Lost in 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
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
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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

SAMHSA Behavioral Health Treatment Services Locator

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Welcome to the Behavioral Health Treatment Services Locator, a confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.

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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).

If nothing pleases: let's talk about depression

Depression . Surely, in the modern world, this word is known to almost everyone - both a child and an adult. It has become so popular that people often refer to any deterioration in mood as depression. Quite often, we can hear from relatives, acquaintances or colleagues: “I was depressed all evening yesterday” or “Again, the boss filled up with work, now I will be depressed all week,” etc. Against this background, the true meaning of depression is depreciated, and for many people in our time it is associated with something insignificant, ordinary, with a person’s desire to “cry” and “wine”.

At the same time, people who really suffer from depression do not admit that they are sick and do not want to voice their problems, so as not to be known as “whiners” and “weaklings”. But even if a person with depression decides to talk about his problems, as a rule, he hears in response: “Pull yourself together!”, “Look how beautiful life is! How can you be depressed?”, “You should be ashamed, others have problems, and nothing, they live!”, he is offered to “cheer up”, “shake up”, “move” and “change the scenery”. Meanwhile, such advice does not help a person suffering from depression in any way, they only make him once again feel like an “egoist” and “pessimist” and reject even the thought of visiting a doctor.

What is depression? Is it a disease? How to distinguish depression from a banal bad mood? And is it really possible to “pull yourself together” and overcome this unpleasant state on your own? Today in our article we will deal with these difficult questions. The doctor of the highest qualification category, candidate of medical sciences, psychiatrist and psychotherapist of the Clinic "SMITRA" Koridze-Datunishvili Manana Nodaryevna will help us in this.

What is depression?

Of course, this is a real disease, registered in the International Classification of Diseases. Depression belongs to the group of affective disorders, in other words, mood disorders. But, of course, this is not the mood disorder that occurs, for example, after a car breakdown or a deuce in an exam.

Depressive disorder is characterized by several factors. First, depression is a long-term, persistent (lasting more than 2 weeks) condition. Secondly, in addition to a decrease in mood, a depressed patient has a significant drop in activity and a decrease in energy. Thirdly, when a patient is depressed, the pace of thinking changes, more often in the direction of slowing down.

A person suffering from depression begins to look at the world pessimistically, loses the ability to experience joy, his judgments become negative, the future seems unpromising. To live at the usual pace, to concentrate, to be interested, to enjoy what used to please - all this becomes difficult or even impossible for a depressed patient. Often there are thoughts of one's own guilt and worthlessness. In addition, even in mild forms of depression, self-esteem and self-confidence may be reduced.

Sleep is disturbed in a depressed patient: either he is exhausted by insomnia and wakes up several hours earlier than usual, or, on the contrary, the duration of sleep can increase significantly. At the same time, in the morning, as a rule, the symptoms of depression intensify and often become almost unbearable.

In addition to the above manifestations, depression may be accompanied by changes in appetite - its increase or decrease - and corresponding changes in weight, as well as severe psychomotor retardation, increased anxiety, and a decrease in libido.

Depression diagnostics

Depression is rich in its manifestations, and against this background, the patient can independently suspect such an ailment. But only a qualified psychiatrist, psychotherapist can finally confirm or deny the presence of the disease and, accordingly, prescribe treatment. The doctor will help determine the amount of care needed by the patient, will diagnose. Sometimes a depressive state and a decrease in vital energy can be a symptom of a serious somatic disease, which is why timely diagnosis and targeted assistance are so important.

Causes of depression

A depressive disorder can occur when a person’s psyche and somatics are subjected to unbearable loads for him personally. Depression can be triggered by chronic stress, a severe physical illness, or a sudden precipitating factor such as the loss of a loved one. Scientists also talk about genetic variants of the causes of depression. In addition, it is possible that one environment of life (family, the habit of perceiving life in a depressive light) matters in the development of depression.

Does depression affect a person's overall health?

On the one hand, depression is a kind of adaptation reaction developed in the process of human evolution. Under certain conditions, it helps to maintain overall mental health and even survive. But in situations where a depressive disorder causes unbearable stress on the body, these stresses can “somatize”, i.e. cause disorders of various organs and systems of the body.

But even without somatization in such a state there is little pleasant: depression can affect the whole life, the formation of goals, the choice of a person in certain situations. The behavior of a person suffering from depression can become reckless, sometimes dangerous for himself and others.

Prevention of depression

No matter how surprising it may sound, it is necessary to start prevention of depression ... from childhood. Certain methods of education will help teach the child to correctly perceive and process information coming from outside, as well as develop adequate ways to respond to various life situations.

For adults, there are also some simple rules to reduce the risk of depressive disorder. All these rules are built on the banal and well-known principles of a healthy lifestyle:

Always get enough sleep! Try to go to bed at the same time, and do not forget to close the room from the light. The sleep hormone (melatonin) can only be produced in complete darkness.
Eat healthy food. Foods rich in vitamins, minerals, and amino acids can help prevent mood swings and restore emotional well-being.
Maintain an active lifestyle. They say movement is the best antidepressant. Physical exercise or walks in the fresh air give the body energy, maintain a good mood and maintain vitality.
Communicate more with positive and pleasant people. Good, pleasant communication will give positive emotions and energize.
Allow yourself to be "a little selfish." Take care of yourself, relax, take time for yourself. A drop of healthy selfishness will benefit any person.

Let's sum it up: how can you still distinguish depression from a bad mood?

In the event of the usual “bad mood”, you know exactly its cause: troubles in the family, problems at work, or just stepped on your foot in public transport and ruined your new shoes. Such a state normally will not last long: after the disappearance of the provoking factor, the settlement of difficulties, or simply after the passage of time, the mood returns to normal, and life will again be enjoyable. Depression, in turn, occurs, as a rule, for no particular reason, or the reaction to a provoking factor is delayed for an abnormally long period.

If you notice signs of depression in yourself, life has ceased to bring joy, the usual things do not give pleasure, you feel guilty about everything that happens around you, and there is simply no strength for life, do not delay contacting a specialist. Turning to a psychotherapist is not scary and not ashamed! In many cases, only a doctor is able to return a person to normal, and in some cases, even save a life.

Do not be afraid to ask for help, because the first step in the treatment of depression is awareness of your problem.
Bright and joyful life to you!

The material was prepared with the participation of the doctor of the highest qualification category, KMN, psychiatrist, psychotherapist of the Clinic "SMITRA" Koridze-Datunishvili Manana Nodaryevna.

What to do if a loved one is depressed: a psychologist explains

Reason and feelings

How to behave if a loved one is depressed? Psychologist explains

Adriana Imzh

14 December 2016 14:31

Afisha Daily continues to ask for advice from psychotherapist Adriana Imzh. This time we figure out how to behave if your friend, relative or loved one is depressed: is it worth feeling guilty for what is happening, will support and participation help him, and what to do if you are angry with him.

Writer Ella Derzai, when reading psychological materials on this topic, suggested replacing the word "depression" with the word "leprosy" - simply because many journalists do not try to figure out the meaning of this word. It seems to me that this approach well illustrates the difficulties of getting the name of the disease beyond the boundaries of psychiatry (when the word begins to denote a number of things that have nothing to do with the original problem). Imagine materials like "Ten Hot Drinks for Leprosy" or "How to Avoid Winter Leprosy?"

So what is depression? Depression is very different.

First, there are three levels of depression—mild, moderate (clinical), and severe (chronic). Mild depression usually goes away on its own in 2-3 months, medium depression can go away on its own or turn into severe depression, if it goes away on its own, then in six months to a year. As a rule, mild and moderate depression can be treated with a psychologist without the use of drugs, but with the use they are faster and easier.

You can no longer confuse severe depression with spleen: a person has a difficult time when he takes great care of himself, including in the sense of hygiene, it is difficult for him to get up, wash dishes, brush his teeth, clean the apartment, leave the house . In very bad situations, he forgets to eat and may die of hunger.

There is a masked depression - this is a depression in which a person is overly cheerful and constantly busy with something so as not to feel how bad he is, how tired and sad he is. This usually leads to a breakdown and the transition of depression to a severe stage.

Depressions are also of different types according to sensations. For example, asthenic depression is a severe loss of a resource due to (usually) heavy workloads and stress. It is characterized by an unpleasant feeling of a weight hanging from you, an inability to rejoice (you wake up in the morning - and it feels like you just worked two shifts in the mine).

Anasthenic depression, or depression with derealization, is characterized by a feeling that the world is not real, the walls are cardboard, the view outside the window is drawn, feelings have died out forever, the world has frozen. This type of depression can also accompany more severe mental diagnoses, such as schizophrenia. Also, depression can be with bipolar disorder - and in the other pole, a person is cheerful and full of energy.

Depression can be caused by a hormonal imbalance after childbirth or due to menopause and aging (in a number of modern countries, antidepressants are automatically prescribed for older people). Such depressions include, for example, postpartum depression.

Endogenous depression is caused by internal biochemical processes in the body, usually leads to lifelong medication, because the body is simply not able (or has lost this ability) to produce the necessary substances on its own. Sometimes - very rarely - such depression leads to such severe conditions that it may be the basis for euthanasia in countries where this is possible.

Atypical depression is usually accompanied by a number of other symptoms that are uncharacteristic of ordinary depression, such as severe anxiety, increased appetite (usually in patients before taking antidepressants, their appetite is just reduced), severe somatic pain.

Depression also differs in causes. Psychogenic depression is caused by severe stress, and psychotypical depression is caused by a predisposition of the nervous system and head injuries.

Also, depression can be childish and adolescent (in this category of patients, it usually occurs as a result of severe trauma - a terrible divorce of parents, school bullying, natural or man-made disasters, wars).

This is our set - quite diverse in terms of reasons, ages, statuses and manifestations.

Finding recommendations for relatives of all depressed patients is difficult. Therefore, it is probably worth starting with an understanding of what kind of depression your loved one has, how long it lasts and what is needed for it to pass.

For example, with asthenic and psychogenic, as well as with childhood and adolescent depression, rest and recovery, love and support of loved ones, hope - hope is very necessary - and faith in a brighter future. Over time, the body will recover itself. And while he is recovering, in general, the approach is the same as with a severe flu - remind him to take pills, hold his hand, stroke his head and sympathize with what is happening.

In more severe cases, care is very much needed: people in this state really find it difficult to do even household chores, and when taking antidepressants, when the body begins to recover, drowsiness also increases (and, as a rule, libido is depressed). Therefore, such things as many hours of sex, extreme sports, a trip to Burma for a week, snowball fights and long shopping trips will not lead to the fact that Princess Nesmeyana will come to life, but to the fact that she will turn into the shadow of Hamlet's father, which can only cursing indistinctly. He will also get sick for sure with something - from a banal cold to some exotic inflammation of the Achilles tendon and neuralgia.

If you are not the cause of depression in a person (you have not betrayed, you have not divorced, you have not tried to drown yourself in acid in a Joker costume), do not blame yourself. Depression, like cancer, is caused by a complex combination of different factors, and you are probably not the most important person there.

On the contrary, the ability to stay with a person in depression without depreciation (are you completely lazy?) is an art of jewelry that is not accessible to every person, even if he has a special education.

And it seems to me that an important factor in being around a depressed person is taking care of yourself. Remember that living next to someone who is constantly worried, afraid, or crying is also not easy. Do not lock yourself at home with him, otherwise depression will defeat you too. Look for support in work, friends, trips to nature (if it makes you happy), shopping, skydiving, watching funny comedies - in general, do not forget about yourself. Your life goes on - as does the life of a person with depression.

Don't forget about responding to aggression. If you are an ordinary active person who is used to living and enjoying life, then a slow, whiny, tired and weak person, who at the same time has not lost either arms or legs, will cause you a lot of irritation. Find yourself a place where you can swear at such a life and such a sad state of affairs.

Distribute your attention evenly so as not to leave the one who is nearby without support, food and help, and yourself without life and pleasures.

If your loved one is seriously ill for a long time, remember that there are support groups for relatives of patients with psychiatric diagnoses, as well as psychologists and psychotherapists who can support you too.

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