Why am i always so sad and angry

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

    What Is Substance Abuse Treatment? A Booklet for Families
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    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).



  • 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

I am sad and angry, not knowing why / well-being

This often happens to me: I am sad, not knowing the reason. There are days when sadness embraces and traps you, when an inexplicable feeling of anger mixes which, combined with a taste of apathy and despondency, will stain and further complicate my reality, or that which can achieve every goal I propose. ..

You may be familiar with this feeling. Moreover, most of us will do everything to ensure that these gray days will no longer appear on our calendar , we would certainly like to forever embrace the sadness of our lives as someone who picks up a brush to remove dust or lint from his favorite coat.

"At that moment I began to feel a terrible sadness, but at the same time I felt something like a tingle in my soul."

-Fyodor Dostoyevsky-

If we feel that it is necessary for a simple reason: we were taught from childhood that there are positive and negative emotions. The latter, as in the case of anger, anger or sadness, must be hidden, avoided, or even worse, absorbed in some unhealthy and unpedagogical practice. A habit that makes us sick, with the promise that in exchange for pretending that everything is going well, we will have a better appearance in front of the outside. nine0005

However, nothing works, and if there are days when I am sad and angry, it must be why . All emotions serve a purpose; this biological component, chemically organized in our brain, has a very clear function, which is not only to facilitate our adaptation, our survival in each of the scenarios in which we move daily.

Sadness, for example, alerts us that something is happening and that it is our duty to stop, slow down and maintain adequate introspection for decision making.. Therefore, there are no "negative emotions", they all fulfill the purpose that we must know and assume . Let's delve deeper into this topic below.

There is a very common reality that most psychologists in their consultations: There are people who are surprised when they receive a diagnosis of depression, patients who were completely sure that what they had been dragging on for several months was just sadness.

In the meantime, other people turn to a therapist or even to an initial consultation asking for treatment for depression when what they are experiencing is simply a clear intolerance of emotions such as sadness, anger or disappointment . This type of reality certainly poses a real problem that makes us re-think the importance of nurturing emotions. Emotion, which as such is "normative" and even necessary for our personal development and for our ability to improve daily, is not always well received and even less understood. Therefore, it is essential that we know the difference between sadness and depression, as well as the practical usefulness of the former. nine0005

Characteristics of sadness and its purpose

We start by defining sadness. Something we must consider first is that this is a normal emotion and that as such we must tolerate and deepen it. On the other hand, the second detail to keep in mind: sadness, like anger, there is always a trigger, motive . Things that often don't happen in depression.

  • Sadness is also a very lively emotion. This term may surprise us, but beyond what we can believe Its purpose is to help us feel strong, vital and courageous in the face of life's adversities. . Sadness "makes us stop and focus," and so you usually feel more tired, slower, less receptive to what surrounds us.
  • This emotion, like anger, requires us to momentarily separate from the outside world in order to orient ourselves and know what is happening, what is bothering us, what hurts us, what irritates us ...

Therefore, if I am sad, I must stop, take time, listen to me, heal me and unravel my mind to find out what causes this condition.

What if I'm depressed?

We cannot exclude in any case that what is taking over us may be depression. Therefore, it is necessary to know their symptoms, their characteristics and the nuances of these psychological abysses. For this reason, never hurts to see a professional before doing weird cabal on our part when "I'm sad". nine0004

However, let's consider some basic characteristics that will help us distinguish it from mere sadness.

  • Although sadness is a normal and functional emotion, Depression is completely dysfunctional and affects all areas of our lives.
  • Also, it is not always necessary for "something to happen" to develop a depressive disorder. Most of the time, there are no triggers, in fact, there are patients with seemingly perfect lives, and despite this, they can't help but feel empty. nine0054
  • The feeling of exhaustion, discomfort and negativity is constant, almost chronic.
  • Life ceases to be interesting, pleasure is not experienced with anything.
  • Sleep problems appear: insomnia or hypersomnia.
  • Negative thoughts are constant, but there is also guilt.
  • On the other hand, to these tiresome states you can add the appearance of ideas connected with suicide.

Every time we face a new day with this feeling, I feel sad and I don't know why, We have a clear commitment to ourselves: to devote time and attention, to understand that all emotions have a purpose. If we do not find this, if what we are experiencing is helplessness and inability to take responsibility for ourselves, it will be necessary to seek psychological help.

6 basic emotions: characteristics and functions development to help us survive, guide our behavior and communicate. Open them! Read more " nine0005

What is bitchy face syndrome and how to live with it

February 13, 2021 Life

A very real diagnosis that can seriously spoil your life.

What is Bitchy Face Syndrome

In 2013, a two-minute video of Bitchy Resting Face appeared on YouTube. The video instantly became popular, scored almost eight million views and three thousand comments. The heroines of the video raise the problem of the “bitchy face” and tell how it ruins their lives. “I don’t want to hit you,” says one of the victims of the syndrome. “It’s just my face.” nine0005

This problem existed before, but after the video they started talking about it seriously. The essence of the syndrome is that the face of its owner in a relaxed state looks angry and unfriendly, although the person does not actually experience these emotions. Due to certain features of appearance, facial expressions can express both discontent, contempt and anger, as well as ridicule, irritation or sadness.

People with bitchy face syndrome come across as a snob, a serial killer, or an evil high school math student. nine0005

As a result, strangers often conclude prematurely that it is better not to approach this person, and friends repeatedly pester with the question: “Are you okay?” The most famous victims of the syndrome are Anna Kendrick, Kristen Stewart, Victoria Beckham, Queen Elizabeth and Kanye West.

Why the face looks bitchy

Neuroscientists conducted an experiment during which they scanned more than 10,000 images of human faces using a special program. And we came to the conclusion that a person is never 100% neutral. Normal score - 97% neutral and 3% other emotes. However, “bitchy” individuals have a lower level of neutrality: it is only 94%. And the percentage of emotions, respectively, is higher - as much as 6%. And the predominant among them is contempt.

The expression of negative emotions in a calm state is a consequence of the peculiarities of the facial muscles. Here are the main ones:

Features of the face What emotions can express
Downturned corners of the mouth

head of the online school of natural rejuvenation "The result is obvious"

Spasmodic facial muscles and slowing down of blood and lymph flow are most often to blame. Another reason is a violation of posture, in which the entire muscular sheet of the face is displaced. The clarity of the oval is lost, ptosis, swelling appear, the corners of the lips creep down, and the nasolabial folds become deeper.

In addition, the outward signs of angry face syndrome can also be a consequence of poor vision: a person squints all the time, straining his facial muscles, and over time this becomes a habit. nine0005

Why women are the main victims of the syndrome

Research has shown that bitchy face syndrome is typical for both men and women. This is a general problem not related to gender differences. Any person, regardless of gender, can have lowered corners of the mouth, furrowed eyebrows and an insufficiently open look, but the paradox is that men do not suffer from the bitchy face syndrome.

Scientists explain this by the fact that the phenomenon is connected not with physiology, but with social norms. For men, a serious, stern or even angry face is in the order of things. In the mass consciousness, it is associated with strength, intelligence, determination and sexuality. nine0005

No one calls a man a bitch if his face looks serious or sad.

Women with a serious or stern face are often accused of arrogance. And it's all about gender stereotypes. There is a social construct in society: "A woman should be gentle." It developed in previous centuries, when a girl in society was assigned the role of a housewife and a “good wife”. She did not have financial independence and equality with men, and the smile on her face was a manifestation of humility. nine0005

Much has changed since then, but the social attitude has remained. Women with insufficiently affable appearance still suffer from gender stereotypes. They can easily be called bitches because of an unfriendly expression on their faces, they can be denied employment or dismiss a lot of gossip behind their backs.

Art project by American artist Tatyana Fazlalizade Stop telling women to smile, edition.cnn.com

How Syndrome Ruins Life

People judge others by their appearance. And no matter how hard we try to change it, the first impression is formed in one tenth of a second - faster than a person has time to realize something. At the same time, the brain has stable reactions to certain facial features:

  • An outwardly attractive person seems to us more competent and intelligent.
  • Pronounced chin, large nose, narrow face are associated with dominance and dominance.
  • Big eyes or an open look - this is kindness, naivety, humility.
  • People with a broad face and puffy cheeks seem kind and open.
Scientists have compiled three types illustrating the "reliability scale": on the left - unreliable, in the center - neutral, on the right - reliable, journals.plos.org

Based on all of this, a person with bitchy face syndrome will almost always make a bad first impression. Others may think that he is an arrogant snob and despises everyone, although in reality everything is not at all like that. This can be a hindrance at a party, as well as when applying for a job or at a business meeting. It has been proven that people with an attractive appearance are more successful and earn 10-12% more.

How to recognize the syndrome in yourself

Check your appearance using the FaceReader program. In the picture, the face should be full face and in a relaxed, calm state. The higher the quality of the photo, the more accurate the result. nine0005

A significant disadvantage of the program is that it does not give the ratio of emotions as a percentage, so it is impossible to say for sure whether you have a syndrome. But if contempt (contempt) is present or prevails among emotions, then there is a possibility that you still have it. Here are the results of Lifehacker employees:

1 / 0

The face of Lifehacker host Irina Rogava is neutral, but expresses surprise, fear, disgust and contempt

2 / 0

The face of our videographer Olesya Shishko is neutral, but the predominant emotion is happiness nine0005

3 / 0

The face of the author Liza Platonova in a calm state expresses surprise, anger and contempt.

  • You are constantly told: "Don't be sad" and asked to smile.
  • You are often asked: "Are you dissatisfied with something?"
  • You have a reputation for being tough, although you don't know how you deserve it.
  • They don't ask you for directions on the street, they don't get to know you and bypass you. nine0054

    How to live with bitchy face syndrome

    Do a facial massage

    It is not able to remove wrinkles and rejuvenate. But the effect is still there: the procedure helps to tighten the oval, cope with tight muscles and relax them. In addition, the face after the massage looks fresher and rested.

    Massage can be done by a beautician or by yourself. To do this, there are many special devices that greatly simplify the process. Important: to get the result, massage must be done regularly. nine0005

    Work on facial expressions

    You can be yourself in the company of friends and relatives, but if you want to make a good impression in public, you have to control emotions.

    For example, you want to look more friendly during communication: try to smile slightly, slightly straining and lifting your cheeks. The corners of the lips will automatically rise. Such a half-smile looks natural and does not cause rejection among others.

    Sometimes a contemptuous expression arises from an insufficiently open look: it seems that a person looks at everyone arrogantly. In such a situation, you need to try to open your eyes a little wider: the look will become more open and not so depressed. nine0005

    Refine your face with make-up

    • The look may look depressed or tired due to an impending eyelid. The problem can be corrected with makeup: draw arrows and lightly touch the inner corners of the eyes with light shadows or a pencil. The "tail" of the arrow should go up. Do not lower it so that the look does not seem sad.
    • For a fresh look, apply blush to the apples of your cheeks and blend them out.
    • Don't use too heavy foundation if you have severe wrinkles. The tone will gather in the folds, emphasizing them. nine0054

    Consult a beautician

    Bitch face syndrome manifestations can be eliminated with the help of cosmetics: mimic wrinkles on the forehead and bridge of the nose can be smoothed out with Botox, the corners of the lips can be lifted with it, and nasolabial folds can be filled with a filler based on hyaluronic acid. But this is an extreme measure. Perhaps, for a start, it is worth working on self-esteem, and not injecting.

    Don't take the problem too seriously

    The syndrome was first talked about in the West, where a smile is a sign of politeness and an integral part of etiquette. People look welcoming and friendly, because it is customary: this is a way to show your disposition to the interlocutor. And if a person does not smile, he violates social norms. And the arrogance and contempt on the face and does raise questions. nine0005

    In Russia, things are different: we don't usually smile for the sake of politeness, and the insincere smile of a stranger is alarming. We begin to think that he is a sycophant or a swindler.

    This feature of the mentality has evolved over the centuries: the life and life of the peasants were a hard struggle for existence, so frown has become a standard facial expression.

    To smile, you need a reason: a good mood, a pleasant companion or a funny joke.

    Learn more