Introverted or depressed

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

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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).

Are introversion and depression related? Difficult answer

Introverts tend to:

prefer quiet time alone to socializing in a group
spend more time listening to others than sharing personal thoughts
stay away from social media crowds
turn to creative or reflective activities to relax and recharge

As people increasingly see a tendency to withdraw from others as a common sign of depression, someone who doesn't know you well might suggest that these traits mean you're depressed or perhaps socially anxiety.

Well-intentioned loved ones may even encourage you to see a professional who can help you "overcome your shyness" or "get along."

Some research suggests a possible link between introversion and depression (more on this later).

However, contrary to what some people might suggest, this link means that you should try to change yourself. Introversion is a personality trait, not something you need to fix or improve.

Are introverts more likely to suffer from depression?

Several studies have found evidence of some connection between introversion and depression.

Introversion as a factor

Research from 2001 suggests that introversion may play a role in depression in the presence of other factors, including:

greater sensitivity to feelings and emotions
neuroticism, a personality trait associated with negative tendencies or anxious feelings

The potential impact of depression on extraversion

On the other hand, other studies show that depression can make people more withdrawn.

A 2012 study looked at how anxiety and depression can change personality over time. The authors of the study compared baseline personality traits with those observed 2 years later. They found that major depression or dysthymia (chronic depression) seemed to lead to higher neuroticism and lower consciousness and extraversion.

Recovery from depression was associated with higher conscientiousness and extraversion, as well as lower neuroticism.

After recovery, extraversion and conscientiousness still tended to be at lower levels (and neuroticism at higher levels) than in participants who never reported depression.

Introversion and suicidal thoughts

Research from 2017 compared 365 people with bipolar disorder and 296 people with major depression with a control group of 315 people.

The results show that people with lower extraversion, especially those who also had higher levels of neuroticism, had a higher risk of suicidal thoughts or behavior.

Introversion, depression, and other mental disorders

A 2009 study suggests that people with major depression and lower levels of extraversion are more likely to also have social anxiety or cluster C personality disorder, for example:

avoidant personality disorder
dependent personality disorder
obsessive-compulsive personality disorder

What about anxiety?

The experts also found some evidence to support the link between introversion and anxiety.

Social anxiety and introversion

The authors of the 2012 study mentioned above emphasized that low extraversion appears to be more strongly associated with depression than with anxiety. However, they also noted that low extraversion may play a role in social anxiety.

Research from 2020 explored in depth the relationship between social anxiety and personality traits.

The authors of the study compared 265 people with social anxiety and 164 people without this condition, dividing people with social anxiety into three main groups:

Cluster 1 included people with high neuroticism and low extraversion.

Cluster 2 included people with low extraversion and high conscientiousness.
Cluster 3 contained high neuroticism and moderate to high extraversion, openness and conscientiousness.

The results showed that people in cluster 1 tend to have more severe symptoms of social anxiety, but only about a third of the participants fit the stereotypical "anxious introvert" profile.

The highest overall levels of social anxiety appeared in cluster 3, a group with moderate to high extraversion, described by the researchers as "anxious extroverts".

These data suggest a complex relationship between personality and mental health symptoms - and here you even begin to consider any external factors.

Life events, personality, and anxiety

A small 2016 study examining the relationship between life events, personality traits, and generalized anxiety disorder found that people with lower extraversion scores also had higher anxiety scores.

The researchers also found that people with anxiety tended to report more unwanted or stressful life events, such as family conflicts in relationships. The results showed that difficult life events may play a role in the development of anxiety.

The study authors stressed that further research is needed to better understand the relationship between personality traits and anxiety. Moreover, the small sample size is not very representative.

Eysenck's theory of personality

Personality researcher Hans Eysenck suggested that personality consists of two main factors: extraversion and neuroticism.

He suggested that people with low levels of extraversion and high levels of neuroticism tend to be more sensitive to stress. When faced with difficult life events, they were more likely to experience anxiety and other emotional distress.

The old studies even seemed to support this theory. A 1998 study of 466 college students found that participants with low extraversion and high levels of neuroticism were more likely to report anxiety and depression after 3 years.

In a 2000 study attempting to replicate these results, researchers looked at two different samples of participants: a survey of 2,677 people aged 18 to 79 and a study of 441 adults aged 70 and over.

Although the results showed that neuroticism seemed to predict both depression and anxiety, the authors of the study did find that high neuroticism and low extraversion combined increased the risk of either condition.

Possible explanations

So what does all this mean for introverts?

First, know that the association between introversion and depression does not automatically mean that one causes the other.

As a rule, one character trait does not cause depression. In fact, depression and other mental disorders usually develop in response to a combination of factors, including genetics, brain chemistry, and life circumstances.

Here are some reasons that may help explain the connection between introversion and depression.

Understanding Introversion Differently

By definition, introversion and extraversion refer to how you get your energy, not to specific behavior.

Some introverts can show extraversion quite convincingly in social settings. For example, your boss's desire to recognize you as a team player may mean that you are making an effort to communicate at work.

This does not make you less introverted, but it means that you will probably feel exhausted and a little tense afterwards. This forced interaction can eventually lead to workplace anxiety, other emotional distress, and burnout.

Also note that avoiding others does not automatically make a person an introvert. Many people with depression tend to avoid friends and loved ones. But this time in itself may not necessarily be positive or productive.

People don't understand or respect your needs

Many people see introverts as shy people who just need to try harder to communicate. If you're an introvert, you've probably heard something similar.

However, when others insist that "joining the crowd" is good for you and push you into unwanted interactions, you may end up feeling so miserable that you avoid social media even more than before in response. .

It makes it easier to protect your energy, really. But if you stay alone, it will also be difficult for you to make friends with people who support your insularity and are interested in who you really are.

This resulting loneliness, which comes from having to defend boundaries that others don't respect, can contribute to depression.

You think you should change yourself

People often associate extraverted personality traits with higher chances of professional and relationship success.

When messages from other people seem to suggest that introversion is a negative trait, you may start to worry that something is wrong with you and try to change that part of yourself.

Personality, however, usually cannot be changed. Forcing yourself into frequent interactions without the time needed to rest and rebuild your emotional reserves is likely to make you unhappier.

The effort required to maintain the facade of extraversion can also contribute to anxiety and depression.

Coping with an introvert

If you think that your introversion may be having an effect on your mental well-being, these strategies may help.

Save your energy for people who understand you

Generally speaking, introverts need more time alone, but that doesn't necessarily mean you want to spend every minute alone.

Developing some connections can help prevent loneliness and improve overall well-being.

However, spending time with one or two people who really understand you and appreciate your personality can be much more valuable than maintaining superficial friendships with people who don't respect your need for space and quiet contemplation.

Our guide to dating an introvert can help.

Find creative ways to express your emotions

As an introvert, you may find it more difficult to share your emotions with others.

You may spend a lot of time thinking about painful feelings that can make your suffering worse. Instead, you may even have a habit of burying those feelings.

While hiding painful feelings won't make them go away, revealing to just one person you trust can go a long way to emotional health.

When communicating with others seems difficult or overwhelming, other types of emotional expression can help you navigate and deal with disturbing thoughts.

You could, for example, try to express your feelings through art, journaling, creative writing, or making music.

Look for interactions that you enjoy

If you want to make new friendships but feel uncomfortable in person, why not explore other forms of communication?

Technology makes it easy to find people with similar interests and slowly get to know them from a distance. Creating rapport and a sense of connection through text or chat can facilitate possible face-to-face interaction.

In short, there are many ways to communicate. Turning to discreet formats like the Internet increases your chances of connecting with other introverts who understand exactly where you come from.

Identify specific areas that you would like to change

While you may not be able to directly change your introverted nature, you can make small changes to better support your introversion and meet your needs at the same time.

Maybe you want to talk more in meetings at work, but you're afraid of being offended. A possible solution could include brainstorming several questions or topics that will be suggested during the meeting so that you can control the interaction.

Or perhaps last minute plans and social interactions without a clear end make you anxious, so you basically decline these invitations.

Instead of just saying “No thanks”, which over time can cause people to stop sending out invitations, you can explain the problem and suggest an alternative solution, for example:

- I think I'd better stay tonight but I would like to see you. Can we schedule another night this week?"
“I would like to hang out tonight. I have time to take out and watch a movie, but then I have to go home to relax before bed. Does it work for you?

When to contact

While introversion is just part of your personality, depression is a mental health condition that can get worse without treatment.

If depression causes you to spend more and more time alone, loved ones may not notice the main signs of depression, so it may be even longer before you decide to contact them.

If you experience persistent feelings of sadness, emotional numbness, lack of motivation, or a low mood, seeing a mental health professional may help.

It is always good to get support if you are experiencing symptoms that:

make daily life and routine more difficult
affect your relationships
create problems at school or work
occur along with unexplained physical symptoms such as fatigue, pain or upset stomach

Your therapist can offer more information about whether you are depressed. They can also help you identify potential causes and triggers for depression and suggest helpful treatments and coping strategies.

Bottom line

If you are an introvert, the time you spend alone helps you relax and recharge. This privacy also allows you to comfortably spend time with people when you choose to do so.

There is absolutely nothing wrong with being an introvert, and spending time alone doesn't always mean you'll develop depression. Many other factors come into play, no matter where you are on the introvert-extrovert spectrum.

However, if you notice signs of depression, loneliness, or other lingering emotional distress, a mental health professional is a good next step.

Who is healthier: extroverts or introverts?

Resume. In the course of numerous studies, evidence has been obtained that personal characteristics have a significant impact on health

Most people, unfortunately, do not take into account personal characteristics when evaluating their health, although back in 1997 in the Journal of Personality and Social Psychology, the results of a study were published, which are evidence that character traits can have a significant impact on the formation of behavioral stereotypes that adversely affect health.

Assumptions that character traits can have a significant impact on health have been expressed by experts for a long time. In one study, researchers analyzed the long-term impact of personality traits on health for the first time, assessing children annually from age 3 to age 21. All study participants were born in New Zealand between 1972 and 1973. By the time the participants reached the age of 3, the researchers identified the main temperamental traits of the children, at 18 they asked them to answer questionnaires that allowed them to assess personal characteristics, and at 21 they analyzed the presence of behaviors that pose a threat to life or health, such as a tendency to use large quantities of alcoholic beverages, non-observance of traffic rules, preference for unprotected sex, or cases of extreme aggressiveness. The main purpose of the work was to assess the influence of a child's personality traits on the likelihood of risky behavior that can lead to the development of pathological conditions in later life. For example, what personal characteristics can provoke the development of alcoholism, which adversely affects the state of the cardiovascular system, the gastrointestinal tract, can contribute to the development of mental health problems and the occurrence of depressive states.

It turned out that >⅓ of the participants did not show any risky behavior or noted no more than one such sign. The scientists emphasized that those children who at the age of 3 were subjected to more strict parental control due to increased impulsivity and irritability, upon reaching the age of 21, were more likely to participate in dangerous activities than their peers. Antisociality and aggressiveness were associated with introversion, one of the main personality types, along with extraversion. Scientists noted that it is impossible to assume that associated features will necessarily be inherent in all representatives of this type. For example, the revealed fact does not mean that every introvert will be an aggressive recluse, and an extrovert will be a careless person who only plays by the rules. The two types are just at opposite ends of the spectrum.

Other studies have provided additional data on possible differences in the health status of extroverts and introverts.

Obesity. In many countries of the world, there is a constant rapid increase in the prevalence of overweight and obesity. It is known that such conditions significantly impair health and reduce life expectancy. Scientists from the Cornell University Food and Brand Lab, USA, studied the impact of childhood eating behavior by offering elementary school children various plate sizes from which they could eat porridge for breakfast. It turned out that children with signs of extraversion in the presence of classmates and teachers tended to choose larger plates and put on them an average of 33% more food than their less sociable peers. This supports the theory that extroverts rely more on external or sensory cues than internal ones.

Based on the results, the researchers concluded that extroverts have an increased risk of obesity. Undoubtedly, regardless of personal characteristics, overweight has a negative impact on health, contributing to the development of cardiovascular diseases, pathologies of the musculoskeletal system and some types of cancer.

Mental health. The American Psychiatric Association (APA) added "Introverted Personality Disorder" to the Diagnostic and Statistical Manual of Disorders more than 30 years ago. To date, experts believe that the preference for calmness and silence does not always indicate a personality disorder, however, in the course of separate studies, results have been obtained confirming an increased risk of developing depressive conditions in introverts.

So, in the course of one of the studies, the results of which were published in the Journal of Personality, scientists found that 74% of patients with depression have introverted traits. And in the course of another work, researchers were surprised to state that extroverts in routine situations feel happier than introverts, regardless of the external context. In addition, introverts often experience reduced psychological well-being and are at increased risk of developing self-injurious behavior.

Some experts mistakenly believe that the distinguishing feature of introverts is the desire for solitude. Dr. Susan Cain, author of Silence: The Power of Introverts in a World That Can't Stop Talking, points out that extroverts and introverts actually react differently to stimuli. Introverts feel most comfortable in those conditions in which there is a minimum amount of stimuli, and there must be intellectual stimuli, but the less events occur, the better.

Immune system. According to the latest research by scientists from The University of Nottingham, UK, extroverts have an undeniable advantage over introverts in the efficiency of the immune system. The researchers analyzed the health status of 121 adult participants, identifying five core personality traits for each, including openness, neuroticism, and conformity. Then the researchers determined the characteristics of the production of leukocytes, which play a major role in protecting the body against infectious agents, and compared the information obtained with personal characteristics.

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