Ways to manage depression and anxiety
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:
- 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
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: 01/05/2023
How to deal with anxiety?
Simple Tips for Controlling Anxiety*
text from the American Anxiety and Depression Association website, translated by the author of the site.
If you are anxious, the following steps can help you cope:
Make time for leisure. Practice yoga, listen to music, meditate, learn relaxation techniques or make time for a massage. Avoiding the problem in a pleasant pastime will free your head from problems.
Eat healthy.
Do not avoid any kind of food. Provide healthy food. Avoid feeling hungry with regular snacks and regular meals.
Limit your intake of alcohol and caffeine , they can increase anxiety and cause panic attacks.
Get enough sleep. Under stress, you need to sleep and rest more than usual.
If anxiety develops, defeat it: Make sure that your breathing is deep. Inhale and exhale slowly.
Slowly count to 10. Repeat and count to 20.
Treat everything with humor. Many problems can be solved with a good laugh.
Maintain a positive attitude. Direct your efforts to replace negative thoughts with positive ones.
Take part in various undertakings. Be active, volunteer or do other community work that requires you to keep in touch with people, which will help you take your mind off your daily worries.
Find out what makes you anxious.
Is it work, family, school or something else?
Keep a journal, record when you feel stressed or anxious, and look for patterns.
Find someone to talk to. Let your friends and family know that you are having a hard time coping with your feelings, tell them how you can be helped.
See a doctor for professional help.
Accept that you can't control everything. Imagine the further development of the situation that worries you: is it really as bad as you think?
Make yourself better. Instead of striving for perfection, which is impossible, be content with how close you get to it.
Exercise daily to keep your body healthy. Follow the advice below.
Get in shape
Stay healthy, manage stress!
To maximize the benefits of exercise, try to include at least 2½ hours of moderate-intensity activity (e.g. brisk walking) per week, at least 1¼ hours of vigorous activity (jogging or swimming), a combination is allowed loads.
5 X 30: Run, walk, bike or dance three to five times a week for 30 minutes.
Instead of endlessly striving for perfection, set yourself daily goals and objectives. It is better to walk every day for 15-20 minutes than to wait for the weekend and arrange a three-four-hour fitness marathon. The fact that the regularity of the load is more important is indicated by multiple scientific data.
Find out for yourself what kinds of activities you enjoy. Sociable people often prefer group activities. Closed - individual lessons are better suited.
Listen to music, audiobooks, or the news during class to take your mind off your daily routine. Many people find it more enjoyable to practice while listening to their favorite songs.
Assemble a "team of like-minded people". By talking with friends, colleagues or partners, it is easier to form the habit of regular exercise.
Be patient when starting a new program. Most people who have previously been sedentary take four to six weeks to develop the strength and coordination that will allow them to exercise effortlessly.
* Recommendations are not intended for use without regular medical supervision. Non-drug anxiety control measures such as autogenic training and meditation may worsen the patient's condition in severe forms of depression and more serious mental illness.
Useful links to popular materials from other sites
- Comic book about depression
- How to avoid irritability at work?
- PHQ-9 Depression Questionnaire
- GAD-7 Anxiety Questionnaire
- Ways to create a peaceful life | Blog 4brain
- How to choose a psychotherapist
Anxiety - expectation of danger or misfortune in the future, accompanied by feelings of anxiety, stress and/or somatic symptoms of tension. At the same time, the source of the expected danger can be both internal and external.
With anxiety in humans, in animals, the constant expectation of a predator attack is similar (Dawid H.
Barlow, 2002, M.G. Craske, S.L. Rauch, R. Ursano, 2009).
Anxiety may be a natural human response to potentially dangerous situations.
Apart from the cases that really threaten with problems, anxiety is often found in both bodily and mental illnesses.
There is a group of mental illnesses in which anxiety is the main symptom: generalized anxiety disorder, obsessive-compulsive disorder (formerly called obsessive-compulsive disorder), panic disorder, post-traumatic stress disorder, social phobias, and other rarer conditions.
In patients who visit a neurologist, anxiety disorder can be one of the factors in the appearance of pain associated with an increase in skeletal muscle tone - more often headaches and more in the neck, less often - pain in the chest and back.
Individual manifestations of anxiety: difficulty breathing, nausea, dizziness, feeling of dry mouth, "lump in the throat" are often considered by patients as symptoms of bodily or neurological diseases.
The search for the cause can go on for years.
It is extremely difficult to make a correct diagnosis on your own. The fact is that anxiety changes the process of thinking - the patient cannot soberly assess the situation. Arise cognitive distortions : complaints and symptoms in the mind of the patient are undoubtedly significant, require maximum attention. In this state, people often become victims of medical fraud. Even a competent doctor who adheres to a certain plan in managing a patient finds it difficult to resist the onslaught and calmly convince the patient that there are no serious problems.
Comparative characteristics of fear of anxiety and depression
| Types of reactions | Fear | Alarm | Depression |
|---|---|---|---|
| Verbal (subjective assessment) | Imminent threat thoughts | Thoughts of danger in the future | Thoughts of loss, fatigue, general weakness |
| Somato-visceral | Sympathetic Nervous System Activation | Muscle tension | Decreased activity |
| Engine | Escape | Avoidance | Refusal to make a decision, delay |
Anxiety: how to deal with heightened anxiety
What causes anxiety
some psychological trauma.
However, the digital era in which we live is making its own adjustments. We are online all the time and are faced with a huge stream of news (both good and bad), which means that we become potential targets for trolling, cyber attacks, system failures and many other unpleasant factors.
The digital revolution has made many people forget about the need for live communication, replacing it with being on social networks that prescribe to measure the level of happiness and success by the number of likes and comments. Hiding from stressful situations behind monitor screens is getting easier: why make an appointment in person or call when you can send a message in a messenger? Even with colleagues it is not necessary to communicate live, because there is a working chat. Once upon a time, the need to deal with everyday affairs forced people to fight their own fears, but digital reality only exacerbates the situation.
Who is at risk
Anxiety can occur for a number of reasons, one of them is genetic predisposition.
Despite the important role of heredity, experts recognize life circumstances as the main triggers: serious events such as graduation from school or the need to leave your home, job change, relocation, separation from a partner, the birth of a child and other situations that force you to change your usual environment and leave your comfort zone. Here, even those who have not had such problems before can face anxiety and panic attacks.
According to Dr. Hendriksen, anxiety is inherent in human nature and indeed largely depends on genetics. “Most often, the cause is an event that leads to uncertainty, or a process whose outcome is unknown,” she notes. "Genetic predisposition does play a significant role - in some families this problem is more common than others," agrees David Carbonell. “I am sure that susceptibility to anxiety disorders is instilled in us from birth. At a certain period of life, this genetic factor begins to manifest itself, for example, panic attacks appear in the range from 18 to 30 years.
