of depression? How many have been there? nine0007
Does depression depend on gender, age, nationality, faith, sexual orientation and place of residence, or are they unrelated to each other?
If there is an addiction, then who is more susceptible to depression: men or women, children or adults, Russians or Americans, Christians or Muslims, heterosexuals or homosexuals, Muscovites or Omsk residents, city dwellers or villagers?
Depression is a mental disorder. Its main manifestations are as follows: decreased mood, inability to enjoy life, severe apathy, pessimism, lack of strength. And the most disturbing symptom is suicidal thoughts. nine0007
It is often difficult for a depressed person to maintain full-fledged relationships even with those closest to him, to do household chores, to take care of himself. And also - to study and work productively, since depression often negatively affects cognitive abilities and brain function in general.
According to the currently main hypothesis of the occurrence of depression - the monoamine theory - during this disease, malfunctions in the work of neurotransmitters occur. These are substances with the help of which brain cells exchange information with each other, in particular monoamines: serotonin, dopamine and norepinephrine. nine0007
Understanding Depression - American Psychiatric Association
Depression is also known to affect certain parts of the brain: for example, the hippocampus, which is responsible for memory and emotional regulation, the prefrontal cortex, which processes information from the hippocampus, and the amygdala, which plays a role in the formation of fear and other emotions.
Go see a doctor
Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don't write prescriptions, we make recommendations. Relying on our point of view or not is up to you. nine0007
What causes depression
Predisposition to depression is determined by various factors. One of the most important is genetics. People whose immediate family members have had the disorder may be more likely to develop it.
Genetic Causes of Major Depressive Disorder - Psychological Medicine
Other significant risk factors are psychological and social.
Psychological factors include, for example, the conditions in which a person grows up and how others treat him during this period. If a child receives a lot of love and support, they are less likely to suffer from depression as an adult. Conversely, those who are often abused and humiliated in childhood have a higher risk of developing this disease. nine0007
Social factors that can trigger depression are, for example, low income and the city and region where the person lives. I will tell you more about this below.
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Another common cause is somatic diseases: hormonal failure or an acute deficiency of some substances. In addition, depression can be provoked by severe stress caused, for example, by the loss of a loved one or the loss of a job. nine0007
How long depression can last
According to a study by Dutch doctors, in 50% of cases, a depressive episode lasted three months. At the same time, more than 20% of the symptoms of the disease did not go away even after two years.
Duration of episodes of major depressive disorder in the Dutch population - British Journal of Psychiatry
Duration of illness depends on the severity and severity of symptoms, individual characteristics and other factors. In addition, some people experience relapses: there is evidence that in 50% of cases depression returns and needs to be treated again. nine0007
How to tell if you have depression
You can tell if a person is depressed by looking at their characteristic signs. The main one is a long-term decrease in mood. It can appear with different intensity. Someone due to depression feels a slight melancholy. Someone - an acute unwillingness to live.
In addition, you should be wary if you lost interest in your favorite activities for a long time - more than a month ago and nothing brings you joy. For example, you absolutely do not want to go for a walk, play sports, see friends and relatives. Or if the feeling of boredom and routine does not leave. Or you are tormented by thoughts about your own uselessness and that you don’t know how and why to live. And the future seems exceptionally gloomy, full of troubles and troubles. nine0007
Another important symptom is a constant feeling of physical weakness. Especially if it makes it difficult to force yourself to get out of bed, get dressed, take a shower and brush your teeth. And I want only one thing - to lie down, looking at one point.
Sleep and eating disorders can also signal depression. For example, insomnia or unusually long - 10-12 hours - sleep. And also a lack of appetite or, conversely, a strong craving for sweet and fatty foods, which provokes frequent overeating. nine0007
How to deal with insomnia
Depressed people often suffer from memory and concentration problems, as well as the ability to process information and make decisions. If you notice that you often cannot choose products in the store, you begin to be late everywhere, forget about things, do your work more slowly, there is a reason to consult a doctor. Especially if all of the above is accompanied by a bad mood and gloomy thoughts.
Complete list of signs of depression
According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, a diagnosis of depression can be made if a person has five or more symptoms of depression within two weeks:
- Low mood or persistent irritability.
- Significant reduction in pleasure or interest in all or almost all activities.
- Decreased or, conversely, increased weight and appetite. nine0146
- Insomnia or too much sleep.
- Psychomotor agitation or inhibition.
- Decreased energy and increased fatigue.
- Feelings of worthlessness and low self-esteem or inadequate guilt.
- Inhibited thinking or reduced alertness.
- Suicidal thoughts.
Online self-diagnosis questionnaires for depression, such as the well-known Beck test, are not worth using: they are very inaccurate. nine0007
Is it possible to cope with depression on your own
In theory, you can cope with depression on your own. But in extremely rare cases - with its mild and short form. The problem is that a person is usually unable to assess the severity and severity of their symptoms and establish the cause of their occurrence.
Therefore, if you suspect a mental disorder, it is better to contact a specialist. It is not so important who it will be at the initial stage: a psychologist, psychotherapist or psychiatrist. You will be helped to understand how to proceed further and whether treatment is necessary. nine0007
Dealing with postpartum depression
Depression is treated with specific medications. Often - in combination with psychotherapy. It has been proven that a combination of approaches gives the best effect. Other methods - mindfulness practices, yoga, physical activity - are useful and effective, but are of an auxiliary nature.
According to the rules in force in Russia, only psychiatrists and psychotherapists can decide on the appointment of drug therapy, select drugs, their dosage and adjust it in the course of treatment. Psychologists without a medical education are not entitled to do this. nine0007
A very small number of cases can be dispensed with without medication: when depression is mild, short-lived, and its symptoms are not pronounced. But again, the decision about this should be made by the doctor. I note that the side effects of modern drugs are much less inconvenient than the symptoms of depression, and they pass quite quickly. Therefore, you should not resist taking medication with all your might.
Treatment of depressive disorders with and without medication - Pharmacopsychiatry
And another important point. Sometimes depression is not an independent disease, but is part of other mental disorders. For example, bipolar affective or schizoaffective. They are treated differently than depression. Therefore, it is very important to make an accurate diagnosis at the very beginning: incorrectly prescribed therapy can aggravate the symptoms of the disease.
How many people suffer from depression
According to the World Health Organization, approximately 5% of the world's inhabitants suffer from depression. The top five countries in terms of the prevalence of depression are Ukraine, the USA, Estonia, Australia and Brazil. In them, this disease affects 5.7-6.3% of the population. nine0007
Russia - in eleventh place. According to WHO, more than 8 million - 5.5% - of the country's inhabitants have depression.Most likely, these estimates are lower than the real numbers. Especially in less developed countries, where medicine is not so well prepared to diagnose and treat mental disorders. In addition, even in developed countries, depression is often not detected. Source: World Population Review, WHO data Most likely, these estimates are lower than the real numbers. Especially in less developed countries, where medicine is not so well prepared to diagnose and treat mental disorders. In addition, even in developed countries, depression is often not detected. Source: World Population Review, WHO data
What affects predisposition to depression
Place of residence. It is believed that residents of large cities are more likely to suffer from mental disorders, including depression. They are constantly exposed to stress due to noise pollution and strong lighting, crowded population, lack of full communication with loved ones and high pace of life.
Urbanization and Mental Disorders - Industrial Psychiatry Journal
But it cannot be argued that living in the countryside is better for the psyche: there is no data on this. In addition, the state of the psyche determines not only the place of residence, but also other factors. It is impossible to separate them from each other. nine0007
If a person lives in a small settlement and at the same time does not experience financial difficulties, communicates enough with relatives, plays sports, then we can assume that he is more likely to be mentally healthy than a conventional city dweller.
Nationality. There is no relationship between nationality and predisposition to depression. On the other hand, the unfavorable socio-economic situation in the country of residence - poverty or political instability - seriously affects the development of any mental disorders. nine0007
Sexuality is also not directly related to depression. But the so-called minority stress that LGBT people experience in modern society makes them more vulnerable to mental disorders.
What is the difference between sex and gender?
Gender and age. But gender may be a risk factor: women are twice as likely to be diagnosed with depression. This is explained not only by physiology, but also by the peculiarities of the social status: women are more often subjected to violence and earn less. They have to balance work, childcare and domestic work, and their career options are limited. nine0007
Why depression is more common among women - Journal of Psychiatry and Neuroscience
In addition, there is a hypothesis that men are simply less likely to seek medical and psychological help. Therefore, they are less likely to be diagnosed with depression.
By the way, depression is not as common in children of both sexes as it is in adults. It affects 3.2% of the general child population. And most often, depression is diagnosed in adults 18-25 years old.
Religion. A significant link between depression and religious beliefs has not yet been found: the results of studies on this subject are contradictory. On the one hand, there is evidence that believers and atheists experience fewer symptoms of depression than those who occupy an intermediate position in relation to religion. nine0007
On the other hand, a large-scale study by scientists from Latin America showed that religious women over 65 years of age have an increased tendency to depression. But the reasons for this are unclear. The issue still needs to be studied.
8 myths about antidepressants
What is the result
Depression is a mental disorder that, according to statistics, affects 5% of people in the world. It may not go away for years. The predisposition to depression is genetic.