Sadness all the time

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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Last Updated: 08/30/2022

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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).

I'm sad and anxious... what does that mean?

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Anti-stressA person among people

There are several reasons why we can experience anxiety and depressed mood. They manifest themselves in different ways, and it can be quite difficult to distinguish between these causes. To do this, you need to have sufficient information, access to which is far from being available to everyone. Educational program on depressive and anxiety disorders was decided by journalists Daria Varlamova and Anton Zainiev 1 .


You are always depressed . This feeling arises, as it were, from scratch, regardless of whether it is raining outside the window or the sun, Monday today or Sunday, an ordinary day or your birthday. Sometimes a strong stress or traumatic event can serve as an impetus, but the reaction may be delayed.

This goes on for a long time . Really long. In clinical depression, a person can stay for six months or a year. One or two days of bad mood is not a reason to suspect that you have a disorder. But if melancholy and apathy relentlessly haunt you for weeks and even months, this is a reason to turn to a specialist. nine0003

Somatic reactions . Sustained mood decline is only one of the symptoms of a biochemical failure in the body. At the same time, other “breakdowns” occur: sleep disturbance, problems with appetite, unreasonable weight loss. Also, patients with depression often have reduced libido and concentration. They feel constant fatigue, it is more difficult for them to take care of themselves, go about their daily activities, work and communicate even with the closest people.


Anxiety haunts you and you can't figure out where it came from . The patient is not afraid of specific things like black cats or cars, but experiences unreasonable anxiety constantly, in the background.

This goes on for a long time . As in the case of depression, for a diagnosis to be made, the anxiety must have been felt for six months or more and not be associated with another disease.

Somatic reactions . Muscle tension, palpitations, insomnia, sweating. Takes your breath away. GAD can be confused with depression. You can distinguish them by the behavior of a person during the day. With depression, a person wakes up broken and powerless, and in the evening becomes more active. With an anxiety disorder, the opposite is true: they wake up relatively calm, but over the course of the day, stress accumulates and their well-being worsens. nine0003


Panic attacks - periods of sudden and intense fear, most often inappropriate to the situation. The atmosphere can be completely calm. During an attack, it may seem to the patient that he is about to die.

Attacks last 20-30 minutes , in rare cases about an hour, and the frequency varies from daily attacks to one in several months.

Somatic reactions . Often, patients do not realize that their condition is caused by fear, and they turn to general practitioners - therapists and cardiologists with complaints. In addition, they begin to be afraid of repeated attacks and try to hide them from others. Between attacks, the fear of waiting is formed - and this is both the fear of the attack itself and the fear of falling into a humiliating position when it occurs. nine0003

Unlike depression, people with panic disorder do not want to die . However, they account for about 90% of all non-suicidal self-harm. This is the result of the body's reaction to stress: the limbic system, responsible for the manifestation of emotions, ceases to provide a connection with the outside world. The person finds himself detached from his body and often tries to harm himself, only to regain the feeling inside the body.


Attacks of fear and anxiety are associated with a frightening object . Even if the phobia has some basis (for example, a person is afraid of rats or snakes because they can bite), the reaction to the feared object is usually disproportionate to its real danger. A person realizes that his fear is irrational, but he cannot help himself.

Anxiety in phobia is so strong that it is accompanied by psychosomatic reactions . The patient is thrown into heat or cold, his palms sweat, shortness of breath, nausea, or palpitations begin. Moreover, these reactions can occur not only in a collision with him, but also a few hours before. nine0003

Social phobia — fear of close attention from others — one of the most common phobias. In one form or another, it occurs in 12% of people. Social phobias are usually associated with low self-esteem, fear of criticism and increased sensitivity to the opinions of others. Social phobia is often confused with sociopathy, but they are two different things. Sociopaths disdain social norms and rules, while sociophobes, on the contrary, are so afraid of judgment from other people that they do not even dare to ask for directions on the street. nine0003


You use (and create) rituals to deal with anxiety. OCD sufferers constantly have disturbing and unpleasant thoughts that they cannot get rid of. For example, they are afraid of hurting themselves or another person, they are afraid of catching germs or contracting a terrible disease. Or they are tormented by the thought that, leaving the house, they did not turn off the iron. To cope with these thoughts, a person begins to regularly repeat the same actions in order to calm down. They can often wash their hands, close the doors or turn off the lights 18 times, repeat the same phrases in their heads. nine0003

A healthy person can also love rituals, but if anxious thoughts and obsessive actions interfere with life and take up a lot of time (more than an hour a day), this is already a sign of a disorder. A patient with obsessive-compulsive disorder realizes that his thoughts can be devoid of logic and divorced from reality, he gets tired of doing the same thing all the time, but for him this is the only way to get rid of anxiety at least for a while.


Depressive and anxiety disorders often co-occur: Up to half of all people with depression have anxiety symptoms, and vice versa. Therefore, doctors may prescribe the same medications. But in each case there are nuances, because the effect of drugs is different.

Antidepressants work well in the long run, but they won't relieve a sudden panic attack. Therefore, patients with anxiety disorder are also prescribed tranquilizers (benzodiazepines are commonly used in the US and other countries, but in Russia since 2013 they have been equated with drugs and withdrawn from circulation). They relieve excitement and have a calming effect on the central nervous system. After such drugs, a person relaxes, becomes sleepy, slow. nine0003

Medicines help but have side effects. Depression and anxiety disorders in the body disrupt the exchange of neurotransmitters. Medicines artificially restore the balance of the right substances (such as serotonin and gamma-amionobutyric acid), but you should not expect miracles from them. For example, from antidepressants, the mood of patients rises slowly, a tangible effect is achieved only two weeks after the start of administration. At the same time, not only will the will return to the person, his anxiety increases. nine0003

Cognitive behavioral therapy: working with thoughts. While medication is indispensable for dealing with severe depression or advanced anxiety disorders, therapy works well for milder cases. CBT is built on the ideas of psychologist Aaron Beck that mood or anxiety tendencies can be controlled by working with the mind. During the session, the therapist asks the patient (client) to talk about their difficulties, and then systematizes his reaction to these difficulties and identifies thought patterns (patterns) that lead to negative scenarios. Then, at the suggestion of the therapist, the person learns to work with his thoughts and take them under control. nine0003

Interpersonal therapy. In this model, the client's problems are seen as a response to relationship difficulties. The therapist, together with the client, analyzes in detail all the unpleasant sensations and experiences and outlines the contours of the future healthy state. Then they analyze the client's relationship to understand what he gets from them and what he would like to receive. Finally, the client and therapist set some realistic goals and decide how long it will take to reach them.

1. D. Varlamova, A. Zainiev “Go crazy! A Guide to Mental Disorders for a Big City Resident” (Alpina Publisher, 2016).

Text: Anton Soldatov Photo source: Getty Images

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Why you are always sad and in a bad mood: 9 reasons and how to deal with it

Our mood is like a swing. At one moment, we glow with happiness and enjoy what is happening, and at another, we want to hide in a corner and never talk to anyone else. nine0003

Such changes are quite natural and are often associated with various external factors and events that happen to us. But what if you are always in a bad mood?

Why does this happen, what is to blame, and how to restore interest in life and the ability to enjoy small things? Now let's look at the main causes of constant sadness and ways to solve the problem.

1 Chronic lack of sleep

We understand how difficult it is to resist the temptation to watch one more episode of your favorite series before bed, but chronic sleep deprivation is a sure way to become not only lethargic and always tired, but also constantly sad, as well as dissatisfied with life. nine0003

And the lack of quality sleep can happen even if you always go to bed before midnight. An uncomfortable bed and pillow, noise, light and even the temperature in the room can negatively affect your night's rest and cause an everlasting feeling of being overwhelmed.

Read about products that will help you sleep even if you live in the city center.

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    7 best sleep products to help you sleep in a noisy city

2 Malnutrition

Overeating makes us feel heavy and lazy, but not eating enough in our daily diet can also be dangerous. Do not forget that food is the necessary "fuel" for your body.

When you miss or forget to eat, your blood glucose drops and this causes your brain to produce cortisol, also known as the stress hormone. And he, in turn, is able to make you feel irritated, angry, depressed and be the reason why you are sad all the time. nine0003

Therefore, even in the busiest schedule, be sure to include several meals and make sure that your diet contains enough vegetables and fruits.

3 Abuse of caffeine

There is nothing wrong with drinking a cup of coffee in the morning and a couple more during the day. But it is categorically not recommended to "sit down" on this invigorating drink and abuse it.

In high doses, caffeine has several side effects, including irritability, anxiety, and nervousness. If you are a real "coffee maniac" who constantly grumbles about life and does not understand why everything infuriates him, try to reduce the dose of your favorite drink to 400 mg per day and check how this will affect your condition. nine0003

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4 Chemical imbalance in the brain or depression

Why are you in a bad mood for no reason? Even if there are no outward reasons to be sad, internal processes, such as a chemical imbalance in your brain or depression, may be to blame. nine0003

Decreased levels of neurotransmitters, such as the "happiness hormones" serotonin and dopamine, can spoil your mood much more than a cup of coffee spilled on your favorite shirt.

Besides the fact that you will be constantly sad, you may also encounter such symptoms as:

  • irritability;
  • loss of interest in favorite activities;
  • desire to isolate;
  • poor concentration. nine0153

Do not ignore these symptoms and see a doctor. He will recommend appropriate treatment, which may include antidepressants or talk therapy sessions with a psychologist.

5 Thyroid disorder

Let's give credit to the thyroid gland. It's one of the body's "motors," producing hormones that help regulate everything from body temperature and weight to skin and hair health, energy levels, and mood.

Therefore, if everything is not all right with her, then your state of health can change for the worse. For example, an overactive thyroid (hyperthyroidism) can make you feel jittery or anxious, while an underactive thyroid (hypothyroidism) can make you less motivated and feel overwhelmed.

Both can be the answer to the question what happened and why there is no mood. To identify these conditions, it is necessary to take blood tests. When the diagnosis is confirmed, the endocrinologist will prescribe the appropriate treatment. nine0003

6 Apnea

Sleep apnea can cause breathing to slow or stop up to 30 times per hour during sleep. While you are not fully awake during these moments and may think that you are sleeping soundly, the quality of nighttime rest is greatly reduced, and as a result, mood during the day can plummet.

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To diagnose sleep apnea, which is a common and treatable condition, doctors may take a medical history, do a physical exam, or recommend a sleep study.

7 Stroke

Sagging face and arms or slurred speech are all well-known symptoms of a stroke. But the consequences of this condition - like any other related to the brain - can greatly affect mood. nine0003

For example, if a stroke occurs in the right frontal lobe of the brain, you may experience “inappropriate euphoria”, while a stroke in the left hemisphere can cause sadness and anxiety in a person.

So if you've had a stroke and feel constantly sad, talk to your doctor about possible treatment.

8 Allergies

You may think you know if you have an intolerance to something, but doctors often suddenly discover that patients are allergic to something else in their environment (like pollen) or diet (gluten is a common culprit) when send them for a blood test. nine0003

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    7 popular myths about allergies (spread by allergy sufferers themselves)

Allergy or sensitivity to gluten has been associated with depressive symptoms that begin to improve with a gluten-free diet, according to some studies.

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