Unplanned pregnancy and 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.
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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Switch to Chrome, Edge, Firefox or SafariMisusing 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. SAMHSA’s 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.
- 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)
- The 2019 National Survey on Drug Use and Health reports that 139.7 million Americans age 12 or older were past month alcohol users, 65.8 million people were binge drinkers in the past month, and 16 million were heavy drinkers in the past month
- About 2.3 million adolescents aged 12 to 17 in 2019 drank alcohol in the past month, and 1.2 million of these adolescents binge drank in that period (2019 NSDUH)
- Approximately 14.5 million people age 12 or older had an alcohol use disorder (2019 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
- 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)
- Data from the 2019 NSDUH reports that 58.1 million people were current (i.e., past month) tobacco users. Specifically, 45.9 million people aged 12 or older in 2019 were past month cigarette smokers (2019 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:
- 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 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)
- An estimated 745,000 people had used heroin in the past year, based on 2019 NSDUH data
- In 2019, there were 10.1 million people age 12 or older who misused opioids in the past year. The vast majority of people misused prescription pain relievers (2019 NSDUH)
- An estimated 1.6 million people aged 12 or older had an opioid use disorder based on 2019 NSDUH data
- Opioid use, specifically injection drug use, is a risk factor for contracting HIV, Hepatitis B, and Hepatitis C. The CDC reports that people who inject drugs accounted for 9 percent of HIV diagnoses in the United States in 2016
- 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
- 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)
- 2019 NSDUH data indicates that 48.2 million Americans aged 12 or older, 17.5 percent of the population, used marijuana in the past year
- Approximately 4.8 million people aged 12 or older in 2019 had a marijuana use disorder in the past year (2019 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
- 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: 04/27/2022
Depression and Pregnancy - Phoenix Center
Women today suffer from depression more than previous generations
Studies show that 1 in 7 women experience prenatal depression or depression during pregnancy .
Women today are more likely than their mothers to experience prenatal depression or depression during pregnancy, according to an open study. Prenatal depression is quite common and affects 10 to 15% of pregnant women.
Depression is a mental disorder that affects the entire body during pregnancy.
Signs of depression during pregnancy can range from loss of interest in enjoyable activities and feelings of worthlessness to changes in appetite and fatigue.
Symptoms of depression during pregnancy are very similar to depression that occurs at other times in life. A pregnant woman may also worry about the birth of her child or about her inferiority and failure as a mother.
Pregnant women who have anxiety problems, who have an unplanned pregnancy, or who are stressed about the baby's well-being are at increased risk of depression during pregnancy. Women who receive fertility treatment are also at increased risk. They may worry about the effect of treatment on pregnancy.
About 17% of mothers reported experiencing severe symptoms of depression, while 25% of mothers reported experiencing depression during pregnancy. Moms in both groups were aged 19up to age 24 when they were interviewed.
Why should young mothers, such as those in an open study, be depressed? We know that financial stress and lack of support increase the risk of depression, and new moms may be less likely to access these financial and interpersonal resources. However, depression during pregnancy can affect women of all ages.
Can maternal depression affect the unborn child?
If left untreated, a mother's depression can negatively affect her baby. There are risks to the developing fetus. When a mother is under stress, cortisol is released, which can negatively affect the development of the baby. According to research, the baby of a depressed mother may be born too small or too early.
Experts say pregnant women with depression should know there are effective treatments available to help them learn how to deal with depression.
The network's open study says that depression rates in young pregnant women are higher than in the 1990s and steps need to be taken to support these mothers-to-be. The results of the study highlight the need to expand screening and resources to support young pregnant women and minimize the potentially far-reaching effects of depression on mothers, their children, and future generations.
Is there an effective treatment?
Experts say both medication and psychotherapy are effective treatments for depression during pregnancy. Psychiatrists say what usually happens is that when a woman finds out she's pregnant, she stops taking her psychiatric medication. Unfortunately, this is not necessarily specified.
There are risks associated with both medication and untreated depression. Pregnant women should always consult a psychiatrist, but often, especially in cases of severe depression, the benefits of antidepressants may outweigh the risks.
In addition to medication, social support is critical for a pregnant woman who is experiencing depression. A formal support group can help, or just connecting with peers and hanging out with friends can help the mom-to-be not feel isolated. Therapies such as Interpersonal Psychotherapy and Cognitive Behavioral Therapy (CBT) have also been shown to be helpful.
To determine which course of treatment is best for you, discuss it with your healthcare provider to discuss the benefits and risks. The goal is to develop a plan that is designed to optimize the overall health of mother and child.
Future fathers can indeed be at the forefront of providing social support during pregnancy. Men should also notice symptoms of depression and encourage women to talk to their psychiatrist and gynecologist about it.
Does depression end after the birth of a child?
Psychiatrists say that depression during pregnancy usually doesn't go away with childbirth. Depression is likely to get worse before it gets better, requiring more serious treatments. That's why it's so important
Bergink V., Kooistra L., Lambregtse-van den Berg M.P., Wijnen H., Bunevicius R., van Baar A. et al. Validation of the Edinburgh Depression Scale during pregnancy // J Psychosom Res. 2011. No. 70(4). pp. 385-389. DOI: 10.1016/j.jpsychores.2010.07.008
Context: …Depression puts pregnant women at higher risk of inadequate prenatal care, increased alcohol use, and weight loss during pregnancy …
Berenson A.B., Breitkopf C.R., Wu Z. H. Reproductive correlates of depressive symptoms among low-income minority women // Obstet Gynecol. 2003 No. 102(6). pp. 1310-1317. DOI: 10.1016/j.obstetgynecol.2003.08.012
Context: …Several studies that have looked at the impact of unplanned pregnancy have shown that women with unplanned pregnancies are at higher risk of depression during pregnancy than women with planned pregnancies …
... Perinatal stress associated with maternal depression leads to a risk of developing behavioral, emotional, cognitive problems in a child, and is also considered as a prerequisite for the formation of mental illness in adolescence  and adulthood  ...
Blier P. Pregnancy, depression, antidepressants and breast-feeding // J. Psychiatry Neurosci. 2006 Vol. 31. No. 4.Pp. 226-228.
Christensen A.L., Stuart E.A., Perry D.F., Le H.N. Unintended pregnancy and perinatal depression trajectories in low-income, high-risk Hispanic immigrants // Prevention science. 2011. No. 12(3).