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Living with mood disorder


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. 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).

Alcohol

Data:

  • 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

Programs/Initiatives:

  • 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

Tobacco

Data:

  • 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

Resources:

  • Tips for Teens: Tobacco
  • Tips for Teens: E-cigarettes
  • Implementing Tobacco Cessation Programs in Substance Use Disorder Treatment Settings
  • Synar Amendment Program

Links:

  • 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

Opioids

Data:

  • 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

Resources:

  • 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

Links:

  • 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

Marijuana

Data:

  • 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.

Resources:

  • 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.

Resources:

  • 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

Mood changes suddenly. How to live with a "bipolar"?

Kim Kardashian's husband, rapper Kanye West, spoke well about this disease. On the cover of his album, he wrote: "I hate being bipolar, it's amazing." More precisely, you can’t say. Our expert is a psychiatrist of the highest category, Corresponding Member of the Russian Academy of Sciences, Professor, Head of the Department of Psychiatry and Narcology, Director of the Institute of Electronic Medical Education of the First Moscow State Medical University named after I. M. Sechenov, Doctor of Medical Sciences Marina Kinkulkina.

The essence of mental illness under the abbreviation BAD (bipolar affective disorder) is in radically sharp, causeless mood swings that occur in a person throughout life. Previously, this disease was called manic-depressive psychosis.

Life at different poles

This is not just about successive sadness or fun, as is often the case with emotional people, but about extreme degrees of either despair or euphoria. The change in these moods can take place both gradually and suddenly, and for no apparent reason.

It is believed that many celebrities of the past suffered from bipolar affective disorder. This illness, however, like other mental disorders, is attributed to Byron and Hemingway, Virginia Woolf and Edgar Poe, Van Gogh, Schumann, Vivien Leigh and many others. There is an assumption that even “our everything” suffered from a mild degree of BAD - in any case, contemporaries often mentioned Alexander Sergeevich’s mood swings.

Many modern stars openly admit to having this mental disorder. In particular, Britney Spears, Miley Cyrus, Selena Gomez, Mariah Carey, Mel Gibson and others admitted this.

Genetics or lifestyle?

BAD also affects men, but the weaker sex more often. This violation can appear at any age: both in a teenager and in an elderly person.

The main risk factor is genetics. However, a specific gene that would be responsible for the development of BAD has not been identified. This is a polygenic disorder, so it does not make sense to take tests to find out how big the risk of getting sick is. Moreover, genetic predisposition is not yet a sentence. This was proven by studies on identical twins, one of whom developed bipolar disorder over the years, while the other did not. There are probably some predisposing factors involved. Some of them are known. It is believed that life at the limit of possibilities, with constant deadlines, stress and chronic sleep deprivation, as well as night shift work, frequent flights with significant change in hourly flights and, of course, the use of psychoactive substances contribute to the development of the disease. Therefore, all this should be avoided. But scientists have yet to find out how the lockdown and pandemic, as well as other stresses of the ill-fated 2020, affect the psyche. Though probably not in the best way.

Don't get bored

BAD, according to various estimates, suffer from fractions of a percent to several percent of the population. Recently, the proportion of affective disorders has increased significantly, which can be explained by improved diagnostics (as well as an increase in the number of stresses).

At first glance, the BAR does not look like something scary and dangerous. To many, this disorder even seems attractive - sometimes sad, sometimes fun, in general, you won’t get bored. In addition, being different from everyone else is now fashionable. And then, it is believed that people with BAD have higher intelligence and creativity than the "gray masses". But even if this is true, then none of those who suffer from it will definitely call BAD a pleasant thing. It is especially difficult for those patients who do not seek medical help on time. Without treatment, both phases of bipolar disorder can last for months (although sometimes the disorder occurs with frequently alternating phases). Moreover, it is impossible to say which of the periods of the disease is more difficult - manic or depressive.

It's hard when the soul feels bad

Those who have experienced depression say that it is the worst thing that can happen. The whole world appears in black, not only mood, but also self-esteem is greatly reduced, the meaning of existence itself is lost. Life is perceived as a chain of tragic mistakes, the patient constantly blames himself for all the troubles and sins, even those that do not even exist. In addition to mental suffering, physical ones also often arise: a person moves as if in a dream, with difficulty, as if weights are weighed on his feet and hands, or as if he is swimming against the current. In addition, pain and tension are felt throughout the body. With an average degree of depression, the stomach often hurts. On this occasion, people turn to doctors, but the diagnosis cannot be made. And the daily pain continues. Psychiatrists call this somatoform symptomatology. With severe depression, many people have the so-called "precordial longing": pain and heaviness in the chest, "a stone on the heart." But even an in-depth examination does not reveal cardiological problems.

Often, with depression, patients (especially the elderly) complain of difficulty in thinking, memory impairment. Doctors suspect they have dementia, but in fact, affective disorders do not affect intelligence, and with treatment, when mood stabilizes, mental abilities are restored.

But the worst consequence of depression is suicide. Most suicide attempts are made in this state. Sometimes people in a very pronounced depression, believing that they have done something irreparable, and believing that the consequences of their actions can harm loved ones, decide on extended suicides, in which they settle scores not only with their lives, but also take their loved ones with them ( more often than children).

Bad when too good

The manic stage of BAD is subjectively more pleasant. Patients are in a great mood: they love the whole world and themselves in it. The reflection in the mirror pleases, there is not the slightest doubt about one’s own talents and mind, there is more than enough strength and energy, a bonus is accelerated mental activity. Many patients in this stage sleep for an hour a day, but do not experience fatigue. Sometimes they are on their feet for days - and at least they are cheerful, like an "energizer". It seems to be great. But no. In the mania phase, desires and ideas arise too quickly, so a person grabs at each new business, but, as a rule, does not complete any one. So productivity at this stage is low. But it would be nice if it was just that /

The main danger of mania is that a person has no criticism at this moment and he can do things that he will later regret very much. For example, he can give away all his property to others (sometimes to unfamiliar people or scammers). Or, say, take loans to go on a trip to the other side of the world. Maybe even steal something - for example, to make an expensive gift. Many patients at these moments enter into hasty intimate relationships, mistaking a chance meeting for the love of their lives (while completely “forgetting” that a wife and four children are waiting at home). Finally, often with mania, people, experiencing euphoria, ignore their severe somatic symptoms, as a result, they do not see a doctor for a long time and thus trigger a serious illness (pneumonia, for example, or COVID-19).

In addition, not all patients in the manic stage are "darlings." Often they show unreasonable aggression if, for example, others do not agree with their "brilliant" ideas. As a result of "angry mania", conflicts and even situations arise that require the intervention of law enforcement agencies and involuntary hospitalization of the patient.

Well Intentioned

The worst thing that relatives and friends of a person with bipolar disorder can do is ignore the problem, devalue suffering, while blaming the patient himself and appealing to his conscience. For example, they call on a depressed person to “pull himself together, not to become limp”, they say that he is “mad with fat” and so on. A patient at the stage of mania is most often accused of immorality, frivolity, irresponsibility, promiscuity in relationships, and so on. However, doing so is like blaming a person with diabetes for not being able to eat sweet cake, or a patient with heart failure for not running a marathon.

BAD is a disease like many others. And she needs to be treated. The sooner you start the right therapy, the sooner you can stabilize the patient's condition and the better the further prognosis will be.

How to "cure"?

On the Internet, you can not only test yourself for any mental disorder, but also learn how to “cure”. Doctors strongly advise against doing this. The smallest harm of self-treatment is that it will not help, but it can also worsen the condition. For example, inadequate intake of antidepressants in bipolar disorder can plunge a person from a depressive phase into a severe manic state, from which it will then be difficult to get out.

Only a psychiatrist (and not a psychologist, neurologist or doctor of any other profile) can identify bipolar disorder and choose the right treatment. Treatment should be strictly individual, it is selected based on the characteristics of a particular patient and taking into account the moment in the course of the disease. The goal of therapy is not only to level the mood of the patient, but also to prevent repeated episodes.

In the treatment of bipolar disorder, the main role is played by drugs for stabilizing mood - mood stabilizers (lithium salts, some anticonvulsants (anticonvulsants) and antipsychotics of new generations). Modern drugs are much better tolerated than their predecessors, have fewer side effects, as they are designed for long-term use over many years. Against the background of their intake, women can even become pregnant. With depression within this disorder, antidepressants are prescribed only in exceptional cases, given the danger of changing from one phase to another.

BAD cannot be cured once and for all, so you often have to take medication for years (with periodic visits to the doctor). But often, when a patient begins to feel good thanks to the medication (such a state - intermission - is completely indistinguishable from full health), he can stop taking the drugs. This is a big mistake that does not allow to achieve a stable result of treatment. After all, it is the long-term use of the maintenance therapy recommended by the doctor that allows you to achieve a stable state and feel the joy of life for many years.

Link to publication: Arguments and facts