What are three signs of depression

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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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    It's Not Your Fault (NACoA) (PDF | 12 KB)
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    After an Attempt: A Guide for Taking Care of Your Family Member After Treatment in the Emergency Department
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    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).



  • 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

Doctors named three main signs of depression the main signs of depression

During the round table of the Izvestia newspaper, Russian doctors named three main signs of depression. As the doctor of medical sciences, head of the department said ... RIA Novosti, 09/19/2018





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And. Pirogov, Russia

Society, Pirogov Russian Medical University, Russia

MOSCOW, Sep 19 — RIA Novosti. During a round table discussion with the Izvestia newspaper, Russian doctors named three main signs of depression.

August 15, 2018, 08:00

Why emotions? The dark side of the intellect affects health N.I. Pirogova Andrey Shmilovich, about 20 percent of the world's population has experienced or will experience the symptoms of this mental disorder at least once.

According to the specialist, autonomic disorders are typical for depression.

August 3, 2018, 10:11

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"If a person wakes up at five o'clock in the morning and his heart beats in his chest, his mouth is dry, if he has problems with the stool and at the same time he experiences acute unreasonable anxiety - this is the first sign," Shmilovich noted.

Rhythmic mood changes should be another alarming signal, the participants of the discussion stressed. As the doctors said, usually in people suffering from a depressive disorder, emotional relief comes in the evening, and these changes become especially noticeable in autumn and spring.

"The third symptom that is almost certainly indicative of clinical depression is anhedonia. It is the loss of pleasure," said the participants in the discussion.

As noted by Shmilovich, depressed patients lose their "biological, animal, subconscious need" to receive joy from what is happening around them.

April 26, 2018, 11:24

Scientists from Russia have found out how depression changes the way the brain works

a computer or a phone - this can be a sign of depression, "says the candidate of medical sciences, deputy director of the Scientific and Practical Center for Mental Health of Children and Adolescents. G.E. Sukhareva Anna Basova.

In addition, according to experts, often depression can be associated with sleep and eating disorders. The experts emphasized that the true cause of the disorder can and should be treated “only with the help of a psychiatrist.”

"Psychiatrists should treat depression": three signs of the disease and how to avoid it

April 7, 2017, 07:48

More than 300 million people in the world today live with depression. Therefore, it is not surprising that the theme of World Health Day, which is celebrated on April 7, is depression.

According to the World Health Organization (WHO), depression is one of the leading causes of ill health and disability worldwide. In the 10 years from 2005 to 2015, the number of people with depression increased by more than 18%. "Because of a lack of support, many people with mental disorders do not seek the treatment they need to live healthy and productive lives," the organization said. The WHO is urging countries to increase investment in mental health, reminding that even in high-income countries, about 50% of people with depression do not receive treatment.

Meanwhile, most depressions are treated on an outpatient basis, if the patient turns to a psychiatrist for help in time. This was told to TASS by the chief freelance specialist of the Ministry of Health of the Russian Federation in psychiatry, director of the State Scientific Institute of Forensic and Social Psychiatry. V.P. Serbian Zurab Kekelidze. “Of course, there are chronic, resistant severe conditions when serious measures must be taken,” the expert added.

From 3.7% of the population to 6.5% in different countries - the percentage of people diagnosed with depression. Russia is in the middle of this list - we have about 5.5%

Kekelidze notes that, according to statistics, there are more women diagnosed with depression. However, this may be partly due not to a predisposition to depression, but to the fact that women are more attentive to their health. “They notice deviations faster, see a doctor more often and are more attentively treated,” he said.

Three signs of depression

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The chief specialist of the Ministry of Health of the Russian Federation in psychiatry notes that a bad mood is not only from real external causes, but also from a disease called "depression".

"Three main signs are standardly distinguished: a feeling of low mood, motor (motor) retardation, idiotic retardation (when a person feels that it has become harder for him to think, to choose words more slowly, a feeling that he is not thinking about anything)," Kekelidze explained .

In addition to the main signs of depression, there are many varieties: masked (mild depression), seasonal, postpartum, depression that accompanies other somatic conditions - Alzheimer's disease, hypothyroidism and many others.

The psychiatrist advises parents to take a closer look at changes in the child's behavior: sleep disturbances, changes in appetite (stopped eating or eats a lot of sweets) can be early signs of depression.

What prevents Russians from treating depression

In Russia, according to Kekelidze, the problem that not all people with depression receive the necessary treatment is due to the lack of habit of taking care of their health preventively, as well as the fact that people in Russia still For the time being, they are afraid of neuropsychiatric dispensaries, where they try not to go unless absolutely necessary. Not the last role is played by the stigmatization of mental illness - hence the fear of turning to a psychiatrist for help.

However, according to the expert, one should not hope that depression will go away on its own. It is a disease, and like any disease, it must be dealt with by a medical specialist.

Depression should be treated by psychiatrists or psychotherapists. But most people do not go to doctors, they are afraid that they will register

The psychiatrist noted that not every patient needs to be registered with a dispensary, and there are a number of criteria for this. The basis is a danger to oneself and others.

According to the expert, depression is characterized by lack of will, so the worst thing you can advise a depressed person is to tell him "get it together", "pull yourself together." A professional psychiatrist or psychotherapist should say this to the patient, because otherwise the feeling of guilt for "not being able to pull himself together" will grow.

The Rule of Three Eights

Read also

Vital necessity: what you might not know about dreams

- to work, eight - to rest.

"Some people sleep for five hours and are convinced that this is enough for them. In fact, other modes of operation are switched on in the brain at this time, which in the end can lead to depressive states," Kekelidze said.

In addition, WHO has established that "depression increases the risk of developing substance use disorders and diseases such as diabetes and heart disease; conversely, people with these health conditions are at increased risk of developing depression.

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