Why do i feel so dead inside

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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    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.

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    For additional resources, please visit the SAMHSA Store.

Last Updated: 08/30/2022

SAMHSA Behavioral Health Treatment Services Locator


Welcome to the Behavioral Health Treatment Services Locator, a confidential and anonymous source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance use/addiction and/or mental health problems.

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The Locator is authorized by the 21st Century Cures Act (Public Law 114-255, Section 9006; 42 U.S.C. 290bb-36d). SAMHSA endeavors to keep the Locator current. All information in the Locator is updated annually from facility responses to SAMHSA’s National Substance Use and Mental Health Services Survey (N-SUMHSS). New facilities that have completed an abbreviated survey and met all the qualifications are added monthly. Updates to facility names, addresses, telephone numbers, and services are made weekly for facilities informing SAMHSA of changes. Facilities may request additions or changes to their information by sending an e-mail to [email protected], by calling the BHSIS Project Office at 1-833-888-1553 (Mon-Fri 8-6 ET), or by electronic form submission using the Locator online application form (intended for additions of new facilities).

Mental Indifference — Master's Program in Psychoanalysis and Psychoanalytic Business Consulting — National Research University Higher School of Economics

The psychiatric phenomena of alexithymia and anhedonia are relevant to our story. The first term, which has Greek roots, was created by psychiatrist Peter Sifneomos in the 1970s and literally translates as "there is no word for emotions"; the second, also of Greek origin, signifies the inability to enjoy normally pleasant things. Two French psychiatrists set the stage for the discussion with the idea of ​​"penseeoperatoire" ("operational thought"), a practical way of thinking and interacting.


In psychiatry, the term "alexithymia" is used to describe people who look like dead fish; only smoldering coals remained from the former fire in them. Such people, with varying degrees of success, try to understand their emotions and moods, but they cannot understand their subtleties. Since they are not sure what they are feeling, they have a hard time expressing their emotions. Instead of showing feelings, they focus on the physical issues. (Remember that ulcers are not caused by what you eat, but by what eats you.)
Despite the strange name, it is not difficult to define alexithymia. Its symptoms are: poor imagination, lack of inner emotional experience, inability to express amusement, a tendency to speak lifelessly and in too much detail. Moreover, from people with such a mental disorder comes a certain sense of mechanicalness that interferes with any spontaneity. (Winston Churchill, describing the Russian politician Vyacheslav Molotov, captured this feature: “I have never seen a person who better embodies the modern idea of ​​a robot. ”) Alexithymics remain calm in conditions that would shock ordinary people. The death of a loved one, the infidelity of a partner, the loss of the opportunity to advance in the service - nothing touches them. All events fall into a black hole of inexpressiveness and emptiness.
Alexithymics are incapable of either empathy or introspection. This, combined with their mechanical responses to conflict, results in psychological illiteracy. They think about the concrete and the objective; metaphors, allusions and hidden meanings are a foreign language for them.
The work environment in which most managers move contributes to the development of alexithymia. So, in the routine life of some insurance companies and banks, there is simply nothing to be surprised or happy about, nothing to be interested in. The lifelessness of a dying company forces executives to suppress their emotions, a process that takes a lot of energy. Like a weightlifter trying to lift a lot of weight, executives who suppress their emotions eventually become exhausted.
There is an emotional division of labor in companies these days: the higher the position a person occupies, the more he will have to restrain himself. Among management members, from managers to senior workers, stricter rules for managing their emotions are being practiced, perhaps due to the expansion of the white-collar and service sectors. Many companies pay attention to the expression of certain emotions. For example, Disneyland, sometimes called the "smile factory," requires its employees to "play" happiness. In other companies, they make it clear that the expression of deep and strong feelings is inappropriate. Few have realized that suppression of emotions (or too strict control of feelings) leads to regressive behavior and infantilization and causes symptoms of stress.

Anhedonia (emotional anesthesia)

The doctrine of hedonism, discovered by the ancient Greeks, says that pleasure, that is, the satisfaction of sensual desires, is the highest good. While most people still hold to this theory, far too many suffer from anhedonia, the inability to experience pleasure. Anhedonic people experience a feeling of complete apathy, loss of interest and dislike for usually pleasant activities; they are dead inside. They do not want to look for new sensations, their attention is weakened, they lack a thirst for life. True anhedonia is a serious psychiatric syndrome. Here we are interested in quasi-anhedonia, that is, a mild form that develops in people who are able to experience pleasure (and they have experienced it before). However, even top management quasi-anhedonia can have a devastating impact on a company, as leadership takes a lot of energy. A dead fish will not have enough energy to lead people to success.

Resurrection of "dead" leaders

What can be done to restore the sense of inspiration? What can you do to rediscover or reinvent yourself? Given the fact that people are the main wealth of the company, how can we discover the creativity in ourselves, our colleagues and subordinates?

Flow feeling

We must discover in ourselves what psychologist Michal Csikzhentmihaly calls the feeling of "flow" - a feeling that is made up of animation, concentration and such involvement that we lose track of time. How to do it?
First, we need a challenge. If we work on difficult tasks that can be completed, we achieve the sensation of conquering Everest that accompanies the feeling of flow. Too difficult or too simple tasks will cause difficulties. Work goals must be achievable: if they are too difficult, anxiety will force you to give up or work to the point of exhaustion; if they are too simple, you will get bored and rusty. Challenge is very important because it forces you to learn. Human beings have a hunger for research that only study can satisfy (as we will see in Chapter 13). Companies that encourage learning and thereby create opportunities for creativity and innovation help their employees feel fit.
Secondly, intermediate results are needed. Small "victories" are very important. If you set and reach a certain milestone along the way to each big goal, you'll get constant feedback, a sense of control over what you're doing, and you'll be able to "celebrate" progress along the way.
Stressful conditions make it harder to maintain the excitement and energy needed to feel flow. They spend too much energy on solving personal problems. However, given the importance of managing emotions and the extent to which leaders serve as a living symbol for their people, emotional expression is essential. Symptoms of alexithymia, anhedonia, or dissociation prevent the manager from being in contact with his employees. This can be played, but over time, leaders and subordinates will feel that their leader is not morally and emotionally with them, that he cannot maintain momentum. Thus, the leader must either prevent the appearance of such symptoms, or seek external help (colleagues or specialists) to get rid of them. Leaders will only be able to help their people stay energized if they look at these issues intelligently.

To the list of articles on Coaching and business consulting
To the list of articles on the Clinical management paradigm
To the list of articles on History and theory of psychoanalysis
To the list of articles by A. V. Rossokhin in the journal "Psychologies"

"I feel like a robot without feelings and thoughts. What to do?"

Ask an expert

Lately I feel empty. There are no thoughts, it seems that there is dead silence in my head. I can even force myself not to feel pain. Like a zombie. Thought it was fatigue. I can't say anything sensible, nothing good comes to mind. I live like a robot that has no soul, only a program. It's scary to realize it. I do not know what to do.

Vladimir, 21 years old

Vladimir, the essence of your problem, in my opinion, is the statement that you “live like a robot”. Let's figure it out. At what point did you feel empty? What preceded this? Perhaps there was some traumatic event that was difficult for you to go through, and you decided to forbid yourself from feeling.

What does dead silence mean to you personally? If you think, this already indicates that there is no emptiness in the head. Try to determine what you would like to fill your thoughts with.

You write that you can't say anything useful. Where did you get this idea, did someone tell you about it? What thoughts and statements do you consider sensible, and which are empty? Try to remember the moment when you felt happy - how did you live then? What helped you feel joy and meaning?

Now you feel that you are living like a robot with a programmed program. What is this program? Who is its creator? Perhaps your parents or your environment? Most likely, you feel that you cannot choose what you like, so you have to follow what you are told.

Everyone can write their own program for themselves. But to do this, you need to really get to know yourself

The soul is something emotional, alive, real. By suppressing your emotions and feelings for a long time, you come to emptiness and loss of yourself. Moreover, you write that you almost do not feel pain. Perhaps you are making yourself a robot, avoiding unpleasant experiences.

Learn more