Skip to main content

Mental Health Medications

Written on . Posted in A-Z Topic Guide.

The following article on Anxiety Disorders is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Medications can play a role in treating mental disorders and conditions and are often used in combination with other treatment approaches such as psychotherapies and brain stimulation therapies. Medications can affect people in different ways, and it may take several tries to find the medication that is most effective with the fewest side effects. It’s important for people to work with a health care provider or mental health professional to develop a treatment plan that meets their needs and medical situation.

Information about medications is updated frequently. Check the U.S. Food and Drug Administration (FDA) Medication Guides webpage  for the latest warnings, patient medication guides, and newly approved medications. The MedlinePlus Drugs, Herbs and Supplements  website also provides information on medications, including side effects and FDA warnings.

This page provides basic information about mental health medications, but it is not a complete source for all medications available and should not be used as a guide for making medical decisions.

Antidepressants

Antidepressants are medications used to treat depression. In some cases, health care providers may prescribe antidepressants to treat other health conditions such as anxiety, pain, and insomnia.

Commonly prescribed types of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and norepinephrine-dopamine reuptake inhibitors (NDRIs).

These medications are commonly prescribed because they improve symptoms related to a broad group of depressive and anxiety disorders and are associated with fewer side effects than older types of antidepressants. Although older antidepressant medications, such as tricyclics and monoamine oxidase inhibitors (MAOIs), are associated with more side effects, they may be the best option for some people.

Antidepressant medications take time to work—usually 4 to 8 weeks—and symptoms such as problems with sleep, appetite, energy, or concentration sometimes improve before mood lifts. It is important for people to follow their health care provider’s directions and take the medication for the recommended amount of time before deciding whether it works.

Common side effects of SSRIs and other antidepressants may include upset stomach, headache, or sexual dysfunction. The side effects are generally mild and tend to improve over time. People who are sensitive to the side effects of these medications sometimes benefit from starting with a low dose, increasing the daily dose very slowly, and adjusting when they take the medication (for example, at bedtime or with food).

Esketamine  is a newer FDA-approved medication for treatment-resistant depression, which may be diagnosed when a person’s symptoms have not improved after trying at least two antidepressant therapies. Esketamine is delivered as a nasal spray in a health care provider’s office, a clinic, or a hospital. It often acts rapidly—typically within a couple of hours—to relieve depression symptoms. People usually continue to take an oral antidepressant to maintain the improvement in symptoms.

Combining antidepressants with medications or supplements that also act on the serotonin system, such as “triptan” medications (often used to treat migraine headaches) and St. John’s Wort (a dietary supplement), can cause a rare but life-threatening illness called serotonin syndrome . Symptoms of serotonin syndrome include agitation, muscle twitches, hallucinations (seeing or hearing things others do not see or hear), high temperature, and unusual blood pressure changes. For most people, the risk of such extreme reactions is low. It is important for health care providers to consider all possible interactions and use extra care in prescribing and monitoring medication combinations that carry above-average risk.

Please note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting the medication or when the dose is changed. People of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline  at 988 or chat at 988lifeline.org . In life-threatening situations, call 911.

Anti-Anxiety Medications

Anti-anxiety medications help reduce symptoms of anxiety, such as panic attacks and extreme fear and worry.

Many medications commonly used to treat depression—including SSRIs and SNRIs—may also be used to treat anxiety. In the case of panic disorder or social anxiety disorder, health care providers typically start with SSRIs or other antidepressants as the first treatment because they have fewer side effects than other medications.

Another common type of anti-anxiety medication is benzodiazepines. These medications are sometimes used to treat generalized anxiety disorder.

Short half-life (or short-acting) benzodiazepines are used to treat the short-term symptoms of anxiety. Health care providers may also prescribe beta-blockers off-label to treat short-term symptoms. People with phobias—an overwhelming and unreasonable fear of an object or situation, such as public speaking—often experience intense physical symptoms. Beta-blockers can help manage these symptoms, such as rapid heart rate, sweating, and tremors.

As short-term treatments, benzodiazepines and beta-blockers can be used as needed to reduce severe anxiety. Taking benzodiazepines over long periods may lead to drug tolerance or even dependence. To avoid these problems, health care providers usually prescribe benzodiazepines for short periods and taper them slowly to reduce the likelihood that a person will experience withdrawal symptoms or renewed anxiety symptoms. Beta-blockers generally are not recommended for people with asthma or diabetes because they may worsen symptoms related to both conditions.

Buspirone  is a different type of medication that is sometimes used to treat anxiety over longer periods. In contrast to benzodiazepines, buspirone must be taken every day for 3 to 4 weeks to reach its full effect and is not effective for treating anxiety on an “as-needed” basis.

Stimulants

Health care providers may prescribe stimulant medications when treating attention-deficit/hyperactivity disorder (ADHD) and narcolepsy . Stimulants increase alertness, attention, and energy. They can also elevate blood pressure, heart rate, and breathing.

Prescription stimulants typically improve alertness and focus for most people, regardless of diagnosis. These medications can markedly improve daily functioning for people with significant focus problems, such as people with ADHD. Although motor hyperactivity associated with ADHD in children usually goes away by the time they reach adolescence, people with ADHD may continue to experience inattention and difficulty with focus into adulthood. As such, stimulant medications can be helpful for adults with ADHD, as well as for children and adolescents with ADHD.

Stimulant medications are safe when taken under a health care provider’s supervision and used as directed. Some children taking them may report feeling slightly different or “funny.” Most side effects of stimulant medications are minor and disappear at lower doses.

Some parents worry that stimulant medications may lead to misuse or dependence, but evidence shows this is unlikely when the medications are used as prescribed. Other challenges with stimulant treatment, such as sleep disturbance and slowed growth, can generally be safely managed in collaboration with the prescribing health care provider while continuing treatment.

Antipsychotics

Antipsychotic medications are typically used to treat psychosis, a condition that involves some loss of contact with reality. People experiencing a psychotic episode often experience delusions (false beliefs) or hallucinations (hearing or seeing things others do not see or hear). Psychosis can be related to drug use or a mental disorder such as schizophrenia, bipolar disorder, or severe depression (also known as “psychotic depression”).

Health care providers may also prescribe antipsychotic medications in combination with other medications to relieve symptoms associated with delirium, dementia, or other mental health conditions. Antipsychotic treatment for older adults necessitates additional care and consideration. The FDA requires that all antipsychotic medication labels include a black-box warning stating that antipsychotics are associated with increased rates of stroke and death in older adults with dementia.

Older, first-generation antipsychotic medications are sometimes called “typical” antipsychotics or “neuroleptics.” Long-term use of typical antipsychotic medications may lead to a condition involving uncontrollable muscle movements called tardive dyskinesia (TD). TD can range from mild to severe. People who think they might have TD should check with their health care provider before stopping their medication.

Newer, second-generation medications are sometimes called “atypical” antipsychotics. Several atypical antipsychotics may be used to treat a broader range of symptoms compared with older medications. For example, these medications are sometimes used to treat bipolar depression or depression that has not responded to antidepressant medication alone. Health care providers may ask people taking atypical antipsychotic medications to participate in regular monitoring to check weight, glucose levels, and lipid levels.

Some symptoms, such as feeling agitated and having hallucinations, typically go away within days of starting antipsychotic medication. Other symptoms, such as delusions, usually go away within a few weeks of starting antipsychotic medication. However, people may not experience the full effects of antipsychotic medication for up to 6 weeks.

If a person’s symptoms do not improve with usual antipsychotic medications, they may be prescribed an atypical antipsychotic called clozapine . People who take clozapine must have regular blood tests to check for a potentially dangerous side effect that occurs in 1% to 2% of people.

Mood Stabilizers

Mood stabilizers are typically used to treat bipolar disorder and mood changes associated with other mental disorders. In some cases, health care providers may prescribe mood stabilizers to augment the effect of other medications used to treat depression. Lithium , an effective mood stabilizer, is approved for the treatment of mania and maintenance treatment of bipolar disorder. Some studies indicate that lithium may reduce the risk of suicide among people taking it for long-term maintenance. Health care providers generally ask people who are taking lithium to participate in regular monitoring to check lithium levels and kidney and thyroid function.

Mood stabilizers are sometimes used to treat depression (usually with an antidepressant), schizoaffective disorder, disorders of impulse control, and certain mental illnesses in children. For people with bipolar depression, health care providers typically prescribe a mood stabilizer and an antidepressant to reduce the risk of switching into mania or rapid cycling.

Some anticonvulsant medications may also be used as mood stabilizers, as they may work better than lithium for some people, such as people with “mixed” symptoms of mania and depression or those with rapid-cycling bipolar disorder. Health care providers generally ask people taking anticonvulsants to participate in regular monitoring to check medication levels and assess side effects and potential interactions with other common medications.

Special Groups: Children, Older Adults, Pregnant People

All types of people take mental health medications, but some groups have special needs and considerations.

Children and Adolescents

Many medications used to treat mental disorders are safe and effective for children and adolescents. However, it is important to know that children may experience different reactions and side effects than adults, and some medications have FDA warnings about potential side effects for younger people.

In some cases, a health care provider may prescribe an FDA-approved medication on an “off-label” basis to treat a child’s symptoms even though the medication is not approved for the child’s specific mental disorder or for use by people under a certain age. Although there has been less research on mental disorders in children than in adults, there is some evidence that medications can be helpful for children. It is important to monitor children and adolescents who take medications on an “off-label” basis.

A child’s health care provider may suggest trying non-medication treatments, such as psychotherapies, first and may add medication later, if necessary. In other cases, the health care provider may suggest non-medication treatment in combination with medication.

Older Adults

People over 65 should take extra care with medications, especially if they are taking many different medications. Older adults have a higher risk of experiencing drug interactions and are often more sensitive to medications. Even healthy older adults react to medications differently than younger people do because older adults’ bodies often process and eliminate medications more slowly.

Before starting a medication, older adults and their family members should talk with a health care provider about any effects the medication may have on physical and mental functioning. The health care provider can also discuss strategies to make it easier to follow the treatment plan, helping to ensure that older adults take the correct medication dose at the correct time.

The National Institute on Aging’s Safe Use of Medicines for Older Adults  booklet offers information and practical tips to help older people take their medications safely.

People Who Are Pregnant or Who May Become Pregnant

Researchers are continuing to investigate the use of mental health medications during pregnancy. The risks associated with taking medication during pregnancy depend on the type of medication and the stage of pregnancy. While no medication is considered universally safe during pregnancy, untreated mental disorders can also pose risks to the pregnant person and the developing fetus.

Pregnant people and health care providers can work together to develop a personalized treatment plan that considers individual needs and circumstances. It is important to weigh the benefits and risks associated with all available treatment options, including psychotherapies, medications, brain stimulation therapies, or a combination of these options. Health care providers may closely monitor a person’s physical and mental health throughout pregnancy and, after delivery, pay particular attention to signs of perinatal or postpartum depression.

Certain medications taken during pregnancy—including some benzodiazepines, mood stabilizers, and antipsychotic medications—have been linked with birth defects, but the risks vary widely and depend on the specific medication.

Antidepressants, especially SSRIs, are generally considered safe for use during pregnancy. Antidepressant medications can cross into the placenta and may reach the fetus, but the risk of birth defects and other problems is very low. Some studies have found an association between third-trimester SSRI exposure and certain symptoms, including breathing problems, in newborns. However, the FDA does not find sufficient evidence for a causal link  and recommends that health care providers treat depression during pregnancy according to the person’s specific needs.

Visit the FDA website for more information about medications and pregnancy .

Understanding Your Medications

People respond to medications in different ways, and it may take several tries to find the medication that is most effective with the fewest side effects. In some cases, people find that a medication helps for a while, and then their symptoms come back. It often takes some time for a medication to be effective, so it is important to stick with the treatment plan and take medication as prescribed.

People should not stop taking a prescribed medication, even if they are feeling better, without the help of a health care provider. A health care provider can adjust the treatment plan and slowly and safely decrease the medication dose. It’s important to give the body time to adjust to the change. Stopping a medication too soon may cause unpleasant or harmful side effects.

If you are prescribed a medication:

  • Tell the health care provider about all other medications, vitamins, and supplements you are already taking.
  • Remind the health care provider about any allergies and any problems you have had with medications in the past.
  • Make sure you understand how to take the medication before you start using it and take your medication as instructed.
  • Talk to the health care provider about possible side effects and what to expect when taking a medication.
  • Don’t take medications prescribed for another person or give your medication to someone else.
  • Call a health care provider right away if you have any problems with your medication or are worried that it might be doing more harm than good. The health care provider will work with you to address any problems and determine next steps.
  • Report serious side effects to the FDA MedWatch Adverse Event Reporting Program.

Contact FDA MedWatch

The FDA is responsible for protecting public health by ensuring the safety, efficacy, and security of drugs (medications), biological products, and medical devices.

Visit FDA MedWatch  to voluntarily report a serious adverse effect, product quality problem, product use error, or product failure that you suspect is associated with the use of an FDA-regulated drug, biologic, medical device, dietary supplement, or cosmetic. You or your health care provider can make a report online  or by calling 1-800-332-1088. You can also report suspected counterfeit medical products to the FDA through MedWatch .

Subscribe to MedWatch Safety Alerts

FDA MedWatch also offers several ways to help you stay informed about medical products that are prescribed, administered, or dispensed every day. You can sign up to receive the MedWatch E-list , which delivers safety information to your email inbox. You can also follow MedWatch on Twitter @FDAMedWatch .

Reports from the Agency for Healthcare Research and Quality

The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help the public, health care professionals, and policymakers make informed health decisions. Recent AHRQ reports include:

Resources from the U.S. National Library of Medicine

The National Library of Medicine (NLM) , part of the National Institutes of Health , is the world’s largest medical library and produces electronic information resources on a range of topics. NLM resources include:

  • DailyMed:  DailyMed contains labeling for prescription and nonprescription drugs for human and animal use. It also contains labeling for additional products such as medical gases, devices, cosmetics, dietary supplements, and medical foods.
  • MedlinePlus: Drugs, Herbs and Supplements:  MedlinePlus is an online resource that provides information and resources about drugs, herbs, and supplements.
  • MedlinePlus: Antidepressants : MedlinePlus is an online resource that provides information and resources about antidepressants.

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Eating Disorders

Written on . Posted in A-Z Topic Guide.

The following article on Anxiety Disorders is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

There is a commonly held misconception that eating disorders are a lifestyle choice. Eating disorders are actually serious and often fatal illnesses that are associated with severe disturbances in people’s eating behaviors and related thoughts and emotions. Preoccupation with food, body weight, and shape may also signal an eating disorder. Common eating disorders include anorexia nervosa, bulimia nervosa, and binge-eating disorder.

Signs and symptoms

Anorexia nervosa

Anorexia nervosa is a condition where people avoid food, severely restrict food, or eat very small quantities of only certain foods. They also may weigh themselves repeatedly. Even when dangerously underweight, they may see themselves as overweight.

There are two subtypes of anorexia nervosa: a “restrictive” subtype and a “binge-purge“ subtype.

  • In the restrictive subtype of anorexia nervosa, people severely limit the amount and type of food they consume.
  • In the binge-purge subtype of anorexia nervosa, people also greatly restrict the amount and type of food they consume. In addition, they may have binge-eating and purging episodes—eating large amounts of food in a short time followed by vomiting or using laxatives or diuretics to get rid of what was consumed.

Anorexia nervosa can be fatal. It has an extremely high death (mortality) rate compared with other mental disorders. People with anorexia are at risk of dying from medical complications associated with starvation. Suicide is the second leading cause of death for people diagnosed with anorexia nervosa.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline  at 988 or chat at 988lifeline.org . In life-threatening situations, call 911.

Symptoms include:

  • Extremely restricted eating
  • Extreme thinness (emaciation)
  • A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight
  • Intense fear of gaining weight
  • Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight

Other symptoms may develop over time, including:

  • Thinning of the bones (osteopenia or osteoporosis)
  • Mild anemia and muscle wasting and weakness
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Severe constipation
  • Low blood pressure
  • Slowed breathing and pulse
  • Damage to the structure and function of the heart
  • Brain damage
  • Multiorgan failure
  • Drop in internal body temperature, causing a person to feel cold all the time
  • Lethargy, sluggishness, or feeling tired all the time
  • Infertility

Bulimia nervosa

Bulimia nervosa is a condition where people have recurrent and frequent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge-eating is followed by behavior that compensates for the overeating such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. People with bulimia nervosa may be slightly underweight, normal weight, or over overweight.

Symptoms include:

  • Chronically inflamed and sore throat
  • Swollen salivary glands in the neck and jaw area
  • Worn tooth enamel and increasingly sensitive and decaying teeth as a result of exposure to stomach acid
  • Acid reflux disorder and other gastrointestinal problems
  • Intestinal distress and irritation from laxative abuse
  • Severe dehydration from purging of fluids
  • Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium, and other minerals) which can lead to stroke or heart attack

Binge-eating disorder

Binge-eating disorder is a condition where people lose control over their eating and have reoccurring episodes of eating unusually large amounts of food. Unlike bulimia nervosa, periods of binge-eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder often are overweight or obese. Binge-eating disorder is the most common eating disorder in the U.S.

Symptoms include:

  • Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period
  • Eating even when you’re full or not hungry
  • Eating fast during binge episodes
  • Eating until you’re uncomfortably full
  • Eating alone or in secret to avoid embarrassment
  • Feeling distressed, ashamed, or guilty about your eating
  • Frequently dieting, possibly without weight loss

Avoidant restrictive food intake disorder

Avoidant restrictive food intake disorder (ARFID), previously known as selective eating disorder, is a condition where people limit the amount or type of food eaten. Unlike anorexia nervosa, people with ARFID do not have a distorted body image or extreme fear of gaining weight. ARFID is most common in middle childhood and usually has an earlier onset than other eating disorders. Many children go through phases of picky eating, but a child with ARFID does not eat enough calories to grow and develop properly, and an adult with ARFID does not eat enough calories to maintain basic body function.

Symptoms include:

  • Dramatic restriction of types or amount of food eaten
  • Lack of appetite or interest in food
  • Dramatic weight loss
  • Upset stomach, abdominal pain, or other gastrointestinal issues with no other known cause
  • Limited range of preferred foods that becomes even more limited (“picky eating” that gets progressively worse)

Risk factors

Eating disorders can affect people of all ages, racial/ethnic backgrounds, body weights, and genders. Eating disorders frequently appear during the teen years or young adulthood but may also develop during childhood or later in life.

Researchers are finding that eating disorders are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Researchers are using the latest technology and science to better understand eating disorders.

One approach involves the study of human genes. Eating disorders run in families. Researchers are working to identify DNA variations that are linked to the increased risk of developing eating disorders.

Brain imaging studies are also providing a better understanding of eating disorders. For example, researchers have found differences in patterns of brain activity in women with eating disorders in comparison with healthy women. This kind of research can help guide the development of new means of diagnosis and treatment of eating disorders.

Treatments and therapies

It is important to seek treatment early for eating disorders. People with eating disorders are at higher risk for suicide and medical complications. People with eating disorders can often have other mental disorders (such as depression or anxiety) or problems with substance use. Complete recovery is possible.

Treatment plans are tailored to individual needs and may include one or more of the following:

  • Individual, group, and/or family psychotherapy
  • Medical care and monitoring
  • Nutritional counseling
  • Medications

Psychotherapies

Family-based therapy, a type of psychotherapy where parents of adolescents with anorexia nervosa assume responsibility for feeding their child, appears to be very effective in helping people gain weight and improve eating habits and moods.

To reduce or eliminate binge-eating and purging behaviors, people may undergo cognitive behavioral therapy (CBT), which is another type of psychotherapy that helps a person learn how to identify distorted or unhelpful thinking patterns and recognize and change inaccurate beliefs.

Medications

Evidence also suggests that medications such as antidepressants, antipsychotics, or mood stabilizers may also be helpful for treating eating disorders and other co-occurring illnesses such as anxiety or depression. The Food and Drug Administration’s (FDA) website  has the latest information on medication approvals, warnings, and patient information guides.

Handouts

Eating Disorders - About More Than FoodEnglish / Español   Let's Talk About Eating DisordersEnglish / Español

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Bipolar Disorder

Written on . Posted in A-Z Topic Guide.

The following article on Anxiety Disorders is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Bipolar disorder (formerly called manic-depressive illness or manic depression) is a mental illness that causes unusual shifts in a person’s mood, energy, activity levels, and concentration. These shifts can make it difficult to carry out day-to-day tasks.

There are three types of bipolar disorder. All three types involve clear changes in mood, energy, and activity levels. These moods range from periods of extremely “up,” elated, irritable, or energized behavior (known as manic episodes) to very “down,” sad, indifferent, or hopeless periods (known as depressive episodes). Less severe manic periods are known as hypomanic episodes.

  • Bipolar I disorder is defined by manic episodes that last for at least 7 days (nearly every day for most of the day) or by manic symptoms that are so severe that the person needs immediate medical care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible. Experiencing four or more episodes of mania or depression within 1 year is called “rapid cycling.”
  • Bipolar II disorder is defined by a pattern of depressive episodes and hypomanic episodes. The hypomanic episodes are less severe than the manic episodes in bipolar I disorder.
  • Cyclothymic disorder (also called cyclothymia) is defined by recurring hypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes.

Sometimes a person might experience symptoms of bipolar disorder that do not match the three categories listed above, and this is referred to as “other specified and unspecified bipolar and related disorders.”

Bipolar disorder is often diagnosed during late adolescence (teen years) or early adulthood. Sometimes, bipolar symptoms can appear in children. Although the symptoms may vary over time, bipolar disorder usually requires lifelong treatment. Following a prescribed treatment plan can help people manage their symptoms and improve their quality of life.

Signs and symptoms

People with bipolar disorder experience periods of unusually intense emotion and changes in sleep patterns and activity levels, and engage in behaviors that are out of character for them—often without recognizing their likely harmful or undesirable effects. These distinct periods are called mood episodes. Mood episodes are very different from the person’s usual moods and behaviors. During an episode, the symptoms last every day for most of the day. Episodes may also last for longer periods, such as several days or weeks.

Symptoms of a Manic Episode Symptoms of a Depressive Episode
Feeling very up, high, elated, or extremely irritable or touchy Feeling very down or sad, or anxious
Feeling jumpy or wired, more active than usual Feeling slowed down or restless
Having a decreased need for sleep Having trouble falling asleep, waking up too early, or sleeping too much
Talking fast about a lot of different things (“flight of ideas”) Talking very slowly, feeling unable to find anything to say, or forgetting a lot
Racing thoughts Having trouble concentrating or making decisions
Feeling able to do many things at once without getting tired Feeling unable to do even simple things
Having excessive appetite for food, drinking, sex, or other pleasurable activities Having a lack of interest in almost all activities
Feeling unusually important, talented, or powerful Feeling hopeless or worthless, or thinking about death or suicide

Sometimes people have both manic and depressive symptoms in the same episode, and this is called an episode with mixed features. During an episode with mixed features, people may feel very sad, empty, or hopeless while at the same time feeling extremely energized.

A person may have bipolar disorder even if their symptoms are less extreme. For example, some people with bipolar II disorder experience hypomania, a less severe form of mania. During a hypomanic episode, a person may feel very good, be able to get things done, and keep up with day-to-day life. The person may not feel that anything is wrong, but family and friends may recognize changes in mood or activity levels as possible symptoms of bipolar disorder. Without proper treatment, people with hypomania can develop severe mania or depression.

Diagnosis

Receiving the right diagnosis and treatment can help people with bipolar disorder lead healthy and active lives. Talking with a health care provider is the first step. The health care provider can complete a physical exam and other necessary medical tests to rule out other possible causes. The health care provider may then conduct a mental health evaluation or provide a referral to a trained mental health care provider, such as a psychiatrist, psychologist, or clinical social worker who has experience in diagnosing and treating bipolar disorder.

Mental health care providers usually diagnose bipolar disorder based on a person’s symptoms, lifetime history, experiences, and, in some cases, family history. Accurate diagnosis in youth is particularly important.

Bipolar disorder and other conditions

Many people with bipolar disorder also have other mental disorders or conditions such as anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), misuse of drugs or alcohol, or eating disorders. Sometimes people who have severe manic or depressive episodes also have symptoms of psychosis, which may include hallucinations or delusions. The psychotic symptoms tend to match the person’s extreme mood. For example, someone having psychotic symptoms during a depressive episode may falsely believe they are financially ruined, while someone having psychotic symptoms during a manic episode may falsely believe they are famous or have special powers.

Looking at a person’s symptoms over the course of the illness and examining their family history can help a health care provider determine whether the person has bipolar disorder along with another disorder.

Risk factors

Researchers are studying possible causes of bipolar disorder. Most agree that there are many factors that are likely to contribute to a person’s chance of having the disorder.

Brain structure and functioning: Some studies show that the brains of people with bipolar disorder differ in certain ways from the brains of people who do not have bipolar disorder or any other mental disorder. Learning more about these brain differences may help scientists understand bipolar disorder and determine which treatments will work best. At this time, health care providers base the diagnosis and treatment plan on a person’s symptoms and history, rather than brain imaging or other diagnostic tests.

Genetics: Some research suggests that people with certain genes are more likely to develop bipolar disorder. Research also shows that people who have a parent or sibling with bipolar disorder have an increased chance of having the disorder themselves. Many genes are involved, and no one gene causes the disorder. Learning more about how genes play a role in bipolar disorder may help researchers develop new treatments.

Treatments and therapies

Treatment can help many people, including those with the most severe forms of bipolar disorder. An effective treatment plan usually includes a combination of medication and psychotherapy, also called talk therapy.

Bipolar disorder is a lifelong illness. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of mood changes, but some people may have lingering symptoms. Long-term, continuous treatment can help people manage these symptoms.

Medications

Certain medications can help manage symptoms of bipolar disorder. Some people may need to try different medications and work with their health care provider to find the medications that work best.

The most common types of medications that health care providers prescribe include mood stabilizers and atypical antipsychotics. Mood stabilizers such as lithium or valproate can help prevent mood episodes or reduce their severity. Lithium also can decrease the risk of suicide. Health care providers may include medications that target sleep or anxiety as part of the treatment plan.

Although bipolar depression is often treated with antidepressant medication, a mood stabilizer must be taken as well—taking an antidepressant without a mood stabilizer can trigger a manic episode or rapid cycling in a person with bipolar disorder.

Because people with bipolar disorder are more likely to seek help when they are depressed than when they are experiencing mania or hypomania, it is important for health care providers to take a careful medical history to ensure that bipolar disorder is not mistaken for depression.

People taking medication should:

  • Talk with their health care provider to understand the risks and benefits of the medication.
  • Tell their health care provider about any prescription drugs, over-the-counter medications, or supplements they are already taking.
  • Report any concerns about side effects to a health care provider right away. The health care provider may need to change the dose or try a different medication.
  • Remember that medication for bipolar disorder must be taken consistently, as prescribed, even when one is feeling well.

It is important to talk to a health care provider before stopping a prescribed medication. Stopping a medication suddenly may lead symptoms to worsen or come back. Read the latest medication warnings, patient medication guides, and information on newly approved medications on the Food and Drug Administration (FDA) website. 

Psychotherapy

Psychotherapy, also called talk therapy, can be an effective part of treatment for people with bipolar disorder. Psychotherapy is a term for treatment techniques that aim to help people identify and change troubling emotions, thoughts, and behaviors. This type of therapy can provide support, education, and guidance to people with bipolar disorder and their families.

Cognitive behavioral therapy (CBT) is an important treatment for depression, and CBT adapted for the treatment of insomnia can be especially helpful as part of treatment for bipolar depression.

Treatment may also include newer therapies designed specifically for the treatment of bipolar disorder, including interpersonal and social rhythm therapy (IPSRT) and family-focused therapy.

Learn more about the various types of psychotherapies.

Other treatment options

Some people may find other treatments helpful in managing their bipolar symptoms:

  • Electroconvulsive therapy (ECT) is a brain stimulation procedure that can help relieve severe symptoms of bipolar disorder. Health care providers may consider ECT when a person’s illness has not improved after other treatments, or in cases that require rapid response, such as with people who have a high suicide risk or catatonia (a state of unresponsiveness).
  • Repetitive transcranial magnetic stimulation (rTMS) is a type of brain stimulation that uses magnetic waves to relieve depression over a series of treatment sessions. Although not as powerful as ECT, rTMS does not require general anesthesia and has a low risk of negative effects on memory and thinking.
  • Light therapy is the best evidence-based treatment for seasonal affective disorder (SAD), and many people with bipolar disorder experience seasonal worsening of depression or SAD in the winter. Light therapy may also be used to treat lesser forms of seasonal worsening of bipolar depression.

Unlike specific psychotherapy and medication treatments that are scientifically proven to improve bipolar disorder symptoms, complementary health approaches for bipolar disorder, such as natural products, are not based on current knowledge or evidence. For more information, visit the National Center for Complementary and Integrative Health website .

Finding treatment

  • A family health care provider is a good resource and can be the first stop in searching for help. 
  • To find mental health treatment services in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357), visit the SAMHSA online treatment locator , or text your ZIP code to 435748.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline  at 988 or chat at 988lifeline.org . In life-threatening situations, call 911.

Coping with bipolar disorder

Living with bipolar disorder can be challenging, but there are ways to help make it easier.

  • Work with a health care provider to develop a treatment plan and stick with it. Treatment is the best way to start feeling better.
  • Follow the treatment plan as directed. Work with a health care provider to adjust the plan, as needed.
  • Structure your activities. Try to have a routine for eating, sleeping, and exercising.
  • Try regular, vigorous exercise like jogging, swimming, or bicycling, which can help with depression and anxiety, promote better sleep, and support your heart and brain health.
  • Track your moods, activities, and overall health and well-being to help recognize your mood swings.
  • Ask trusted friends and family members for help in keeping up with your treatment plan.
  • Be patient. Improvement takes time. Staying connected with sources of social support can help.

Long-term, ongoing treatment can help control symptoms and enable you to live a healthy life.

Handouts

English / Español  Bipolar Disorder in Children and Teens English / Español 

Bipolar Disorder in Teens and Young Adults - Know the Signs English / Español

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Child and Adolescent Mental Health

Written on . Posted in A-Z Topic Guide.

The following article on Anxiety Disorders is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Mental health is an important part of overall health for children as well as adults. For many adults who have mental disorders, symptoms were present—but often not recognized or addressed—in childhood and adolescence. For a young person with symptoms of a mental disorder, the earlier treatment is started, the more effective it can be. Early treatment can help prevent more severe, lasting problems as a child grows up.

Warning signs

It can be tough to tell if troubling behavior in a child is just part of growing up or a problem that should be discussed with a health professional. But if there are behavioral signs and symptoms that last weeks or months, and if these issues interfere with the child’s daily life at home and at school, or with friends, you should contact a health professional.

Young children may benefit from an evaluation and treatment if they:

  • Have frequent tantrums or are intensely irritable much of the time
  • Often talk about fears or worries
  • Complain about frequent stomachaches or headaches with no known medical cause
  • Are in constant motion and cannot sit quietly (except when they are watching videos or playing video games)
  • Sleep too much or too little, have frequent nightmares, or seem sleepy during the day
  • Are not interested in playing with other children or have difficulty making friends
  • Struggle academically or have experienced a recent decline in grades
  • Repeat actions or check things many times out of fear that something bad may happen

Older children and adolescents may benefit from an evaluation if they:

  • Have lost interest in things that they used to enjoy
  • Have low energy
  • Sleep too much or too little, or seem sleepy throughout the day
  • Spend more and more time alone, and avoid social activities with friends or family
  • Diet or exercise excessively, or fear gaining weight
  • Engage in self-harm behaviors (such as cutting or burning their skin)
  • Smoke, drink alcohol, or use drugs
  • Engage in risky or destructive behavior alone or with friends
  • Have thoughts of suicide
  • Have periods of highly elevated energy and activity, and require much less sleep than usual
  • Say that they think someone is trying to control their mind or that they hear things that other people cannot hear

Mental illnesses can be treated. If you are a child or teen, talk to your parents, school counselor, or health care provider. If you are a parent and need help starting a conversation with your child or teen about mental health, find resources for families from the Substance Abuse and Mental Health Services Administration. If you are unsure where to go for help, ask your pediatrician or family doctor.

It may be helpful for children and teens to save several emergency numbers to their cell phones. The ability to get immediate help for themselves or for a friend can make a difference.

  • The phone number for a trusted friend or relative
  • The non-emergency number for the local police department
  • 988 Suicide & Crisis Lifeline: 988

If you or someone you know needs immediate help, call or text the 988 Suicide & Crisis Lifeline at 988.

Educational resources

  • Get Excited about the Brain!: This science education activity book intended for children ages 8-12 years old helps kids learn facts about the brain through games and puzzles about brain science and research.
  • Getting to Know Your Brain: Dealing with Stress: Test your knowledge about stress and the brain. Also learn how to create and use a “stress catcher” to practice strategies to deal with stress.
  • Guided Visualization: Dealing with Stress: Learn how the brain handles stress and practice a guided visualization activity.
  • Stand Up to Stress!: This free, printable coloring and activity book for children ages 8-12 teaches kids about stress and anxiety and offers tips for coping in a healthy way.
  • Stress Catcher: This is a printable, “fortune teller” craft for children that offers coping strategies to help manage stress and other difficult emotions.

Federal resources

 

Handouts

ADHD in Adults - What You Need to Know English / Español Stand Up To Stress! Children's Activity Book (1)    English / Español

Teen Depression - More Than Just Moodiness English / Español Autism Spectrum Disorder English / Español

Bipolar Disorder in Children and Teens English / Español       English / Español

Children and Mental Health - Is This Just a StageEnglish / Español    English / Español

Get Excited About The Brain - Acitvity Book English / Español   Helping Children and Adolescents Cope with Traumatic Events English / Español

Let's Talk About Eating Disorders English / Español  PANDAS - Questions and Answers English / Español

Stress Catcher English / Español   The Teen Brain - 7 Things to Know English / Español

Understanding Psychosis English / Español    I'm So Stressed Out! Fact SheetEnglish / Español

I'm So Stressed Out! Fact Sheet English (factsheet) / English (infographic) / Español (hoja informativa) / Español (infografía)

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Older Adults and Mental Health

Written on . Posted in A-Z Topic Guide.

The following article on Anxiety Disorders is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Why is it important to take care of our mental health as we age?

As people age, they may experience certain life changes that impact their mental health, such as coping with a serious illness or losing a loved one. Although many people will adjust to these life changes, some may experience feelings of grief, social isolation, or loneliness. When these feelings persist, they can lead to mental illnesses, such as depression and anxiety.

Mental health is important at every stage of life. Effective treatment options are available to help older adults manage their mental health and improve their quality of life. Recognizing the signs and seeing a health care provider are the first steps to getting treatment.

Mental health includes emotional, psychological, and social well-being. Learn more about taking care of your mental health.

What are symptoms of mental disorders in older adults?

  • Noticeable changes in mood, energy level, or appetite
  • Feeling flat or having trouble feeling positive emotions
  • Difficulty sleeping or sleeping too much
  • Difficulty concentrating, feeling restless, or on edge
  • Increased worry or feeling stressed
  • Anger, irritability, or aggressiveness
  • Ongoing headaches, digestive issues, or pain
  • Misuse of alcohol or drugs
  • Sadness or hopelessness
  • Thoughts of death or suicide or suicide attempts
  • Engaging in high-risk activities
  • Obsessive thinking or compulsive behavior
  • Thoughts or behaviors that interfere with work, family, or social life
  • Engaging in thinking or behavior that is concerning to others
  • Seeing, hearing, and feeling things that other people do not see, hear, or feel

Help is available: If you are unsure where to go for help, ask a health care provider. Communicating well with your health care provider can improve your care and help you come up with a treatment plan that works for you. Read about tips to help prepare and get the most out of your visit. For additional resources, including questions to ask your health care provider, visit the Agency for Healthcare Research and Quality.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. In life-threatening situations, call 911.

Health hotlines

  • 988 Suicide & Crisis Lifeline: The Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. Call or text 988 to connect with a trained crisis counselor. Support is also available via live chat. Para ayuda en español, llame al 988. 
  • Veterans Crisis Line: This helpline is a free, confidential resource for veterans of all ages and circumstances. Call 1-800-273-8255, press 1; text 838255; or chat online to connect with 24/7 support.
  • Disaster Distress Hotline: This helpline from the Substance Abuse and Mental Health Services Administration provides immediate crisis counseling for people experiencing emotional distress related to any natural or human-caused disaster. The helpline is free, multilingual, confidential, and available 24 hours a day, 7 days a week. Call or text 1-800-985-5990.
  • NIH Health Info Lines

Federal resources

Handouts

Generalized Anxiety Disorder_ When Worry Gets Out of Control English / Español  Chronic Illness and Mental Health English / Español

 

English / Español  FAQs About Suicide English / Español

What Is Telemental Health English / Español

 

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Women and Mental Health

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Mental disorders can affect women and men differently. Some disorders are more common in women such as depression and anxiety. There are also certain types of disorders that are unique to women. For example, some women may experience symptoms of mental disorders at times of hormone change, such as perinatal depression, premenstrual dysphoric disorder, and perimenopause-related depression. When it comes to other mental disorders such as schizophrenia and bipolar disorder, research has not found differences in the rates at which men and women experience these illnesses. But women may experience these illnesses differently – certain symptoms may be more common in women than in men, and the course of the illness can be affected by the sex of the individual. Researchers are only now beginning to tease apart the various biological and psychosocial factors that may impact the mental health of both women and men.

Mental health includes emotional, psychological, and social well-being. Learn more about taking care of your mental health.experience different symptoms. Some symptoms include:

Warning Signs

Women and men can develop most of the same mental disorders and conditions, but may 

  • Persistent sadness or feelings of hopelessness
  • Misuse of alcohol and/or drugs
  • Dramatic changes in eating or sleeping habits
  • Appetite and/or weight changes
  • Decreased energy or fatigue
  • Excessive fear or worry
  • Seeing or hearing things that are not there
  • Extremely high and low moods
  • Aches, headaches, or digestive problems without a clear cause
  • Irritability
  • Social withdrawal
  • Suicidal thoughts

Mental disorders can be treated: If you are unsure where to go for help, ask your family doctor. Communicating well with your health care provider can improve your care and help you both make good choices about your health. Read about tips to help prepare and get the most out of your visit. 

If you or someone you know is in a crisis, get help immediately. You can call 911 or call or text the 988 Suicide & Crisis Lifeline at 988.

Federal Resources

Handouts

 

Depression in Women - 5 Things You Should Know English / Español  Perinatal Depression English / Español

Let's Talk About Eating Disorders English / Español

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Men and Mental Health

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Men and Mental Health

While mental illnesses affect both men and women, the prevalence of mental illnesses in men is often lower than women. Men with mental illnesses are also less likely to have received mental health treatment than women in the past year. However, men are more likely to die by suicide than women, according to the Centers for Disease Control and Prevention. Recognizing the signs that you or someone you love may have a mental disorder is the first step toward getting treatment. The earlier that treatment begins, the more effective it can be.

Mental health includes emotional, psychological, and social well-being. Learn more about taking care of your mental health.

Warning Signs

Men and women can develop most of the same mental disorders and conditions but may experience different symptoms. Some symptoms include:

  • Anger, irritability, or aggressiveness
  • Noticeable changes in mood, energy level, or appetite
  • Difficulty sleeping or sleeping too much
  • Difficulty concentrating, feeling restless, or on edge
  • Increased worry or feeling stressed
  • Misuse of alcohol and/or drugs
  • Sadness or hopelessness
  • Suicidal thoughts
  • Feeling flat or having trouble feeling positive emotions
  • Engaging in high-risk activities
  • Aches, headaches, digestive problems without a clear cause
  • Obsessive thinking or compulsive behavior
  • Thoughts or behaviors that interfere with work, family, or social life
  • Unusual thinking or behaviors that concern other people

Mental disorders can be treated: If you are unsure where to go for help, ask your family doctor. Communicating well with your health care provider can improve your care and help you both make good choices about your health. Read about tips to help prepare and get the most out of your visit. 

If you or someone you know is in a crisis, get help immediately. You can call 911 or call or text the 988 Suicide & Crisis Lifeline at 988.

Federal Resources

  • Brother, You’re on My Mind: This National Institute on Minority Health and Health Disparities initiative uses a variety of activities to raise awareness of the mental health challenges associated with depression and stress that affect African American men and their families.
  • Men’s Health: National Library of Medicine’s MedlinePlus offers resources on men’s health (en Español).
  • Mental Health for Men: This blog post from the U.S. Department of Health and Human Services’ Office on Women’s Health discusses the importance of supporting men’s mental health.
  • National Center for PTSD: A program of the U.S. Department of Veterans Affairs, this Center offers targeted information for anyone interested in post-traumatic stress disorder (including Veterans, family, and friends). 
  • Preventing Suicide Among Men in the Middle Years: Recommendations for Suicide Prevention Programs: This Suicide Prevention Resource Center created this resource to help state and community suicide prevention programs design and implement projects to prevent suicide among men in the middle years.

Substance Abuse and Mental Health Services Administration: SAMHSA offers publications addressing the specific needs of men.

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Suicide Prevention

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

If You Know Someone in Crisis

Call or text the 988 Suicide & Crisis Lifeline at 988 (para ayuda en español, llame al 988). The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call 911 in life-threatening situations. If you are worried about a friend’s social media updates, you can contact safety teams at the social media company. They will reach out to connect the person with the help they need.

The Veterans Crisis Line connects Service members and Veterans in crisis, as well as their family members and friends, with qualified Department of Veteran’s Affairs (VA) responders through a confidential toll-free hotline, online chat, or text messaging service. Dial 1-800-273-8255 and Press 1 to talk to someone or send a text message to 838255 to connect with a VA responder.  You can also start a confidential online chat session at Veterans Crisis Chat.

Introduction

Suicide is a major public health concern. In 2020, suicide was the 12th leading cause of death overall in the United States, claiming the lives of over 45,900 people. Suicide is complicated and tragic, but it is often preventable. Knowing the warning signs for suicide and how to get help can help save lives.

What is Suicide?

Suicide is when people harm themselves with the goal of ending their life, and they die as a result.

A suicide attempt is when people harm themselves with the goal of ending their life, but they do not die.

Avoid using terms such as “committing suicide,” “successful suicide,” or “failed suicide” when referring to suicide and suicide attempts, as these terms often carry negative meanings.

Warning Signs

Warning signs that someone may be at immediate risk for attempting suicide include:

  • Talking about wanting to die or wanting to kill themselves
  • Talking about feeling empty or hopeless or having no reason to live
  • Talking about feeling trapped or feeling that there are no solutions
  • Feeling unbearable emotional or physical pain
  • Talking about being a burden to others
  • Withdrawing from family and friends
  • Giving away important possessions
  • Saying goodbye to friends and family
  • Putting affairs in order, such as making a will
  • Taking great risks that could lead to death, such as driving extremely fast
  • Talking or thinking about death often

Other serious warning signs that someone may be at risk for attempting suicide include:

  • Displaying extreme mood swings, suddenly changing from very sad to very calm or happy
  • Making a plan or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun
  • Talking about feeling great guilt or shame
  • Using alcohol or drugs more often
  • Acting anxious or agitated
  • Changing eating or sleeping habits
  • Showing rage or talking about seeking revenge

It is important to note that suicide is not a normal response to stress. Suicidal thoughts or actions are a sign of extreme distress and should not be ignored. If these warning signs apply to you or someone you know, get help as soon as possible, particularly if the behavior is new or has increased recently.

Here are five steps you can take to #BeThe1To help someone in emotional pain:

5 Action Steps Graphic

  1. ASK: “Are you thinking about killing yourself?” It’s not an easy question, but studies show that asking at-risk individuals if they are suicidal does not increase suicides or suicidal thoughts.
  2. KEEP THEM SAFE: Reducing a suicidal person’s access to highly lethal items or places is an important part of suicide prevention. While this is not always easy, asking if the at-risk person has a plan and removing or disabling the lethal means can make a difference.
  3. BE THERE: Listen carefully and learn what the individual is thinking and feeling. Research suggests acknowledging and talking about suicide may reduce rather than increase suicidal thoughts.
  4. HELP THEM CONNECT: Save the 988 Suicide & Crisis Lifeline number (call or text 988) and the Crisis Text Line number (741741) in your phone so they’re there if you need them. You can also help make a connection with a trusted individual like a family member, friend, spiritual advisor, or mental health professional.
  5. STAY CONNECTED: Staying in touch after a crisis or after being discharged from care can make a difference. Studies have shown the number of suicide deaths goes down when someone follows up with the at-risk person.

Risk Factors

Suicide does not discriminate. People of all genders, ages, and ethnicities can be at risk. Suicidal behavior is complex, and there is no single cause. The main risk factors for suicide are:

  • Depression, other mental disorders, or substance use disorder
  • Chronic pain
  • A history of suicide attempts
  • Family history of a mental disorder or substance use
  • Family history of suicide
  • Exposure to family violence, including physical or sexual abuse
  • Presence of guns or other firearms in the home
  • Having recently been released from prison or jail
  • Exposure, either directly or indirectly, to others’ suicidal behavior, such as that of family members, peers, or celebrities

Most people who have risk factors will not attempt suicide, and it is difficult to tell who will act on suicidal thoughts. Although risk factors for suicide are important to keep in mind, someone who is showing warning signs of suicide may be at higher risk for danger and need immediate attention.

Stressful life events (such as the loss of a loved one, legal troubles, or financial difficulties) and interpersonal stressors (such as shame, harassment, bullying, discrimination, or relationship troubles) may contribute to suicide risk, especially when they occur along with suicide risk factors.

Family and friends are often the first to recognize the warning signs of suicide, and they can take the first step toward helping a loved one find mental health treatment. 

Identifying People at Risk for Suicide

Treatments and Therapies

Effective, evidence-based interventions are available to help people who are at risk for suicide.

Brief Interventions

Psychotherapies

Multiple types of psychosocial interventions have been found to help individuals who have attempted suicide (see below). These types of interventions may prevent someone from making another attempt.

Medication

Some individuals at risk for suicide might benefit from medication. Health care providers and patients can work together to find the best medication or medication combination, as well as the right dose. Because many individuals at risk for suicide often have a mental illness or substance use problems, individuals might benefit from medication along with psychosocial intervention.

Clozapine is an antipsychotic medication used primarily to treat individuals with schizophrenia. To date, it is the only medication with a specific U.S. Food and Drug Administration (FDA) indication for reducing the risk of recurrent suicidal behavior in patients with schizophrenia or schizoaffective disorder.

If you are prescribed a medication, be sure you:

  • Talk with your health care provider or a pharmacist to make sure you understand the risks and benefits of the medications you’re taking.
  • Do not stop taking a medication without talking to your health care provider first. Suddenly stopping a medication may lead to “rebound” or worsening of symptoms. Other uncomfortable or potentially dangerous withdrawal effects also are possible.
  • Report any concerns about side effects to your health care provider right away. You may need a change in the dose or a different medication.
  • Report serious side effects to the FDA MedWatch Adverse Event Reporting program online or by phone at 1-800-332-1088. You or your health care provider may send a report.

For the most up-to-date information on medications, side effects, and warnings, visit the FDA website.

Collaborative Care

Collaborative Care is a team-based approach to mental health care. A behavioral health care manager will work with the person, their primary health care provider, and mental health specialists to develop a treatment plan. Collaborative care has been shown to be an effective way to treat depression and reduce suicidal thoughts.

Federal Resources

  • The African American Youth Suicide: Report to Congress is a response by the U.S. Department of Health and Human Services that builds upon the 2019 Congressional Black Caucus report, “Ring the Alarm: The Crisis of Black Suicide in America.” The report examines patterns of youth suicide by race and ethnicity, what is known about youth suicide decedent characteristics, information on risk and protective factors, interventions, and remaining knowledge gaps.
  • The Suicide Prevention Resource Center (SPRC) is the only federally supported resource center devoted to advancing the implementation of the National Strategy for Suicide Prevention. SPRC is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA).
  • The American Indian and Alaska Native (AI/AN) National Suicide Prevention Strategic Plan is a national initiative addressing suicide prevention, based on fostering collaborations across Tribes, Tribal organizations, Urban Indian organizations, and the Indian Health Service (IHS). The IHS Suicide Prevention and Care site provides resources to support suicide prevention efforts, and to help communities and individuals understand and obtain services related to suicide.
  • The Center for Disease Control and Prevention’s (CDC) Suicide Prevention webpage provides resources for communities and states to support suicide prevention efforts.
  • MedlinePlus offers information about suicide from the U.S. National Library of Medicine.
  • National Action Alliance for Suicide Prevention is a public-private partnership working to advance the National Strategy for Suicide Prevention.
  • The Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention outlines the actions that communities and individuals can take to reduce the rates of suicide and help improve resilience.
  • #BeThe1To is the National Suicide Prevention Lifeline’s message to spread the word about actions everyone can take to prevent suicide.
  • Ask Suicide-Screening Questions (ASQ) is free screening resource for medical settings (e.g., emergency departments, inpatient medical/surgical units, outpatient clinics/primary care) that can help nurses or physicians successfully identify youth at risk for suicide.

Handouts

5 Action Steps for Helping Someone in Emotional Pain English / Español    FAQs About SuicideEnglish / Español

Warning Signs of Suicide English / Español

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Help for Mental Illnesses

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

If you or someone you know has a mental illness, is struggling emotionally, or has concerns about their mental health, there are ways to get help. Use these resources to find help for you, a friend, or a family member.

Please note that the resources on this page are provided for informational purposes only. The list is not comprehensive and does not constitute an endorsement by MHANYS.

Get Immediate Help in a Crisis

Call 911 if you or someone you know is in immediate danger or go to the nearest emergency room.

988 Suicide & Crisis Lifeline
Call or text 988; Llame al 988 (para ayuda en español)
Use Lifeline Chat on the web (English only)
The Lifeline provides 24-hour, confidential support to anyone in suicidal crisis or emotional distress. Call or text 988 to connect with a trained crisis counselor. 

Veterans Crisis Line
Use Veterans Crisis Chat on the web 
The Veterans Crisis Line is a free, confidential resource that connects veterans 24 hours a day, 7 days a week with a trained responder. The service is available to all veterans and those who support them, even if they are not registered with the VA or enrolled in VA healthcare.

Disaster Distress Helpline
Call or text 1-800-985-5990
The disaster distress helpline provides immediate crisis counseling for people who are experiencing emotional distress related to any natural or human-caused disaster. The helpline is free, multilingual, confidential, and available 24 hours a day, 7 days a week.

If you are worried about a friend’s social media updates, you can contact safety teams at the social media company. They will reach out to connect the person with the help they need. 

Find a Health Care Provider or Treatment

Treatment for mental illnesses usually consists of therapy, medication, or a combination of the two. Treatment can be given in person or through a phone or computer (telemental health). It can sometimes be difficult to know where to start when looking for mental health care, but there are many ways to find a provider who will meet your needs.

Primary Care Provider: Your primary care practitioner can be an important resource, providing initial mental health screenings and referrals to mental health specialists. If you have an appointment with your primary care provider, consider bringing up your mental health concerns and asking for help.

Federal Resources: Some federal agencies offer resources for identifying health care providers and help in finding low-cost health services. These include:

National Agencies and Advocacy and Professional Organizations: Advocacy and professional organizations can be a good source of information when looking for a mental health professional. They often have information on finding a mental health professional on their website, and some have practitioner locators on their websites. Examples include but are not limited to:

State and County Agencies: The website of your state or county government may have information about health services in your area. You may be able to find this information by visiting their websites and searching for the health services department.

Insurance Companies: If you have health insurance, a representative of your insurance company will know which local providers are covered by your insurance plan. The websites of many health insurance companies have searchable databases that allow you to find a participating practitioner in your area.

University, College, or Medical Schools: Your local college, university, or medical school may offer treatment options. To find these, try searching on the website of local university health centers for their psychiatry, psychology, counseling, or social work departments.

Help for Service Members and Their Families: Current and former service members may face different mental health issues than the general public. For resources for both service members and veterans, please visit:

Deciding if a Provider is Right for You

Once you find a potential provider it can be helpful to prepare a list of questions to help you decide if they are a good fit for you. Examples of questions you might want to ask a potential provider include:

  • What experience do you have treating someone with my issue?
  • How do you usually treat someone with my issue?
  • How long do you expect treatment to last?
  • Do you accept my insurance?
  • What are your fees?

Treatment works best when you have a good relationship with your mental health professional. If you aren’t comfortable or are feeling like the treatment is not helping, talk with your provider, or consider finding a different provider or another type of treatment.

Children and adolescents that don’t have a mental health professional should consider speaking with a health care provider or another trusted adult.

Do not stop current treatment without talking to your health care provider.

Join a Study

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions, including mental illnesses. The goal of clinical trials is to determine if a new test or treatment works and is safe.

Although individual participants may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. We have new and better treatment options today because of what clinical trials uncovered years ago.

Be part of tomorrow’s medical breakthroughs. Talk to your health care provider about clinical trials, their benefits and risks, and if one is right for you.

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Depression

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Depression (also called major depressive disorder or clinical depression) is a common but serious mood disorder. It causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.

To be diagnosed with depression, the symptoms must be present for at least two weeks.

There are different types of depression, some of which develop due to specific circumstances.

  • Major depression, which includes symptoms of depression most of the time for at least 2 weeks that typically interfere with one’s ability to work, sleep, study, and eat.
  • Persistent depressive disorder (also called dysthymia), which often includes less severe symptoms of depression that last much longer, typically for at least 2 years.
  • Perinatal depression, which occurs when a woman experiences major depression during pregnancy or after delivery (postpartum depression).
  • Seasonal affective disorder, which comes and goes with the seasons, typically starting in late fall and early winter and going away during spring and summer.
  • Depression with symptoms of psychosis, which is a severe form of depression where a person experiences psychosis symptoms, such as delusions (disturbing, false fixed beliefs) or hallucinations (hearing or seeing things that others do not see or hear).

Individuals with bipolar disorder (formerly called manic depression or manic-depressive illness) also experience depressive episodes, in which they feel sad, indifferent, or hopeless, combined with a very low activity level. But a person with bipolar disorder also experiences manic episodes, or unusually elevated moods in which the individual might feel very happy, irritable, or “up,” with a marked increase in activity level.

Examples of other types of depressive disorders newly added to the diagnostic classification of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) include disruptive mood dysregulation disorder (diagnosed in children and adolescents) and premenstrual dysphoric disorder (PMDD).

Signs and Symptoms

The Centers for Disease Control and Prevention (CDC) has recognized that having certain mental disorders, including depression and schizophrenia, can make people more likely to get severely ill from COVID-19. 

If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:

  • Persistent sad, anxious, or “empty” mood
  • Feelings of hopelessness, or pessimism
  • Feelings of irritability, frustration, or restlessness 
  • Feelings of guilt, worthlessness, or helplessness
  • Loss of interest or pleasure in hobbies and activities
  • Decreased energy, fatigue, or feeling “slowed down”
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, early morning awakening, or oversleeping
  • Changes in appetite or unplanned weight changes
  • Thoughts of death or suicide, or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not ease even with treatment
  • Suicide attempts or thoughts of death or suicide

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many. Several persistent symptoms in addition to low mood are required for a diagnosis of major depression, but people with only a few – but distressing – symptoms may benefit from treatment as well. The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.

Risk Factors

Depression is one of the most common mental disorders in the United States. Research suggests that genetic, biological, environmental, and psychological factors play a role in depression.

Depression can happen at any age, but often begins in adulthood. Depression is now recognized as occurring in children and adolescents, although it sometimes presents with more prominent irritability than low mood. Many chronic mood and anxiety disorders in adults begin as high levels of anxiety in children.

Depression, especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease. These conditions are often worse when depression is present, and research suggests that people who have depression and another medical illness tend to have more severe symptoms of both illnesses. Sometimes medications taken for these physical illnesses may cause side effects that contribute to depression. A doctor experienced in treating these complicated illnesses can help work out the best treatment strategy.

Risk factors include:

  • Personal or family history of depression
  • Major life changes, trauma, or stress
  • Certain physical illnesses and medications

Treatment and Therapies

Depression, even the most severe cases, can be treated. The earlier treatment begins, the more effective it is. Depression is usually treated with medications, psychotherapy, or a combination of the two. If these treatments do not reduce symptoms, electroconvulsive therapy (ECT) and other brain stimulation therapies may be options to explore.

Quick Tip: No two people are affected the same way by depression and there is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best for you.

Medications

Antidepressants are medicines commonly used to treat depression. They may help improve the way your brain uses certain chemicals that control mood or stress. You may need to try several different antidepressant medicines before finding the one that improves your symptoms and has manageable side effects. A medication that has helped you or a close family member in the past will often be considered.

Antidepressants take time – usually 4 to 8 weeks – to work, and often, symptoms such as sleep, appetite, and concentration problems improve before mood lifts, so it is important to give medication a chance before deciding whether it works.

If you begin taking antidepressants, do not stop taking them without talking to your health care provider. Sometimes people taking antidepressants feel better and then stop taking the medication on their own, and the depression returns. When you and your health care provider have decided it is time to stop the medication, usually after a course of 6 to 12 months, the health care provider will help you slowly and safely decrease your dose. Stopping them abruptly can cause withdrawal symptoms.

Please Note: In some cases, children, teenagers, and young adults under 25 may experience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. This warning from the U.S. Food and Drug Administration (FDA) also says that patients of all ages taking antidepressants should be watched closely, especially during the first few weeks of treatment.

If you are considering taking an antidepressant and you are pregnant, planning to become pregnant, or breastfeeding, talk to your health care provider about any increased health risks to you or your unborn or nursing child.

To find the latest information about antidepressants talk to your health care provider.

Psychotherapies

Several types of psychotherapy (also called “talk therapy” or “counseling”) can help people with depression by teaching new ways of thinking and behaving and how to change habits that contribute to depression. Examples of evidence-based approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).

Brain Stimulation Therapies

If medications do not reduce the symptoms of depression, electroconvulsive therapy (ECT) may be an option to explore. Based on the latest research:

  • ECT can provide relief for people with severe depression who have not been able to feel better with other treatments.
  • Electroconvulsive therapy can be an effective treatment for depression. In some severe cases where a rapid response is necessary or medications cannot be used safely, ECT can even be a first-line intervention.
  • Once strictly an inpatient procedure, today ECT is often performed on an outpatient basis. The treatment consists of a series of sessions, typically three times a week, for two to four weeks.
  • ECT may cause some side effects, including confusion, disorientation, and memory loss. Usually these side effects are short-term, but sometimes memory problems can linger, especially for the months around the time of the treatment course. Advances in ECT devices and methods have made modern ECT safe and effective for most patients. Talk to your doctor and make sure you understand the potential benefits and risks of the treatment before giving your informed consent to undergoing ECT.
  • ECT is not painful, and you cannot feel the electrical impulses. Before ECT begins, a patient is put under brief anesthesia and given a muscle relaxant. Within one hour after the treatment session, which takes only a few minutes, the patient is awake and alert.

Other more recently introduced types of brain stimulation therapies used to treat medicine-resistant depression include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS). Other types of brain stimulation treatments are under study. 

Natural Products

FDA has not approved any natural products for depression. While research is ongoing, some people find natural products, including vitamin D and the herbal dietary supplement St. John’s wort, to help depression. Do not use St. John’s wort or other dietary supplements for depression before talking to your provider. For more information, visit the National Center for Complementary and Integrative Health website.

How can I find help?

If you think you may have depression, start by making an appointment to see your health care provider. This could be your primary care practitioner or a health provider who specializes in diagnosing and treating mental health conditions. 

Beyond Treatment: Things You Can Do

Once you begin treatment, you should gradually start to feel better. Here are other tips that may help you or a loved one during treatment for depression:

  • Try to get some physical activity. Just 30 minutes a day of walking can boost mood.
  • Try to maintain a regular bedtime and wake-up time.
  • Eat regular, healthy meals.
  • Do what you can as you can. Decide what must get done and what can wait.
  • Try to connect with other people, and talk with people you trust about how you are feeling.
  • Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better.
  • Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.

Handouts

Chronic Illness and Mental Health - Recognizing and Treating Depression English / Español    Perinatal Depression English / Español

Depression in Women - 5 Things You Should Know English / Español  Depression English / Español

Men and Depression English / Español  Seasonal Affective Disorder (SAD) - More Than the Winter Blues  English / Español 

Seasonal Affective DisorderEnglish / Español  Teen Depression - More Than Just Moodiness English / Español 

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Caring For Your Mental Health

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Mental health includes emotional, psychological, and social well-being. It affects how we think, feel, act, make choices, and relate to others. Mental health is more than the absence of a mental illness—it’s essential to your overall health and quality of life. Self-care can play a role in maintaining your mental health and help support your treatment and recovery if you have a mental illness.

About Self-Care

Self-care means taking the time to do things that help you live well and improve both your physical health and mental health. When it comes to your mental health, self-care can help you manage stress, lower your risk of illness, and increase your energy. Even small acts of self-care in your daily life can have a big impact.

Here are some tips to help you get started with self-care:

  • Get regular exercise. Just 30 minutes of walking every day can help boost your mood and improve your health. Small amounts of exercise add up, so don’t be discouraged if you can’t do 30 minutes at one time.
  • Eat healthy, regular meals and stay hydrated. A balanced diet and plenty of water can improve your energy and focus throughout the day. Also, limit caffeinated beverages such as soft drinks or coffee.
  • Make sleep a priority. Stick to a schedule, and make sure you’re getting enough sleep. Blue light from devices and screens can make it harder to fall asleep, so reduce blue light exposure from your phone or computer before bedtime.
  • Try a relaxing activity. Explore relaxation or wellness programs or apps, which may incorporate meditation, muscle relaxation, or breathing exercises. Schedule regular times for these and other healthy activities you enjoy such as journaling.
  • Set goals and priorities. Decide what must get done now and what can wait. Learn to say “no” to new tasks if you start to feel like you’re taking on too much. Try to be mindful of what you have accomplished at the end of the day, not what you have been unable to do.
  • Practice gratitude. Remind yourself daily of things you are grateful for. Be specific. Write them down at night, or replay them in your mind.
  • Focus on positivity. Identify and challenge your negative and unhelpful thoughts.
  • Stay connected. Reach out to your friends or family members who can provide emotional support and practical help.

Self-care looks different for everyone, and it is important to find what you need and enjoy. It may take trial and error to discover what works best for you. In addition, although self-care is not a cure for mental illnesses, understanding what causes or triggers your mild symptoms and what coping techniques work for you can help manage your mental health.

When to Seek Professional Help

Seek professional help if you are experiencing severe or distressing symptoms that have lasted 2 weeks or more, such as:

  • Difficulty sleeping
  • Appetite changes that result in unwanted weight changes
  • Struggling to get out of bed in the morning because of mood
  • Difficulty concentrating
  • Loss of interest in things you usually find enjoyable
  • Inability to perform usual daily functions and responsibilities

Don’t wait until your symptoms are overwhelming. Talk about your concerns with your primary care provider, who can refer you to a mental health professional if needed. If you don’t know where to start, read the National Institute of Mental Health (NIMH) Tips for Talking With a Health Care Provider About Your Mental Health PDF linked below. 

What to Do in a Crisis

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org. This service is confidential, free, and available 24 hours a day, 7 days a week. In life-threatening situations, call 911. 

Featured Videos

NIMH Expert Discusses Managing Stress & Anxiety: Learn coping techniques to help maintain your mental health during the COVID-19 pandemic and when to get professional help.

GREAT: Helpful Practices to Manage Stress and Anxiety: Learn about helpful practices to manage stress and anxiety. GREAT was developed by Dr. Krystal Lewis, a licensed clinical psychologist at NIMH.

Getting to Know Your Brain: Dealing with Stress: Test your knowledge about stress and the brain. Also learn how to create and use a “stress catcher” to practice strategies to deal with stress.

Guided Visualization: Dealing with Stress: Learn how the brain handles stress and practice a guided visualization activity.

Mental Health Minute: Stress and Anxiety in Adolescents: Got 60 seconds? Take a mental health minute to learn about stress and anxiety in adolescents.

Federal Resources

Handouts

I'm So Stressed Out! Fact SheetEnglish / Español    My Mental Health - Do I Need HelpEnglish / Español

Tips for Talking with a Health Care Provider About Your Mental HealthEnglish / Español

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics

Attention-Deficit/Hyperactivity Disorder

Written on . Posted in A-Z Topic Guide.

The following article is from the National Institute of Mental Health (NIMH). While this material has been expert-reviewed, it is not NIMH or MHANYS intention to provide specific medical advice. Both MHANYS and NIMH advise readers to consult with a qualified health care provider for diagnosis, treatment, and answers to personal questions.

Overview

Attention-deficit/hyperactivity disorder (ADHD) is marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. People with ADHD experience an ongoing pattern of the following types of symptoms:

  • Inattention means a person may have difficulty staying on task, sustaining focus, and staying organized, and these problems are not due to defiance or lack of comprehension.
  • Hyperactivity means a person may seem to move about constantly, including in situations when it is not appropriate, or excessively fidgets, taps, or talks. In adults, hyperactivity may mean extreme restlessness or talking too much.
  • Impulsivity means a person may act without thinking or have difficulty with self-control. Impulsivity could also include a desire for immediate rewards or the inability to delay gratification. An impulsive person may interrupt others or make important decisions without considering long-term consequences.

Signs and Symptoms

Some people with ADHD mainly have symptoms of inattention. Others mostly have symptoms of hyperactivity-impulsivity. Some people have both types of symptoms.

Many people experience some inattention, unfocused motor activity, and impulsivity, but for people with ADHD, these behaviors:

  • Are more severe
  • Occur more often
  • Interfere with or reduce the quality of how they function socially, at school, or in a job

Inattention

People with symptoms of inattention may often:

  • Overlook or miss details and make seemingly careless mistakes in schoolwork, at work, or during other activities
  • Have difficulty sustaining attention during play or tasks, such as conversations, lectures, or lengthy reading
  • Not seem to listen when spoken to directly
  • Find it hard to follow through on instructions or finish schoolwork, chores, or duties in the workplace, or may start tasks but lose focus and get easily sidetracked
  • Have difficulty organizing tasks and activities, doing tasks in sequence, keeping materials and belongings in order, managing time, and meeting deadlines
  • Avoid tasks that require sustained mental effort, such as homework, or for teens and older adults, preparing reports, completing forms, or reviewing lengthy papers
  • Lose things necessary for tasks or activities, such as school supplies, pencils, books, tools, wallets, keys, paperwork, eyeglasses, and cell phones
  • Be easily distracted by unrelated thoughts or stimuli
  • Be forgetful in daily activities, such as chores, errands, returning calls, and keeping appointments

Hyperactivity-Impulsivity

People with symptoms of hyperactivity-impulsivity may often:

  • Fidget and squirm while seated
  • Leave their seats in situations when staying seated is expected, such as in the classroom or the office
  • Run, dash around, or climb at inappropriate times or, in teens and adults, often feel restless
  • Be unable to play or engage in hobbies quietly
  • Be constantly in motion or on the go, or act as if driven by a motor
  • Talk excessively
  • Answer questions before they are fully asked, finish other people’s sentences, or speak without waiting for a turn in a conversation
  • Have difficulty waiting one’s turn
  • Interrupt or intrude on others, for example in conversations, games, or activities

Primary care providers sometimes diagnose and treat ADHD. They may also refer individuals to a mental health professional, such as a psychiatrist or clinical psychologist, who can do a thorough evaluation and make an ADHD diagnosis.

For a person to receive a diagnosis of ADHD, the symptoms of inattention and/or hyperactivity-impulsivity must be chronic or long-lasting, impair the person’s functioning, and cause the person to fall behind typical development for their age. Stress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD. Therefore, a thorough evaluation is necessary to determine the cause of the symptoms.

Most children with ADHD receive a diagnosis during the elementary school years. For an adolescent or adult to receive a diagnosis of ADHD, the symptoms need to have been present before age 12.

ADHD symptoms can appear as early as between the ages of 3 and 6 and can continue through adolescence and adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in children who primarily have symptoms of inattention, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.

ADHD symptoms can change over time as a person ages. In young children with ADHD, hyperactivity-impulsivity is the most predominant symptom. As a child reaches elementary school, the symptom of inattention may become more prominent and cause the child to struggle academically. In adolescence, hyperactivity seems to lessen and symptoms may more likely include feelings of restlessness or fidgeting, but inattention and impulsivity may remain. Many adolescents with ADHD also struggle with relationships and antisocial behaviors. Inattention, restlessness, and impulsivity tend to persist into adulthood.

Risk Factors

Researchers are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other disorders, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors that might raise the risk of developing ADHD and are studying how brain injuries, nutrition, and social environments might play a role in ADHD.

ADHD is more common in males than females, and females with ADHD are more likely to primarily have inattention symptoms. People with ADHD often have other conditions, such as learning disabilities, anxiety disorder, conduct disorder, depression, and substance use disorder.

Treatment and Therapies

While there is no cure for ADHD, currently available treatments may reduce symptoms and improve functioning. Treatments include medication, psychotherapy, education or training, or a combination of treatments.

Medication

For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Sometimes several different medications or dosages must be tried before finding the right one that works for a particular person. Anyone taking medications must be monitored closely by their prescribing doctor.

Stimulants. The most common type of medication used for treating ADHD is called a “stimulant.” Although it may seem unusual to treat ADHD with a medication that is considered a stimulant, it works by increasing the brain chemicals dopamine and norepinephrine, which play essential roles in thinking and attention.

Under medical supervision, stimulant medications are considered safe. However, like all medications, they can have side effects, especially when misused or taken in excess of the prescribed dose, and require an individual’s health care provider to monitor how they may be reacting to the medication.

Non-stimulants. A few other ADHD medications are non-stimulants. These medications take longer to start working than stimulants, but can also improve focus, attention, and impulsivity in a person with ADHD. Doctors may prescribe a non-stimulant: when a person has bothersome side effects from stimulants, when a stimulant was not effective, or in combination with a stimulant to increase effectiveness.

Although not approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of ADHD, some antidepressants are used alone or in combination with a stimulant to treat ADHD. Antidepressants may help all of the symptoms of ADHD and can be prescribed if a patient has bothersome side effects from stimulants. Antidepressants can be helpful in combination with stimulants if a patient also has another condition, such as an anxiety disorder, depression, or another mood disorder. Non-stimulant ADHD medications and antidepressants may also have side effects.

Doctors and patients can work together to find the best medication, dose, or medication combination. Learn the basics about stimulants and other mental health medications and check the FDA website for the latest medication approvals, warnings, and patient information guides.

Psychotherapy and Psychosocial Interventions

Several specific psychosocial interventions have been shown to help individuals with ADHD and their families manage syzmptoms and improve everyday functioning.

For school-age children, frustration, blame, and anger may have built up within a family before a child is diagnosed. Parents and children may need specialized help to overcome negative feelings. Mental health professionals can educate parents about ADHD and how it affects a family. They also will help the child and his or her parents develop new skills, attitudes, and ways of relating to each other.

All types of therapy for children and teens with ADHD require parents to play an active role. Psychotherapy that includes only individual treatment sessions with the child (without parent involvement) is not effective for managing ADHD symptoms and behavior. This type of treatment is more likely to be effective for treating symptoms of anxiety or depression that may occur along with ADHD.

Behavioral therapy is a type of psychotherapy that aims to help a person change their behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a person how to:

  • Monitor their own behavior
  • Give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting

Parents, teachers, and family members also can give feedback on certain behaviors and help establish clear rules, chore lists, and structured routines to help a person control their behavior. Therapists may also teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.

Cognitive behavioral therapy helps a person learn how to be aware and accepting of one’s own thoughts and feelings to improve focus and concentration. The therapist also encourages the person with ADHD to adjust to the life changes that come with treatment, such as thinking before acting, or resisting the urge to take unnecessary risks.

Family and marital therapy can help family members and spouses find productive ways to handle disruptive behaviors, encourage behavior changes, and improve interactions with the person with ADHD.

Parenting skills training (behavioral parent management training) teaches parents skills for encouraging and rewarding positive behaviors in their children. Parents are taught to use a system of rewards and consequences to change a child’s behavior, to give immediate and positive feedback for behaviors they want to encourage, and to ignore or redirect behaviors they want to discourage.

Specific behavioral classroom management interventions and/or academic accommodations for children and teens have been shown to be effective for managing symptoms and improving functioning at school and with peers. Interventions may include behavior management plans or teaching organizational or study skills. Accommodations may include preferential seating in the classroom, reduced classwork load, or extended time on tests and exams. The school may provide accommodations through what is called a 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP). 

To learn more about the Individuals with Disabilities Education Act (IDEA), visit the U.S. Department of Education’s IDEA website.

Stress management techniques can benefit parents of children with ADHD by increasing their ability to deal with frustration so that they can respond calmly to their child’s behavior.

Support groups can help parents and families connect with others who have similar problems and concerns. Groups often meet regularly to share frustrations and successes, to exchange information about recommended specialists and strategies, and to talk with experts.

The National Resource Center on ADHD, a program of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD®) supported by the Centers for Disease Control and Prevention (CDC), has information and many resources. You can reach this center online or by phone at 1-866-200-8098.

Tips to Help Kids and Adults with ADHD Stay Organized

For Kids:

Parents and teachers can help kids with ADHD stay organized and follow directions with tools such as:

  • Keeping a routine and a schedule. Keep the same routine every day, from wake-up time to bedtime. Include times for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or a bulletin board. Write changes on the schedule as far in advance as possible.
  • Organizing everyday items. Have a place for everything, (such as clothing, backpacks, and toys), and keep everything in its place.
  • Using homework and notebook organizers. Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home necessary books.
  • Being clear and consistent. Children with ADHD need consistent rules they can understand and follow.
  • Giving praise or rewards when rules are followed. Children with ADHD often receive and expect criticism. Look for good behavior and praise it.

For Adults:

A professional counselor or therapist can help an adult with ADHD learn how to organize their life with tools such as:

  • Keeping routines.
  • Making lists for different tasks and activities.
  • Using a calendar for scheduling events.
  • Using reminder notes.
  • Assigning a special place for keys, bills, and paperwork.
  • Breaking down large tasks into more manageable, smaller steps so that completing each part of the task provides a sense of accomplishment.

Handouts

ADHD in Adults - What You Need to Know English / Español  ADHD in Adults - What You Need to Know English / Español

Mental Health Association in New York State (MHANYS) has additional resources that can be accessed through its main website. These resources include links to advocacy and policy work, school-based programs, mental health wellness training programs and more.

MHANYS
mhanys.org

Advocacy and Policy
mhanys.org/advocacy-policy

Mental Health Community Partners
mhcommunitypartners.org

CarePath™
mhanys.org/carepath

SMHRT: Family Education
https://www.mentalhealthednys.org/family-education-webinar-series/

Data Source
National Institute of Mental Health: Mental Health Information Health Topics www.nimh.nih.gov/health/topics