Self treating 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

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    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).



  • 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


  • 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



  • 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


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


  • 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



  • 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


  • 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


  • 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



  • 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.


  • 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.


  • 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

Depression: symptoms, signs and treatment



Mikhail Sergeevich

Experience 21 years

Psychotherapist, member of the Russian Professional Psychotherapeutic League

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The concept of "depression", as a whole complex of depressive disorders is called in medicine, indicates a serious violation of a person's activity and a decrease in his interest in the world around him and his own life. Establishing the exact cause of depression can be difficult, since several factors are possible: hereditary, physiological, neurological and psychosocial. It is possible to make an accurate diagnosis after studying the patient's history. The course of treatment involves a combination of several methods at once: conservative, psychotherapeutic and other measures.

Disease etiology

The classification of depression according to the current edition of the Manual of Mental Disorders implies a division into the following groups:

  • major depressive disorder;
  • chronic depressive disorder;
  • depressive disorder of specified or unspecified etiology: premenstrual disorders, depression due to health disorders, consequences of taking psychoactive drugs.

Most cases of depression have a clear age relationship: adolescence or age 20-30 years. Due to the peculiarities of the psyche, women are more prone to depressive manifestations, the exact causes of this phenomenon have not yet been established. These or other depressive symptoms occur in 30% of patients seeking medical help. Less than 10% of those who applied showed signs of deep depression, requiring competent medical intervention.

The state of demoralization associated with unpleasant incidents in the patient's life is significantly different from clinical depression. There are a number of characteristic signs indicating temporary psycho-emotional difficulties that disappear within a few days without specific treatment:

  • deterioration in mood is manifested by outbreaks and is not permanent, protracted;
  • as events change, a person's mood improves, and the mental state returns to normal;
  • low mood may alternate with gaiety and a stable state of health;
  • the patient does not have suicidal thoughts, feelings of self-loathing and feelings of worthlessness.

With the patient's tendency to depressive states during demoralization, individual signs of major depression may be observed. But even they do not allow talking about a disease that requires immediate help.

Causes of depression

Experts associate the manifestations of depression with environmental factors and genetic predisposition. However, they invariably point to the impossibility of accurately identifying the cause of the disease. Official medicine recognizes a hereditary trace in more than half of the diagnosed cases: in first-line relatives, identical twins. According to popular theories, the development of a depressive state can be affected by malfunctions of the hypothalamus, pituitary gland or adrenal glands, which produce hormones important for humans. Violations in the interaction of these organs can cause protracted depressive states.

A significant role in the appearance of signs of major or chronic depression is played by the psycho-emotional state, disturbed due to experienced problems: divorce, loss of a loved one, financial losses. In the absence of a predisposition to severe mental disorders, these events do not cause prolonged depressive states. If the patient has a tendency to anxiety, the risk of dangerous symptoms increases.

Speaking about the female predisposition to depression, experts indicate as the reasons:

  • exposure to daily stress due to high mental stress;
  • high risk of thyroid dysfunction;
  • hormonal changes associated with the menstrual cycle or menopause;
  • increased levels of monoamine oxidase, an enzyme that breaks down neurotransmitters that determine the patient's mood level.

Against the background of clinical depression, the patient may show signs of somatic diseases: hormonal disorders, brain tumors, strokes, multiple sclerosis and Parkinson's disease.

Symptomatic picture of the disease

Signs of depression largely depend on the nature of the disease and help specialists make an accurate diagnosis.

  1. In a state of major depression, the patient has a tired and sad appearance, lack of eye contact, emotionlessness, depression and restrained speech. Violations of diet and personal hygiene are possible. Also among the characteristic symptoms of depression: decreased interest in favorite activities, insomnia, weight loss or rapid weight gain, indecision, inability to concentrate, obsessive thoughts of death or suicide, lethargy.
  2. In chronic depressive disorder, symptoms persist for 2 years or more. The patient has anxiety, obvious personality disorders, increased criticality towards himself and others, isolation and low self-esteem. In addition, increased fatigue, inability to concentrate, a feeling of hopelessness, insomnia or excessive sleepiness, weakness and low mood indicate a chronic condition.
  3. Against the background of premenstrual depressive disorder in women, a week before the expected date of the start of the cycle, there are sharp mood swings, anger and irritability, a state of anxiety and tension. Interest in habitual activities decreases, concentration of attention falls, increased fatigue and a feeling of depression are noted. Up to 6% of women of childbearing age suffer from the listed symptoms of depression in women with PMS at various periods of life.
  4. In depressive disorders with an unknown etiology, patients of both sexes have anxiety, characteristic manic syndromes (feeling of superiority, talkativeness or high spirits), a decrease in emotional reaction to pleasant events, states of delirium or hallucinations, psychomotor retardation.

The symptomatic picture of different types of depression has an individual color for each patient. However, all persons suffering from depression invariably have common features of a particular disease, which simplifies the diagnosis.

Complications of depression

The growth of the pathological situation against the background of the patient's refusal of professional assistance can cause the following dangerous phenomena:

  • increase in symptoms of depression;
  • increased incidence of depression;
  • prolonged illness, the duration of which increases as the attacks become more frequent;
  • cases of double depression, when severe psychological problems are superimposed on more “superficial” experiences and stages of depression develop that are difficult to treat;
  • difficulties with the selection of appropriate therapy, when the disease is not amenable to classical methods of correction and requires the use of more "heavy" drugs with a high risk of side effects.

Depression diagnostics

The treatment of depression is the field of activity of the therapist, psychologist and psychiatrist, optimally - their collegial cooperation. Special questionnaires, complaints of patients and their relatives about characteristic changes in well-being and mood allow to recognize the signs of depression and make an accurate diagnosis. In personal communication with the patient, the doctor clarifies the duration of the course of the disease, and also delicately finds out the appearance of possible thoughts about harming himself or others. Also, concomitant pathological conditions are subject to mandatory study: a tendency to use alcohol and drugs, smoking, immoderate nutrition, etc.

Of great importance is the differential diagnosis of depression, which makes it possible to distinguish this disease from other similar mental pathologies: bipolar disorder, anxiety, demoralization, signs of dementia, or hormonal disorders associated with impaired thyroid function. At the same time, a number of clinical examinations are carried out: a complete blood count, measurement of thyroid hormone levels, electrolyte balance, blood levels of prohibited psychotropic substances.

Methods of treatment

Treatment for depression includes:

  • drug treatment is developed taking into account the patient's condition, response to previous courses and the risk of side effects. Drugs of the antidepressant group suppress the action of certain hormones that contribute to the development of depressive states and restore hormonal balance in the body.
  • maintenance treatment implies a regular visit to a specialist to monitor the results of treatment, adjust the chosen course, obtain the necessary clarifications, etc.
  • additional methods of influence: psychotherapy, phototherapy, electroshock therapy, methods of deep brain stimulation, etc.

If all the recommendations of the specialist are followed and the course is completed in full, stable positive results can be achieved within a few weeks, while reducing the risk of recurrence of depressive conditions.

Frequently asked questions about depression

How to get rid of depression on your own?

Attempts to deal with depression on their own usually end in failure and the appearance of signs of a deeper disorder. Only an experienced doctor will be able to determine the type of disease and choose the best treatment tactics. Folk remedies, uncontrolled intake of antidepressants "on the advice of friends", withdrawal into oneself - only tighten the knot of the problem and can cause deeper mental disorders with a simultaneous deterioration in physical health.

Why is depression dangerous?

Voluntary refusal of a course of treatment with the intention to overcome the disease on their own can have the most serious consequences: the appearance of suicidal thoughts, deep mental disorders, more frequent seizures, degradation of the personality in professional and family terms, the appearance of addiction to alcohol and drugs. It is useless to act on all of these symptoms with conventional methods of treatment, and taking potent drugs can cause side effects.

How to beat depression?

It is important to understand that depression is not a temporary deterioration in mood, but a serious mental disorder. And it will be possible to cope with it only after completing a course of complex treatment with the obligatory intake of prescribed drugs and additional methods for correcting the psycho-emotional state. Treatment under the supervision of an experienced specialist will help to completely cope with the disease and reduce the risk of relapse even when exposed to negative factors.

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Depression treatment in St. Petersburg | ICh RAS

Treatment of patients with depression at the Clinic of the Institute of Human Chemistry RAS

Complex forms of depression put a person to bed, blocking the sun's rays and the blue sky from him. All the colors of life fade, there is a desperate hopelessness and oppressive anxiety. The patient does not leave the house, refuses to eat, he has thoughts of suicide. According to statistics, depression affects about 20% of the population in developed countries of the world. Most people are not well aware of the characteristic manifestations and consequences of this disease. Therefore, many patients seek qualified help at a depression treatment clinic when the condition becomes severe.

Symptoms of depression

Depression is not temporary mood swings that every person experiences on a daily basis. This is a serious disorder that requires the mandatory intervention of a doctor. In a depressed state, a person has negative thoughts, a pessimistic outlook on life, a feeling of hopelessness arises, and joy disappears.

One should be on guard when depression does not go away and begins to affect all areas of life:

  • psycho-emotional state affects working capacity;
  • there are problems in communication;
  • there are constant conflicts in the family;
  • markedly reduced self-esteem;
  • there are thoughts about leaving life.

An important condition for effective treatment of depression is timeliness. The sooner a person turns to a specialist, the faster he will overcome the disease. Today, psychiatry has a whole arsenal of methods to combat depression.

In addition to the main ones, there are other methods of treatment. These are phototherapy, homeopathy, sleep deprivation, electroconvulsive therapy, insulin therapy. The doctor can prescribe physiotherapy, massage, hirudotherapy, acupuncture, give recommendations on changing lifestyle and nutrition. It is believed that greater effectiveness of treatment is achieved by combining psychotherapy, pharmacotherapy and other methods.

Short-term depression can go away on its own, but often it develops into a long-term stage, when the patient needs medical help. The psychotherapists of our clinic select an individual program for the treatment of depression, which includes both taking medications and a course of psychological assistance to the patient.

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