In denial about 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.

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Last Updated: 08/30/2022

SAMHSA Behavioral Health Treatment Services Locator


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The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

Denial - anger - bargaining - depression - acceptance. Edition 66.RU in five stages of mental quarantine — news about health in Yekaterinburg

Marina Shuleva, PR director:

— I walk through the stages like in a large amusement park, each time bypassing denial. Apparently, there is still too much queue for this attraction. Most of all, of course, I like the carousel " Acceptance" . But the ticket for it is too expensive, and the ride is too short.

That's why my subconscious mind drags me more and more often to the attraction " Depression" . It is somewhat similar to the “Engine from Romashkovo” in the TsPKiO: a rusty little train, painted with bright colors, creaking, slowly drags in a circle to the same song, from which after 10 minutes it starts to feel sick. Cheap. Angrily. Seasick. And getting off on the go is difficult.

Dima Shlykov, editor-in-chief:

Stuck in anger stage . I can't help myself. Infuriates. Everything. From the outside, it's probably not very noticeable. But the demons of malice and destruction rage in me. Sometimes they break out. I am very ashamed of myself afterwards. Sounds like some kind of hormonal imbalance. Or is it just the result of daily suppression of emotions. But now it will not work to not press them. Too much has accumulated.

I caught myself really wanting to grab things and throw them at the wall. While I restrain myself and even try to direct my demons in a peaceful direction. I thought that I was not the only one, and together with the demons I figured out a cool (no) business idea in the elite segment. For a lot of money, based on the photographs of the customer in a conditionally empty room, we accurately reproduce the interior of his apartment. And then we launch him there for two hours and let him do whatever he wants: beat, tear, crush, break, kick and torment. I think it will be in demand. And the longer the quarantine, the higher the demand will be.

Sasha Morozova, journalist:

— A week ago I wrote to my sister that I have depression . It is in the context of the five stages of acceptance. A week later, acceptance seems to have begun. In any case, I'm glad that I still have a job that pays, and there is a fear of losing it. Hmm… judging by how gloomily I described it all, and by the fact that I enjoy my work, I still have depression.

Olya Koryukova, SMM guru:

- All I experience during self-isolation is relief . Seriously. As the comedian Idrak Mirzalizade rightly noted: “Finally, I am not the only one standing still.” No need to worry anymore about the fact that the passport is gathering dust on the shelf, and for a whole year I have not reached the pool. I legitimately waste my life

Dasha Nemchaninova, journalist:

— My entire regime of self-isolation consists of three stages — anger, depression and acceptance . And most often I am chatting throughout the day from state to state. Right now, I'm in the acceptance phase. It seems that she is used to what is happening around. Found some positives. I even like that the day follows the same schedule: get up at the same time, have breakfast, work, do exercises, go to the store, go to bed. Everything is clear and calm. But it is now.

Depression sets in from time to time, when you don't want anything at all. Such apathy that you have to force yourself to do something. And sometimes I feel angry: “Oh my God! Yes, how this coronavirus and quarantine shook me! Why can't I go and go where I want? How terrible it is to wear a mask in the store when your nose itches terribly!” At such moments, I just wait for everything inside me to calm down again and that very calm “acceptance” of the situation will come.

Lesha Zemlyakov, journalist:
— I had no denial, much less anger. It was immediately acceptance of . Probably, this is the case when I treat what is happening philosophically. I won’t say that I feel eschatological delight, but I’m not 100% sure that I want the quarantine to end as soon as possible. A unique and very interesting situation (primarily in terms of people's behavior), despite all its horror. And, I am sure, we will remember and analyze it for a long time. You say I'm crazy? It seems not. Yes, it's definitely acceptance.

Kirill Zaitsev, journalist:
- This is definitely acceptance of . True, with the message: “Well, […] (a synonym is used for the word what, - approx. ed. ) to do.”

Polina Dikushina, SMM guru:

— I started with accepting . When it became clear that we were going remote and self-isolating, I took it absolutely calmly. I understood the inevitability and saw how it all works in other cities/countries. I prepared and tried to make the most of it for myself. I started cooking more, exercising at home more often and pretending that nothing had changed at all.

And then it dawned on me that all this was hard and scary, and most importantly, that he would be with us for a long time. And immediately flew into the stage " depression ", which is very close to me. Despair and horror, loss of interest in life - it's all about me now. Other stages were not even touched on a tangent. This is bad? Just awful. I don’t know how all this would have ended for me if work hadn’t taken up most of my life.

Polina Pavlova, managing editor:
— I go through these five stages every day. New day, new circle.

Denial is the morning, from the first alarm until the moment I sit down at my laptop. Anger is before noon, when plans are made for the day and it becomes clear how much pain and suffering there will be in this day. Bargaining is the shortest stage. It's a moment of tiny enlightenment and hope that things won't be so bad. The main part of the day is depression . And closer to 18:00, when it is already quite obvious that no work will end for a few more hours, comes the acceptance of .

Artem Ocheretin, editor of special projects:
- In order not to go through the second circle, I decided to bring comfort in the stage of " Acceptance" . Catch a few life hacks.

  • Exactly 60 minutes of a lunch break is saved due to the fact that the food is ready and just waiting behind your back (or seven steps from the workplace - whatever). Spend 10 minutes eating and 50 minutes walking around the house. It doesn't matter how many laps. An antiseptic in your pocket and a mask on your face are important.
  • Exactly at 18:00 we change the office chair for a hard stool. Guaranteed not to stick to the computer before midnight.
  • Oh, it's already 20:00 and your butt has become uncomfortably square? Turn off your computer, you are no longer friends. Look what he did to you, oh-oh-oh!
  • I read somewhere that any new task will gladly wait five minutes while I do the bar. Expectation: “Problem — Plank — Problem — Plank — Problem — Planck.” Reality: "10 tasks - a sandwich."

At what stage are you now?

Tell us on social networks: Facebook, VKontakte, Instagram or in our telegtam chat

5 stages of making the inevitable, changes and managerial decisions ⋆ NewRealGoal

5 stages of making the inevitable, changes and managerial decisions

Before you change what Something incredibly important to you must be in jeopardy.
Richard Bach. Messiah's Pocket Guide

Most of us face change with fear. The new reality - whether it is a change in the company's strategy, pay systems, planned layoffs - causes us concern, as well as an unexpected diagnosis, which was revealed during a routine preventive examination. The "degree" of emotions, of course, is different, but their spectrum is almost the same. From the initial shock: "No, this can't happen to me!" before accepting the inevitability: "Well, you need to start living differently." Why is that?

This is quite understandable by human nature. Changes are for us the threat of various losses:

  • stability;
  • situation control;
  • status;
  • competencies;
  • career opportunities;
  • money;
  • social connections;
  • workstations, etc.

And to losses, even potential ones, people react primarily emotionally, including protective mechanisms.

This basic defense mechanism is well known as the 5 stages of response to change by E. Kübler-Ross. An eminent psychologist once described in her cult book "On Death and Dying" ("On Death and Dying", 1969) emotional reactions of seriously ill and dying people, and identified 5 key stages of emotional response: the need to adapt to the new reality. In a sense, change is the death of the status quo. As Anatole France wrote: “ Every change, even the most desired one, has its own sadness, for what we part with is part of ourselves. One must die to one life in order to enter another.”

Let's look at the behavior of people and the possible actions of management at each stage.

1. Denial

At the initial stage of denial, people are usually afraid that the changes will be negative for them personally : “The company may need this, but I don’t need it! I have stable and familiar responsibilities.” Denial can manifest itself in the fact that:

  • people do not come to the meetings devoted to the change project, under any convenient pretext;
  • they do not participate in discussions;
  • they are indifferent or demonstratively busy with routine bureaucratic duties.

What can be done at this stage:

  1. provide as much information as possible through various communication channels about the goals and reasons for the changes;
  2. give people time to understand the changes;
  3. stimulate discussion and participation of people.

2. Anger0233 losses

that they carry with them: “This is unfair! Not! I can't accept it!"

As a result, employees at this stage may:

  • endlessly complain instead of working;
  • fall into accusations and criticism;
  • get irritated more than usual, cling to trifles.

In fact, openly expressed anger indicates people's involvement, and that's good! This is an opportunity for managers to let employees "let off steam" of strong emotions, and, at the same time, to analyze the expressed skepticism and doubts - they may not be unfounded.

Some suggestions at this stage:

  1. first listen to people, without trying to dissuade them, acknowledge their feelings;
  2. suggest ways to make up for losses that employees fear, such as additional training, retraining, flexible hours, etc.;
  3. encourage people to direct their work energy towards the implementation of changes instead of criticism and idle talk;
  4. stop outright sabotage, but do not respond with aggression for aggression.

3. Bargaining

This is an attempt to delay the inevitable. We try to “make a deal” with management or with ourselves to delay change or find a way out of the situation: “If I promise to do this, will you not allow these changes in my life?” For example, an employee starts working overtime in an attempt to avoid an upcoming layoff.

Bargaining is a sign that people are already starting to look towards the future . They have not yet parted with their fears, but are already looking for new opportunities and are negotiating.

It is very important here:

  1. to direct people's energy in a positive direction, not to reject their ideas;
  2. stimulate brainstorming, strategic sessions;
  3. help employees evaluate their careers and opportunities in a new way.

4. Depression

If the previous stage has a negative outcome, people will be in a state of depression, depression, uncertainty about the future and lack of energy: “Why try? It won't do any good anyway. " In this case, by depression we mean a defensive reaction, not a mental disorder.

Signs of depression in the company are:

  • general mood of apathy;
  • increase in sick leave and absences from work;
  • staff turnover increase.

Tasks at this stage:

  1. acknowledge existing difficulties and problems;
  2. eliminate remaining fears, doubts and indecision;
  3. help people get out of depression, support any attempt at action and provide positive feedback;
  4. show employees a personal example of involvement in the change project;

5. Acceptance

Although this is the final stage, leaders need to understand that acceptance does not necessarily mean agreement. People understand that further resistance is pointless, and begin to assess the prospects: “Okay, it's time to work. Let's think about possible options and solutions." Often, acceptance comes after the first short-term results. You can see the manifestations of this stage in the fact that employees: