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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

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✚ Generalized Anxiety Disorder. Neuropsychiatric clinic of Professor Minutko. Article #5849

It is of interest to understand the pathogenesis aspects (genetic, neuroimaging, neuroendocrine and psychophysiological, etc.) of generalized anxiety disorder (GAD).

GAD is one of the most common mental disorders, affecting almost 20% of adults throughout their lives. GAD is characterized by excessive worry and anxiety about a range of events or activities (eg, work, school performance, etc.) that the individual finds difficult to control. Symptoms required for a diagnosis of generalized anxiety disorder include feelings of restlessness (anxiety), ease of fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance (note: according to the American classification, only one symptom should be present in children).

GAD has high rates of comorbidity, especially between GAD and major depressive disorder (MDD), which range from 40% to 95%. In fact, GAD/MDD comorbidity has been reported more frequently than either MDD or GAD. GAD is often a precursor to MDD, and if GAD is effectively treated, it reduces the risk of developing MDD, and some patients with MDD never have the full set of GAD symptoms.

At the biological level, studies that have been done on a single unit of analysis (such as brain data) have often emphasized similar outcomes for depression and anxiety. For example, the amygdala has shown increased activity in both anxiety and depression, and dual studies show high genetic correlations between MDD and GAD. However, MDD and GAD can be differentiated in relation to biology, particularly when using resting functional magnetic resonance (R-fMRI).

Chronic stress can significantly affect the homeostatic biological system by increasing allostatic load (i.e., the effect of stress on the human body). Increased cumulative effects of stress on the human body (allostatic load) are associated with many adverse health outcomes, including mental illnesses such as generalized anxiety disorder (GAD).

Implementation of a pharmacogenomics or metabolomics protocol to inform drug choice may improve outcomes of generalized anxiety disorder pharmacotherapy. For childhood, there are critical neurobiological "windows of development" that may be ideal for achieving the best results in the prevention and treatment of neuropsychiatric disorders, including GAD.

Genes are estimated to contribute 30%-50% to the development of anxiety disorder, and conversely, the development of anxiety disorder associated with non-genetic factors is approximately 50% to 70%. Environmental factors (eg, stress, trauma, etc.) are likely to contribute to the development of anxiety disorders through epigenetic mechanisms, which may influence the development of anxiety even from the prenatal period of fetal development. For example, mothers with a diagnosis of anxiety disorder who were not treated with anxiety medication have been shown to have altered cord blood and genome DNA methylation of the glucocorticoid receptor (NR3C1) gene, which may increase the child's risk of developing an anxiety disorder later on. Understanding the genetic and epigenetic mechanisms of the development of generalized anxiety disorder (GAD) is important for building more complete neurobiological concepts and developing the most effective preventive and therapeutic strategies for the treatment of this neurotic disorder. One general study of GAD association with the genome found a significant genome association between a single nucleotide polymorphism (rs78602344) intron to thrombospondin 2 ( THBS2 ) and GAD symptoms in a population sample of Hispanic adults (researchers found that DNA methylation indicated that global methylation levels were higher in adults with anxiety, more anxiety was associated with greater DNA expression.

Category blog posts:

Biological Psychiatry

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Features of dental treatment of children with myodystrophy

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  • Features of dental treatment of children with myodystrophy

Features of anesthesia in the treatment of dental diseases in pediatric patients with various forms of myodystrophy (DMD)

To date, it has already been proven that in people with DMD, anesthesia with inhalation anesthetics does not lead to malignant hyperthermia, but nevertheless, it can cause the development of a severe complication - rhabdomyolysis, and also potentiate hyperkalemia (a sharp increase in the level of potassium in the blood), which causes severe cardiac arrhythmias. Rhabdomyolysis is the breakdown of skeletal muscle resulting in the release of myoglobin into the bloodstream, causing kidney damage. Therefore, in patients with DMD, anesthesia with inhalation anesthetics is CONTRAINDICATED.

Congenital myodystrophies are genetic diseases (more than 30 are known) characterized by progressive muscle weakness and loss of muscle mass. Depending on the type of disease, the clinical picture also develops, the main criteria of which are the time of onset of symptoms of the disease, the degree of their severity and increase.

In our pediatric dental practice, we most often encounter patients with the following types of congenital myopathies: Duchenne disease (detected in one in 4000, boys are ill) in preschool children, Becker and Erba-Roth myopathy in older children and adolescents. With DMD, there is sometimes a decrease in intelligence.

What should be done if patients with DMD, due to their dental status, age and/or mental characteristics, need dental treatment under sedation? The most important thing when conducting a quality medical intervention is safety and painlessness. Therefore, our clinic has developed a special algorithm for providing anesthetic management of patients with this pathology.

The treatment plan for the child is drawn up taking into account the course of the underlying disease (degree of compensation, medication, recommendations of the attending physician) and the complexity of the upcoming treatment according to the dental profile. Then we choose the most appropriate sedation option.

Firstly, it is the adaptation of the child to the upcoming treatment according to the “from simple to complex” method, followed by treatment of the most difficult teeth under nitrous oxide sedation. The safety of using nitrous oxide in patients with DMD is clinically proven, ZAX is the drug of choice in these clinical situations.

Second, intravenous sedation. Intravenous sedation makes it possible to cure all teeth in one visit. Minus - the need for catheterization of a vein in a child in the mind (when treated under inhalation anesthesia, access to the vein is provided after the child falls asleep).

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