How to deal with a depressed teenager

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 help a teenager cope with depression. Tips for parents: 08 February 2019, 07:07


February 08, 2019, 07:07


Has your teenage child suddenly become nervous and irritable, or, conversely, sad and thoughtful? What is this, a bad mood? Or is there something more serious behind the odd behavior?

Most teenagers usually quickly return to their normal state after a sharp change in mood, typical of this age. However, those who experience sadness, doom, or increased nervousness for weeks or even months are more likely to be depressed.

The reasons for it can be very different - a change in the usual environment, a new school, divorce of parents, unrequited love, conflicts with teachers or peers, etc. Stress, rapidly changing hormones and lack of sleep exacerbate the problem. In a state of depression, adolescents are more at risk of rash acts and actions, as well as drug addiction, self-torture and even suicide.

Depression often causes behavioral changes. Adolescents can avoid society, become easily excitable, withdraw into themselves. Academic performance may also worsen, indifference to studies, previously beloved activities and hobbies appears.

Attentive parents may notice changes in a teenager's condition by how much he sleeps, how much his appetite or concentration of attention. Self-esteem and self-confidence in a state of depression can also decrease.

The most important thing you can do in these situations is to acknowledge that something is wrong with your son or daughter. It never hurts if you seek the help of a medical professional. The doctor will be able to rule out possible health problems that may be causing depression and will refer your child to a psychologist if necessary.

Depression is considered a disease of the brain. Fortunately, curable. An ever-growing body of scientific evidence in this area supports the neurobiological aspect of depression. Genetic factors and social experiences can lead to changes in brain neurotransmitters, neuroplasticity and neural networks in the brain, and hormonal dysregulation.

Psychotherapeutic talks and, if necessary, medication are very effective for teenagers. They will become much better if they begin to understand and manage their moods and feelings, learn to think positively and accept themselves without self-criticism and judgment. It has been proven that early detection and treatment of depression can help prevent or minimize its negative consequences.

Meanwhile, parents themselves can also help teenagers cope with depression.
1. Be honest. Explain to your teenager that depression is temporary and can be managed.

2. Be patient . Help your teen build self-esteem and be more patient with treatment if needed.

3. Encourage good habits . Daily exercise (even walking), proper sleep, outdoor activities, and a healthy diet can help fight depression.

4. Encourage openness. Give your teen space to express their feelings without judgment. If you disagree with his decisions or actions, tell him so.

5. Show family support . Make time for your teen to spend time with family members who support them, especially those who can cheer them up and lift their spirits.

6. Encourage active participation . Make it easy for your daughter or son to connect and spend time with friends.

7. Talk about friendship . Remind your teen that reliable friends will always be around, and unreliable people should not be friends. Remind them that relationship problems won't last forever.

It is very important that in a crisis situation, parents remain calm and patient and support a teenager who should not feel lonely and abandoned. As a rule, growing up children judge you by actions, not by words, so it is necessary to show teenagers your own positive example, not to judge or deceive them, and also to show unobtrusive care and attention to their problems.

Material prepared by Almaz Sharman, professor of medicine.
Read other useful articles on health and disease prevention at

A teenager in depression: psychologist's advice on how to avoid trouble

Parents of teenagers often pay attention to the fact that their children suddenly change: until recently, a cheerful child loses interest in studies, friends, and life in general. He is not happy with everything. The son or daughter looks tired, refuses to eat. Lose weight or, conversely, gain weight. Many tend to attribute this to a transitional age, but it is important not to miss the onset of depression. How to recognize it and sound the alarm in time, says Elena Sizikova, a psychologist at the Kutuzovsky family center.

— What symptoms should alert parents?

- Sleep disturbance - insomnia or drowsiness. The child may complain of difficulty concentrating. Experience feelings of worthlessness and guilt (often unfounded). Sometimes depression in children manifests itself in behavior - hyperactivity, enuresis, school failure. The teenager is restless, obnoxious, denies everything. It comes to antisocial or aggressive behavior. May become sullen, avoid family contact. Or vice versa - to seem too emotional, sensitive, especially with peers. He does not care about his appearance, his performance at school.

— Why is this condition dangerous?

- It is often accompanied by obsessive thoughts about death, suicidal intentions or attempts. A teenager in this state can start using alcohol and drugs. Depression in a teenager should not be underestimated: it can lead to serious, dangerous, even irreparable consequences.

- How to prevent this? What to do if symptoms of depression appear?

- If you know or suspect that your child is thinking about death or is a member of destructive groups in social networks, then you should urgently seek help from a psychologist. For example, to one of the family centers in Moscow. It's hard to do it on your own.

If we are talking about the prevention of teenage depression, then it is important to understand that adolescence is a very difficult, conflicting age. It is impossible to avoid conflict situations. Yes, and you don't need to. The most important thing is to try to create such a psychological climate in the family so that the teenager feels supported, knows that he is heard and considered.

- It's easy to say, but how can parents create such an atmosphere?

- There are several methods: active emotional support for a child in a state of depression and encouragement of his positive aspirations. This will help ease the situation. It is possible and necessary to teach a teenager to socialize and overcome stress - psychologists will also help here. Another method is to expand the time perspective and self-understanding.

- You said that conflicts should not be avoided, and a positive atmosphere cannot be created in a short time. How to behave when conflict is inevitable?

- Clearly express your fears and concerns to the teenager so that he can understand them. Bring a teenager to a frank conversation to find out what is happening to him. He must know that he will be listened to without criticism and condemnation. An adult needs to show his willingness to listen and understand, which does not mean forgiveness at all. It simply creates a solid foundation on which to build further relationships. A teenager needs his parents to listen to him, but not give advice until he himself asks them about it. It is difficult to come to terms with this, but parents need to accept and understand: a teenager does not have to follow the advice of elders at all. He makes his choice.

Only with this approach is it possible to have a meaningful dialogue between two equal people - an adult and a teenager. Only on such a basis can constructive communication and behavior be built.


If you hear

Please tell me

Never say

"I hate studying, class..."

"What's going on with us that makes you feel this way?"

"When I was your age... you're just lazy!"

"Everything seems so hopeless..."

“Sometimes we all feel overwhelmed. Let's think about what problems we have and which one needs to be solved first"

"Better think of those who are worse off than you"

"Everyone would be better off without me!"

"You mean a lot to us and I'm worried about your mood.

Learn more