How to fight depression and anxiety

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

How to deal with anxiety?

Simple Tips for Controlling Anxiety*

text from the American Anxiety and Depression Association website, translated by the author of the site.

If you are anxious, the following steps can help you cope:

Make time for leisure. Practice yoga, listen to music, meditate, learn relaxation techniques or make time for a massage. Avoiding the problem in a pleasant pastime will free your head from problems. nine0005

Eat healthy. Do not avoid any kind of food. Provide healthy food. Avoid feeling hungry with regular snacks and regular meals.

Limit your intake of alcohol and caffeine , they can increase anxiety and cause panic attacks.

Get enough sleep. Under stress, you need to sleep and rest more than usual.

If anxiety develops, defeat it: Make sure that your breathing is deep. Inhale and exhale slowly.

Slowly count to 10. Repeat and count to 20.

Treat everything with humor. Many problems can be solved with a good laugh.

Maintain a positive attitude. Direct your efforts to replace negative thoughts with positive ones.

Take part in various undertakings. Be active, volunteer or do other community work that requires you to keep in touch with people, which will help you take your mind off your daily worries. nine0005

Find out what makes you anxious. Is it work, family, school or something else?

Keep a journal, record when you feel stressed or anxious, and look for patterns.

Find someone to talk to. Let your friends and family know that you are having a hard time coping with your feelings, tell them how you can be helped.

See a doctor for professional help.

Accept that you can't control everything. nine0010 Imagine the further development of the situation that worries you: is it really as bad as you think?

Make yourself better. Instead of striving for perfection, which is impossible, be content with how close you get to it.

Exercise daily to keep your body healthy. Follow the advice below.

Get in shape

Stay healthy, manage stress! nine0005

To maximize the benefits of exercise, try to include at least 2½ hours of moderate-intensity activity (e.g. brisk walking) per week, at least 1¼ hours of vigorous activity (jogging or swimming), a combination is allowed loads.

5 X 30: Run, walk, bike or dance three to five times a week for 30 minutes.

Instead of endlessly striving for perfection, set yourself daily goals and objectives. It is better to walk every day for 15-20 minutes than to wait for the weekend and arrange a three-four-hour fitness marathon. The fact that the regularity of the load is more important is indicated by multiple scientific data. nine0005

Find out for yourself what kinds of activities you enjoy. Sociable people often prefer group activities. Closed - individual lessons are better suited.

Listen to music, audiobooks, or the news during class to take your mind off your daily routine. Many people find it more enjoyable to practice while listening to their favorite songs.

Assemble a "team of like-minded people". By talking with friends, colleagues or partners, it is easier to form the habit of regular exercise. nine0005

Be patient when starting a new program. Most people who have previously been sedentary take four to six weeks to develop the strength and coordination that will allow them to exercise effortlessly.

* Recommendations are not intended for use without regular medical supervision. Non-drug anxiety control measures such as autogenic training and meditation may worsen the patient's condition in severe forms of depression and more serious mental illness. nine0005

Useful links to popular materials from other sites
  • Comic book about depression
  • How to avoid irritability at work?
  • PHQ-9 Depression Questionnaire
  • GAD-7 Anxiety Questionnaire
  • Ways to create a peaceful life | Blog 4brain
  • How to choose a psychotherapist

Anxiety - expectation of danger or misfortune in the future, accompanied by feelings of anxiety, stress and/or somatic symptoms of tension. At the same time, the source of the expected danger can be both internal and external. nine0005

With anxiety in humans, in animals, the constant expectation of a predator attack is similar (Dawid H. Barlow, 2002, M.G. Craske, S.L. Rauch, R. Ursano, 2009).

Anxiety may be a natural human response to potentially dangerous situations.

Apart from the cases that really threaten with problems, anxiety is often found in both bodily and mental illnesses.

There is a group of mental illnesses in which anxiety is the main symptom: generalized anxiety disorder, obsessive-compulsive disorder (formerly called obsessive-compulsive disorder), panic disorder, post-traumatic stress disorder, social phobias, and other rarer conditions. nine0005

In patients who visit a neurologist, anxiety disorder can be one of the factors in the appearance of pain associated with an increase in skeletal muscle tone - more often headaches and more in the neck, less often - pain in the chest and back.

Individual manifestations of anxiety: difficulty breathing, nausea, dizziness, feeling of dry mouth, "lump in the throat" are often considered by patients as symptoms of bodily or neurological diseases. The search for the cause can go on for years.

It is extremely difficult to make a correct diagnosis on your own. The fact is that anxiety changes the process of thinking - the patient cannot soberly assess the situation. Arise cognitive distortions : complaints and symptoms in the mind of the patient are undoubtedly significant, require maximum attention. In this state, people often become victims of medical fraud. Even a competent doctor who adheres to a certain plan in managing a patient finds it difficult to resist the onslaught and calmly convince the patient that there are no serious problems.

Comparative characteristics of fear of anxiety and depression

Types of reactions Fear Alarm Depression
Verbal (subjective assessment) Imminent threat thoughts Thoughts of danger in the future Thoughts of loss, fatigue, general weakness
Somato-visceral Sympathetic Nervous System Activation Muscle tension Decreased activity
Engine Escape Avoidance Refusal to make a decision, delay

Psychiatrist told how to cope with anxiety, and what to do for people with prolonged depression - Teacher's newspaper

Psychotherapist Galina Pavlova gave some advice on overcoming anxiety. They will be useful to people who have lost their peace and sleep amid the ongoing events of .


The events that are taking place in the world plunge many Russians into depression. The state of anxiety, which does not leave day or night, deprives you of sleep, inner peace, prevents you from competently prioritizing and getting out of the situation with the least losses.

The nervous system suffers, chronic pathologies become aggravated, thoughts appear that frighten relatives. What to do in such a situation?

In search of an answer to a question that readers of the Uchitelskaya Gazeta online publication have been asking especially often lately, a UG.RU correspondent turned to a psychiatrist, a psychotherapist Galina PAVLOVA .

– There is really a lot of negativity in the world, in the space surrounding us. Hence the wave of aggression that began at the height of the pandemic. Coronavirus, loss of loved ones, lockdown, remote work and education… All this contributed to the emergence and development of anxiety disorders, depression, panic attacks, sleep problems, both newly emerged and intensified, exacerbation of chronic diseases.

Symptoms may appear, such as constant or too strong situational anxiety, which occurs, for example, after watching the news, communicating with relatives from the opposite side, and many have them. Sometimes this can lead to a state of horror, panic with vegetative symptoms - tachycardia, tremor of the hands, body, chills, rise in blood pressure, lowering mood up to severe apathy, depression, a sense of hopelessness, a dead end. nine0005

Sleep may be disturbed - either it is difficult for a person to fall asleep due to experiences, obsessive thoughts, or frequent awakenings, nightmares and unpleasant dreams, early rises are noted. Therefore, it is really very important when similar symptoms appear in time to contact a specialist who will objectively assess your condition, select a treatment and give recommendations.

It is also worth helping yourself. We need to take care of ourselves, limit the flow of negative information, realize that we cannot change what is happening in the world, we cannot know for sure what will happen next, but it is in our power to maintain our peace of mind and the health of loved ones, support those who need it, ask for help when needed.

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