Overwhelmed with 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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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:
- Medications for Substance Use Disorders
- 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: 03/22/2023
symptoms, causes in men and women, remedies
Lack of vitality, unwillingness to get out of bed, bad mood for a long time, and even unwillingness to live are all signs of depression. Depression has a negative effect on the health and general well-being of a person. That is why it is so important to get medical help from a specialist in time.
How to determine the presence of depression?
Pathology can appear after experienced stressful situations. If there is no disorder, after the problem is resolved, a good mood returns to the person.
But when the cause is eliminated, and apathy, depression and loss of strength do not leave the person, it is necessary to seek help from a specialist. It may also decrease performance.
You can determine the presence of depression on your own, but you should not self-medicate even at an early stage of development. This should be done by a doctor, since self-medication can only aggravate everything.
Depression in women is often postpartum, as their lives change dramatically, and sleepless nights add fatigue. This is where frustration and apathy come in.
When the pathology is in advanced form, then a person has the following symptoms of depression - not only a bad mood and impotence, but also persistent disorders of the nervous system. There are also symptoms such as: a significant decrease in self-esteem, disadaptation in society, despondency and loss of interest in any events.
In physiological terms, appetite changes, intimate needs and energy decrease, sleep and bowel function are disturbed (constipation, weakness, fatigue during physical and intellectual stress are observed), pain in the body (in the heart, in muscles, in the stomach area).
The patient shows signs of depression such as loss of interest in other people, a tendency to frequent solitude, refusal of entertainment, use of alcohol and psychotropic substances.
Mental signs of depression include difficulty in concentrating, concentrating, making decisions, slowness of thinking, a pessimistic view of the future with a lack of perspective and thoughts about the meaninglessness of one's existence, suicide attempts, due to their uselessness, helplessness, insignificance.
Causes of depression
The appearance of the disorder is not influenced by age category or social class. Most often, depression appears against the background of stressful negative situations, with constant failures - then a person falls into despair from the inability to somehow influence the course of events.
But in addition to the social factor, severe psychological trauma can also lead to the development of depression, for example: family breakup, death of a loved one, a serious illness that affects not only the patient himself, but also his relatives.
In this case, depressions are referred to as reactive.
The likelihood of depression increases with changes in hormonal levels: during adolescence, after delivery, with the onset of menopause, and also in old age. It can affect the emotional and physical level.
Another factor is brain damage and somatic pathologies. Often depression affects patients who have had a stroke, suffering from a chronic lack of blood circulation in the brain, after a traumatic brain injury.
The causes of depression can manifest themselves as a result of the side effects of drugs (benzodiazepines, corticosteroids). Often this condition disappears on its own after the drug is discontinued.
Types of depression
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Neurotic - people with low self-esteem, insecure, straightforward people often suffer. They constantly feel a sense of injustice, and apathy arises from this.
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Clinical - bad mood, loss of energy, problems with appetite and sleep.
Often there is a tendency to suicide. This clinical picture can last at least 2 weeks. -
Vegetative - manifested by such signs as tachycardia, a drop in blood pressure, tinnitus.
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Psychogenic - develops after severe psychological trauma - divorce, loss of a loved one, dismissal from work, betrayal, etc. Accompanied by mood swings, anxiety, excessive sensitivity.
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Masked - often the disease manifests itself secretly. Apathy, solitude and a decrease in interest in life can only appear as negativity and fatigue accumulate.
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Asthenic - the condition is manifested by fatigue, sleep disturbance, emotional imbalance due to accumulated difficulties, stress, physical and psychological stress.
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Postpartum - usually occurs 10-14 days after delivery. A young mother shows an increased sense of excitement for the baby, and constant lack of sleep and fatigue worsen the situation even more.
In addition, the hormonal background also affects the state of the mother. -
Somatogenic - attacks occur due to disturbances in the endocrine system, the formation and growth of neoplasms, both benign and malignant.
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Alcoholic - depression is accompanied by excessive consumption of alcoholic beverages. The post-alcohol state is accompanied by an uncontrolled craving for alcohol and the growth of withdrawal syndrome when alcohol is refused.
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Bipolar - the patient is changing euphoria depressive, manic disorder. But in the period between these phenomena, caused by various factors: stress, loss of means of popularity, etc., a person lives an ordinary life and does not show symptoms of the disease.
How does depression develop in stages?
First, the patient has a depressed state, which he himself attributes to fatigue, a hard working week, drinking alcohol and other reasons. At the same time, he wants to retire from others and at the same time is afraid to be alone.
Then the stage of acceptance arises: the awareness of the dangerous state comes, the problem worsens, the intensity of negative thoughts grows, the body and the immune system fail.
The third stage - in the absence of adequate therapy, the patient loses control over himself, aggression increases.
Diagnosis and treatment of depression
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To identify the disease, experienced specialists use short questionnaires - screening tools to identify symptoms: anxiety, anhedonia (loss of pleasure from life), suicidal tendencies. Thanks to this, it is possible to determine whether the patient has chronic depression, symptoms and treatments for depression, what form and severity it is.
To fully understand the picture of the disease, the doctor needs to familiarize himself with the symptoms that indicate depression, and not another psychological disorder.
For the treatment of depression, you can contact the following specialists:
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Psychiatrist - treatment of depression with hypnosis, drugs for acute mental pathologies - schizophrenia, mental retardation, epilepsy, as well as other less severe ailments - neurosis, depression, alcoholism, drug addiction, etc.
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Psychotherapist – treatment is carried out through special therapy, which provides for explanations, conversations, search for solutions to problems together with the patient.
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Psychologist - consults the patient, cannot prescribe drugs and examinations. Clinical psychologists use modern test methods to identify problems that caused a psychological disorder.
The main directions of therapy in treatment are psychotherapy, pharmacotherapy, social therapy.
A necessary condition for the effectiveness of treatment is cooperation and trust in the doctor. It is important to strictly follow the prescription of the therapy regimen, visit the doctor regularly, and give a detailed account of your condition.
Preparations for the treatment of depression
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For the treatment of the disorder, antidepressants are used for anxious depression or when the pathology is accompanied by lethargy.
Antidepressants are prescribed directly by a doctor and are not recommended for self-administration. The action of many antidepressants manifests itself two weeks after administration, their dosage for the patient is determined individually.
In bipolar depression, depression is treated with insomnia. While it has a negative effect on a healthy person, in a patient with a psychological disorder, sleep deprivation, on the contrary, brings the psyche back to normal.
Moderate or mild depression requires the appointment of drugs on a light, natural basis (herbal).
Where to get tested and treated for depression in Krasnoyarsk?
If you or your loved ones show signs of an emotional disorder, you should immediately contact a specialist. Since depression can lead to dangerous consequences:
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isolation from society
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deterioration in appearance
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relationship problems
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low performance or its complete absence
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sexual problems
Contact the private clinic "Medunion" in Krasnoyarsk, get examined and treated for depression.
Our phone number for appointment +7 (391) 202-95-54.
Neurologist Elena Akulova tells how depression is diagnosed
Elena Mikhailovna Akulova took part in a round table on the diagnosis of depression and anxiety disorders. The doctor shared with her colleagues her experience of working with patients suffering from depression. However, this topic is relevant not only for professionals: everyone knows the feeling of anxiety, depressed mood, dissatisfaction with oneself, irritability, but not everyone knows where the fine line lies between just a bad mood and depression, which requires the intervention of a specialist.
Bad mood or depression?
If you have lost interest in what used to bring you pleasure, you feel tired and get tired quickly, you find it difficult to force yourself to move, do something, and a depressed mood haunts you daily, and this state lasts for more than two weeks, you may you depression.
In addition, pay attention to symptoms such as:
- emotional arousal or, conversely, lethargy;
- self-blame, tension, irritability, dissatisfaction with oneself, decreased confidence and self-esteem;
- passivity, alcohol abuse;
- negative thoughts, pessimism, difficulty in making decisions, memory loss, concentration, indecision;
- thoughts of death and suicide;
- early awakenings, insomnia or increased sleepiness;
- eating disorders - loss or uncontrolled increase in appetite;
- decreased sexual desires;
- possible violation of bowel function, pain in the area of various organs.
It turns out that depression and pain are interrelated: up to 50% of patients with depression suffer from pain. In this case, the examination will not reveal organic disorders - the bodily cause of pain, since it is a manifestation of latent depression (somatoform disorder).
If the painful condition is prolonged, it is better not to postpone the visit to a specialist (psychotherapist or neurologist).
How does a doctor diagnose depression?
How does a doctor diagnose depression?
First of all, the doctor will ask about what exactly is bothering you. It is important to know how long your mood has decreased, whether you have recently been exposed to stress, etc. It matters whether you have previously sought medical help, whether antidepressant therapy was effective, the frequency (daily / seasonal) of exacerbation of painful symptoms, whether you have chronic somatic diseases.
The severity of depression is assessed according to a special scale and using a questionnaire.
The doctor may order additional tests, examinations and consultations.
Is depression treatable?
Of course, today depressive states are treated with the help of modern medicines and psychotherapy methods. The patient may be prescribed antidepressants, tranquilizers, antipsychotics.
Some antidepressants are either stimulant or inhibitory and may cause sexual dysfunction, insomnia, and weight changes. Therefore, patients often stop therapy.
We prescribe to the patient only those drugs that are highly effective, have practically no side effects, and have a minimum of unwanted drug interactions. Including indications - brintellix, which begins to act already in the first week of admission and has a positive effect even with severe depression. New generation drugs are safe, do not lead to weight gain, do not cause drowsiness and are well tolerated.
Case studies
Elena Mikhailovna helps patients even in the most difficult cases, when depression is combined with other pathologies.
Patient D. (70 years old). The patient came to the clinic with complaints of a forced persistent torso tilt to the left, pain in the back, decreased mood, anxiety, sleep disturbances, deterioration of memory, attention, fatigue. The doctor made a diagnosis, including a depressive disorder with cognitive impairment. After a course of treatment in our hospital (antidepressive and botulinum therapy), a month later, the patient's mood improved, he began to sleep well, his back pain stopped bothering him, and his body position improved.
Patient L (51 years old). A top manager of a large company applied to the Yauza Clinical Hospital. The reason for the appeal is tearfulness, anxiety, mood swings, irritability, nervousness, sleep disturbances, twitching in the right infraorbital region. Treatment in other clinics did not bring results. Elena Mikhailovna made, among others, a diagnosis of anxiety-depressive disorder with mild cognitive impairment.
