How to help my child with anxiety 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.

• 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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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

Children's anxiety. How to help an anxious child? | "Four-leaf clover"

Children's anxiety

Anxiety is commonly referred to as an increased tendency to experience apprehension and worry. In some situations, anxiety is justified and even useful: it mobilizes a person, allows you to avoid danger or solve a problem. This is the so-called situational anxiety. But sometimes anxiety accompanies a person in all life circumstances, even objectively favorable ones. That is, it becomes a stable personality trait. Such a person experiences constant unaccountable fear, an indefinite sense of threat. Any event is perceived as unfavorable and dangerous. nine0005

An anxious child is constantly depressed, on guard, it is difficult for him to establish contact with others, the world is perceived as frightening and hostile.

An anxious child is constantly depressed, on guard, it is difficult for him to establish contact with others, the world is perceived as frightening and hostile. Low self-esteem and a gloomy look at the future are constantly fixed. nine0006

Signs of anxiety:

• The child cannot work for a long time without getting tired
• He has difficulty concentrating on something
• Any occupation causes unnecessary anxiety
• During the performance of the task is very tense, constrained
• Embarrassed more than others
• Often talks about tense situations
• Blushing in unfamiliar surroundings
• Complains about having nightmares
• His hands are usually cold and damp
• He often has stool disorder
• Sweats profusely when excited
• Does not have a good appetite
• Sleeps restlessly, falls asleep with difficulty
• Shy, many things cause him fear
• Usually restless, easily upset
• Often unable to hold back tears
• Does not tolerate waiting well
• Doesn't like to take on new business
• Unsure of yourself and your abilities
• Afraid to face difficulties

Preschool anxiety
It is often difficult for parents to understand why their child may be worried. Well, what problems can there be at his age: dressed, well-fed, the yard is full of friends, a lot of toys, loving relatives ?! nine0005 However, the presence of childhood anxiety problems signals that in the life of a small person, not everything is as smooth as it seems to adults. This condition should never be ignored. In addition, it doesn’t matter if you have a son or a daughter, at this age anxiety does not depend on the child’s gender.

Anxiety is inherent in a person, regardless of age. In children from 1 to 3 years of age, the most common fears are caused by sharp loud sounds, sudden pain, for example, during vaccinations, and as a result, a negative reaction to doctors. In the age range from 3 to 5 years, anxiety in preschoolers often manifests itself in the form of fears such as fear of the dark, closed space, and loneliness. At the age of 5 to 7 years, fear of death is often added. If you notice anxiety in your child, in no case should you let this problem go by itself. nine0006

In the age range from 3 to 5 years, anxiety in preschoolers often manifests itself in the form of such fears as fear of the dark, closed space, loneliness. At the age of 5 to 7 years, fear of death is often added.

School anxiety
The age from 7 to 11 years can become very difficult. At this time, the child's life changes, he becomes an adult, he is entrusted with the mission of studying well, behaving correctly, being better, diligent, smarter than his peers. nine0006

Usually, anxiety manifests itself 1.5 months after the start of the school year, it is in connection with this that schoolchildren need rest - holidays from 1 to 1.5 weeks.

Usually, anxiety manifests itself 1.5 months after the start of the school year, it is in connection with this that schoolchildren need rest - holidays from 1 to 1.5 weeks.

Sometimes anxiety is related to more serious problems. So, with the help of a professional psychologist at the Four-Leaf Clover Clinic of Restorative Psychology, a child can be diagnosed with a mental disorder, neurosis at an early stage. nine0006

Where does increased anxiety come from?

1. If there is a constant anxious and suspicious atmosphere in the house. If the parents themselves are constantly afraid of something and worry about something. This condition is very contagious, the child adopts from adults an unhealthy form of reaction to everything, even to ordinary life events.
   
2. If the child lacks information (or uses incorrect information). Try to keep track of what he reads, what programs he watches, what emotions he experiences. It is sometimes difficult for adults to understand how children interpret this or that event. nine0005
3. Anxious children can grow up not only with anxious parents. The authoritarian style of parenting in the family also does not contribute to the inner peace of the child.
   

Parents who do not doubt and do not worry know exactly what and how to achieve in life. And most importantly - what they want to achieve from their child. Such a child must constantly live up to the high expectations of adults. He is in a situation of constant and intense expectation: he managed or failed to please his parents. It is especially difficult for a child if the demands and reactions of adults are unpredictable and inconsistent. nine0006

A child's internal conflict can be caused by:

• Contradictory demands made by parents or parents and the school (kindergarten). For example, parents do not let their child go to school because they feel unwell, and the teacher puts a “deuce” in a journal and scolds him for skipping a lesson in the presence of other children.
  
• Inadequate requirements, most often overstated. For example, parents repeatedly repeat to the child that he must certainly be an excellent student, they cannot come to terms with the fact that the child receives at school not only "five" and is not the best student in the class. nine0005
• Negative demands that humiliate the child, put him in a dependent position. For example, a caregiver or teacher says to a child: “If you tell me who behaved badly in my absence, I won’t tell my mother that you got into a fight.”
  

Experts believe that in preschool and younger preschool age boys are more anxious, and after 12 years - girls. At the same time, girls are more worried about relationships with other people, and boys are more worried about violence and punishment. nine0005
Having committed some “unseemly” act, the girls worry that their mother or teacher will think badly of them, and their girlfriends will refuse to be friends with them. In the same situation, boys are likely to be afraid that they will be punished by adults or beaten by their peers.

How to help an anxious child?

• Raise the child's self-esteem
  

To achieve success in this matter, it is necessary that an adult himself see the dignity of the child, treat him with respect (and not just with love) and be able to notice all his successes, even the smallest ones. nine0006

• Teaching a child to manage their behavior
  

It is necessary to teach the ability to manage oneself in situations that cause the greatest anxiety in the child

• Teach the child to relax
  

It is important for all children to be able to relax, but for anxious children it is simply a necessity, because the state of anxiety is accompanied by a clamping of different muscle groups.
It is very useful for such a child to attend group psycho-corrective classes - after consultation with a psychologist. The topic of childhood anxiety is well developed in psychology, and usually the effect of such activities is palpable. nine0006

Prevention of anxiety. Recommendations to parents.

• Communicating with your child, do not undermine the authority of other significant people.
  

For example, you can’t say to a child: “Your teachers understand a lot, better listen to your grandmother!”.
Be consistent in your actions, do not forbid the child for no reason what was allowed before.

• Consider children's abilities, do not demand from them what they cannot do. nine0025

If a child is given some kind of educational Subject with difficulty, it is better to once again help him and provide support, and when even the slightest success is achieved, do not forget to praise him.

• Trust your child, be honest with him and accept him for who he is.
  

If for some objective reasons it is difficult for a child to study, choose a circle for him to his liking so that classes in it bring joy to the child and he does not feel disadvantaged. nine0006

If parents are not satisfied with the behavior and success of their child, this is not a reason to deny him love and support. Let your child live in an atmosphere of warmth and trust, and then all his many talents will manifest.

If you have any questions on this topic, write or call us +7 (3822) 33–44–77.
Yours truly, Four Leaf Clover.

We wish you happiness and prosperity!

We recommend you specialists: Kupriyanova Irina Evgenievna, Zaichenko Tatyana Vladimirovna, Serykh Nadezhda Sergeevna, Glushko Tatyana Valerievna

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Dealing with anxiety in children and adolescents. Advice for Parents - Empathy

Just like adults, children and teens experience a lot of anxiety from time to time, and that's normal. But when anxiety begins to affect the well-being of the child, it already needs to be dealt with. What parents can do to help their child cope with expressed anxiety, says Azat Nasifullin, a psychiatrist and child psychiatrist at the Empathy Center. nine0006

What causes anxiety in children?

At any age, children can feel anxiety about all sorts of things, but don't get scared right away - it's normal to experience many of these worries at different stages of a child's development.

For example, separation anxiety is very common in children aged 6 months to 3 years. They may become "sticky" and whiny when separated from their parents. This is natural for this period of development of the child, which usually ends at 2-3 years. nine0006

Preschoolers often develop specific fears and phobias. In early childhood it is normal to be afraid of animals, insects, heights, darkness, but these fears usually disappear gradually on their own.

There may be other periods of increased anxiety in a child's life. For example, many children and teenagers are very anxious when they start a new school, or before tests and exams.

What are the signs of anxiety in children?

When young children experience anxiety, they may not always understand or express how they feel. In this case, parents should alert the following features in the behavior of children: nine0006

• they became irritable, whiny, clingy;
• have trouble sleeping;
• often wake up at night or cannot fall asleep for a long time, can come to their parents in bed;
• start to urinate in bed;
• see nightmares.

Anxiety becomes a problem when it interferes with a child's daily life. Imagine schoolchildren in front of a test: they are all, of course, anxious, but some children are so anxious and afraid that they cannot bring themselves to go to school. nine0006

Severe anxiety can harm children's mental and emotional well-being and lower self-esteem. Children can become withdrawn and avoid situations that cause them anxiety by any means, up to refusing to leave the house.

The following situations can signal the presence of increased anxiety in older children:

• the child does not have enough self-confidence to try something new, it seems to him that he is not able to cope with simple everyday tasks; nine0025
• the child has trouble concentrating;
• have problems sleeping or eating;
• there are flashes of irritability, anger;
• the child has a lot of negative thoughts, he thinks that something bad will happen to him;
• the child begins to avoid everyday activities such as meeting friends, walking outside, going to school.

Why is my child worried? nine0257

The causes of increased anxiety in children can be different. For example, children often find it difficult to adapt to new environments and may experience anxiety because of this. Typical cases are moving or changing educational institutions.

Children who have had an unpleasant or traumatic experience, such as a car accident or house fire, may also suffer from anxiety later on.

Family quarrels and conflicts can also cause children and adolescents to feel insecure and anxious. Finally, some children are generally more prone to anxiety than others. nine0006

How to help a child with anxiety?

To help your child deal with anxiety, the first step is to talk to him about what is bothering him. Reassure the child and show that you understand his feelings.

If the child is old enough, explain to him what anxiety is and what physical effect it has on the body. Describe anxiety as a wave that breaks in and then recedes.

In addition to talking to your child about his anxiety, it is important to help him find a solution to a particular worrying situation. And the best strategy is not to avoid, but to recognize your anxiety and prepare a plan of action in advance in this situation. nine0006

Other ways to relieve anxiety in children and adolescents:

• teach your child to recognize the signs of anxiety;
• Encourage your child to manage their anxiety on their own and seek help when needed.
• children of all ages find support in a clear daily routine, so try to stick to the usual routine in any conditions;
nine0024 If your child is worried about negative events such as bereavement or separation, find books or movies to help them understand their feelings.
• if you know a change is coming, such as a move, prepare your child for it by talking about what needs to happen and why, while being careful not to become overly anxious yourself;
• for young children, distraction can be helpful. For example, if they are worried on the way to somewhere, then on the way they can play a simple game, for example, who will notice more red cars; nine0025
• take an empty tissue box and turn it into a "worry box". Have the child write down or draw their worries and “put” them in the box. At the end of the day or week, take the box apart with your child and discuss any accumulated fears and concerns.

Unfortunately, it is not always possible for parents to help their child cope with anxiety on their own. If the condition of the child does not improve, despite all the measures taken, then you need to contact a specialist. on mental health, who knows how to work with young patients. nine0006

How can we help?