How to get free counseling for depression

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
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    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

Where to get free psychological help: 10 resources that will save you from depression


Chaos in life, defenselessness, despair, hopelessness - are these words about you? If the answer is yes, then know that there is always a way out of difficult situations. Let it sound trite, but after the black stripe there always comes a white one.

The first way to solve a problem is to share your feelings with parents or friends who can help with valuable advice, share your pain. But if, for some reason, you cannot tell your loved ones about what is worrying you, or their support does not help you recover, then another option is to seek help from specialists. And for free. In this article, we have collected 10 resources where you can get free psychological help.

1. Internet Service of the Emergency Psychological Aid of the Ministry of Emergency Situations of Russia

On this site you can anonymously ask a question to the psychologist of the service. In the "Questions to the psychologist" section, your message will be displayed and a written answer from the specialist will appear within a few hours. You can anonymously ask a question once, and in order to communicate with a psychologist in the format of personal communication, you must register on the site.

👉🏼 Psychological help line is also available to you: +7 (495) 989-50-50 . Please note: if you are calling from outside of Moscow, calls from other regions may be charged.

2. Helpline for children, teenagers and their parents

Children's helpline is a free, safe and anonymous help of psychologists. To get the support of specialists, you do not need to provide your personal data, give answers to questions that you would not like to voice. Everything is strictly confidential. Secondly, you can contact the helpline several times and not worry about money, because the calls are free. In addition, on the site you can read interesting and useful articles and life hacks on a variety of topics.

👉🏼 Phone: 8-800-2000-122 .

3. “Your territory. Online". Daily psychological help for teenagers and youth

Turning to this resource, you can ask for free psychological help from consultants in the chat, tell about your difficult situation, share feelings and experiences. Assistance is provided to adolescents and youth up to 23 years of age. "Your territory. Online also respects the principles of anonymity, confidentiality and respect for you and your history. Friendships, relationships, emotional state - the list of problems you can address is huge.

👉🏼 E-mail: [email protected]
👉🏼 You can also write to the chat on the site.

4. Help is nearby. Psychological and informational online help for teenagers under 18

Another resource "Help is nearby" is aimed at providing help to teenagers. Here you can chat with experts on topics such as relationships, health, the meaning of life and more. You can chat with a consultant online in real time or write a letter to a psychologist by leaving a request on the official website. Within a week you will receive a response to your mail from a qualified specialist.

5. On-line counseling room for adolescents and youth

Resuprs will allow you to contact a psychologist and psychotherapist free of charge on any topic that concerns you. Before you decide to write to specialists, you can check the site for questions from other users and answers from experts (suddenly, a similar problem has already been addressed).

6. We are Nearby 2020. Free crisis psychological assistance

Initially, the project was created to support people during the coronavirus pandemic, but now as many as 9 have appeared on the servicehelp lines not only for those suffering from covid, but also for children, adolescents, their parents and other categories of citizens.

Professional psychologists work every day, they are ready to help anyone who finds himself in a difficult life situation. In order to seek expert advice, you need to leave a request on the site, describe your problem in it and indicate the day and time convenient for communicating with a psychologist. A specialist will contact you within one or two days.

👉🏼 Emergency number: +7 (958) 577-17-35
👉🏼 Website: we are

Regional charitable public organization providing psychological assistance to the population by psychologists with disabilities

The unique project "Helping Others" is also designed to provide free psychological assistance. The difference from other projects is that consultations are carried out by psychologists with disabilities.

You can apply for free psychological support by calling the Helpline via Skype (all details are listed on the official website) or chat with specialists on a special forum. The answer will come within 3-10 days.

8. "We are near." Anonymous chat for teenagers

The resource "We are near" will also allow you to contact professional psychologists and ask all your questions. In addition, on the site you can read interesting articles about friendship, relationships, work and get acquainted with lists of interesting and instructive films and books.

Communication with specialists takes place in writing via chat.

9. Site of psychologists

The service allows you to correspond with several users on the forum. After registration, you can choose the format that is convenient for you. "Collection of opinions" is the case where both specialists and ordinary users of the site can give answers. But the "Demo-consultation" will provide an opportunity to analyze your problem in detail with one of the psychologists.

10.Really. Application for finding people by their interests and characteristics

Last but not least, the Realy application. Thanks to this resource, you can find people with whom you would really be interested in communicating. No, no, this is not something like a dating site, where the emphasis is on finding a soul mate. First of all, attention is directed to the search for soulmates. The main goal of the application is to fight loneliness, find friends and like-minded people.

Remember, girl, the darkest night is before dawn. Everything will be fine!

Anastasia Juba, Alisa Karpenko


  • Psychology
  • Depression
  • Mental Health
  • Mental Health
  • Health
  • 903 9000 Free psychological assistance: where to contact 9000 9000 9000 9000. with depression

    Author profile

    I am in a bad mood almost all the time, apathy, I constantly dig in my head and do not see the point in life. This has been going on for three years or more.

    I suspect that I have depression and a midlife crisis - in six months I will be 42. Although I was not officially diagnosed, because I did not turn to specialists.

    I still can’t afford a paid psychologist or psychiatrist, and I don’t want to go to a psycho-neurological dispensary under a compulsory medical insurance policy: I live in a small town and I’m afraid to meet acquaintances there.

    I decided to contact organizations that can listen and advise for free. I didn’t think that I would be relieved of depression or taught to accept myself for who I am - free sessions, as a rule, have strict time limits. But I wanted to determine what format of communication helps me and whether I need it at all.

    I tell you how I communicated with specialists and whether it made me feel better.

    What you need to know about the work of the brain

    The main thing about effective ways not to succumb to stress and thinking errors is in your mail twice a month on Fridays. Free of charge

    How I chose psychological centers

    It took several days to choose the right psychological help centers for me. Here are my criteria.

    Accessibility for all. Many psychological support centers have a specialization. For example, there are organizations only for cancer patients or people who have experienced violence. Therefore, I chose organizations that work with all categories of people.

    Not for emergency use. I did not contact the psychological assistance center of the Ministry of Emergency Situations - I do not have an emergency case, for example, a suicide attempt. I am sure that psychologists would talk to me, but perhaps at that moment a person with an emergency problem could not reach them.

    How to get help from a psychologist for free: 11 support centers

    Help promptly. I was ready to wait from one to three days. But in some services, you have to wait for your turn for three to four weeks.

    I applied to the Center for Psychoanalytic Counseling at the Higher School of Economics, but I had to wait three weeks for my turn. On some sites, psychologists do not give consultations, but simply comments.

    I left a message on one of them describing the problem, and I received three short comments from psychologists. I wanted to be talked to in more detail and given more recommendations.

    One of the answers I received

    To get a normal consultation, you had to pay. On average, a psychologist's hour of work cost 2,000-3,000 rubles.

    They communicate, not send psychological tricks. I contacted the Volunteer Psychologists psychological assistance group, chose a psychologist to chat with, but he was busy and could not help. Then the group suggested using a technique that helps to cope with stress, anxiety and relieve depression.

    I didn’t manage to talk to the volunteer psychologists Instead of talking, I was offered a breathing exercise

    But I wanted to talk to a living person, and not just breathe correctly. That's why I didn't do this exercise.


    Not just a conversation: 7 myths about psychotherapy

    Even though many organizations were unsuitable or too busy for me, I found ways to discuss my problems with a specialist.

    Forum of psychologists b17

    On some psychological sites you can get a free consultation. I chose and registered there under a pseudonym - the rules do not prohibit this, and I decided not to impersonate.

    Anyone can get a free demo version of the consultation - this is an active correspondence with a specialist on the site for an hour and a half. When time runs out, communication can be continued if both the psychologist and the client are ready for this. It will also be possible to create a new topic and take a trial version of the consultation from another specialist.

    First session

    I created a topic in which I briefly described my problem: that I stopped believing that something good was waiting for me in life, and also that I was worried about age-related changes in appearance.

    This message is in the public domain of the site A few minutes after I created the topic, a psychologist wrote to me and offered a trial consultation

    I could refuse to communicate if I did not like the psychologist for some reason. I had no such reasons - the face of the future interlocutor seemed to me conducive to communication. I also went to his profile, looked at diplomas, found out that he is a member of the Association for Cognitive Behavioral Therapy, Master of Psychology. I didn't know if CBT was right for me, but I decided to give it a try.

    After we agreed on the time of the session, the specialist suggested that I take a depression test beforehand and send him a link to the results.


    I spent 73,000 R on the fight against depression and was able to get rid of it

    I was asked to take such a test

    There were 21 blocks in the test with one question: how did you feel this week and today?

    But each block is devoted to a new topic: for example, feelings of guilt, fear of the future, feelings of joy and disappointment in one's life, thoughts of suicide.

    This block is devoted to self-disappointment The result of the test is moderate depression, although it is indicated that a diagnosis cannot be made on one test and you need to contact a specialist

    We started a correspondence with a psychologist the next morning. At first, I felt a little awkward and didn't know where to start. I felt uneasy that I was straining a stranger with my problems. Perhaps if I paid him money, it would be easier for me.

    The psychologist started the conversation first and said that, judging by the test, I have signs of depression and he needs to find out exactly how they manifest themselves. He was interested in how long ago the mood swings appeared, how often they happen, and whether there was a time in my life when I was happy.

    The psychologist asked leading questions, trying to find out the cause of my condition.

    I answered the questions honestly, because I understood that there was no point in lying. Although I did not expect that a trial consultation would solve my problem. For this one session was not enough.

    Approximately in the middle of the session, the psychologist tried to identify my main problems and formulated them point by point - the fear of age-related changes, the fear of being unnecessary and the fear of a monotonous life.

    The specialist said that antidepressants might help me, but in order to buy them, I first need to see a psychiatrist

    Result. Chat correspondence lasted an hour and a half. And it helped me in some way: I looked at my problems from the outside.

    But this communication was not enough for me - the psychologist managed only to grope a little for the reasons for my condition.

    Second session

    To get another demo, I created a second thread. This time I focused not on depression, but on a midlife crisis.

    My new topic

    Five minutes later, a family psychologist from Belarus responded to my problem. The profile indicated that in her work she uses Gestalt therapy, a method of cognitive control over experiences and a system for working through negative feelings. All of these were new terms for me, and I decided to just give it a try.

    Similarly, the psychologist began to ask leading questions to determine the causes of my condition. For example, I asked about what I don’t like about my appearance and at what age I liked my figure the most, and vice versa.

    I answered frankly The psychologist tried to find out who in my environment in childhood or adolescence influenced my attitude towards my own appearance

    During the consultation, I had to recall an extremely difficult experience of early adolescence, which I tried to forget. I had a congenital anomaly on my face, and my peers teased me because of it. I had several operations, and the problem was solved, but the people around me did not speak kinder about my appearance. I didn’t tell my parents about my suffering: it cannot be said that we had a trusting relationship. Besides, for some reason I was ashamed to complain about it when there were more serious problems around.

    The psychologist advised me to rewrite the script of my life. To do this, I had to mentally plunge into the past and imagine that those around me who teased me spoke only good words to me. She said that this would allow me to look at myself differently, with more warmth.


    How to accept your appearance: 5 tips

    The next day I tried to do this exercise, but instead of relief, I only felt aggression towards people with whom the negative was associated. And at the same time to my parents, who did not notice my problems.

    Perhaps the method would have worked if I had continued therapy. And not by correspondence, but at face-to-face meetings. It is difficult to follow the recommendations alone.

    Exercise proposed by the psychologist

    Result. In general, I liked the second consultation: the specialist quickly managed to open me up, bring me to frankness and find the reasons for my inner dissatisfaction - she got to the bottom of the moments of my youth, which I almost forgot about, and brought me to negative emotions.

    Of course, the second session did not help me from my depression either, but psychologically I felt better. Perhaps the thing is that I was able to talk frankly with someone about my problems and try to correct some mistakes.

    Video call to the "I am an asset" service

    After talking with psychologists on the forum, I decided to try video consultation. At one of the women's forums, I learned that there is an anti-crisis psychological center "I am an asset." This is a non-profit organization from Novosibirsk, but online psychologists communicate with everyone.

    I left a request for a consultation on the website, in which I indicated my phone number, email address and briefly described my problem.

    This is how my application for a consultation looked like. The next day, a psychologist wrote to me in Telegram and offered to choose a time for a consultation.

    The psychologist asked me to describe the problem in more detail. She also explained that under the conditions of the center I can get three free consultations. And if I want, I can send the application again and communicate with the psychologist.

    The psychologist had an endearing appearance: an open look, a sincere smile, but I still felt out of place - a stranger was looking at me, with whom I had to share my innermost.

    I honestly admitted that I did not know how to start a conversation, and she began to ask questions: how long have I been depressed, what exactly am I feeling and what is bothering me right now. I answered honestly, but the feeling of awkwardness did not go away, and instead of completely opening up to my interlocutor, I thought about how I look, whether I seem fat or stupid to her.

    Then I found a way to get rid of this state - I began to look not at the psychologist, but at the picture in the room. There was a feeling that I was communicating with an invisible interlocutor. It helped open up.

    The psychologist listened attentively without interrupting, then asked questions and summarized the main aspects and then clarified whether she understood me correctly. For example, "Did I understand you correctly: are you worried about the feeling of loneliness in your family and you have no one to talk heart to heart with, because you are afraid that you will not be understood, judged and considered weak?"

    Community 09.09.21

    What is a midlife crisis and does it really exist?

    Then I asked her to evaluate my situation from the outside, and she correctly expressed her thoughts. She said that she thought I was really depressed and needed help. But since I have been in this state for a long time, psychotherapy sessions can alleviate my condition, but not solve the problem. She recommended seeing a psychiatrist because psychologists can't prescribe antidepressants.

    It is important that she did not judge me even for the bad things I had done. And the main thing is that she managed to open me and pull out one of the main problems of childhood. I was morally pressured by my father in my childhood and youth. He controlled, dictated his terms and lectured constantly. I financially depended on him, endured and silently hated him.

    Then Marina asked me to close my eyes and mentally plunge into this moment, where I am a small child, and next to me is my father, who scolds me.

    I succeeded, and the psychologist told me to tell him everything from the bottom of my heart without restraining myself. I did it out loud. Then I had to imagine how his face changes from surprise and anger, he gets up and leaves. This visualization should help me feel that I can stand up for myself. And it really had a small effect - at that moment I felt relieved, as if I had done what I had really wanted for a long time.

    Result. Compared to texting, the video call session had a very strong effect. I saw and felt that the person is not indifferent to my problems and does not just sit out time in a free session, but really empathizes and tries to help.


    8 myths about antidepressants

    Of course, I did not get rid of my depression in one session, but it became much easier for me. My mood lifted. Partly because I spoke out and a sympathetic person listened to me. Before that, I had never been so frank with anyone, and this is very important, because you can’t tell your relatives and friends everything.

    In addition, I realized that I had not overcome the difficult experiences of my childhood and youth. In fact, I just hid from him, tried not to remember. But the problems remain, and I need to work with them. I'm not sure that this can be dealt with without a specialist.

    Marina said that we could call again, but these sessions would not relieve me of depression, because I have been in this state for several years. According to her, I need to seek help from a psychiatrist: he can prescribe antidepressants. I decided that she was right, and in the near future I want to turn to a psychiatrist.

    How psychologists work in the anti-crisis assistance center

    Elena Zhilina

    psychologist, head of the anti-crisis psychological center "I am an asset"

    Psychologists, not psychiatrists, work with our patients, so we do not prescribe medications. We do not treat, but advise people. We often use a proactive approach in our work - this is when a psychologist asks the right, open questions, and the person himself finds those solutions that are acceptable to him.

    Let's take, for example, the classic of the genre - burnout. The patient is burned out at work or in the family, and the psychologist asks him a question: where do you get the energy to recharge? After all, everyone has their own recipe: one needs to go to the dacha for three days and sleep, another needs to go on a trip, and the third needs to go to the bathhouse with friends.

    The person himself knows how to solve his problem, but he cannot find it, and the psychologist helps him in this. Therefore, this is not a treatment, but a joint work of a specialist and a client.

    Of course, if we see obvious signs of schizophrenia, split personality or deep depression in a person, we recommend that he contact a psychiatrist or a psychotherapist.

    We conduct a large number of consultations remotely. Now the people are socializing and rebuilding - even people of the adult generation are calm about audio and video communication. Although, during personal contact, a psychologist can count the emotional range of a person, for example, in a conversation, he begins to twitch his leg or his face suddenly twists. The specialist understands that he has found a lever with which to work. These things are missing in the remote format, so the efficiency is, of course, lower.

    But on the other hand, there are cases when a person with depression is difficult to get out into the street and does not have the strength to go to a psychologist. If a psychologist talks to a patient on the phone or in instant messengers, he can find points on which he will slowly begin to rely on in order to get him out of a depressive state. And in this case, remote work will work better than face-to-face counseling.


    I called two organizations - the regional psychotherapy center in the Perm region and the Sisters charity center. In both organizations, it was not psychologists who spoke to me, but a former teacher and social worker who had undergone psychological training. I learned about this from them during a conversation. The centers also employ psychologists and psychotherapists.

    Regional Psychotherapy Center

    Only residents of the Perm Territory consult on the hotline. I am from another region and called there by mistake, but they talked to me, perhaps as an exception. The consultant introduced himself, asked for information about me: name, age, city where I live, and how I learned about their hotline. According to him, these data are needed for their internal statistics and they will not go anywhere else. Then I said that I was worried about depressive symptoms, and he began to ask about my life: am I married, where do I work, how do I spend my leisure time, do I have children.

    Everything was pretty predictable until he asked why I only had one child. I mentioned that I once had an abortion, and the consultant said: “Nightmare! This is murder!” It was very unpleasant, because I called to feel better, and as a result I heard harsh criticism.

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    The specialist asked me to imagine what it would be like if I had many children. I replied that one was enough for me. But he insisted that in that case I would have no time to be bored and think about problems.

    The specialist did not use psychological techniques during the conversation, but simply tried in a very peculiar way to find a way to improve my mood. He found out that I write texts and advised me to write short humorous stories from my life every day. And then, when there are a lot of them, try to release a fun book.

    He tried to dispel my worries about age, but he had the opposite effect. He said that every 11 years people’s bodies are renewed, and at 44 this process stops and a person gets old: he wants something less, he hurts one or the other. It turns out that I have two and a half years left before my old age. To drive away these thoughts, I simply switched to something else.

    My interlocutor also suggested giving her husband pleasant surprises more often, for example, sometimes meeting him from work in an apron. After all, a healthy sex life reduces anxiety levels and improves mood.

    Result. The telephone conversation took an hour and was very superficial - I felt that the consultant was tired of conversations and advice, in addition, I expected condemnation from him, so I did not want to be too frank. There was no participation in his voice, it seemed that he did not understand me and thought that I was depressed from boredom and from the fact that I had only one child. After the conversation, there was an unpleasant aftertaste. I did not call this center again.

    Sisters Charitable Center

    Communication with the consultant of the Sisters center, which helps women who have experienced violence, but not only them, was just the opposite. A woman with a kind, sympathetic voice answered me. I said that I was often in a bad mood and I thought I was depressed.

    She tried to find out if I had this condition for a long time, and also if it lasts all the time or if there are any enlightenments. She asked me what my job was and how my state of mind affects everyday life. I answered that I work from home, but this condition was before freelancing, so depression has nothing to do with my work and does not affect it.

    Then, during the conversation, the specialist suggested that I might not have depression, but simply dissatisfaction with my life. After all, people often sum up some results. Usually this happens on round dates, for example, at 30 or 40 years old, and if they see that they have not achieved something, they are very worried about it. Third-party things can influence this. For example, even the fact that a friend has a car and a luxurious apartment, which I can only dream of.

    I replied that perhaps it was so. I have lived most of my life and have not learned how to earn enough to travel, drive a new car, wear expensive clothes. And now it seems to me that time is running out and I will not have time to achieve this.

    She also asked if I had any support: friends, relatives, whom you can just come and talk to. I replied that I have relatives, friends, but I don't want to complain and burden them with my problems. It seems to me that they won’t understand me, besides, I don’t want to look pathetic.

    My interlocutor said that all people need support and sympathy and that I can call at least every day. But ideally, if I regularly go to face-to-face consultations with a psychologist. And since I don't have that opportunity yet, she gave me some cool tips.

    To begin with, I recommended reading a book by psychologist Andrew Matthews, Happiness in Hard Times, which teaches people to find reasons to be happy all the time. And then apply this knowledge in life.

    She also advised the "balance wheel" technique. It was invented by American businessman Paul Mayer. It helps a person understand which of the areas of life he is dissatisfied with and what he needs to change.

    The point is to draw a circle, divide it into several sectors, each of which will be a sphere of life. For example, career, personal life, friendship, finance, hobbies, travel. Then each area must be evaluated on a scale from 1 to 10. Then, having seen the big picture, you can immediately understand what needs to be corrected.

    Only areas that are significant to you can be included in your balance wheel. Only areas that are significant to you can be included in your balance wheel.

    The consultant also advised me to write down all my affairs on a piece of paper in the morning. And when I fulfill them, then put a tick in front of me and at the end of the day praise myself even for the smallest thing. For example, write, in plans: hand over the project to the boss, cook dinner, wash the dishes, play with the dog, drink coffee. This should boost self-esteem.

    And in order to understand what I really want, Evgenia recommended that I keep a diary and write down in it all my thoughts that come to mind. And then read them. It is important to ask yourself questions in writing: what do I want now? What worries me? What will make me happy? So, according to her, it is easier for a person to understand his "wishlist".

    Result. After this heart-to-heart talk, my spirits lifted. I no longer wanted to think about the bad, and I tried to drive away negative thoughts. The next day, I tried to write down my affairs, put ticks and praise myself. It works, and I really became a little more comfortable - I clearly saw that I do a lot of things in a day, but I don’t even get gratitude for it from myself. Now I've started doing it all the time.


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    What to do if there are signs of depression, but there is no money for a psychologist

    Nastasya Solomina


    Author profile

    In some cases, depression cannot be managed on its own and the help of a psychiatrist is needed. So even with financial difficulties, it is important to consult a doctor so that he can identify the severity of depression. This can be done under compulsory medical insurance, but even if you do it for money, it will cost less than the services of a psychologist - a couple of psychiatric appointments may be enough. At the same time, the doctor will prescribe drugs that will help you feel better, lead to healing and stable remission.

    In addition, depression can also occur due to somatic disorders, such as malfunction of the thyroid gland. A person in this case feels constantly tired, he has no energy, constant apathy and a negative emotional background. It is worth contacting a therapist and taking several tests.

    If depression is mild and the person cannot or does not want to see a psychologist, then it is worth starting with lifestyle changes. It is important to communicate with other people, eat tasty and varied food, and have enough rest. After all, if you take a mentally healthy person, place him in a closed room, do not let him communicate with anyone and do something interesting, there is a high probability that he will develop a depressive state. Our psyche also reacts to what is happening around us.

    It also happens that there are depressive symptoms, but there is no depression. Symptoms can be caused, for example, by prolonged stress. Therefore, a person needs to figure out what is happening to him. Self-help or looking inward will help with this - did he have any traumatic events associated with grief and loss, prolonged stress at work or in his personal life. In general, some kind of experience that provoked a depressive state.

    To better understand yourself without a psychologist, I would recommend books like Beat Depression Before It Beats You by Robert Leahy and Mind Rules Mood by Greenberger and Padeschi. They offer self-help protocols that are mainly based on the principle of behavioral activation. This principle suggests that you do not wait for the condition to improve in order to take action. On the contrary, we help ourselves with the help of our actions. For example, we find time and place to do things that bring pleasure or at least brought pleasure before.

    What is the result

    1. On websites and centers, psychologists first of all look for paying clients and give trial sessions only so that a person can choose a specialist with whom he will be comfortable. It is unlikely that during this time it will be possible to solve some problem.
    2. Correspondence with a psychologist, at least in my case, is ineffective. Much more I liked the consultations by videoconference and by phone.
    3. During the session, it is important to turn off extraneous thoughts, such as what they think of you or how you look. This will help you focus on the problem and eventually solve it.
    4. Support hotlines are a real lifesaver that can help a person at a critical moment. To talk to a consultant, you do not need to leave a request and wait a long time. And if you come across a sympathetic caring specialist, then you can call him at least every day.
    5. After talking with specialists, I felt better: my mood improved and some kind of lightness appeared in my soul.
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