[
    "What is psychosis?\nPsychosis refers to a collection of symptoms that affect \nthe mind, where there has been some loss of contact with reality. During an episode of psychosis, a person’s thoughts and perceptions are disrupted and they may have difficulty recognizing what is real and what is not.\nWho develops psychosis?\nIt is difficult to know the number of people who experience psychosis. Studies estimate that between 15 and 100 people out of 100,000 develop psychosis each year. \nPsychosis often begins in young adulthood when a person \nis in their late teens to mid-20s. However, people can experience a psychotic episode at younger and older ages and as a part of many disorders and illnesses. For instance, older adults with neurological disorders may be at higher risk for psychosis. \nWhat are the signs and symptoms of \npsychosis?\nPeople with psychosis typically experience delusions",
    "psychosis?\nPeople with psychosis typically experience delusions \n(false beliefs, for example, that people on television are sending them special messages or that others are trying to hurt them) and hallucinations (seeing or hearing things that others do not, such as hearing voices telling them to do something or criticizing them). Other symptoms can include incoherent or nonsense speech and behavior that is inappropriate for the situation. \nHowever, a person will often show changes in their \nbehavior before psychosis develops. Behavioral warning signs for psychosis include:\n• Suspiciousness, paranoid ideas, or uneasiness  \nwith others\n• Trouble thinking clearly and logically• Withdrawing socially and spending a lot more time alone\n• Unusual or overly intense ideas, strange feelings, or a lack of feelings \n• Decline in self-care or personal hygiene\n• Disruption of sleep, including difficulty falling asleep and reduced sleep time\n• Difficulty telling reality from fantasy",
    "• Difficulty telling reality from fantasy\n• Confused speech or trouble communicating\n• Sudden drop in grades or job performance\nAlongside these symptoms, a person with psychosis may also experience more general changes in behavior that include: \n• Emotional disruption \n• Anxiety \n• Lack of motivation\n• Difficulty functioning overall\nIn some cases, a person experiencing a psychotic episode may behave in confusing and unpredictable ways and may harm themselves or become threatening or violent toward others. The risk of violence and suicide decreases with treatment for psychosis, so it is important to seek help. If you find that you are experiencing these changes in behavior or notice them in a friend or family member and they begin to intensify or do not go away, reach out to a health care provider. \nThe National Institute of Mental Health (NIMH) has information  on ways to get help and find a health  \ncare provider or access treatment at www.nimh.nih.gov/findhelp .",
    "care provider or access treatment at www.nimh.nih.gov/findhelp . \nIf you or someone you know is struggling or having \nthoughts of suicide, call or text the 988 Suicide & \nCrisis Lifeline  at 988  or chat at 988lifeline.org . In \nlife-threatening situations, call 911.\nUnderstanding  \nPsychosis",
    "What causes psychosis?\nThere is no one cause of psychosis. Psychosis appears to \nresult from a complex combination of genetic risk, differences in brain development, and exposure to stressors or trauma. Psychosis may be a symptom of a mental illness, such as schizophrenia, bipolar disorder, or severe depression. However, a person can experience psychosis and never be diagnosed with schizophrenia or any other disorder. \nFor older adults, psychosis symptoms can be part of a \nphysical or mental illness that emerges later in life. Psychosis can also be a symptom of some diseases of older age, including Parkinson’s disease, Alzheimer’s disease, and related dementias.\nOther possible causes of psychosis include sleep \ndeprivation, certain prescription medications, and the misuse of alcohol or drugs. A mental illness, such as schizophrenia, is typically diagnosed by excluding these other causes. \nA qualified mental health professional (such as a",
    "A qualified mental health professional (such as a \npsychologist, psychiatrist, or social worker) can provide  \na thorough assessment and accurate diagnosis. Find tips to help prepare for and get the most out of your visit at  www.nimh.nih.gov/talkingtips . For additional resources, \nincluding questions to ask your health care provider,  \nvisit the Agency for Healthcare Research and Quality at www.ahrq.gov/questions . \nHow is psychosis treated?\nStudies have shown that it is common for a person to have psychotic symptoms for more than a year before receiving treatment. Reducing this duration of untreated psychosis is critical because early treatment often means better recovery. A qualified psychologist, psychiatrist, or social worker can make a diagnosis and help develop a treatment plan.\nTreatment of psychosis usually includes antipsychotic",
    "Treatment of psychosis usually includes antipsychotic \nmedication. There are several different types of antipsychotic medications, and they have different side effects, so it is important to work with a health care provider to determine the medication that is most effective with the fewest side effects. \nTreatment also often includes other elements. There is \nsubstantial research support for coordinated specialty care, which is a multi-element, recovery-oriented team approach to treating psychosis that promotes easy access to care and shared decision-making among specialists, the person experiencing psychosis, and family members. People experience better outcomes from coordinated specialty care if they begin treatment as soon as possible after psychotic symptoms emerge. \nCoordinated specialty care is now the standard of care for \nearly psychosis, according to “The American Psychiatric Association Practice Guideline for the Treatment of \nPatients With Schizophrenia.”",
    "Clinical trials studying psychosis and related disorders\nNIMH supports a wide range of research, including clinical \ntrials that look at new ways to prevent, detect, or treat diseases and conditions, such as psychosis. The goal of a clinical trial is to determine if a new test or treatment works and is safe. Although people may benefit from being part of a clinical trial, they should know that the primary purpose of a clinical trial is to gain new scientific knowledge so that others can be better helped in the future.\nResearchers at NIMH and around the country conduct \nclinical trials with people experiencing psychosis and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information and to find a clinical trial, visit www.nimh.nih.gov/clinicaltrials . NIMH research on coordinated specialty care",
    "The Recovery After an Initial Schizophrenia Episode (RAISE) research project, supported by NIMH, established coordinated specialty care as an effective treatment for early psychosis and identified important elements for helping people lead productive, independent lives. Learn more about the RAISE studies at www.nimh.nih.gov/raise . \nNIMH continues to prioritize research on and expansion of treatments for early psychosis with the launch of the Early Psychosis Intervention Network (EPINET) in 2019. Through EPINET, NIMH funded awards to establish a national data coordinating center and regional scientific hubs connected to more than 100 coordinated specialty care programs that provide early psychosis treatment in 17 states. The EPINET website provides resources for researchers, health care providers, administrators, and people experiencing psychosis and their families. The website is found at https://nationalepinet.org . \nCoordinated specialty care consists of multiple components:",
    "Coordinated specialty care consists of multiple components:\n• Individual or group psychotherapy  is tailored to a person’s \nrecovery goals. Cognitive and behavioral therapies focus on developing the knowledge and skills necessary to build resilience and cope with aspects of psychosis while maintaining and achieving personal goals.\n• Family support and education  programs  teach  \nfamily members about psychosis as well as coping, communication, and problem-solving skills. Family members who are informed and involved are more prepared to help loved ones through the recovery process.\n• Medication management  (also called pharmacotherapy)",
    "• Medication management  (also called pharmacotherapy) \nmeans tailoring medication to a person’s specific needs by selecting the appropriate type and dose of medication to help reduce psychosis symptoms. Like all medications, antipsychotic medications have risks and benefits. People should talk with a health care provider about side effects, medication costs, and dosage preferences (daily pill or monthly injection).\n• Supported employment and education  services  focus \non return to work or school, using the support of a coach to help people achieve their goals.\n• Case management  provides opportunities for people \nwith psychosis to work with a case manager to address practical problems and improve access to needed support services. \nLearn more about the components of coordinated specialty care at www.nimh.nih.gov/raise .",
    "Learn more about the components of coordinated specialty care at www.nimh.nih.gov/raise .  \nPeople with psychosis should be involved in their treatment planning and consulted in making decisions about their care. Their needs and goals should drive the treatment programs, which will help them stay engaged throughout the recovery process.\nIt is important to find a mental health professional who is \ntrained in psychosis treatment and who makes the person feel comfortable. With early diagnosis and appropriate treatment, it is possible to recover from psychosis. Some people who receive early treatment never have another psychotic episode. For other people, recovery means the ability to lead a fulfilling and productive life, even if psychotic symptoms sometimes return.",
    "NIH Publication No. 23-MH-8110 \nRevised 2023How can I find help?\nNIMH does not endorse specific psychosis clinics or \nevaluate individual practitioners’ professional qualifications or competencies. However, several organizations are available to assist in finding a treatment program in your area. The following is not a comprehensive list of all programs, and a program’s inclusion on the list does not constitute an endorsement by NIMH.\n• Early Assessment and Support Alliance (EASA) : \nEASA offers a National Early Psychosis Directory  that lists early psychosis programs across the  United States. The directory is available at  www.easacommunity.org/national-directory.php . \nFor more information about EASA, visit  www.easacommunity.org . \n• Early Psychosis Intervention Network (EPINET) :",
    "• Early Psychosis Intervention Network (EPINET) : \nEPINET’s Early Psychosis Intervention Network Clinics provide treatment and services to individuals with early psychosis across 17 states. The list of states with early psychosis clinics is found at  https://nationalepinet.org/epinet-clinics . \nFor more information about EPINET, visit  https://nationalepinet.org .\n• National Alliance on Mental Illness (NAMI) : The NAMI \nHelpLine  can connect you with the NAMI office in your \nstate and help you find programs close to home.  Find ways to get help at www.nami.org/help . \nAlso, you can talk with someone at the NAMI HelpLine, Monday–Friday, 10:00 a.m.–10:00 p.m. ET, by: \n■ Calling 1-800-950-NAMI (6264)\n■ Texting “HelpLine” to 62640\n■ Emailing helpline@nami.org\nFor more information about NAMI, visit www.nami.org .\n• Psychosis-Risk and Early Psychosis Program Network (PEPPNET) : PEPPNET supports an Early",
    "• Psychosis-Risk and Early Psychosis Program Network (PEPPNET) : PEPPNET supports an Early \nPsychosis Program Directory that provides services to people at risk for or experiencing early psychosis. The directory is available at https://med.stanford.edu/peppnet/interactivedirectory.html . \nFor more information about PEPPNET, visit  https://med.stanford.edu/peppnet . \n• Substance Abuse and Mental Health Services Administration (SAMHSA) : SAMHSA has an  \nEarly Serious Mental Illness Treatment Locator \nfor finding mental health treatment facilities and \nprograms. Find a facility in your state at  www.samhsa.gov/esmi-treatment-locator . \nFor more information about SAMHSA, visit  \nwww.samhsa.gov . \nFor more information\nMedlinePlus (National Library  \nof Medicine)\nhttps://medlineplus.gov   \n(en español: https://medlineplus.gov/\nspanish )\nClinicalTrials.gov\nwww.clinicaltrials.gov   \n(en español: https://salud.nih.gov/\ninvestigacion-clinica ) Reprints",
    "www.clinicaltrials.gov   \n(en español: https://salud.nih.gov/\ninvestigacion-clinica ) Reprints\nThe information in this publication is in the public domain and may be reproduced or copied without permission. However, you may not reuse or copy the images in the publication. If you use our information, please cite the National Institute of Mental Health. To learn more about reusing NIMH content, refer to www.nimh.nih.gov/reprints .National Institute of Mental HealthOffice of Science Policy, Planning, and Communications  \nPhone: 1-866-615-6464  \nEmail: nimhinfo@nih.gov  \nwww.nimh.nih.gov  \nFollow NIMH on  \nSocial Media @NIMHgov",
    "5Action Steps to Help Someone \nHaving Thoughts of Suicide\nWe can all take steps to help prevent suicide. Knowing the warning signs \nfor suicide and how to get help can save lives.\nHere are 5 steps you can take to #BeThe1To help someone who is having \nthoughts of suicide:\n1. ASK:\n“Are you thinking about suicide?” It’s not an easy question to ask, but it can help \nstart a conversation. Studies show that  asking people  if they are suicidal does not \nincrease suicidal behavior or thoughts.\n2. BE THERE: \nListening without judgment is key to learning what the person is thinking and feeling. Research suggests  acknowledging and talking about suicide  may reduce \nsuicidal thoughts.\n3. HELP KEEP THEM SAFE: \nReducing access to highly lethal items or places can help prevent suicide. Asking the person if they have a plan and making lethal means less available or less deadly can help the person stay safe when suicidal thoughts arise.\n4. HELP THEM CONNECT:",
    "4. HELP THEM CONNECT:\nConnecting the person with the 988 Suicide & Crisis Lifeline ( call or text 988 ) and \nother community resources can give them a safety net when they need it. You can also help them reach out to a trusted family member, friend, spiritual advisor, or mental health professional.\n5. FOLLOW UP: \nStaying in touch with the person after they have experienced a crisis or been discharged from care can make a difference. Studies show that supportive, ongoing contact  can play an important role in suicide prevention.\nFor more information on suicide prevention:\nwww.nimh.nih.gov/suicideprevention\nwww.bethe1to.com\nNIMH Identifier No. OM 24-4315 \nRevised 2024",
    "• Generally is a response to \nan external cause, such as taking a big test or arguing with a friend..\n• Goes away once the situation is resolved.  \n• Can be positive or negative. For example, it may inspire you to meet a deadline, or it may cause you to lose sleep.• Generally is internal,  \nmeaning it’s your \nreaction to stress.\n• Usually involves a \npersistent feeling of \napprehension or \ndread that doesn’t go \naway, and that interferes \nwith how you live your life.\n• Is constant, even if there \nis no immediate threat. Feeling overwhelmed? Read this fact sheet to learn whether it’s \nstress or anxiety, and what you can do to cope.  \nIs it stress or anxiety? \nLife can be stressful—you may feel stressed about \nperformance at school, traumatic events (such as a pandemic, a natural disaster, or an act of violence), or a life change. Everyone feels stress from time to time.\nWhat is stress? Stress is the physical or mental",
    "What is stress? Stress is the physical or mental \nresponse to an external cause, such as having a lot of homework or having an illness. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time.\nWhat is anxiety? Anxiety is your body’s reaction to \nstress and can occur even if there is no current threat. If that anxiety doesn’t go away and begins to interfere with your life, it could affect your health. You could experience problems with sleeping, or with your immune, digestive, cardiovascular, and reproductive systems. You also may be at higher risk for developing a mental illness such as an anxiety disorder or depression. More information about anxiety disorders is available at www.nimh.nih.gov/anxietydisorders . \nSo, how do you know \nwhen to seek help? \nStress vs. AnxietyI’M SO \nSTRESSED \nOUT! \nStressBoth Stress  \nand Anxiety Anxiety\nBoth stress and anxiety \ncan affect your mind and  \nbody. You may experience \nsymptoms such as:",
    "Both stress and anxiety \ncan affect your mind and  \nbody. You may experience \nsymptoms such as: \n• Excessive worry\n• Uneasiness\n• Tension\n• Headaches or body pain\n• High blood pressure\n• Loss of sleepFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH",
    "More Resources\n• NIMH: Anxiety Disorders \n(www.nimh.nih.gov/anxietydisorders )\n• NIMH: Caring for Your Mental Health (www.nimh.nih.gov/mymentalhealth )\n• NIMH: Child and Adolescent Mental Health  (www.nimh.nih.gov/children )• NIMH: Tips for Talking With a Health Care Provider About Your Mental Health (www.nimh.nih.gov/talkingtips )\n• Centers for Disease Control and Prevention: Anxiety and Depression in Children  \n(www.cdc.gov/childrensmentalhealth/depression.html )\nIt’s important to manage your stress.  \nEveryone experiences stress, and sometimes that stress can feel overwhelming. \nYou may be at risk for an anxiety disorder if it feels like you can’t manage the stress and if the symptoms of your stress: \n• Interfere with your everyday life.\n• Cause you to avoid doing things.\n• Seem to be always present. \nNIH Publication No. 20-MH-8125Follow NIMH on  \nSocial Media @NIMHgovwww.nimh.nih.gov Coping With Stress  \nand Anxiety\nLearning what causes or triggers your stress and what",
    "and Anxiety\nLearning what causes or triggers your stress and what \ncoping techniques work for you can help reduce your anxiety and improve your daily life. It may take trial and error to discover what works best for you. Here are some activities you can try when you start to feel overwhelmed: \n• Keep a journal. \n• Download an app that provides relaxation exercises \n(such as deep breathing or visualization) or tips for practicing mindfulness, which is a psychological process of actively paying attention to the present moment.\n• Exercise, and make sure you are eating healthy, regular meals. \n• Stick to a sleep routine, and make sure you are getting enough sleep. \n• Avoid drinking excess caffeine such as soft drinks or coffee. \n• Identify and challenge your negative and unhelpful thoughts. \n• Reach out to your friends or family members who help you cope in a positive way.Recognize When You  \nNeed More Help \nIf you are struggling to cope, or the symptoms of",
    "Need More Help \nIf you are struggling to cope, or the symptoms of \nyour stress or anxiety won’t go away, it may be time to talk to a professional. Psychotherapy (also called talk therapy) and medication are the two main treatments for anxiety, and many people benefit from a combination of the two. \nIf you or someone you know has a mental illness, is \nstruggling emotionally, or has concerns about their mental health, there are ways to get help. Find more information on the National Institute of Mental Health (NIMH) website at  www.nimh.nih.gov/findhelp .\nIf you are in immediate distress or are thinking about hurting yourself, call or text the 988 Suicide & Crisis Lifeline at 988  or chat at 988lifeline.org .",
    "CELEBRATING\nYEARS\nNational Institute  \nof Mental Health\nTransforming the Understanding \nand Treatment of Mental Illnesses\n\nVision\nNIMH envisions a world in which mental \nillnesses are prevented and cured.\nAbout NIMH\nThe National Institute of Mental Health (NIMH) is the lead federal agency for research on mental disorders. NIMH is one of the 27 Institutes and Centers that make up the National Institutes of Health (NIH), the largest biomedical research agency in the world. NIH is part of the U.S. Department of Health and Human Services (HHS).\nMission\nNIMH aims to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way forprevention, recovery,and cure.",
    "On July 3, 1946, President Harry S. Truman signed \nthe National Mental Health Act. In addition to its broad purpose of improving “the mental health of the people of the United States,” the act enabled the founding, three years later, of the National Institute of Mental Health, now part of the National Institutes of Health.\nFor 75 years, NIMH has been at the forefront of mental health \nresearch. Our mission is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. The institute’s influence is \nwidespread; NIMH-supported research has played a pivotal role in advancing our understanding of the brain, developing groundbreaking treatments and therapies, and improving the quality and availability of mental health care.\nNumerous NIMH-funded advances achieved over the last 75 years made it challenging to decide",
    "Numerous NIMH-funded advances achieved over the last 75 years made it challenging to decide \nwhat to highlight as we celebrate this milestone anniversary. As such, we aim to broadly present our history and a sampling of basic, translational, and clinical research—from research aimed at understanding how the brain impacts behavior to translational efforts to uncover novel treatment targets to clinical studies testing innovative interventions in real-world settings. There are many impactful stories of discovery driven by dedicated scientists here at NIMH and across the country, and we will continue to share them beyond this anniversary year.\nWe owe a great deal of thanks to the broader scientific, advocacy, legislative, and professional",
    "We owe a great deal of thanks to the broader scientific, advocacy, legislative, and professional \ncommunities and the public for their instrumental support. I also want to personally thank the many devoted NIMH employees, past and present, and our collaborators at other NIH institutes, centers, and offices for their enthusiastic commitment to NIMH’s mission. Finally, I want to thank everyone who has contributed to this celebration by sharing their time, expertise, and experiences. It is an honor and a privilege to serve as the director of a federal agency with such an inspirational and exciting mission.\nI invite everyone to join us as we reflect on the successes and challenges of the past 75 years \nand look forward to the advances to come.\nJoshua A. Gordon, M.D., Ph.D.\nDirector, National Institute of Mental HealthJoshua A. Gordon, M.D., Ph.D.\nDirector of NIMH\nForeword",
    "75 Years of Progress\nand Landmark Events\nThe National Institute of Mental Health (NIMH) was established in 1949, \nspurred by U.S. Public Health Service efforts predating World War II and reports of widespread mental illness among service members. NIMH’s \noriginal mission had three main components: to train mental health \nprofessionals; to foster the spread of community-based mental health services; and to promote clinical, behavioral, and biological mental health research. The institute has seen many changes over the past 75 years, including shifts in organizational structure and administrative control and rapid developments in science and technology. Throughout this time, NIMH has maintained an unwavering commitment to guiding the nation as the lead federal agency for research on mental disorders.\nThis booklet provides an overview of NIMH’s 75-year history, charting a timeline",
    "This booklet provides an overview of NIMH’s 75-year history, charting a timeline \nof key events and major research programs and public health initiatives. The timeline includes a selection of pivotal discoveries made by NIMH researchers and grantees, many of whom have received Nobel Prizes, Lasker Awards, and other accolades for their groundbreaking scientific achievements. The timeline also tracks NIMH’s evolving research priorities and efforts to balance basic research with translational work to advance treatments for mental disorders and address mental health disparities. For a more comprehensive view, read the “Learn More About NIMH History” section at the back of this booklet and visit www.nimh.nih.gov/75years.\n1",
    "On July 3, President Harry S. Truman signed the \nNational Mental Health Act, which called for establishing a National Institute of Mental Health.\nPresident Harry S. Truman. Credit Frank Gatteri, United States Army. \nCourtesy of Harry S. Truman Library & Museum.\nOn August 15, U.S. Surgeon General Thomas Parran, Jr., M.D., and several nationally \nknown psychiatrists attended the first meeting of the National Advisory Mental Health Council. The group was tasked with advising NIMH on its policies and activities.\nOn July 1, the U.S. Public Health Service Division of Mental Hygiene awarded \nthe first mental health research grant, “Basic Nature of the Learning Process,” to Winthrop N. Kellogg, Ph.D., of Indiana University.\nOn April 1, NIMH was formally established under the direction of psychiatrist and public health advocate Robert H. Felix, M.D., as one of the first institutes of the National Institutes of Health (NIH).\n1946",
    "1946\n2There is also a special need for research on mental diseases and abnormalities. We have done pitifully little about mental \nillnesses. Accurate statistics are lacking, but there is no doubt that there are at least two million persons in the United States who are mentally ill and that as many as 10 million will probably need hospitalization for mental illness for some period in the course of their lifetime. A great many of these persons would be helped by proper care.\nPresident Harry S. Truman\nSpecial Message to Congress Recommending a ComprehensiveHealth Program“\n”\n1947\n1949\nRobert H. Felix, M.D., NIMH director from 1949 to 1964.Courtesy of National Library of Medicine.",
    "31951\n1952In June, the first scientific director of NIMH, Seymour Kety, M.D., Ph.D., began \nbuilding a joint basic intramural research program for NIMH and the newly created National Institute of Neurological Diseases and Blindness (NINDB). This research program evolved into the NIMH Intramural Research Program, the internal research division of NIMH. As of 2023, the NIMH Intramural Research Program comprised more than 650 staff and more than 40 research groups conducting basic, clinical, and translational research to advance understanding of the diagnosis, causes, treatment, and prevention of mental disorders.\nOn December 20, psychiatrist Robert A. Cohen, M.D., created a joint NIMH–\nNINDB clinical research program in time for the opening of the NIH Clinical Center in July 1953.\nOn July 28, the Mental Health Study Act of 1955 (Public Law [P.L.] 84-182) called for \n“an objective, thorough, and nationwide analysis and reevaluation of the human and economic problems of mental illness.”",
    "On August 2, Congress passed the Health Amendments Act of 1956 (P.L. 84-911). \nTitle V of the legislation allowed NIMH to award “special project grants” about mental health. In expanding NIMH’s existing mandate, the act enabled NIMH to be more involved in community-based mental health efforts and programs.\nOn October 16, NIMH created the Psychopharmacology Service Center to",
    "On October 16, NIMH created the Psychopharmacology Service Center to \ncoordinate the large-scale testing of new compounds. The congressionally funded effort, led by Jonathan O. Cole, M.D., spurred the discovery of the blockbuster drugs chlorpromazine and meprobamate to treat mental disorders. The center later evolved into the Early Clinical Drug Evaluation Unit, a collaborative program capable of conducting large nationwide clinical trials. This program, later renamed the New Clinical Drug Evaluation Unit, held an annual meeting that became a critical meeting in this domain, bringing together NIH researchers, academic investigators, industry scientists, U.S. and international regulators, and other professionals working in various aspects of drug development and clinical trials. Output from the program influenced the evolution of treatment research and the development of new treatments and treatment strategies. 1955\n1956",
    "The report, Action for Mental Health, assessed mental health conditions and \nresources throughout the United States “to arrive at a national program that would approach adequacy in meeting the individual needs of the mentally ill people of America.” The report commanded the attention of President John F. Kennedy, who established a cabinet-level interagency committee to examine the recommendations and determine an appropriate federal response.1961\n4\nTraining Mental Health Professionals",
    "4\nTraining Mental Health Professionals\nIn 1941, there were only 3,000 psychiatrists in the United States, nowhere near enough to provide care on the scale Dr. Felix envisioned. In 1948, NIMH began awarding grants to academic research and medical school programs, and through the next decade, the bulk of NIMH funding went toward these training programs. The grants were heavily weighted toward psychiatry—Dr. Felix even devised a funding formula: 40% went to psychiatry, and 20% each went to psychology, social work, and nursing. Due largely to NIMH efforts, by 1960, the number of psychiatrists in America exceeded 10,000. The NIMH mission later refocused on supporting research and the training of researchers; the institute no longer directly supports the training of mental health professionals.\nNIMH Efforts Greatly Increased the Number of U.S. Psychiatrists After WWII200040006000800010000\n1941 19603,000>10,000",
    "5On February 5, President Kennedy submitted a special message to Congress—the \nfirst presidential message to the legislature on mental health issues. Energized by the president’s focus, Congress passed the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963 (P.L. 88-164) on October 31, beginning a new era in federal support for mental health services. NIMH assumed responsibility for monitoring the nation’s community mental health center programs.\nA provision in the Social Security Amendments of 1965 (P.L. 89-97) provided funds \nand a framework for a new Joint Commission on the Mental Health of Children to recommend national action for child mental health. The Community Mental Health Centers Act Amendments of 1965 (P.L. 89-105) also passed this year, which authorized grants to help pay the salaries of professional and technical personnel in federally funded community mental health centers.\n19651963",
    "19651963\nMost of the major diseases of the body are beginning to give ground in man’s increasing struggle to find their cause and cure. But the public understanding, treatment, and prevention of mental disabilities have not made comparable progress since the earliest days of modern history…This situation has been tolerated far too long. It has troubled our national conscience—but only as a problem unpleasant to mention, easy to postpone, and despairing of solution.\nPresident John F. Kennedy\nSpecial Message to Congress on Mental Illness and Mental Retardation\nPresident John F. Kennedy signed the Mental Retardation Facilities and Community Mental Health Centers Construction Act on October 31, 1963. Credit: Cecil Stoughton. White House Photographs. Courtesy of John F. Kennedy Presidential Library and Museum, Boston, Massachusetts.\n“\n”",
    "In response to President Lyndon B. Johnson’s pledge to apply scientific research \nto social challenges, NIMH refocused its efforts on fighting specific mental health problems. The institute established centers for research, training, and services covering topics such as schizophrenia, substance use, suicide prevention, crime, and child and family mental health. The National Center for Prevention and Control of Alcoholism was also established due to the emerging public recognition of alcoholism as a disease.\nOn January 1, NIMH was separated from NIH by executive order and made an \nindependent division within the U.S. Public Health Service. However, the NIMH Intramural Research Program, which conducted studies in the NIH Clinical Center and other NIH facilities, remained at NIH under an agreement for joint administration between NIH and NIMH.\n61966\n1967\nCognitive Behavioral Therapy",
    "61966\n1967\nCognitive Behavioral Therapy\nIn the 1960s, Aaron Beck, M.D., and Albert Ellis, Ph.D., conducted NIMH-supported research that led to the development of cognitive therapy, now known as cognitive behavioral therapy (CBT). CBT began to gain widespread adoption as a form of psychotherapy in the 1970s and 1980s. During this time, studies demonstrated the effectiveness of CBT for treating various mental disorders, including depression, anxiety, and phobias.\nSince then, CBT has become one of the most widely used forms \nof psychotherapy, with numerous research studies supporting its effectiveness. It is often used in combination with other treatments, such as medication, and has been adapted for use in various settings, including schools, hospitals, and community clinics.\nOn September 29, 2006, Dr. Beck received the prestigious Albert \nLasker Basic Medical Research Award for the development of CBT, which transformed the understanding and treatment of many mental disorders.",
    "7On August 13, U.S. Department of Health, Education, and Welfare Secretary \nJohn W. Gardner, Ph.D., transferred administrative control of St. Elizabeths Hospital—the federal government’s only civilian psychiatric hospital—to NIMH. Research was an important part of the work of St. Elizabeths through its Clinical Pharmacology Research Center, which made significant contributions to neurological and clinical research.\nOn April 1, NIMH became a component of the Health Services and Mental Health \nAdministration within the U.S. Public Health Service.1967\nSt. Elizabeths Hospital in Washington, D.C., was home to NIMH’s pathbreaking Clinical \nPharmacology Research Center, which was founded in 1958 by Joel Elkes, M.D. (pictured front row, second from left). NIMH continued to conduct research on the hospital campus until 1999. Credit: Joel Elkes. Courtesy of Office of NIH History & Stetten Museum.\n1968",
    "8Impact of the Civil Rights Movement\nAfter the passage of the 1964 Civil Rights Act, a group of Black psychiatrists \nbecame determined to meet the challenge of institutional racism head-on. They considered racism a type of mental illness and argued that Black Americans were underrepresented in and underserved by NIMH.\nThis group of Black psychiatrists—led by Chester M. Pierce, M.D., at \nHarvard University and James P. Comer, M.D., M.P.H., at Yale University—began a series of contentious negotiations with NIMH leadership and other influential White psychiatrists. This culminated in a confrontation between the newly organized Black Psychiatrists of America and White attendees at the May 1969 American Psychiatric Association convention. The Black Psychiatrists of America demanded a center dedicated to Black mental health at NIMH, prioritization of research and training programs for Black psychiatrists, and creation of new mental health programs forBlack Americans.",
    "Dr. Comer, UCLA psychiatrist J. Alfred Cannon, M.D., M.P.H., and NIMH \nDirector Bertram S. Brown, M.D., developed a framework for the proposed tenth NIMH center. The Center for Minority Group Mental Health Programs was established in the fall of 1970 as NIMH’s first official effort to increase the representation of people from minority groups among extramural awardees and intramural positions. By 1971, the center had launched a minority fellowship program and begun awarding research and training grants.\nProminent Black psychiatrists James P. Comer, M.D., M.P.H. (right), and J. Alfred Cannon, \nM.D. (second from right), worked with NIMH to create the Center for Minority Group MentalHealth Programs in 1970. Courtesy of Center for the History of Medicine, Harvard University.",
    "91970\nJulius Axelrod, Ph.D. Courtesy of National Library of Medicine.On April 6, the U.S. Food and Drug Administration (FDA) approved lithium as a \ntreatment for mania, a feature of bipolar disorder. This treatment, informed by NIMH-supported research, led to sharp drops in inpatient days and suicide rates among people with bipolar disorder and reduced economic costs associated with the illness. The FDA later approved lithium for the maintenance treatment of bipolar disorder. \nOn October 15, NIMH intramural researcher Julius Axelrod, Ph.D., and two other",
    "On October 15, NIMH intramural researcher Julius Axelrod, Ph.D., and two other \nresearchers received the Nobel Prize in Physiology or Medicine for research on the chemistry of nerve transmission. Dr. Axelrod’s work established that norepinephrine was inactivated through “reuptake” by the same cells that secreted it. The discovery led to the development of selective serotonin reuptake inhibitors (SSRIs), the first blockbuster neuropharmacological medication since the 1950s. SSRIs are a class of medications commonly used as antidepressants. They work by increasing brain levels of serotonin, a neurotransmitter involved in regulating mood, appetite, and sleep.",
    "On December 31, the Comprehensive Alcohol Abuse and Alcoholism Prevention, \nTreatment, and Rehabilitation Act (P.L. 91-616) established the National Institute on Alcohol Abuse and Alcoholism (NIAAA) within NIMH.\nOn March 21, Congress passed the Drug Abuse Office and Treatment Act (P.L. \n92-255), which called for the future establishment of a National Institute on DrugAbuse (NIDA) within NIMH.\nNIMH went through a series of organizational moves. The institute temporarily \nrejoined NIH on July 2 with the abolishment of the Health Services and Mental Health Administration. The Alcohol, Drug Abuse, and Mental Health Administration—composed of NIAAA, NIDA, and NIMH—was established as the successor organization.\nOn May 14, the Alcohol, Drug Abuse, and Mental Health Administration was officially \nestablished when President Richard Nixon signed the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act Amendments of 1974 (P.L. 93-282).",
    "The Community Mental Health Centers Amendments of 1975 outlined requirements \nfor national standards, quality assurance programs, and data collection, which set the stage for performance criteria in community mental health centers.\nOn February 17, President Jimmy Carter established the President’s Commission on \nMental Health by executive order. President Carter charged the commission with reviewing the nation’s mental health needs and making recommendations to the president on how best to meet these needs. First Lady Rosalynn Carter served as the honorary chair of the commission.\nOn April 27, the President’s Commission on Mental Health submitted its final",
    "On April 27, the President’s Commission on Mental Health submitted its final \nreport to President Carter. The report contained more than 100 recommendations for expanding existing programs and creating new ones to make the community mental health center program more flexible and to extend mental health services. The report’s appendices included three additional volumes with recommendations from more than 20 task panels focused on a wide range of mental health and substance use issues.1970\n101972\n1973\n1974\n1975\n1977\n1978",
    "11In October, NIMH released preliminary results from its Epidemiological Catchment \nArea Survey. Most notably, the survey found that nearly one in five Americans suffered from a diagnosable psychiatric disorder within any six-month period. The effort, underway since 1977, was conducted by research teams at five universities and looked at rates of mental disorders in five cities. The extensive survey allowed for the accurate categorization of specific disorders in a general population for the first time.\nOn October 7, President Carter signed the Mental Health Systems Act (P.L. 96-\n398). The act created a complex federal, state, and local partnership focused on preventing mental illnesses. It expanded the Community Mental Health Center program and extended help to “chronically mentally ill individuals, children and youth, elderly individuals, racial and ethnic minorities, women, poor persons, and persons in rural areas.”",
    "NIMH participated in developing the U.S. Surgeon General’s Report, Toward a \nNational Plan for the Chronically Mentally Ill, a sweeping effort to improve services and fine-tune various federal entitlement programs for those with severe, persistent mental disorders.\nOn August 13, President Ronald Reagan signed the Omnibus Budget Reconciliation \nAct of 1981 (P.L. 97-35). This act repealed the Mental Health Systems Act and consolidated the treatment and rehabilitation service programs of the Alcohol, Drug Abuse, and Mental Health Administration into a single block grant that enabled each state to administer its allocated funds. With the repeal of most of the community mental health legislation and the establishment of block grants, the federal role shifted to providing technical assistance to increase the capacity of state and local mental health service professionals.\nOn November 18, NIMH intramural researcher Louis Sokoloff, M.D., Ph.D., received",
    "On November 18, NIMH intramural researcher Louis Sokoloff, M.D., Ph.D., received \nthe Lasker Basic Medical Research Award, considered the “American Nobel Prize” of clinical medical research. Previous researchers had found evidence for changing glucose levels in the brain but could not link those changes to specific brain regions. Dr. Sokoloff developed a noninvasive technique to track the movement of a radioactive analog of glucose in the brain, which allowed researchers to measure glucose metabolism and map brain function. This technique paved the way for the development of positron emission tomography (PET) imaging of the living brain.1980\n1981",
    "12In research supported by NIMH, zoologist Fernando Nottebohm, Ph.D., discovered \nthe formation of new neurons in the brains of adult songbirds. This evidence of neurogenesis (the process by which new neurons are formed in the brain) opened an exciting and clinically promising new line of research in brain science. It was 15 years, however, before investigators found evidence for continued neurogenesis in the brains of adult humans.\nResearchers in the NIMH Intramural Research Program published one of the",
    "Researchers in the NIMH Intramural Research Program published one of the \nearliest studies of seasonal affective disorder. The seminal study, which described patients who experienced depressive symptoms that emerged during the fall and winter and went away during the spring and summer, provided the first working definition of the disorder. Norman Rosenthal, M.D., and Thomas Wehr, M.D., both in the NIMH Clinical Psychobiology Branch, led the research. FrederickGoodwin, M.D., NIMH scientific director and chief of intramural research, wasalso a contributor. Study results also showed that light therapy had a robustantidepressant effect, effectively reducing depressive symptoms in people withseasonal affective disorder.\nOn October 1, the U.S. Department of Health and Human Services transferred \nadministrative control of St. Elizabeths Hospital from NIMH to the city of Washington, D.C. NIMH retained research facilities on the hospital grounds.",
    "The FDA approved SSRIs for treating depression. Building on the pioneering work \nof Dr. Axelrod and others at NIMH, researchers demonstrated the effectiveness of SSRIs as antidepressant medications. In the decades following FDA approval, SSRIs became one of the most widely prescribed antidepressants in the world due in part to their relatively mild side effects compared to other medications.1983\n1984\n1987",
    "13On July 25, in response to reports by the advisory councils of NIMH and the \nNational Institute of Neurological Disorders and Stroke, President George H.W. Bush signed a declaration designating the 1990s the “Decade of the Brain.”\nOn September 25, NIMH staff, members of Congress, and mental health advocates \nattended a ceremony for the dedication of the NIMH Neuroscience Center andthe NIMH Neuropsychiatric Research Hospital, located on the St. Elizabeths Hospital grounds.1989\nThe human brain, a three-pound mass of interwoven nerve cells that controls our activity, is one of the most magnificent—and mysterious—wonders of creation. The seat of human intelligence, interpreter of senses, and controller of movement, this incredible organ continues to intrigue scientists and layman alike.\nPresident George H.W. Bush\nProclamation by the President of the United States of America ”",
    "President George H.W. Bush\nProclamation by the President of the United States of America ”\nNIMH Director Lewis L. Judd, M.D., worked closely with members of Congress to have the 1990s dubbed the “Decade of the Brain.” From left are Senator Pete Domenici, Senator Donald Riegle Jr., President George H.W. Bush, Health and Human Services Secretary Louis Wade Sullivan, M.D., Dr. Judd, and Representative Silvio O. Conte. Courtesy of George Bush Presidential Library and Museum.\n“",
    "Psychologist Marsha M. Linehan, Ph.D., and colleagues published findings from \ntheir NIMH-supported research on dialectical behavior therapy (DBT), a new treatment approach for people with borderline personality disorder. DBT enhanced standard change-oriented techniques from cognitive behavioral therapy with concepts of acceptance and validation of one’s present situation and emotional state. DBT also focused on helping people build skills to manage intense emotions, reduce self-destructive behaviors, and improve relationships. This study and later research showed that adults who received DBT engaged in fewer and less severe suicidal behaviors, had fewer inpatient days in the hospital, and were more likely to stay in therapy than those who received standard care. Later studies showed DBT to reduce suicidal behavior in adolescents. Later in her career, Dr. Linehan discussed her lived experience and how it helped inform novel strategies to treat mental illness and reduce suicide risk.",
    "On July 10, President Bush signed the ADAMHA Reorganization Act (P.L. 102-\n321), abolishing the Alcohol, Drug Abuse, and Mental Health Administration. The research components of NIMH, NIAAA, and NIDA rejoined NIH, thereby reuniting NIMH with the leading medical research agency in the United States and ensuring the future of neuroscience and mental health research. The service components of each institute became part of a new U.S. Public Health Service agency—the Substance Abuse and Mental Health Services Administration. Within NIMH, new offices were created to support research on prevention, special populations, rural mental health, and HIV/AIDS. \nNIMH coordinated a multi-institute effort to launch the Human Brain Project, a \ncomprehensive neuroscience database accessible via an international computer network through cutting-edge imaging, computer, and network technologies.\nOn October 3, President Bill Clinton established the National Bioethics Advisory",
    "On October 3, President Bill Clinton established the National Bioethics Advisory \nCommission. The commission issued the resulting report, Research Involving Persons With Mental Disorders That May Affect Decision-Making Capacity, in 1999. This report informed NIMH policies to safeguard and improve protections for human participants in clinical mental health research.\nAt the request of Congress, NIH created the NIH Autism Coordinating Committee to \nincrease the quality of research on autism spectrum disorder. The director of NIMH was made co-chair of the committee along with the director of the National Institute of Child Health and Human Development.1992\n141991\n1993\n1996\n1997",
    "1998NIMH launched several long-term, large-scale, multisite, community-based \nclinical studies to determine the effectiveness of certain treatments. Specifically, \nthe studies focused on treatments for depression, treatments for bipolar disorder, \nand antipsychotic medications as part of treatment for schizophrenia and for \nthe management of psychosis and behavioral symptoms associated with \nAlzheimer’s disease.\n1999The NIMH  Neuroscience C enter and NIMH Neuropsychiatric Research Hospital were \nrelocated from St. Elizabeths Hospital grounds in Washington , D.C., to the NIH campus \nin Bethesda, Maryland, in response to the recommendations of the 1996 review of \nthe NIMH Intramural R\nesearch Program by the Intramural Planning Committee.\nIn June, NIMH developed materials and helped organize the first White House\n \nConference on Mental Health in Washington, D.C. The conference brought",
    "Conference on Mental Health in Washington, D.C. The conference brought \ntogether national leaders, mental health scientific and clinical personnel, patients, and consumers to discuss needs and opportunities to understand and treat mental disorders.\nIn July, U.S. Surgeon General David Satcher, M.D., Ph.D., released The Surgeon \nGeneral’s Call to Action to Prevent Suicide. Another report, Mental Health: A Report of the Surgeon General, followed in December. NIMH and other federal agencies collaborated to prepare both landmark reports.\n15\nAerial shot of the NIH campus. Courtesy of Office of NIH History and Stetten Museum.",
    "In December, the main findings from the Multimodal Treatment of ADHD study were \npublished. NIMH sponsored the multisite study to compare the leading treatment approaches for attention-deficit/hyperactivity disorder (ADHD), one of the most common developmental disorders in childhood. Study participants included nearly 600 children, ages 7-9 years, seen at six study sites. In contrast to previous short-term studies, this study examined treatment effects for up to 14 months. Results showed that a combination treatment approach that included both medication and behavior therapy and a medication-only approach were both generally more effective in reducing ADHD symptoms compared to behavioral treatment alone or routine community care. The study also showed that these benefits lasted for as long as 14 months. Subsequent analyses and publications examined the impact of the interventions on various areas of functioning and the long-term course of youth in the study.",
    "On October 9, researchers Eric Kandel, M.D., Ph.D., Paul Greengard, Ph.D., and \nArvid Carlsson, M.D., Ph.D., received the 2000 Nobel Prize in Physiology or Medicine for their respective research on the functioning of signal transduction proteins in learning, memory, and movement. Dr. Kandel and Dr. Greengard conducted NIMH-supported research for more than 30 years. Dr. Kandel, who worked in the NIMH Intramural Research Program in the 1950s, received the prize for his research on the functional modification of synapses, which allow neurons to communicate in the brain. His work established that the formation of memories is a consequence of short- and long-term changes in the biochemistry of neurons and showed that these changes occur at the level of synapses.\nThe Nobel Prize recognized Dr. Greengard’s discovery that dopamine and several",
    "The Nobel Prize recognized Dr. Greengard’s discovery that dopamine and several \nother transmitters can alter the functional state of neuronal proteins. These findings made it clear that signaling between neurons could alter their function not only in the short term but also in the long term. In addition, Dr. Greengard discovered that subsequent environmental signals could reverse such changes.\nOn October 17, President Clinton signed the Children’s Health Act of 2000 (P.L. 106-\n310), which created the Interagency Autism Coordinating Committee to coordinate all autism-related efforts within the U.S. Department of Health and Human Services. By 2001, NIMH had been designated to lead implementation of the Interagency Autism Coordinating Committee, with the NIMH director as the committee chair.\n161999\n2000",
    "17On November 3, Nancy Andreasen, M.D., Ph.D., a psychiatrist whose research \nwas supported by NIMH for many years, received the National Medal of Science for her groundbreaking work in schizophrenia that joined behavioral science with neuroscience and neuroimaging.\nNIMH and other federal agencies collaborated to prepare a report on the Surgeon \nGeneral’s Conference, Children’s Mental Health: A National Action Agenda. Released by Surgeon General Dr. Satcher, this report indicated that the poor mental health of many children and adolescents in the United States represented a national public health crisis. The National Action Agenda outlined goals and strategies to improve services for children and adolescents with mental and emotional disorders.\nIn September, NIMH published a national conference report, Mental Health and",
    "In September, NIMH published a national conference report, Mental Health and \nMass Violence: Evidence-Based Early Psychological Intervention for Victims/Survivors of Mass Violence: A Workshop to Reach Consensus on Best Practices. Although most people recover from a traumatic event over time, the report indicated that early psychological intervention guided by qualified mental health professionals could reduce the harmful psychological and emotional effects of exposure to mass violence. NIMH collaborated with the U.S. Department of Defense, other federal agencies, and the American Red Cross to prepare this report.\nNIMH established the Limited Access Data Repository, the institute’s first effort to",
    "NIMH established the Limited Access Data Repository, the institute’s first effort to \nprovide an infrastructure that could support data sharing among extensive NIMH-funded clinical studies. The repository served as a platform for researchers to access datasets to conduct secondary analyses until 2017, when data from those clinical trials were moved to the NIMH Data Archive.2000\n2002\n2003",
    "NIMH’s large-scale practical clinical trial—the Treatment of Adolescent Depression \nStudy—published significant first-phase results on the most effective treatment for adolescents with depression. The study showed that a combination of cognitive behavioral therapy and the medication fluoxetine (the only FDA-approved antidepressant for children and adolescents at the time) was most effective at treating depression over 12 weeks.\nThe study’s principal investigator, John March, M.D., M.P.H., presented additional",
    "The study’s principal investigator, John March, M.D., M.P.H., presented additional \nresults to NIMH’s National Advisory Mental Health Council in September 2006. These results, which extended the study’s time frame to 18 weeks, once again showed that the combination of cognitive behavioral therapy and fluoxetine provided the fastest, most effective treatment for adolescent depression. Although psychotherapy alone was a viable option for adolescents who could not take medication, it took an additional six months to achieve the improvement seen with treatment that included medication.\nThe Clinical Antipsychotic Trials of Intervention Effectiveness research program—",
    "The Clinical Antipsychotic Trials of Intervention Effectiveness research program—\nanother NIMH large-scale practical clinical trial—provided the first real-world test of antipsychotic medications for people with schizophrenia. Its first phase compared the effectiveness and side effects of four newer medications and one older medication for treating schizophrenia. All the medications—even the older, less expensive medication, perphenazine—showed comparable effectiveness. However, many people in the study stopped taking the medications due to intolerable side effects or a failure to control symptoms adequately. \nResults from the first phase of the study were released in 2006 and showed that",
    "Results from the first phase of the study were released in 2006 and showed that \nantipsychotic medications commonly prescribed to treat delusions, aggression, hallucinations, and similar symptoms of Alzheimer’s disease could also benefit some people with schizophrenia. Still, the medications were no more effective than a placebo when considering adverse side effects. The study advanced the field by directly comparing multiple antipsychotic drugs within a single trial. The extensive information provided by this direct comparison helped clinicians determine the best medication for individual patients.\n2005\n182004",
    "19The NIMH-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) \nresearch program reported a series of results over the course of the year. A large-scale practical clinical trial led by NIMH, the study was also the nation’s largest clinical trial of treatments for depression at the time. The results provided real-world insight into depression treatment, including alternate options for people who do not respond to SSRIs, and highlighted opportunities for personalized approaches to depression care.\nSequenced Treatment Alternatives to Relieve Depression\nThe Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study tested the effectiveness of different antidepressant medications. It was the largest and longest study ever conducted to evaluate depression treatment. The first study phase included 2,876 participants receiving care at 41 clinical sites around the United States. \nA key strength of STAR*D was its focus on people receiving treatment in",
    "A key strength of STAR*D was its focus on people receiving treatment in \nprimary care and other real-world settings. The study had fewer exclusion criteria than usual clinical trials, and almost half the study sites were primary care. Participants’ depression symptoms and medication side effects were measured using standardized clinician and patient rating scales, which helped clinicians track participants’ progress throughout the study and provide them with consistent, measurement-based care.\nSTAR*D aimed to use a highly systematic approach to test depression",
    "STAR*D aimed to use a highly systematic approach to test depression \ntreatments. All study participants were initially treated with citalopram, a standard antidepressant medication. Only about 30% of participants achieved remission in this initial trial. Those who did not achieve remission with citalopram alone were treated with an additional medication or switched to a different medication, with the option of adding cognitive therapy in both cases. Over the course of the study, clinicians continued to make treatment decisions in a consistent, stepwise manner based on this augment-or-switch approach.\nAt the end of 12 months, 70% of participants had achieved symptom-free \nstatus. However, many participants needed to try two or three medications and go through several months of treatment before finding a medication that worked for them. This result underscored the importance of continuing to try new treatments when initial efforts do not work.",
    "The STAR*D trial showed the limitations of existing treatments for \ndepression and for whom certain medications were most likely to work. The study also helped move the field toward personalized, measurement-based care and demonstrated the feasibility of conducting large-scale, community-based trials across many settings.2006",
    "Building on previous research, several studies in the NIMH Intramural Research \nProgram demonstrated that the medication ketamine could relieve symptoms of depression within hours in people with treatment-resistant depression, a marked contrast to existing medications that could take weeks to have noticeable effects. These studies also helped identify possible underlying mechanisms, moving scientists closer to understanding how to develop new fast-acting antidepressant medications.\nOn December 19, President George W. Bush signed the Combating Autism Act of \n2006 (P.L. 109-416). The measure called for increased research on autism spectrum disorder. The Interagency Autism Coordinating Committee, co-chaired by the NIMH director, was also reauthorized and chartered as a federal advisory committee.\nFindings from the Systematic Treatment Enhancement Program for Bipolar",
    "Findings from the Systematic Treatment Enhancement Program for Bipolar \nDisorder research project, an NIMH practical clinical trial, revealed that people with bipolar disorder were more likely to recover from a depressive episode and stay well over the longer term if their treatment included both intensive psychotherapy and medication.\n20\nNew Hope for Treatment-Resistant Depression\nNIMH-sponsored studies have shown that ketamine can be an effective treatment option for people with depression who have not responded to SSRIs and other antidepressant medications. NIMH intramural researchers carried out much of this work. \nIn 2006, NIMH intramural researchers Husseini Manji, M.D., and Carlos",
    "In 2006, NIMH intramural researchers Husseini Manji, M.D., and Carlos \nZarate, M.D., along with Dennis Charney, M.D., at Mt. Sinai Medical School, reported findings from the first study investigating ketamine for people with treatment-resistant depression. The researchers found that ketamine produced rapid, robust, and relatively sustained antidepressant effects in patients who had already tried several antidepressant medications without seeing improvement. \nDr. Zarate and other intramural researchers have continued this work, \ninvestigating the neurobiological mechanisms that drive ketamine’s therapeutic effects and examining ketamine as a possible treatment for people with bipolar depression and anhedonia and people experiencing suicidal thoughts.\n2007",
    "21In August, NIMH published its Strategic Plan for Research with four primary \nobjectives:\n•Promote discovery in the brain and behavioral sciences to fuel research\non the causes of mental disorders\n•Chart mental illness trajectories to determine when, where, and how tointervene\n•Develop new and better interventions that incorporate the diverse needs\nand circumstances of people with mental illnesses\n•Strengthen the public health impact of NIMH-supported research\nThe Child/Adolescent Anxiety Multimodal Study e\nxamined strategies for treating",
    "The Child/Adolescent Anxiety Multimodal Study e\nxamined strategies for treating \nclinically significant anxiety among children ages 7-17 years. Results of the six-site clinical trial revealed that, although the combination of cognitive behavioral therapy and antidepressant medication was most effective at treating anxiety, each treatment alone was also effective. The findings indicated that clinicians and families have several viable treatment options for young people with anxiety disorders, depending on treatment availability and preferences.\nThe Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) \nlaunched as a partnership between NIMH and the U.S. Army to conduct research to help reduce suicide rates among members of the military. The multisite, multiyear study, which included soldiers in all phases of service, was the largest study of mental health risk and resilience ever conducted among military personnel.",
    "The study showed a rise in suicide deaths from 2004 to 2009 not only among \ncurrently and previously deployed soldiers but also among soldiers who were never deployed. Nearly half of soldiers who reported a previous suicide attempt indicated that their first attempt was prior to enlistment. Soldiers also reported higher rates of certain mental disorders than civilians. Results from Army STARRS have informed actionable strategies to enhance mental health and reduce suicide risk among members of the military and civilians.\nTwelve NIMH staff members received the 2008 Hubert H. Humphrey Award for \nService to America for their work addressing veterans’ mental health needs. These staff members developed a new initiative to support research that would describe and evaluate national, state, and local programs addressing the mental health needs of returning service members and their families.2008",
    "The NIH Blueprint for Neuroscience Research launched the Human Connectome \nProject as a Blueprint Grand Challenge. Supported by NIMH and other Blueprint partners, the Human Connectome Project aimed to map the neural pathways that underlie human brain function. The effort expanded to measuring macroscale brain connections across the lifespan.\n22The Human \nConnectome Project\nThe goal of the Human Connectome Project was to acquire and share \ndata about the structural and functional connectivity of the human brain. Researchers studied the brain’s complex wiring by collecting data from thousands of research participants using state-of-the-art brain imaging technologies. Researchers also collected participants’ DNA, demographic information, and behavioral data to examine how genetics and the environment influence brain connectivity.\nThe project was the first time that researchers combined different",
    "The project was the first time that researchers combined different \nbrain imaging technologies to map the brain’s long-range connections systematically. This research paved the way for a deeper understanding of how our brain circuitry changes as we age or because of psychiatric and neurologic conditions.\nThe Human Connectome Project led to new data models, informatics, and \nanalytic tools that advanced researchers’ ability to image and analyze brain connections. These advances played a major role in accelerating progress in the emerging human connectomics field and contributed to the formation of the Brain Research Through Advancing Innovative Neurotechnologies\n® \nInitiative, or The BRAIN Initiative®.\nWhite matter fiber architecture from the \nConnectome Scanner dataset. Shown \nare the corpus callosum and brainstem \npathways. The fibers are color coded by \ndirection: red = left-right, green = anterior-\nposterior, blue = ascending-descending \n(RGB = XYZ). Courtesy of Laboratory of",
    "posterior, blue = ascending-descending \n(RGB = XYZ). Courtesy of Laboratory of \nNeuro Imaging and Martinos Center for \nBiomedical Imaging, Consortium of the \nHuman Connectome Project,\nwww.humanconnectomeproject.org.2009",
    "23The Treatment of SSRI-Resistant Depression in Adolescents research project was \nan NIMH-funded practical clinical trial that examined difficult-to-treat depression among adolescents across multiple sites. The study showed that teens who did not respond to a first antidepressant medication were more likely to see symptom improvement if they switched to another antidepressant and added psychotherapy instead of only switching medications.\nIn July, NIMH launched the Research Domain Criteria (RDoC) initiative, providing \na research framework for developing new ways of classifying mental disorders based on behavioral dimensions and neurobiological measures. The intent was to apply modern research approaches in genetics, neuroscience, and behavioral science to studying mental illnesses, independently from the classification systems by which patients were typically grouped.\nOn November 10, NIMH intramural researcher Mortimer Mishkin, Ph.D., was",
    "On November 10, NIMH intramural researcher Mortimer Mishkin, Ph.D., was \nawarded the National Medal of Science at a White House ceremony. In studies spanning more than five decades, Dr. Mishkin and colleagues examined the neural mechanisms underlying perception and memory. Dr. Mishkin’s work explored how the brain processes input from vision, hearing, and touch to encode memory and shed light on the organization of memory and memory disorders in humans.\nOn July 6, the Grand Challenges in Global Mental Health initiative began. Co-\nled and funded by NIMH, the Grand Challenges brought together the largest-ever international Delphi panel—more than 400 participants representing work conducted in 60 countries—to determine priorities for research relevant to mental, neurological, and substance use disorders.2009\nThe overlapping circles in the RDoC",
    "The overlapping circles in the RDoC \nframework represent the integration and intersection of multiple components—including lifespan development, environmental factors, and fundamental biobehavioral processes—in mental health research, as well as various ways to measure these intertwined components. Courtesy of NIMH.\n2010\n2011",
    "On August 25, NIMH was named by the White House as a “Champion of Change” \nfor its efforts supporting research on suicide prevention. The White House Champions of Change initiative celebrated diverse individuals and organizations making an impact in communities and helping the country rise to the challenges of the 21st century.\nOn August 31, President Barack Obama signed an executive order directing key",
    "On August 31, President Barack Obama signed an executive order directing key \nfederal departments and agencies, including NIH, to expand suicide prevention strategies and improve access to mental health and substance abuse treatment services for veterans, service members, and their families. The order also called for developing a National Research Action Plan with strategies to improve the diagnosis and treatment of post-traumatic stress disorder (PTSD) and other mental health conditions. NIMH led NIH’s participation in the action plan, which made significant progress in establishing common data elements to guide research on traumatic stress and suicide risk prevention and developing scalable interventions for PTSD and suicide prevention.\nResearchers in the NIMH Intramural Research Program published the Ask Suicide-",
    "Researchers in the NIMH Intramural Research Program published the Ask Suicide-\nScreening Questions (ASQ) measure—a brief screening instrument clinicians can administer in 20 seconds to identify a patient’s risk for suicide. An NIMH-led multisite study showed that a “yes” to any of the measure’s four questions identified 97% of young people at risk for suicide among those screened in pediatric emergency departments. Additional NIMH research subsequently validated the ASQ in pediatric inpatient care and integrated it into an evidence-based pathway for youth suicide prevention. This pathway served as a scientific basis for the Blueprint for Youth Suicide Prevention developed by the American Academy of Pediatrics and the American Foundation for Suicide Prevention. \nIn 2014, intramural researchers led a multisite study that confirmed the ASQ as",
    "In 2014, intramural researchers led a multisite study that confirmed the ASQ as \na valid screening tool for suicide risk in adults. The researchers then expanded these studies into an ASQ Toolkit that clinicians can use to identify and manage suicide risk in both children and adults in a variety of medical settings. Intramural researchers have also worked with NIMH experts in global mental health and international collaborators to translate the ASQ into more than 20 languages and validate the ASQ through research in other countries. By enabling culturally responsive early identification and assessment of people at high risk for suicide, the ASQ Toolkit has enhanced suicide prevention for youth and adults in medical settings worldwide.\n242011\n2012",
    "25On April 2, President Obama announced the launch of the Brain Research \nThrough Advancing Innovative Neurotechnologies® Initiative, or The BRAIN \nInitiative®—a major initiative focused on revolutionizing our understanding \nof the human brain. The president proposed $100 million for the first year of what he called “the next great American project.” NIH, the Defense Advanced Research Projects Agency, the National Science Foundation, and several private laboratories and foundations began working to develop the next generation of tools for decoding the language of the brain.\nOn September 20, Thomas C. Südhof, M.D., and Richard H. Schelle r, Ph.D., received \nthe Lasker Basic Medical Research Award. The researchers, whose work had \nbeen supported by NIMH, were recognized for their work mapping the molecular \nmechanisms involved in neurotransmitter release. Dr. Südhof later received the \n2013 Nobel Prize in Physiology or Medicine for his NIMH-supported research on",
    "2013 Nobel Prize in Physiology or Medicine for his NIMH-supported research on \nhow the brain sends and receives chemical messages.The human brain is the most complicated biological structure \nin the known universe. We’ve only just scratched the surface in understanding how it works or, unfortunately, doesn’t quite work when disorders and disease occur…This is just the beginning of a 12-year journey, and we’re excited to be starting the ride.\nFormer NIH Director Francis S. Collins, M.D., Ph.D.\nAnnouncement on the unveiling of the BRAIN Initiative ”\nNIH Director Dr. Francis Collins introduced President Barack Obama at the BRAIN Initiative event at the White House in 2013. Credit: Official White House photo by  Chuck Kennedy.2013\n“",
    "26NIMH launched the Emergency Department Screening for Teens at Risk for \nSuicide study in a network of hospital emergency departments across the United States as a part of the institute’s research agenda for suicide prevention. The study aimed to develop and test a personalized, computer-based suicide risk screening tool for teenagers that could improve screening and enable earlier intervention. In 2021, researchers involved in the study developed a computerized adaptive screening tool, which correctly identified more than 80% of youth who went on to attempt suicide in the three months following screening. The screener has offered a valuable tool for rapidly identifying youth at risk for suicide in emergency departments.Brain Research Through Advancing Innovative \nNeurotechnologies® Initiative\nThe Brain Research Through Advancing Innovative Neurotechnologies® \nInitiative, or The BRAIN Initiative®, established with the aim of revolutionizing",
    "Initiative, or The BRAIN Initiative®, established with the aim of revolutionizing \nour understanding of the human brain, was announced by President Obama \nin 2013. In the years leading up to this announcement, scientists had made several landmark discoveries that paved the way for unprecedented collaboration and discovery across scientific fields. Researchers sequenced the human genome for the first time, created new tools for mapping neuronal connections, and developed high-resolution imaging technologies. At the same time, the field saw the maturation of nanoscience and the rise of biological engineering. Together, these breakthroughs created an opportunity to unlock the mysteries of the brain.\nBuilding on recent discoveries, the BRAIN Initiative aimed to accelerate",
    "Building on recent discoveries, the BRAIN Initiative aimed to accelerate \nthe development and application of innovative technologies to produce a revolutionary, dynamic picture of the human brain. This dynamic picture would show how individual cells and complex neural circuits interact in both time and space, providing unprecedented opportunities to understand brain function and dysfunction. Dozens of leading technology firms, academic institutions, scientists, and other key contributors to the field of neuroscience have recognized the importance of these aims and made significant commitments to advancing the BRAIN Initiative.\n2014",
    "27On April 2, the NIMH-funded BrainSpan Atlas of the Developing Human Brain \nconsortium project reported its first major findings. The effort was intended to provide a comprehensive three-dimensional atlas of the brain and profile gene activity across the brain, beginning prenatally.\nNIMH adopted a new policy for clinical trials that required future trials to follow an \nexperimental therapeutics approach. Under this mechanism-based approach to intervention development and testing, trials are designed not only to test whether an intervention works but also to advance understanding of how the intervention works. The policy stipulated that clinical trials must also meet new recruitment, data sharing, and reporting standards.\nNIMH published a new Strategic Plan for Research. Informed by the successes and",
    "NIMH published a new Strategic Plan for Research. Informed by the successes and \nchallenges of recent years, the plan updated the strategic objectives outlined in 2008 to balance the need for long-term investments in basic research with urgent mental health needs. The four strategic objectives in the 2015 plan were:\n•Define the mechanisms of complex behaviors\n•Chart mental illness trajectories to determine when, where, and howto intervene\n•Strive for prevention and cures\n•Strengthen the public health impact of NIMH-supported research\nHuman adult whole brain, cortex—gyral. \nCourtesy of Allen BrainSpan Atlas of the \nDeveloping Human Brain,\nhttps://brainspan.org/static/atlas.2014\n2015",
    "The Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study \n(STARRS-LS) was launched as an extension of Army STARRS, representing a partnership between NIMH and the U.S. Army, U.S. Department of Defense, and U.S. Department of Veterans Affairs. STARRS-LS researchers continued to analyze Army STARRS data while also collecting new data to learn about suicide risk and mental health among military personnel throughout their Army careers and during the transition to civilian life.\nResearchers in NIMH’s Recovery After an Initial Schizophrenia Episode (RAISE) \ninitiative reported that treating people with first-episode psychosis using a team-based coordinated specialty care approach produced better clinical and functional outcomes than typical community care. Investigators also found that treatment was most effective for people who received care soon after psychosis symptoms began.2015\n28Recovery After an Initial Schizophrenia Episode Initiative",
    "28Recovery After an Initial Schizophrenia Episode Initiative\nNIMH launched the Recovery After an Initial Schizophrenia Episode (RAISE) research initiative in 2008 to test the effectiveness and implementation of  \ncoordinated specialty care (CSC) to treat first-episode psychosis in communities across the United States. NIMH funded RAISE and called for developmentally informed, comprehensive, patient-centered interventions to meet the needs of youth experiencing the earliest stages of serious mental illness.\nNIMH engaged extensively with organizations and communities—including",
    "NIMH engaged extensively with organizations and communities—including \nfederal partners, advocacy groups, professional organizations, and local and state mental health authorities—to ensure RAISE findings would be relevant and actionable for rapid translation into clinical practice. These collaborations, coupled with RAISE findings demonstrating the effectiveness of CSC, created the momentum for targeted federal support of CSC services and broad expansion of CSC treatment programs nationwide. \nBased on RAISE results, the Centers for Medicare & Medicaid Services \nposted a bulletin for state Medicaid directors about covering CSC as an evidence-based treatment for first-episode psychosis. The Veterans Health Administration and the U.S. Department of Labor also endorsed CSC. \nUltimately, RAISE not only contributed to a new way to organize and deliver \ntreatment, but it also produced findings that changed the standard of practice for early schizophrenia treatment in the United States.",
    "292015On February 6, NIMH announced the creation of the Early Psychosis Intervention \nNetwork (EPINET), designed to link treatment centers for early psychosis in a network of evidence-based coordinated specialty care programs. The initiative was built on the insights developed during the NIMH RAISE initiative. By 2020, EPINET included a data coordinating center, eight scientific hubs, and more than 100 community clinics in a national learning health system aimed at improving services and outcomes for thousands of people experiencing an initial episode of psychosis.\nNIMH supported the launch of a major BRAIN Initiative effort to discover and \ncatalog the brain’s “parts list.” This effort, known as the BRAIN Initiative Cell Census Network, was established as a cooperative network of comprehensive centers, specialized laboratories, and an integrated data center.\nOn April 29, results published from the Emergency Department Safety Assessment",
    "On April 29, results published from the Emergency Department Safety Assessment \nand Follow-up Evaluation study showed that hospital emergency departments can play a vital role in reducing suicide attempts among adults. The study was the largest emergency department-based suicide intervention trial ever conducted in the United States, taking place over five years in eight hospitals across seven states. The results showed that screening, followed by safety planning guidance and periodic phone check-ins after discharge, led to a 30% decrease in suicide attempts compared to standard emergency department care. The study was another example of NIMH’s prioritized suicide prevention research agenda.\nOn July 11, NIMH proposed the creation of the NIMH Data Archive to serve as an",
    "On July 11, NIMH proposed the creation of the NIMH Data Archive to serve as an \nonline resource for investigators seeking to share data, tools, methods, and analyses from research with human participants. The NIMH Data Archive, which was built upon the preexisting National Database for Autism Research, brought together other digital repositories, including the Research Domain Criteria Database, the National Database for Clinical Trials Related to Mental Illness, and the NIH Pediatric MRI Repository.2017\nBefore we can fully understand how our brains work, we need to understand how the parts work. Making molecular, anatomical, and functional data about brain cells available to the broad research community will speed our understanding of how cells and circuits are organized, revealing the rules of communication within the world’s most complex known organ.\nFormer NIH Director Francis S. Collins, M.D., Ph.D.\nSpeech on the BRAIN Initiative “\n”",
    "30NIH released the first dataset from the Adolescent Brain Cognitive Development℠ \nStudy, the largest long-term study of brain development and child health ever conducted in the United States, to the scientific community through the NIMH Data Archive. The comprehensive dataset—including measures of brain development; social, emotional, and cognitive development; mental health; substance use and attitudes; gender identity and sexual health; and various physical health and environmental factors—allowed researchers to address numerous questions related to adolescent brain development to help inform future prevention and treatment efforts, public health strategies, and policy decisions.\nNIH launched the Helping to End Addiction Long-term\n® Initiative as an ambitious, \nhigh-priority effort across the institutes to speed scientific solutions to stem",
    "high-priority effort across the institutes to speed scientific solutions to stem \nthe opioid public health crisis. Launched in April 2018, the initiative focused on improving prevention and treatment strategies for opioid misuse and addiction and enhancing pain management. As a major partner in the initiative, NIMH led a research program focused on optimizing the delivery of services for people with opioid use disorder, mental disorders, and suicide risk. NIMH-supported efforts have included research to adapt the collaborative care model to treat co-occurring mental and substance use disorders and a program to reduce suicide deaths by identifying people at risk when seen in primary care settings.\nResearchers in the NIMH Intramural Research Program collaborated with the Indian",
    "Researchers in the NIMH Intramural Research Program collaborated with the Indian \nHealth Service (IHS) to pilot suicide risk screening in IHS emergency departments serving American Indian/Alaska Native communities. A follow-up quality improvement project further demonstrated the feasibility of suicide risk screening in IHS emergency departments. Intramural researchers subsequently used these findings to guide the implementation of suicide risk screening in more than 100 IHS medical settings (including 22 emergency departments) around the United States.\nOn March 5, the FDA approved esketamine as a fast-acting and noninvasive",
    "On March 5, the FDA approved esketamine as a fast-acting and noninvasive \ntreatment for depression that works via a different neurochemical pathway from other antidepressants. In the 1990s, Dr. Charney and another researcher, John Krystal, M.D., found that intravenous ketamine improved depressive symptoms within hours rather than the usual days or weeks. In the 2000s, research led by intramural researchers Dr. Manji and Dr. Zarate showed that ketamine worked by blocking the NMDA receptor in brain cells. Their research also showed that ketamine stimulated the activity of the AMPA receptor. Dr. Manji built on this finding to produce an alternative way of delivering ketamine in the form of esketamine, which is delivered via nasal spray.2018\n2019",
    "31On March 19, the FDA approved the medication brexanolone as the first \nsuccessful treatment for severe postpartum depression. In the 1980s and 1990s, NIMH intramural researcher Steven Paul, M.D., showed that the neurosteroid allopregnanolone promoted anesthesia during pregnancy by stimulating the inhibitory neurotransmitter GABA. Subsequent research demonstrated that brexanolone, an intravenous form of allopregnanolone, treated postpartum depression by continuing the stimulation of GABA into the postpartum period.\nNIMH established the Advanced Laboratories for Accelerating the Reach and",
    "NIMH established the Advanced Laboratories for Accelerating the Reach and \nImpact of Treatments for Youth and Adults with Mental Illness research center program to support the advancement of clinical research and practice. The program was designed to leverage practice-based infrastructure, stakeholder engagement, and transdisciplinary research teams capable of incorporating insights from new fields and emerging technologies. These innovative components were expected to speed the translation of research into clinical practice. At launch, the program comprised research teams at eight centers. By 2023, the program had expanded to 14 centers focused on a range of populations and spanning a variety of real-world settings where services are delivered.2019",
    "The approval of brexanolone is a cause for celebration for psychiatric neuroscience, as it represents a true bench-to-bedside success for our field. The promise of basic neuroscience to provide truly novel and effective treatments for psychiatric disorders has for a long time been only that: a promise. But not anymore.\nNIMH Director Joshua A. Gordon, M.D., Ph.D.\nNIMH Director’s Message“\n”",
    "322019\nNIMH published a new Strategic Plan for Research, which provided a framework \nfor research to leverage new opportunities for scientific exploration and addressed new challenges in mental health. The four goals outlined in the 2020 plan formed a broad roadmap for the institute’s research priorities, ranging from fundamental science to public health impact:\n•Define the brain mechanisms underlying complex behaviors\n•Examine mental illness trajectories across the lifespan\n•Strive for prevention and cures\n•Strengthen the public health impact of NIMH-supported researchImpact of the \nCoronavirus Pandemic\nCoronavirus (COVID-19), a \ndisease caused by the SARS-CoV-2 virus, was discovered in December 2019 and quickly spread around the world.",
    "The COVID-19 pandemic disproportionately impacted people in underserved and minoritized communities. People in these communities experienced greater rates of illness and death due to SARS-CoV-2 infection and broader mental health consequences of the pandemic’s social, behavioral, and economic impacts. Reports indicated that many people experienced a decline in mental health during the pandemic, including increased symptoms of depression and anxiety and increased rates of substance use. \nIn response, NIMH funded research to understand the long-term mental \nhealth impacts of the pandemic and evaluate scalable interventions that could meet the increased mental health needs of diverse populations. NIMH committed to prioritizing research on COVID-19 and funding studies examining the pandemic’s ongoing impacts and effective ways to support mental health during public health emergencies.\n3D illustration of coronavirus.\nCredit: www.istockphoto.com/portfolio/\nBlackJack3D.\n2020",
    "NIH launched a public-private partnership to meet the urgent need for early \ntherapeutic interventions for people at risk of developing schizophrenia.  The Accelerating Medicines Partnership\n® program for schizophrenia brought \ntogether NIH, the FDA, and multiple nonprofit and private organizations in a united effort to better understand underlying biological pathways and identify  \nnew treatment targets.\nThe BRAIN Initiative Cell Census Network unveiled an atlas of cell types and an \nanatomical neuronal wiring diagram for the mammalian primary motor cortex, derived from detailed studies of mice, monkeys, and humans. This publicly available resource represented the culmination of an international collaboration by more than 250 scientists at more than 45 institutions across three continents. The findings appeared in 17 associated papers published in a dedicated issue of the journal Nature.\n332021\nA multicolor visualization of the \nmouse primary motor cortex \ntranscriptomic taxonomy",
    "332021\nA multicolor visualization of the \nmouse primary motor cortex \ntranscriptomic taxonomy \noverlaid with mapped neuronal \ncells surrounded by color-\ncoordinated pictures of \ndifferent types of neurons \n(GABAergic, glutamatergic, \nchandelier, etc.) and their \nelectrophysiological signatures.  \nCredit: BRAIN Initiative Cell \nCensus Network, Nature, \nhttps://creativecommons.org/\nlicenses/by/4.0.The Accelerating Medicines Partnership® program for \nschizophrenia furthers NIMH’s ongoing commitment to \nresearch improving the lives of people with early psychosis and schizophrenia. This innovative partnership is an exciting opportunity to accelerate research that will spur new pharmacologic approaches to early intervention, leading to positive impacts in the lives of patients with schizophrenia.\nNIMH Director Joshua A. Gordon, M.D., Ph.D.\nAnnouncement on the launch of the Accelerating Medicines Partnership® \nprogram for schizophrenia“\n”2020",
    "In December, U.S. Surgeon General Vivek H. Murthy, M.D., issued The U.S. Surgeon \nGeneral’s Advisory on Protecting Youth Mental Health. The advisory, developed with input from NIMH and other federal agencies, recognized mental health as an essential part of overall health and acknowledged the effects of the COVID-19 pandemic on youth mental health. The advisory included recommendations to increase timely data collection and research to identify and respond to youth mental health needs.\nNIMH supported the launch of two transformative projects through the BRAIN",
    "NIMH supported the launch of two transformative projects through the BRAIN \nInitiative: the BRAIN Initiative Cell Atlas Network and the Armamentarium for Precision Brain Cell Access. The BRAIN Initiative Cell Atlas Network represented the next step in NIH’s efforts to generate a complete reference atlas of cell types and circuits in the human brain across the lifespan. The Armamentarium for Precision Brain Cell Access aimed to generate tools that would allow researchers to target specific brain cells and neural circuits. Together, these BRAIN 2.0 projects aimed to transform our understanding of brain cell types and provide the precise tools needed to access them, helping unravel the complex workings of the human brain and inform treatments of brain disorders. \nThe White House Report on Mental Health Research Priorities, published in \nFebruary, outlined administration-wide needs and opportunities to advance",
    "February, outlined administration-wide needs and opportunities to advance \nmental health research. Areas of emphasis included addressing mental health inequities, understanding and leveraging digital mental health interventions, and supporting and expanding the mental health workforce. NIMH substantively contributed to development of the report, which highlighted several NIMH-supported research initiatives.\nIn May, U.S. Surgeon General Murthy issued The U.S. Surgeon General’s Advisory on \nSocial Media and Youth Mental Health. The advisory called for urgent action to clarify the mental health impacts of social media use, maximize the benefits and minimize the harms of social media platforms, and create safer and healthier online environments. NIMH and other federal agencies advised on the preparation of the report. \nNIMH celebrated its 75th anniversary. A yearlong program of events launched with",
    "NIMH celebrated its 75th anniversary. A yearlong program of events launched with \nthe inaugural scientific symposium, “The Evolution of Mental Health Research.” Over the anniversary year, NIMH sponsored numerous activities, including symposiums, lectures, and sessions at scientific meetings. NIMH also shared stories of discovery and inspiration from its past, present, and future.\n342021\n2022\n2023\nFor more information, stories, and highlighted research,  \nvisit www.nimh.nih.gov/75years",
    "35Future Directions\nOver the last 75 years, NIMH has been at the forefront of scientific \nadvances that have transformed our understanding of mental illnesses and generated evidence-based approaches to mental health care. Our \nsuccesses are a testament to the hard work, bright minds, and innovative \nspirit of those contributing to the institute’s mission.\nLooking back on the many NIMH-supported advancements gives reason to \ncelebrate and provides perspective for moving forward. Mental illnesses are common, affecting tens of millions of people in the United States—and worldwide—each year. Suicide remains an urgent public health concern and one of the leading causes of death in the United States. \nWe need to continue to drive research that defines the biological underpinnings",
    "We need to continue to drive research that defines the biological underpinnings \nof these disorders and the ongoing translational and clinical research to turn that knowledge into effective treatment options. Although we cannot predict the next public health emergency or the complex scientific questions that will arise, we can prepare to meet such challenges by setting an ambitious research agenda and building a talented, diverse cohort of mental health researchers to see it through.\nThe evolving NIMH Strategic Plan for Research maps our path. We have charted \nnumerous routes—from basic research to translational efforts to clinical studies testing novel approaches in community settings. We are also ready to adapt to the challenges and opportunities ahead.\nOver the next 75 years and beyond, NIMH will continue to prioritize excellent",
    "Over the next 75 years and beyond, NIMH will continue to prioritize excellent \nscience that brings hope and solutions to people with mental illnesses, their families, and their communities. We remain mindful of the journey ahead and draw strength from the hope that drives us forward. \nLearn more about the NIMH Strategic Plan for Research at  \nwww.nimh.nih.gov/strategicplan",
    "36\nName Tenure\nRobert H. Felix 1949–1964\nStanley F. Yolles 1964–1970\nBertram S. Brown 1970–1977\nFrancis N. Waldrop (Acting) 1977–1978\nHerbert Pardes 1978–1984\nLarry Silver (Acting) 1984\nShervert H. Frazier 1984–1986\nFrank J. Sullivan (Acting) 1986–1988\nLewis L. Judd 1988–1990\nAlan I. Leshner (Acting) 1990–1992\nFrederick K. Goodwin 1992–1994\nRex William Cowdry (Acting) 1994–1996\nSteven E. Hyman 1996–2001\nRichard K. Nakamura (Acting) 2001–2002\nThomas R. Insel 2002–2015\nBruce Cuthbert (Acting) 2015–2016\nJoshua A. Gordon 2016–PresentNIMH Directors",
    "37Learn More About\nNIMH History\nThe following sources provide more information on NIMH and its history:\nOrigin Story\nBrand, J. L. (1965). The National Mental Health Act of 1946: A retrospect. Bulletin of the History of \nMedicine, 39(3), 231−245.\nGrob, G. N. (1996). Creation of the National Institute of Mental Health. Public Health Reports, 111(4), \n378−381.\nScientific ResearchAxelrod, J. (1986). Doing research in the intramural program of the National Institutes of Health. \nPerspectives in Biology and Medicine, 29(3), 131−137.\nCohen, R. A. (1984). Studies on the etiology of schizophrenia. In DeWitt Stetten, Jr., & W.T. Carrigan \n(Eds.), NIH: An account of research in its laboratories and clinics (pp. 13−34). Academic Press.\nEllenberg, J. H. (1997). A conversation with Morton Kramer. Statistical Science, 12(2), 103−107.Ferreras, I. G. (Ed.). (2004). Mind, brain, body, and behavior: Foundations of neuroscience and \nbehavioral research at the National Institutes of Health. IOS Press.",
    "behavioral research at the National Institutes of Health. IOS Press. \nInsel, T. R., & Landis, S. C. (2013). Twenty-five years of progress: The view from NIMH and NINDS. \nNeuron. 80(3), 561−567.\nKopin, I. J. (1984). Neurotransmitters and neuropsychopharmacology. In DeWitt Stetten, Jr., & \nW. T. Carrigan (Eds.), NIH: An account of research in its laboratories and clinics  (pp. 36−47). \nAcademic Press.\nPickren, W. E., & Schneider, S. F. (Eds.). (2005). Psychology and the National Institute of \nMental Health: A historical analysis of science, practice, and policy. American Psychological Association.\nOrganizational HistoryBrown, B. S. (1998). NIMH before (1946-1970) and during the tenure of director Bertram S. \nBrown, M.D. (1970-1978): The early years and the public health mission. American Journal of Psychiatry, 155(9), 9−13.\nBrown, B. S., & Okura, K. P. (1995). A brief history of the center for minority group mental health",
    "programs at the National Institute of Mental Health. In Charles V. Willie, Patricia Perri Rieker, Bernard M. Kramer, & Bertram S. Brown (Eds.), Mental health racism and sexism (pp. 397−426). Taylor & Francis.",
    "38\nFrazier, S. H. (1998). NIMH during the tenure of director Shervert H. Frazier, M.D. (1984-1986):  \nThe mental disorder-based reorganization and research on schizophrenia and severe  \nmental disorders. American Journal of Psychiatry, 155(9), 20−24.\nGoodwin, F. K. (1998). NIMH during the tenure of director Frederick K. Goodwin, M.D. (1992-1994): The \nreturn to NIH and the fight for parity. American Journal of Psychiatry, 155(9), 32−35.\nHyman, S. E. (1998). NIMH during the tenure of director Steven E. Hyman, M.D. (1996-present): \nThe now and future of NIMH. American Journal of Psychiatry, 155(9), 36−40.\nJudd, L. L. (1998). Historical highlights of the National Institute of Mental Health from 1946 to the \npresent. American Journal of Psychiatry, 155(9), 3−8.\nJudd, L. L. (1998). NIMH during the tenure of director Lewis L. Judd, M.D. (1987-1990): The decade of \nthe brain and the four national research plans. American Journal of Psychiatry, 155(9), 25−31.",
    "the brain and the four national research plans. American Journal of Psychiatry, 155(9), 25−31.\nPardes, H. (1998). NIMH during the tenure of director Herbert Pardes, M.D. (1978-1984): The \npresident’s commission on mental health and the reemergence of NIMH’s scientific mission. \nAmerican Journal of Psychiatry, 155(9), 14−19.\nSegal, J. (Ed.). (1975). Research in the service of mental health: Report of the research task force \nof the National Institute of Mental Health. National Institute of Mental Health.\nShaping National Mental Health PolicyFoley, H. A. (1975). Community mental health legislation: The formative process . Lexington Books. \nFoley, H. A., & Sharfstein, S. S. (1983). Madness and government: Who cares for the mentally ill? \nAmerican Psychiatric Press.\nGrob, G. N. (1987). The forging of mental health policy in America: World War II to new frontier. \nJournal of the History of Medicine and Allied Sciences, 42(4), 410−446.",
    "Journal of the History of Medicine and Allied Sciences, 42(4), 410−446.\nGrob, G. N. (2000). Mental health policy in late twentieth century America. In Roy W. Menninger \n& John C. Nemiah (Eds.), American psychiatry after World War II (1944-1994) (pp. 232−258). American Psychiatric Press.\nGrob, G. N., & Goldman, H. H. (2006). The dilemma of federal mental health policy: Radical \nreform or incremental change? Rutgers University Press.\nInsel, T. (2022). Healing: Our path from mental illness to mental health. Penguin Press.Kolb, L. C., Frazier, S. H., & Sirovatka, P. (2000). The National Institute of Mental Health: Its influence \non psychiatry and the nation’s mental health. In Roy W. Menninger & John C. Nemiah (Eds.), American psychiatry after World War II (1944-1994) (pp. 207−231). American Psychiatric Press.\nFor complete documentation of the information in this publication, consult:\nOffice of NIH History & Stetten Museum  \nhttps://history.nih.gov   National Library of Medicine",
    "Office of NIH History & Stetten Museum  \nhttps://history.nih.gov   National Library of Medicine  \nwww.nlm.nih.gov",
    "The following are registered service marks and trademarks of the U.S. \nDepartment of Health and Human Services (HHS):\n• Adolescent Brain Cognitive Development℠ Study \n• Brain Research Through Advancing Innovative Neurotechnologies® \nand The BRAIN Initiative®\n• ACCELERATING MEDICINES PARTNERSHIP®\n• Helping to End Addiction Long-term®\nThis publication was made possible by the NIMH 75th Anniversary \nSteering Committee and Working Groups; former and current NIMH staff; the NIMH research community; and those who shared their expertise, experience, and stories.\nThis information was reviewed by historical consultant and historian\nDr. Kenneth Durr.\nWith the exception of the images, the information in this publication is in the",
    "Dr. Kenneth Durr.\nWith the exception of the images, the information in this publication is in the \npublic domain and may be reused or copied without permission. Please cite the National Institute of Mental Health as the source. You may not reuse or copy the images. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright.\n40",
    "Contact the National Institute of Mental Health\n6001 Executive Boulevard \nMSC 9663 \nBethesda, MD 20892-9663\nEmail: nimhinfo@nih.gov\nwww.nimh.nih.gov\nFollow us on social media:\nwww.nimh.nih.gov/socialmedia\nNIH Publication No. 23-MH-8213",
    "How do I get help \nfor depression?\n■Talk to a trusted adult (such as\nyour parent or guardian, teacher, orschool counselor) about how you’vebeen feeling.\n■Ask your doctor about options forprofessional help. Depression canbe treated with psychotherapy (alsocalled “talk therapy”), medication,or a combination of medication andtalk therapy.\n■Try to spend time with friends orfamily,  even if you don’t feel like\nyou want to.\n■Stay active and exercise,  even if\nit’s just going for a walk. Physicalactivity releases chemicals, such asendorphins, in your brain that canhelp you feel better.\n■Try to keep a regular sleep schedule.\n■Eat healthy foods.Do I have \ndepression?\n■Do you often feel sad, anxious,\nworthless, or even “empty”?\n■Have you lost interest inactivities you used to enjoy?\n■Do you get easily frustrated,irritable, or angry?\n■Do you find yourself withdrawingfrom  friends and family?\n■Are your grades dropping?\n■Have your eating or sleepinghabits changed?",
    "■Are your grades dropping?\n■Have your eating or sleepinghabits changed?\n■Have you experienced anyfatigue or memory loss?\n■Have you thought about suicideor harming yourself?\nDepression looks different for everyone. You might have many of the symptoms listed above or just a few. Teen Depression: More than just moodiness\nBeing a teenager can be tough, but it shouldn’t feel hopeless. If you \nhave been feeling sad most of the time for a few weeks or longer and you’re not able to concentrate or do the things you used to enjoy, talk to a trusted adult about depression.\nYou’re not alone, and help is avail able. You can feel better.  \nTo get help, call or text the 988 Suicide & Crisis Lifeline at 988 or chat a t 988lifeline.org .\nnimh.nih.gov/depression\nNIMH Identifier No. OM 22-4321",
    "If these warning signs apply to you or someone you know,  \nget help as soon as possible, particularly if the behavior is new  \nor has increased recently.\n988 Suicide & Crisis Lifeline  \nCall or text 988  \nChat at  988lifeline.orgCrisis Text Line  \nText “HELLO” to 741741\nNational Institute\nof Mental HealthWARNING SIGNS OF SUICIDE :\nThe behaviors listed below may be some of the signs that \nsomeone is thinking about suicide.\nwww.nimh.nih.gov/suicidepreven tion\nNIMH Identifier No. OM 22-4316FEELING: \n Empty, hopeless, trapped, or having  \nno reason to live\n Extremely sad, more anxious, agitated, or full of rage\n Unbearable emotional or physical painTALKING ABOUT:\n Wanting to die\n Great guilt or shame\n Being a burden  to others\nCHANGING BEHAVIOR, SUCH AS:\n Making a plan or \nresearching ways to die\n Withdrawing from friends,  \nsaying goodbye, giving  \naway important items,  or making a will Taking dangerous risks such as \ndriving extremely fast\n Displaying extreme mood swings",
    "driving extremely fast\n Displaying extreme mood swings\n Eating or sleeping more or less\n Using drugs or alcohol more often",
    "Attention-Deficit/\nHyperactivity Disorder: \nWhat You Need to Know",
    "What is ADHD?\nAttention-deficit/hyperactivity disorder (ADHD) is a developmental disorder marked by persistent \nsymptoms of inattention, hyperactivity, and impulsivity. Some people mostly have symptoms of inattention. Others mostly have symptoms of hyperactivity and impulsivity. Some people have both types of symptoms. \nSymptoms begin in childhood and can interfere with daily life, including social relationships and \nschool or work performance. ADHD is well-known among children and teens, but many adults also have the disorder. Effective treatments are available to manage symptoms. \n What are the symptoms of ADHD?\nPeople with ADHD may experience an ongoing pattern of:\n ►Inattention : Difficulty paying attention\n ►Hyperactivity : Showing too much energy or moving and talking too much\n ►Impulsivity : Acting without thinking or having difficulty with self-control\nSigns of inattention can include frequent difficulty with :",
    "Signs of inattention can include frequent difficulty with :\n ►Paying attention to details, leading to careless mistakes at school, work, or during other activities\n ►Concentrating on tasks or activities, for instance, while having conversations, taking tests, completing assignments, or reading papers\n ►Listening when spoken to directly\n ►Following instructions or finishing tasks at school, work, or home \n ►Organizing tasks and activities, managing time, and meeting deadlines\n ►Completing tasks that require sustained attention, such as homework, large projects, and complicated forms \n ►Losing things, such as backpacks, books, keys, wallets, and phones\n ►Getting easily distracted by unrelated thoughts or stimuli\n ►Forgetting about daily activities, such as chores, errands, and events, or other important things, like assignments, appointments, and phone calls\nSigns of hyperactivity and impulsivity can include often :\n ►Fidgeting, tapping hands or feet, or squirming while seated",
    "►Fidgeting, tapping hands or feet, or squirming while seated\n ►Moving around when expected to remain seated, such as in the classroom or office, or feeling restless in these situations\n ►Running, climbing, or moving around at times when it is not appropriate \n ►Being constantly “on the go” and acting as if driven by a motor\n ►Being unable to quietly play or take part in hobbies and activities \n ►Talking excessively \n ►Answering questions before they are fully asked or finishing other people’s sentences\n ►Struggling to wait or be patient, such as when playing a game or waiting in line\n ►Interrupting or intruding on others, for example, in conversations, games, or meetings",
    "What causes ADHD?\nResearchers are not sure what causes ADHD, although many studies suggest that genes play a large \nrole. Like many other disorders, ADHD probably results from a combination of factors. \nIn addition to genetics, researchers are looking at differences in brain development and neurobiology \namong people with ADHD compared to those without the disorder. They are also studying environmental factors that might increase the risk of developing ADHD, including brain injuries, nutrition, and social environments.\nHow is ADHD diagnosed? \nBased on their specific symptoms, a person can be diagnosed with one of three types of ADHD:\n ►Inattentive : Mostly symptoms of inattention but not hyperactivity or impulsivity\n ►Hyperactive-impulsive : Mostly symptoms of hyperactivity and impulsivity but not inattention\n ►Combined : Symptoms of both inattention and hyperactivity and impulsivity",
    "►Combined : Symptoms of both inattention and hyperactivity and impulsivity\nADHD symptoms must begin in childhood (before age 12). Symptoms often continue into the teen years and adulthood. The criterion for a diagnosis differs slightly based on age.  \n ►Children up to 16 years must show at least six symptoms of inattention, hyperactivity and impulsivity, or both.\n ►Adults and youth over 16 years must show at least five symptoms of inattention, hyperactivity and impulsivity, or both.\nTo be diagnosed with ADHD, a person’s symptoms must also:\n ►Occur for at least 6 months\n ►Be present in two or more settings (for example, at home, at work, in school, or with friends)\n ►Interfere with or impair social, school, or work functioning",
    "►Interfere with or impair social, school, or work functioning\nStress, sleep disorders, anxiety, depression, and other physical conditions or illnesses can cause similar symptoms to those of ADHD. A health care provider needs to do a thorough evaluation to determine the cause of symptoms, make a diagnosis, and identify effective treatments.\nPrimary care providers sometimes diagnose and treat ADHD, or they may refer the person to a mental \nhealth professional. During an evaluation, a provider usually:\n ►Examines the person’s mental health and medical history, including their mood and past or current health conditions.\n ►Looks at the person’s current or, if an adult, childhood behavior and school experiences. To obtain this information, the provider may ask for permission to talk with family, friends, partners, teachers, and others who know the person well and have seen them in different settings to learn about behaviors and experiences at home, school, or elsewhere.",
    "►Uses standardized behavior rating scales or ADHD symptom checklists to determine whether the person meets the criteria for a diagnosis of ADHD.\n ►Administers psychological tests that look at cognitive skills, such as working memory, executive functioning (abilities such as planning and decision-making), visual and spatial abilities, or reasoning. Such tests can help identify psychological or cognitive (thinking-related) strengths and challenges and identify or rule out possible learning disabilities.",
    "Does ADHD look the same in everyone?\nAnyone can have ADHD. However, boys and men tend to display more hyperactive and impulsive \nsymptoms, while girls and women are more likely to be diagnosed with inattentive ADHD. \nADHD can also be diagnosed at any age, although symptoms must have begun in childhood (before \nage 12). Adults with ADHD often have a history of problems with school, work, and relationships. \nADHD symptoms may change as a person gets older. \n ►Children show hyperactivity and impulsivity as the most common symptoms. As academic and \nsocial demands increase, symptoms of inattention often become more prominent and begin to interfere with academic performance and peer relationships. \n ►Adolescents  usually show less hyperactivity and may appear as restless or fidgeting. Symptoms of",
    "inattention and impulsivity typically continue and may cause academic, organizational, or relationship challenges. Teens with ADHD are more likely to engage in impulsive, risky behaviors, such as substance use and unsafe sexual activity. \n ►Adults, including older adults,  can show inattention, restlessness, and impulsivity, although, in \nsome people, those symptoms become less severe and less impairing. They may also be irritable, have a low tolerance for frustration and stress, or experience frequent or intense mood changes. \nSome adults may not have been diagnosed with ADHD when younger because their teachers or family did not recognize the disorder, they had a mild form of the disorder, or they managed well until experiencing the demands of adulthood. But it is never too late to seek a diagnosis and treatment for ADHD and other mental health conditions that may co-occur with it. Effective treatment can make day-to-day life easier for people with ADHD and their families.",
    "How is ADHD treated?\nAlthough there is no cure for ADHD, current treatments may help reduce symptoms and improve functioning. Common treatments for ADHD are medication, psychotherapy, and other behavioral interventions. For children, treatment often includes parent education and school-based programs. \nResearchers are studying new treatments for people with ADHD, such as cognitive training and \nneurofeedback. These options are usually explored only after medication and psychotherapy have \nalready been tried. For many people, treatment involves a combination of elements.\nMedication\nStimulants are the most common type of medication used to treat ADHD, and research shows them to \nbe highly effective. They work by increasing levels of brain chemicals involved in thinking and attention. \nLike all medications, stimulants can have side effects and must be prescribed and monitored by a",
    "Like all medications, stimulants can have side effects and must be prescribed and monitored by a \nhealth care provider. Tell the provider about other medications you or your child are taking. Medications for common health problems, such as diabetes, anxiety, and depression, can interact with stimulants, in which case, a provider can suggest other medication options. \nHealth care providers sometimes prescribe nonstimulant medications like antidepressants to treat \nADHD. However, the U.S. Food and Drug Administration (FDA) has not approved these medications specifically for ADHD. Sometimes, a person must try several different medications or dosages before finding the one that works for them.\nNIMH has information on stimulants and other mental health medications at www.nimh.nih.gov/\nmedications . You can learn more about specific medications, including the latest approvals, side \neffects, warnings, and patient information, on the FDA website at www.fda.gov/drugsatfda .",
    "Psychotherapy and behavioral interventions \nPsychological interventions for ADHD can take many forms and be combined with medication and \nother elements for parents, families, and teachers. Adding therapy to an ADHD treatment plan can help some people better cope with daily challenges, gain confidence, or manage impulsive and risky behaviors. \nTherapy is especially helpful if ADHD co-occurs with other mental disorders, such as anxiety, \ndepression, conduct problems, or substance use disorders. You can learn about other mental disorders at www.nimh.nih.gov/health .\nSeveral psychosocial interventions have been shown to help manage symptoms and improve functioning. \n ►Behavioral therapy helps a person change their behavior. It might involve practical assistance, such as organizing tasks or completing schoolwork, learning social skills, or monitoring one’s behavior. \n ►Cognitive behavioral therapy  helps a person become aware of attention and concentration",
    "►Cognitive behavioral therapy  helps a person become aware of attention and concentration \nchallenges and work on skills to improve focus and organization and complete daily tasks (for instance, by breaking large tasks into smaller, more manageable steps).\n ►Family and marital therapy  helps family members learn to handle disruptive behaviors, encourage \nbehavior changes, and improve interactions with children and partners.\nSome people find it helpful to get support from a professional life coach or ADHD coach who can teach them skills to improve daily functioning. \nFor more information on psychotherapy, including what to look for in a therapist and how to find one, \nvisit www.nimh.nih.gov/psychotherapies .\nParent education and support",
    "visit www.nimh.nih.gov/psychotherapies .\nParent education and support\nTherapy for children and teens requires parents to play an active role. Treatment sessions with the child alone are more likely to be effective for treating symptoms of anxiety or depression that may co-occur with ADHD than for managing core symptoms of the disorder. \nMental health professionals can educate parents about the disorder and how it affects a family. They \nalso can help parents develop new skills, attitudes, and ways of relating to their child. Examples include parenting skills training, stress management techniques for parents, and support groups that help parents and families connect with others who have similar concerns.\nSchool-based programs\nMany children and teens with ADHD benefit from school-based behavioral interventions and",
    "Many children and teens with ADHD benefit from school-based behavioral interventions and  \nacademic accommodations. Interventions include behavior management plans or classroom-taught organizational and study skills. Accommodations include preferential seating in the classroom, reduced classwork, and extended time on tests and exams. Schools may provide accommodations through what is called a 504 Plan or, for children who qualify for special education services, an Individualized Education Plan (IEP).  \nTo learn more about special education services and the Individuals with Disabilities Education Act, \nvisit https://idea.ed.gov .",
    "Cognitive training\nCognitive training approaches involve repeatedly using a program or activity over several  \nweeks to improve specific functions, such as memory or attention. Exercises are tailored to the person’s ongoing performance. \nCognitive training is shown to modestly improve the tasks being practiced. For instance, research shows \nthe training can help memory, attention, inhibition, planning, and cognitive flexibility in people with ADHD. However, these improvements don’t usually translate to changes in core ADHD symptoms of impulsivity and hyperactivity.\nNeurofeedback",
    "Neurofeedback\nNeurofeedback is a noninvasive technique in which an electronic device monitors and records a person’s brain activity, providing them with immediate feedback to support self-regulation. The device measures brain activity through such means as EEG or fMRI scans and feeds the information back to the person, usually in the form of a computer screen or visual cue. Through this feedback, people learn to self-regulate their brain activity to directly alter the associated behavior. The assumption is that, with repeated, real-time information, people can change their internal brain activity, with observable effects on behavior and cognition. \nFor people with ADHD, neurofeedback is used to train and improve specific cognitive functions.",
    "For people with ADHD, neurofeedback is used to train and improve specific cognitive functions. \nAlthough it is shown to help reduce some ADHD symptoms, the effects of neurofeedback remain lower than those seen from medication and psychotherapy. Additional research is needed to refine the treatment and determine for whom it works and under what conditions.\nComplementary health approaches\nSome people may explore complementary health approaches to manage symptoms of ADHD. These can include natural products, vitamins and supplements, diet changes, and acupuncture. Others find  \nit helpful to make lifestyle changes, like adding more physical exercise to their daily schedule.\nUnlike psychotherapy and medication that are scientifically shown to improve ADHD symptoms, \ncomplementary health approaches generally have not been found to treat ADHD effectively and do not qualify as evidence-supported interventions.",
    "For more information, visit the National Center for Complementary and Integrative Health at  \nwww.nccih.nih.gov/health/attention-deficit-hyperactivity-disorder-at-a-glance . \nHow can I find help?\nIf you’re unsure of where to get help, a health care provider is a good place to start. They can refer \nyou to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help figure out the next steps. Find tips for talking with a health care provider about your or your child’s mental health at www.nimh.nih.gov/talkingtips . \nThe Centers for Disease Control and Prevention (CDC) has information about ADHD symptoms, diagnosis, and treatment, as well as additional resources for families and providers, at www.cdc.gov/adhd .\nThe Substance Abuse and Mental Health Services Administration (SAMHSA) also has resources  \nfor finding support at https://findsupport.gov  and locating mental health services in your area at",
    "https://findtreatment.gov . For additional resources, visit www.nimh.nih.gov/findhelp .",
    "How can I help myself?\nMedication and therapy are the most effective treatments for ADHD. Other strategies may also help \nmanage symptoms.\n ►Get regular exercise, especially when feeling hyperactive or restless.\n ►Eat regular, healthy meals.\n ►Get plenty of sleep. Try to turn off screens at least 1 hour before bedtime and get between 7–9 hours of sleep every night.\n ►Stick to a consistent routine. \n ►Work on time management and organization. Prioritize time-sensitive tasks and write down assignments, messages, appointments, reminders, and important thoughts. \n ►Take short breaks during tasks that require sustained attention to help maintain focus and prevent burnout. Break large tasks into smaller, more manageable steps.\n ►Connect with people and maintain relationships. Schedule activities with friends, particularly supportive people who understand your challenges with ADHD. \n ►Take medications as directed. Avoid alcohol, tobacco, and drugs not prescribed for you.",
    "►Take medications as directed. Avoid alcohol, tobacco, and drugs not prescribed for you.\nHow can I help my child?\n ►Be patient, flexible, and understanding. ADHD can be frustrating both for people who have it and the people in their lives. ADHD may make it hard for your child to perform certain tasks or behaviors. Some children may need to use different strategies to help them succeed.  \n ►Use clear, simple, direct language to explain rules and expectations. Reward behaviors that meet these expectations with positive reinforcement. Provide consistent praise or rewards for acting in a desired way.\n ►Offer practical help, such as on tasks like cleaning and organizing, or simply be present and engaged while your child works, which can give them a sense of accountability and motivation and help them stay focused and on track.\n ►Provide opportunities to explore different activities and interests. Help your child discover their unique talents and build confidence in their abilities.",
    "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, \ncall 911 .",
    "Clinical trials\nClinical trials are research studies that look at ways to prevent, detect, or treat diseases and \nconditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\nNIMH supports clinical trials across the United States. Talk to a health care provider about clinical \ntrials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials . \nFor more information\nLearn more at www.nimh.nih.gov/health . For information about various health topics, visit the \nNational Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .\nContact us\nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications \n60\n01 Executive Boulevard, MSC 9663",
    "60\n01 Executive Boulevard, MSC 9663  \nBethesda, MD 20892-9663  Phone: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov   \nEn español: www.nimh.nih.gov/espanol  \nReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright . \nU.S. DEP ARTMENT  OF HEALTH A ND HUMAN S ERVICES \nNational Institutes of Health \nNIH Publication No. 24-MH-8300 \n2024",
    "ADHD in Adults: \nThings to Know4\nFrom the NATIONAL INSTITUTE of  MENTAL HEALTH\n1Adults can have ADHD. \nAttention-deficit/hyperactivity disorder (ADHD) is \nmarked by a persistent pattern of inattention and/or hyperactivity and impulsivity that makes it hard to function in at least two areas of life, such as at home, school, or work.\nAdults with ADHD may experience the following \ntypes of symptoms:\n ►Inattention : Difficulty paying attention, staying on \ntask, or being organized\n ►Hyperactivity : Excessive activity or restlessness, \neven at inappropriate times, and difficulty engaging in quiet activities \n ►Impulsivity : Acting without thinking or having \ntrouble with self-controlBased on their symptoms, a person can be diagnosed with one of three types of ADHD: inattentive, hyperactive-impulsive, or combined.\nAdults with ADHD often have a history of poor",
    "Adults with ADHD often have a history of poor \nacademic performance, work problems, or strained relationships. They may find it challenging to stay organized, stick to a job, keep appointments, perform daily tasks, or complete large projects. They may be restless, try to do multiple things at once, or engage in risky or impulsive behaviors. \nADHD is considered a developmental disorder because symptoms must begin  \nin childhood—but many adults also have ADHD.\n2 ADHD symptoms can cause problems in daily life.\nADHD symptoms interfere with daily functioning. In adults, symptoms can lead to:\n ►Difficulty paying attention and often getting distracted\n ►Disorganization and procrastination\n ►Poor time management, planning, or organization\n ►Trouble remembering daily tasks\n ►Frequently losing things or being forgetful in activities\n ►Frequently interrupting others or being very talkative\n ►Trouble focusing on a large task or multitasking\n ►Trouble following instructions or finishing projects",
    "►Trouble following instructions or finishing projects\n ►Difficulty sitting still for long periods and often moving or fidgeting\n ►Feelings of restlessness and a need for constant activity or stimulation\n ►Choosing immediate rewards over future rewards or consequencesMany people show some of these behaviors some of the time. However, for adults with ADHD, they are more severe, frequent, and persistent, interfering with daily life, occurring across multiple situations, and lasting at least 6 months.\nADHD often co-occurs with other mental disorders \nand can make them harder to treat. Sleep problems are especially prevalent, affecting up to 70% of adults with ADHD.\nSymptoms continue into adulthood for many  \npeople with ADHD, but they may change with age. For instance, inattentive symptoms often persist  as people get older, whereas hyperactivity and impulsivity are more likely to decline. Learn  \nmore about symptoms and types of ADHD at  www.nimh.nih.gov/ADHD .",
    "3ADHD is diagnosed differently in children and adults.\nADHD can be diagnosed in childhood or adulthood. \nHowever, adults must have shown symptoms much earlier, starting before age 12. \nThe main difference between diagnosing ADHD  \nin children and adults is the number of symptoms. \nAdults or adolescents over 16 years must show  five (instead of six) symptoms of inattention or hyperactivity and impulsivity. \nHow can a provider know if I showed \nADHD symptoms as a child?\nDiagnosing ADHD in adulthood is complicated  \nby the need to show symptoms before age 12.  \nFor this reason, a diagnosis relies heavily on past reports of behavior. \nTo help diagnose ADHD, a primary care provider or \nmental health professional may ask to talk to people who know you well, such as a partner, family members, and friends, to learn about your behavior in different situations and during childhood. They may look at school reports or other childhood records.\nA provider will also talk to you and may ask you to",
    "A provider will also talk to you and may ask you to \ndo the following: \n ►Complete clinical interviews, behavior rating scales, or symptom checklists to determine whether you meet the criteria for a diagnosis  \nof ADHD.\n ►Take psychological tests that look at cognitive processes, such as memory, planning, decision-making, reasoning, and thinking, to identify strengths and challenges and possible learning disabilities.\n ►Report on your mood and current and past medical conditions to rule out alternative diagnoses and establish an overall treatment plan.Why wasn’t I diagnosed with  \nADHD earlier? \nThere are many reasons someone may not be \ndiagnosed with ADHD until adulthood. For instance, your teachers and parents may not have recognized the disorder or may have provided supportive environments that helped you thrive despite it. Or you may have a milder form of ADHD that could be managed well until faced with the stresses and demands of adulthood, especially at work.",
    "ADHD symptoms among girls and women  \nare especially likely to have been missed in childhood. Sex differences in diagnosis rates begin to even out in adulthood. \nIt is never too late to seek a diagnosis and treatment \nfor ADHD and any other mental health condition that may occur with it. Effective treatment can make day-to-day life easier for many adults and their \nfamilies. Find tips for talking with a health care \nprovider at www.nimh.nih.gov/talkingtips .\nYou can learn more about getting help at  www.nimh.nih.gov/findhelp . The Substance Abuse \nand Mental Health Services Administration (SAMHSA) provides information about finding support at https://findsupport.gov  and locating mental health \nservices in your area at https://findtreatment.gov .",
    "4Treatment is available for adults with ADHD.\nTreatment for ADHD can reduce symptoms and \nimprove functioning. The most common treatments for ADHD in adults are:  \n ►Medication, usually stimulant medications\n ►Psychotherapy, like behavioral and cognitive behavioral therapy\nEffective treatment often involves a combination  of elements. Sometimes, people must try several treatments before finding the one that works  for them.\nNIMH has information on stimulants and  \nother mental health medications at  www.nimh.nih.gov/medications . You can  \nlearn about psychotherapy, including what  to look for in a therapist and how to find one, at www.nimh.nih.gov/psychotherapies .Some adults may find it helpful to get support from a life coach or ADHD coach who can teach them executive function skills to improve daily functioning. Others try lifestyle changes, like adding more physical exercise to their daily schedule.\nPeople whose ADHD symptoms cause impairment",
    "People whose ADHD symptoms cause impairment \nat work may qualify for reasonable accommodations under the Americans with Disabilities Act (ADA). You can learn more about the ADA at www.ada.gov .\nFind additional resources\nThe following organizations have more information on ADHD:\n ►Attention Deficit Disorder Association : \nOffers an array of resources to find help, including virtual support groups and a professional directory, at https://add.org\n ►Children and Adults with Attention-Deficit/Hyperactivity Disorder :  \nHosts a National Resource Center with information, links, and resources at https://chadd.org/nrc\n ►Centers for Disease Control and Prevention :  \nProvides information and resources on ADHD symptoms, diagnosis, and treatment options at  www.cdc.gov/adhd\nNote : This resource list is for informational purposes only. It is not comprehensive, and an organization’s \ninclusion does not constitute an endorsement by NIMH.",
    "What are clinical trials and why are they important? \nClinical trials are research studies that look  \nat ways to prevent, detect, or treat diseases and conditions.\nThese studies help show whether a treatment \nis safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care.  Other people, such as those with health conditions, join to try treatments that aren’t widely available.\nNIMH supports clinical trials across the  \nUnited States. Talk to a health care provider about clinical trials and whether one is right  \nfor you. For more information, visit   \nwww.nimh.nih.gov/clinicaltrials .\nFor more information\nLearn more at www.nimh.nih.gov/\nhealth . For information about various \nhealth topics, visit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .National Institute of Mental Health  Office of Science Policy, Planning,  and Communications",
    "6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  \nPhone: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.govReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as a source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright.\nNIH Publication No. 24-MH-3573 2024Follow us on  \nsocial media @NIMHgov",
    "Autism  \nSpectrum  \nDisorder",
    "What is autism spectrum disorder?\nAutism spectrum disorder (ASD) is a neurological and developmental disorder \nthat affects how people interact with others, communicate, learn, and behave. Although autism can be diagnosed at any age, it is described as a “developmental disorder” because symptoms generally appear in the first two years of life.\nAccording to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) , a \nguide created by the American Psychiatric Association that health care providers \nuse to diagnose mental disorders and developmental disorders, people with ASD often have:\n●Difficu\nlty with social communication and interaction with other people\n●Rest\nricted interests and repetitive behaviors\n●Symp\ntoms that affect their ability to function in school, work, and other areas\nof life\nAutism is known as a “spectrum” disorder because people with autism have a \nrange of characteristics, needs, strengths, and challenges.",
    "range of characteristics, needs, strengths, and challenges.\nPeople of all ages, races, ethnicities, sexes, and economic backgrounds can be \ndiagnosed with ASD. Although ASD can be a lifelong disorder, treatments, \nservices, and supports can improve a person’s health, well-being, and daily \nfunctioning. T he American Academy of Pediatrics recommends that all children \nreceive\n screening for autism. Caregivers should talk to their child’s health care \nprovider about ASD screening or evaluation.\nWha\nt are the signs and symptoms of ASD?\nThe list below gives some examples of different types of behaviors that are \ncommon among people diagnosed with ASD. Not all people with ASD will have all behaviors, but most will have several of the behaviors listed below.\nSocial communication and social interaction behaviors may include:\n●Maki\nng little or inconsistent eye contact\n●Appe\naring not to look at or listen to people who are talking\n●Infr",
    "●Appe\naring not to look at or listen to people who are talking\n●Infr\nequently sharing interest, emotion, or enjoyment of objects or activities\n(including infrequently pointing at or showing things to others)\n●Not re\nsponding or being slow to respond to one’s name or other verbal bids\nfor attention\n●Havi\nng difficulties with the back and forth of conversation\n●Ofte\nn talking at length about a subject of interest without considering social\ncues or conversational give-and-take\n●Disp\nlaying facial expressions, movements, and gestures that do not match\nwhat is being said",
    "●Having an unusual tone of voice that may sound flat, lacking emotion or  \ntonal variation \n ●Having trouble understanding another person’s point of view or being unable to predict or understand other people’s actions\n ●Difficulties adjusting behavior to different social situations \n ●Difficulties sharing in imaginative play or in making friends\nRestrictive/repetitive behaviors may include:\n ●Repeating certain behaviors or having unusual behaviors, such as repeating words or phrases (a behavior called echolalia )\n ●Having a lasting intense interest in specific topics, such as numbers, details, or facts\n ●Showing overly focused interests, such as with moving objects or with parts of objects\n ●Becoming upset by slight changes in a routine and having difficulty with transitions\nAutistic people often have sensory differences such as:\n ●Being more sensitive or less sensitive than other people to sensory input, such as light, sound, clothing, or temperature",
    "People with ASD also may experience sleep problems and irritability. \nPeople on the autism spectrum also may have many strengths, including:\n ●Being able to learn things in detail and remember information for long periods \nof time\n ●Being strong visual and auditory learners\n ●Excelling in math, science, music, or art\nWhat causes ASD?\n Researchers do not know the primary causes of ASD, but studies suggest that a person’s genes and aspects of their environment may affect development in ways that lead to ASD. Some factors that are associated with an increased likelihood of developing ASD include:\n ●Having a sibling with ASD\n ●Having older parents\n ●Having a very low birth weight ●Having certain genetic conditions (such as Down syndrome or Fragile X syndrome)\nNot everyone who has these factors will develop ASD.\nHow is ASD diagnosed?",
    "Not everyone who has these factors will develop ASD.\nHow is ASD diagnosed?\nHealth care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by the age of 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.",
    "Diagnosis in young children\nDiagnosis in young children is often a two-stage process.\nStage 1: General developmental screening during well-child checkups\nEvery child should receive well-child checkups with a pediatrician or an early \nchildhood health care provider. The American Academy of Pediatrics recommends that all children receive screening for developmental delays at their 9-, 18-, and 24- or 30-month well-child visits, with specific autism screenings at the 18- and 24-month well-child visits. A child may receive additional screenings if they have an increased likelihood of developing ASD or developmental problems. \nConsidering caregivers’ experiences and concerns is an important part of the",
    "Considering caregivers’ experiences and concerns is an important part of the \nscreening process for young children. The health care provider may ask questions about the child’s behaviors and evaluate those answers together with information from ASD screening tools and clinical observations of the child. To learn more about ASD screening, visit the Centers for Disease Control and \nPrevention (CDC) website at www.cdc.gov/autism/diagnosis .\nThe health care provider may refer the child for additional evaluation if they show \ndevelopmental differences in behavior or functioning during this screening process.\nStage 2: Additional diagnostic evaluation\nIt is important to accurately detect and diagnose children with ASD as early as possible, as this will shed light on their unique strengths and challenges. Early detection can also help caregivers determine which services, educational programs, and behavioral therapies are most likely to be helpful for their child.",
    "A team of health care providers who have experience diagnosing ASD will \nconduct the diagnostic evaluation. This team may include child neurologists, developmental behavioral pediatricians, speech-language pathologists, child psychologists and psychiatrists, educational specialists, and occupational therapists. \nThe diagnostic evaluation is likely to include:\n ●Medical and neurological examinations\n ●Assessment of the child’s cognitive abilities\n ●Assessment of the child’s speech and language abilities\n ●Observation of the child’s behavior\n ●An in-depth conversation with the child’s caregivers about the child’s behavior \nand development\n ●Assessment of age-appropriate skills needed to complete daily activities independently, such as eating, dressing, and toileting\n ●Questions about the child’s family history",
    "Because ASD is a complex disorder that sometimes occurs with other conditions \nor learning disorders, the comprehensive evaluation may include blood tests and a hearing test.\nThe outcome of this evaluation may result in a formal diagnosis and \nrecommendations for treatment.\nDiagnosis in older children and adolescents\nCaregivers and teachers are often the first to recognize ASD symptoms in older children and adolescents. The school’s special education team may perform an initial evaluation and then recommend that a child receive additional evaluation from their primary health care provider or a health care provider who specializes in ASD.\nA child’s caregivers may talk with these health care providers about the child’s",
    "A child’s caregivers may talk with these health care providers about the child’s \nsocial difficulties, including problems with subtle communication. These subtle communication differences may include problems understanding tone of voice, facial expressions, or body language. Older children and adolescents may have trouble understanding figures of speech, humor, or sarcasm. They also may have challenges forming friendships with peers. \nIt is also important for the health care provider to learn about the child’s strengths \nso they can tailor their recommendations for services and supports. \nDiagnosis in adults\nDiagnosing ASD in adults is often more difficult than diagnosing ASD in children. In adults, some ASD symptoms can overlap with symptoms of mental disorders such as an anxiety disorder or attention-deficit/hyperactivity disorder (ADHD).\nAdults who have questions about whether they may be on the autism spectrum",
    "Adults who have questions about whether they may be on the autism spectrum \nshould talk with a health care provider and ask for a referral for an ASD evaluation. Although evaluation for ASD in adults is still being refined, adults can be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. The expert will ask about:\n ●Social interaction and communication challenges\n ●Sensory issues ●Repetitive behaviors\n ●Restricted interests\nThe evaluation may also include a conversation with caregivers and family members to learn about the person’s early developmental history, which can help ensure an accurate diagnosis. \nObtaining a correct diagnosis of ASD as an adult can help people understand \npast challenges, identify personal strengths, and find the right kind of help. Studies are underway to determine the types of services and supports that are most helpful for autistic transition-age youth and adults.",
    "What treatments and services are available for ASD?\nInterventions, services, and supports for ASD are most effective when they begin \nas soon as possible after diagnosis. Receiving appropriate care and services can help address a person’s specific needs and challenges while also helping them learn new skills and build on their strengths.\nPeople with ASD have a wide range of issues and needs, which means there is \nno single best approach. Working closely with health care and service providers is an important part of finding the right combination of interventions, services, and supports. \nInterventions and Services",
    "Interventions and Services\nPeople with ASD may be referred to health care and service providers who specialize in various intervention approaches, including behavioral, psychological, educational, occupational, physical, or speech-language therapy. These interventions and services are often highly structured and intensive and may involve caregivers, siblings, and other family members. These programs may help people:\n ●Learn social, communication, and language skills\n ●Manage behaviors that interfere with daily functioning and well-being\n ●Increase or build on strengths\n ●Learn life skills for living independently \n ●Find housing, educational supports, and job coaching or training\nMedication\nA health care provider may prescribe medication to treat specific symptoms, including:\n ●Aggression\n ●Anxiety and depression\n ●Attention\n ●Hyperactivity ●Irritability\n ●Repetitive behavior\n ●Self-injurious behavior",
    "●Attention\n ●Hyperactivity ●Irritability\n ●Repetitive behavior\n ●Self-injurious behavior\nRead the most up-to-date information on medication, side effects, and warnings on the U.S. Food and Drug Administration (FDA) website at www.fda.gov/drugsatfda .",
    "Finding services, programs, and resources\nMany services, programs, and other resources are available to help people with \nautism and their families. Here are some tips for finding these additional resources:\n●Con\ntact a health care provider, local health department, school, community\ncenter, or autism advocacy group to learn about special programs or\nloc\nal resources.\n●Find\n an autism support group. Sharing information and experiences can help\npeople with autism and their caregivers learn about treatment options andautism-related programs.\n●Kee\np records of your conversations and meetings with health care providers\nand teachers. This information helps when it is time to decide which programsand services are appropriate.\n●Kee\np copies of health care reports and evaluations. This information may help\npeople with autism qualify for special programs.\nWhere can I learn more about ASD?\nFor more information about ASD, visit:\n●Cen\nters for Disease Control and Prevention\nwww\n.cdc.gov/autism",
    "●Cen\nters for Disease Control and Prevention\nwww\n.cdc.gov/autism\n●Euni\nce Kennedy Shriver  National Institute of Child Health and Human\nDevelopment\nwww\n.nichd.nih.gov/health/topics/autism\n●Int\neragency Autism Coordinating Committee\nhtt\nps://iacc.hhs.gov\n●Nat\nional Institute on Deafness and Other Communication Disorders\nwww\n.nidcd.nih.gov/health/autism-spectrum-disorder-communication-\nproblems-children",
    "Clinical trials\nClinical trials are research studies that look at ways to prevent, detect, or treat \ndiseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\nNIMH supports clinical trials across the United States. Talk to a health care \nprovider about clinical trials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nFor more information\nLearn more at www.nimh.nih.gov/health . For information about various  \nhealth topics, visit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .\nNational Institute of Mental Health Office of Science Policy, Planning, and Communications 6001 Executive Boulevard, MSC 9663  \nBethesda, MD 20892-9663",
    "Bethesda, MD 20892-9663  \nnimhinfo@nih.gov   \nwww.nimh.nih.gov/health  \nwww.nimh.nih.gov/espanol  \nReprints\nThe information in this publication is in the public domain and may be reused  or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content  at www.nimh.nih.gov/copyright .\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 25-MH-8084 Revised 2025",
    "Disorder Bipolar\nin Children  \nand Teens",
    "Does your child go through extreme changes in mood and \nbehavior?  Does your child get much more excited or much more \nirritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows in mood and energy levels more often than other children? Do these mood changes affect how your child acts at school or home?\nSome children and teens with these symptoms may have bipolar \ndisorder , a mental illness that causes unusual shifts in mood, \nenergy, activity levels, and day-to-day functioning. With treatment, \nchildren and teens with bipolar disorder can improve over time.\nWhat is bipolar disorder?\nBipolar disorder (formerly called manic-depressive illness or manic",
    "What is bipolar disorder?\nBipolar disorder (formerly called manic-depressive illness or manic \ndepression) is a mental illness that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. It is a common misperception that children cannot have bipolar disorder. Although most people are diagnosed with bipolar disorder in adolescence or adulthood, the symptoms can appear earlier in childhood. \nBipolar disorder is not the same as the typical ups and downs every child \ngoes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly.\nChildren with bipolar disorder sometimes feel very happy or “up” and are \nmuch more energetic and active than usual. This is called a manic episode . \nChildren with bipolar disorder sometimes feel very sad or “down” and are \nmuch less active than usual. This is called a depressive episode . Bipolar",
    "much less active than usual. This is called a depressive episode . Bipolar \ndisorder is often episodic, but it usually lasts a lifetime. \nBipolar disorder symptoms can make it hard to perform well in school or get \nalong with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide. Early diagnosis and treatment can lead to better functioning and well-being over the long term.\nSigns and symptoms of bipolar disorder may overlap with symptoms of other \ndisorders that are common in young people, such as attention-deficit/hyperactivity disorder (ADHD), conduct problems, major depression, and anxiety disorders.",
    "Diagnosing bipolar disorder can be complicated and requires a careful and \nthorough evaluation by a trained, experienced mental health professional.\nWith treatment, children and teens with bipolar disorder can manage their \nsymptoms and lead full, active lives.\nWhat causes bipolar disorder?\nThe exact causes of bipolar disorder are unknown, but several factors may contribute to the illness.\nFor example, researchers are beginning to uncover genetic factors linked to \nbipolar disorder and other mental illnesses. Research shows that a person’s chances of having bipolar disorder are higher if they have a close family member with the illness, which may be because they have the same genetic variations. However, just because one family member has bipolar disorder does not mean other family members will have it. Many genes are involved in the disorder, and no single gene causes it.\nResearch also suggests that people with a genetic risk of having bipolar",
    "Research also suggests that people with a genetic risk of having bipolar \ndisorder may be more likely to develop the disorder after experiencing trauma or other stressful life events.\nSome research studies have found differences in brain structure and function \nbetween people with bipolar disorder and people without it. Researchers are examining these differences to learn more about possible causes and effective treatments.\nWhat are the symptoms of bipolar disorder?\nMood episodes in bipolar disorder include intense emotions and significant changes in sleep habits, activity levels, thoughts, or behaviors. Children and teens with bipolar disorder may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that often last for several days or weeks. During an episode, symptoms occur every day and last for most of the day.",
    "These mood and activity changes are very different from the child’s usual \nbehavior and the behavior of healthy children and teens.\nChildren and teens having a manic episode  may:\n• Show intense happiness or silliness for long periods of time.\n• Have a very short temper or seem extremely irritable.",
    "• Talk fast about a lot of different things.\n• Have trouble sleeping but do not feel tired.\n• Have trouble staying focused and experience racing thoughts.\n• Seem overly interested or involved in pleasurable but risky activities.\n• Do risky or reckless things that show poor judgment.\n• Have an inflated sense of ability, knowledge, and power.\nChildren and teens having a depressive episode  may:\n• Feel frequent and unprovoked sadness.\n• Show increased irritability, anger, or hostility.\n• Complain a lot about physical pain, such as stomachaches and headaches.\n• Start sleeping a lot more.\n• Have difficulty concentrating.\n• Feel hopeless and worthless.\n• Have difficulty communicating or maintaining relationships.\n• Eat too much or too little.\n• Have low energy and no interest in activities they usually enjoy.\n• Think about death or have thoughts of suicide.\nCan children and teens with bipolar disorder have  \nother problems?",
    "Can children and teens with bipolar disorder have  \nother problems?\nYoung people with bipolar disorder can have several problems at the same \ntime. For example,  they may also be at risk of misusing alcohol or drugs. \nSometimes extreme behaviors go along with mood episodes. During manic episodes, young people with bipolar disorder may take extreme risks that they wouldn’t usually take or that could cause them harm or injury. During depressive episodes, some young people with bipolar disorder may think about running away from home or have thoughts of suicide.\nIf your child shows signs of suicidal thinking, take these signs seriously and \ncall your child’s health care provider.\nIf your child is struggling or having thoughts of suicide, call or text the 988 \nSuicide & Crisis Lifeline at  988  or chat at 988lifeline.org . This service is \nconfidential, free, and available 24 hours a day, 7 days a week.",
    "How is bipolar disorder diagnosed?\nA health care provider will ask questions about your child’s mood, sleeping \npatterns, energy levels, and behavior. There are no blood tests or brain scans that can diagnose bipolar disorder. However, the health care provider may use tests to determine if something other than bipolar disorder is causing your child’s symptoms. Health care providers may need to know about medical conditions in the family, such as depression or substance use.\nOther disorders—such as ADHD, disruptive mood dysregulation disorder, \noppositional defiant disorder, conduct disorder, and anxiety disorders—have symptoms like those of bipolar disorder. It can be challenging to distinguish bipolar disorder from depression that occurs without mania, referred to as “major depression.” A health care provider who specializes in working with children and teens can carefully evaluate your child’s symptoms to provide an accurate diagnosis.\nHow is bipolar disorder treated?",
    "How is bipolar disorder treated?\nChildren and teens can work with their health care provider to develop a treatment plan to help them manage their symptoms and improve their quality of life. It is important to follow the treatment plan, even when your child is not currently experiencing a mood episode. Steady, dependable treatment works better than treatment that starts and stops. \nSeveral types of medication can help treat symptoms of bipolar disorder.",
    "Several types of medication can help treat symptoms of bipolar disorder. \nChildren respond to medications in different ways. They may need to try different types of medication to find the one that works best for them. Some children may need more than one type of medication because their symptoms are complex. Health care providers usually try to prescribe the fewest number of medications and the smallest doses possible to help treat a child’s symptoms. Always tell your child’s health care provider about any medication side effects. Do not stop giving your child a prescribed medication without speaking to a health care provider. Stopping medication suddenly can be dangerous and can make symptoms worse.\nDifferent kinds of psychosocial therapy can also help children and their",
    "Different kinds of psychosocial therapy can also help children and their \nfamilies manage the symptoms of bipolar disorder. Therapies based on scientific research—including cognitive behavioral approaches and family-focused therapy—can provide support, education, and guidance to youth and their families. These therapies teach skills that can help people manage bipolar disorder, including skills for maintaining routines, enhancing emotion regulation, and improving social interactions.",
    "What can children and teens expect from treatment?\nWith treatment, daily functioning and well-being can improve over time. \nTreatment is more effective when health care providers, caregivers, and young people work together.\nSometimes a child’s symptoms may change or disappear and then come back. \nWhen this happens, your child’s health care provider may recommend changes to the treatment plan. Treatment can take time but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.\nYour child’s health care provider may recommend keeping a daily life chart or \nmood chart to track your child’s moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.\nHow can I help my child or teen?\nHelp begins with an accurate diagnosis and treatment. Talk to your child’s health care provider about any symptoms you notice.",
    "If your child has bipolar disorder, here are some basic things you can do:\n• Be patient.\n• Encourage your child to talk, and listen to your child carefully.\n• Pay attention to your child’s moods, and be alert to any major changes.\n• Understand triggers and learn strategies for managing intense emotions \nand irritability.\n• Help your child have fun.\n• Remember that treatment takes time: Sticking with the treatment plan can help your child get better and stay better.\n• Help your child understand that treatment can make life better.\nHow does bipolar disorder affect caregivers and families?\nCaring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a child’s mood episodes and other symptoms—such as short tempers and risky behaviors—can challenge any caregiver.\nIt is important that caregivers take care of themselves, too. Find someone you",
    "It is important that caregivers take care of themselves, too. Find someone you \ncan talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.",
    "Where do I go for help?\nIf you’re unsure of where to get help, your doctor, pediatrician, or other  \nfamily health care provider is a good place to start. A health care provider  \ncan refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating bipolar disorder and can evaluate your child’s symptoms.\nLearn more about getting help on the National Institute of Mental Health \n(NIMH) website at www.nimh.nih.gov/findhelp . The Substance Abuse \nand Mental Health Services Administration has an online tool at  https://findtreatment.samhsa.gov  to help you find mental health  \nservices in your area.\nIf 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 \n988lifeline.org . In life-threatening situations, call 911 .\nWhat should I know about clinical trials?",
    "What should I know about clinical trials?\nNIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions—including bipolar disorder. Although individuals 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.\nResearchers at NIMH and around the country conduct clinical trials with \npatients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .",
    "Reprints\nThis publication is in the public domain and may be reproduced or copied \nwithout permission from NIMH. We encourage you to reproduce and use NIMH publications in your efforts to improve public health. If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more about citing NIMH publications, refer to www.nimh.nih.gov/reprints . \nFor More Information\nNIMH website  \nwww.nimh.nih.gov  \nwww.nimh.nih.gov/espanol  (en español)\nMedlinePlus  (National Library of Medicine)  \nhttps://medlineplus.gov  \nhttps://medlineplus.gov/spanish  (en español)\nClinicalTrials.gov   \nwww.clinicaltrials.gov  \nhttps://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health Office of Science Policy, Planning, and Communications 6001 Executive Boulevard  \nRoom 6200, MSC 9663 Bethesda, MD 20892-9663 Toll-free: 1-866-615-6464  \nEmail: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov  \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES",
    "Website: www.nimh.nih.gov  \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 23-MH-8081 Revised 2023National Instituteof Mental Health",
    "National Institute\nof Mental Healthwww.nimh.nih.gov/bipolardisorderBipolar Disorder in Teens and \nYoung Adults: Know the Signs\nBipolar disorder is a mental illness that causes unusual and extreme  \nshifts in mood, marked by episodes of mania and depression.  \nDuring these episodes, symptoms last for days or weeks at a time.\nIf you or someone you know is struggling or having thoughts of suicide, help is available.\nFor c risis c ounseling a nd support, \ncall or text \n988 \n(988 Suicide & Crisis Lifeline).In life-threatening situations,  \ncall 911.Common signs & symptoms of mania\n•Showing intense happiness or silliness\n•Having a very short temper or seeming extremely irritable\n•Talking very fast or having racing thoughts\n•Having an inflated sense of ability, knowledge, and power\n•Doing reckless things that show poor judgment\n•Feeling very sad or hopeless\n•Feeling lonely or isolating from others\n•Eating too much or too little\n•Having little energy and no interest in usual activities",
    "•Eating too much or too little\n•Having little energy and no interest in usual activities\n•Sleeping too muchCommon signs & symptoms of depression\nNIMH Identification No. OM 23-4318",
    "Bipolar \nDisorder",
    "What is bipolar disorder?\nBipolar disorder is a mental illness that can be chronic (persistent or constantly \nrecurring) or episodic (occurring occasionally and at irregular intervals). People sometimes refer to bipolar disorder with the older terms manic-depressive disorder or manic depression.\nEveryone experiences ups and downs, but with bipolar disorder, the range of mood \nchanges can be extreme. People with the disorder have manic episodes or unusually elevated moods in which the person might feel excessively happy, irritable, or “up,” with a marked increase in activity level compared to their usual self. They might also have depressive episodes, in which they feel sad, indifferent, or hopeless, combined with a very low activity level and an inability to function. Some people have hypomanic episodes, which are like manic episodes but are less severe, and don’t interfere as much with daily life.\nMost of the time, bipolar disorder symptoms start during late adolescence or early",
    "Most of the time, bipolar disorder symptoms start during late adolescence or early \nadulthood. Occasionally, children may experience bipolar disorder symptoms. \nAlthough symptoms may come and go, bipolar disorder usually requires lifelong \ntreatment and does not go away on its own. Bipolar disorder can be an important factor in suicide, job loss, ability to function, and family discord. However, proper treatment can lead to better functioning and improved quality of life.\nWhat are the symptoms of bipolar disorder?\nSymptoms of bipolar disorder can vary. An individual with the disorder may have manic episodes, depressive episodes, or “mixed” episodes. A mixed episode has both manic and depressive symptoms. \nThese mood episodes cause symptoms that last a week or two, or sometimes",
    "These mood episodes cause symptoms that last a week or two, or sometimes \nlonger. During an episode, the symptoms last every day for most of the day. Feelings are intense and happen with changes in behavior, energy levels, or activity levels that are noticeable to others. In between episodes, mood usually returns to a healthy baseline. But in many cases, without adequate treatment, episodes occur more frequently as time goes on.\nSome people with bipolar disorder may have milder symptoms than others. For \nexample, hypomanic episodes may make an individual feel very good and productive; they may not feel like anything is wrong. However, family and friends may notice mood swings and changes in activity levels as unusual behavior, and depressive episodes may follow hypomanic episodes.",
    "Symptoms of a Manic Episode Symptoms of a Major Depressive Episode\nFeeling very up, high, elated, \nextremely irritable, or touchyFeeling very down, sad, or anxious\nFeeling jumpy or wired, or being more active than usualFeeling slowed down or restless\nRacing thoughts Trouble concentrating or making decisions\nDecreased need for sleepTrouble falling asleep, waking up too early, or sleeping too much\nTalking fast about a lot of different things (“flight of ideas”)Talking very slowly, feeling unable to find anything to say, or forgetting a lot\nExcessive appetite for food, drinking, sex, or other pleasurable activitiesLack of interest in almost all activities\nFeeling able to do many things at once without getting tiredUnable to do even simple things\nFeeling unusually important, talented, or powerfulFeeling hopeless or worthless, or thinking about death or suicide\nDifficulty maintaining work responsibilities, social activities, or relationships\nTypes of bipolar disorder",
    "Types of bipolar disorder\nPeople are diagnosed with three basic types of bipolar disorder that involve clear \nchanges in mood, energy, and activity levels. These moods range from manic episodes to depressive episodes. \n ●Bipolar I disorder  is defined by manic episodes that last at least 7 days (most of \nthe day, nearly every day) or when manic symptoms are so severe that hospital care is needed. Usually, separate depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of mood disturbance with mixed features are also possible. The experience of four or more episodes of mania or depression within a year is termed “rapid cycling.”\n ●Bipolar II disorder is defined by a pattern of depressive and hypomanic episodes, but the hypomanic episodes are less severe than the manic episodes in bipolar I disorder. Many people with bipolar II disorder spend extended periods in a persistent, low-grade depressive state.",
    "●Cyclothymic disorder  (also called cyclothymia) is defined by recurrent \nhypomanic and depressive symptoms that are not intense enough or do not last long enough to qualify as hypomanic or depressive episodes. \n“Other specified and unspecified bipolar and related disorders” is a diagnosis that refers to bipolar disorder symptoms that do not match the three major types of bipolar disorder outlined above.",
    "What causes bipolar disorder?\nThe exact cause of bipolar disorder is unknown. However, research suggests that a \ncombination of factors may contribute to the illness.\nGenetics\nBipolar disorder often runs in families, and research suggests this is mostly explained by heredity—people with certain genes are more likely to develop bipolar disorder than others. Many genes are involved, and no one gene can cause the disorder. \nBut genes are not the only factor. Studies of identical twins have shown that one \ntwin can develop bipolar disorder while the other does not. Though people with a parent or sibling with bipolar disorder are more likely to develop it, not everyone with a family history of bipolar disorder will develop it. Research also suggests that people with a genetic risk of having bipolar disorder may be more likely to develop it after experiencing trauma or other stressful life events.\nBrain structure and function",
    "Brain structure and function\nResearch shows that the brain structure and function of people with bipolar disorder may differ from those of people who do not have bipolar disorder or other mental disorders. Learning about the nature of these brain changes helps researchers better understand bipolar disorder and, in the future, may help predict which types of treatment will work best for a person with bipolar disorder. \nHow is bipolar disorder diagnosed?\nTo diagnose bipolar disorder, a health care provider may complete a physical exam, order medical testing to rule out other illnesses, and refer the person for an evaluation by a mental health professional.\nBipolar disorder is diagnosed based on the severity, length, and frequency of an \nindividual’s symptoms and experiences over their lifetime, and their family history. \nSome people have bipolar disorder for years before it is diagnosed for several",
    "Some people have bipolar disorder for years before it is diagnosed for several \nreasons. People with bipolar II disorder may seek help only for depressive episodes, and hypomanic episodes may go unnoticed.\nMisdiagnosis may happen because some bipolar disorder symptoms are like those \nof other illnesses. For example, people with bipolar disorder who also have psychotic symptoms can be misdiagnosed with schizophrenia. To avoid such misdiagnosis, it is important to consider the course of the disorder over the past days and weeks, rather than focusing solely on the current symptoms. Some health conditions, such as thyroid disease, can cause symptoms like those of bipolar disorder. The effects of some prescribed, recreational, or illicit drugs can sometimes mimic or worsen mood symptoms.\nIf subtle signs of bipolar disorder are missed and an initial depressive episode is",
    "If subtle signs of bipolar disorder are missed and an initial depressive episode is \ntreated with antidepressant medication alone (without a mood stabilizer), a manic episode or rapid cycling may be triggered.",
    "Conditions that can co-occur with bipolar disorder\nMany people with bipolar disorder also have other mental disorders or conditions, \nsuch 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, such as 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.\nLooking at symptoms over the course of the illness and the person’s family history can \nhelp determine whether a person has bipolar disorder along with another disorder.\nHow is bipolar disorder treated?",
    "How is bipolar disorder treated?\nTreatment helps many people, even those with the most severe forms of bipolar disorder. Mental health professionals treat bipolar disorder with medications, psychotherapy, or a combination of treatments.\nMedications\nCertain medications can help control the symptoms of bipolar disorder. Some people may need to try several different medications before finding the ones that work best. Different medications may be used to treat an acute mood episode compared to those used to help manage symptoms over the long term. The most common types of medications that doctors 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.\nBipolar depression is often treated with a mood stabilizer or an atypical antipsychotic.",
    "Bipolar depression is often treated with a mood stabilizer or an atypical antipsychotic. \nFor some people experiencing a depressive episode, antidepressants may be added to these medications. However, antidepressants are not used alone because they can trigger a manic episode or rapid cycling in a person with bipolar disorder. Medications that target sleep or anxiety are sometimes added to mood stabilizers as part of a treatment plan. \nTalk with your health care provider to understand the risks and benefits of each \nmedication. Report any concerns about side effects to your health care provider right away. Avoid stopping medication without talking to your health care provider first. Learn more about mental health medications at www.nimh.nih.gov/medications . \nRead the most up-to-date information on medications, side effects, and warnings on the U.S. Food and Drug Administration (FDA) website at www.fda.gov/drugsatfda .\nPsychotherapy",
    "Psychotherapy\nPsychotherapy (sometimes called talk therapy) is a term for various treatment techniques that aim to help a person identify and change troubling emotions, thoughts, and behaviors. Psychotherapy can offer support, education, skills, and strategies to people with bipolar disorder and their families.",
    "Some types of psychotherapy can be effective treatments for bipolar disorder when \nused with medications, including interpersonal and social rhythm therapy, which aims to understand and work with an individual’s biological and social rhythms. Interpersonal relationships are at the heart of family-focused therapy, which has been shown to help adolescents and adults when introduced with mood-stabilizing medication following an episode of bipolar depression or mania. Cognitive behavioral therapy (CBT) is an important treatment for depression, and CBT adapted for the treatment of insomnia can be especially helpful as a component  of the treatment of bipolar depression. Learn more about psychotherapy at  www.nimh.nih.gov/psychotherapies .\nOther treatments\nSome people may find other treatments helpful in managing their bipolar  \ndisorder symptoms.\n ● Electroconvulsive therapy (ECT)  is a brain stimulation procedure that can help",
    "● Electroconvulsive therapy (ECT)  is a brain stimulation procedure that can help \nrelieve severe symptoms of bipolar disorder. ECT is usually considered if an individual’s illness has not improved after other treatments, such as medication or psychotherapy, or in cases that require rapid response, such as with suicide risk or catatonia (a state of unresponsiveness).\n ●Transcranial magnetic stimulation (TMS) is a type of brain stimulation that uses \nmagnetic pulses, rather than the electrical stimulation of ECT, to relieve depression symptoms over a series of treatment sessions. Although not as powerful as ECT, TMS does not require general anesthesia and presents less risk of memory loss or adverse cognitive effects.\nLearn more about ECT and TMS at www.nimh.nih.gov/braintherapies .\n ●Light therapy is the best evidence-based treatment for seasonal affective disorder (SAD), and  many people with bipolar disorder experience seasonal",
    "worsening of depression in the winter, in some cases to the point of SAD. Morning light therapy could also be considered for lesser forms of seasonal worsening of bipolar depression. \nComplementary health approaches\nThe FDA has not approved any complementary health approaches for treating bipolar disorder. However, some individuals with bipolar disorder may explore options like dietary supplements, herbs, yoga, massage, acupuncture, tai chi, exercise, and relaxation techniques to support overall wellness and manage stress. Unlike specific psychotherapy and medication treatments that are scientifically proven to improve bipolar disorder symptoms, complementary health approaches have not been comprehensively studied.\nSome complementary health approaches may be used safely alongside standard \ntreatments for bipolar disorder. It is important to talk to a health care provider to \ndetermine a treatment plan. For more information, visit the National Center for",
    "determine a treatment plan. For more information, visit the National Center for \nComplementary and Integrative Health website at www.nccih.nih.gov .",
    "How can I find help?\nIf you have concerns about your mental health, talk to a primary care provider.  \nThey can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. \nFind tips for talking with a health care provider about your mental health at  \nwww.nimh.nih.gov/talkingtips .\nYou can learn more about getting help at www.nimh.nih.gov/findhelp . The \nSubstance Abuse and Mental Health Services Administration (SAMHSA) also provides information about finding support at https://findsupport.gov  and locating \nmental health services in your area at https://findtreatment.gov .\nHow can I help myself?\n ●Get treatment and stick with it. Treatment is the best way to start feeling better.\n ●Keep medical and therapy appointments.\n ●Take medication and treatment as directed.\n ●Structure activities. Keep a routine for eating, sleeping, and exercising.",
    "●Structure activities. Keep a routine for eating, sleeping, and exercising.\n ●Try exercise like jogging, swimming, or bicycling, which can help with depression \nand anxiety, promote better sleep, and support heart and brain health.\n ●Avoid using drugs and alcohol.\n ●Keep a life chart or mood journal to help recognize your mood swings.\n ●Ask for help when trying to stick with your treatment.\n ●Be patient. Improvement takes time. Social support helps.\nRemember, bipolar disorder is a lifelong illness, but long-term, ongoing treatment can help manage symptoms and enable you to live a healthy life.\nHow can I help a loved one with bipolar disorder?\nIt can be difficult to know how to help a friend or family member with bipolar disorder. Here are some things you can do:\n ●Offer emotional support, understanding, patience, and encouragement.\n ●Listen and be open to their experiences.\n ●Understand triggers and be alert to any major mood changes.\n ●Include your loved one in fun activities.",
    "●Include your loved one in fun activities.\n ●Remind the person that getting better is possible with the right treatment.\n ●Offer practical help, such as driving your loved one to health care appointments or picking up prescriptions.\n ●Take care of yourself, too.\nIf you or someone you know is struggling or having thoughts of suicide, call \nor text the 988 Suicide and Crisis Lifeline at 988  or chat at 988lifeline.org . \nIn life-threatening situations, call 911 .",
    "Clinical trials \nClinical trials are research studies that look at ways to prevent, detect, or treat \ndiseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those \nwith health conditions, join to try treatments that aren’t widely available. \nNIMH supports clinical trials across the United States. Talk to a health care provider \nabout clinical trials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials . \nFor more information\nLearn more at www.nimh.nih.gov/health . For information about various health topics, \nvisit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .\nContact us\nNational Institute of Mental HealthOffice of Science Policy, Planning, and Communications 6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663",
    "866-615-6464  \nnimhinfo@nih.govwww.nimh.nih.govwww.nimh.nih.gov/espanol\nReprints\nThe information in this publication is in the public domain and may be reused  or copied without permission. However, you may not reuse or copy images.  Please cite the National Institute of Mental Health as the source. Read our  copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 25-MH-8088 Revised 2025",
    "Borderline  \nPersonality  \nDisorder",
    "What is borderline personality disorder?\nBorderline personality disorder is a mental illness that severely impacts a \nperson’s ability to regulate their emotions. This loss of emotional control can increase impulsivity, affect how a person feels about themselves, and negatively impact their relationships with others. Effective treatments are available to manage the symptoms of borderline personality disorder. Learn more about the disorder, how it’s diagnosed, and how to find support. \nWhat are the signs and symptoms?\nPeople with borderline personality disorder may experience intense mood swings and feel uncertainty about how they see themselves. Their feelings for others can change quickly, and swing from extreme closeness to extreme dislike. These changing feelings can lead to unstable relationships and emotional pain. \nPeople with borderline personality disorder also tend to view things in extremes,",
    "People with borderline personality disorder also tend to view things in extremes, \nsuch as all good or all bad. Their interests and values can change quickly, and they may act impulsively or recklessly.\nOther signs or symptoms may include: \n ●Efforts to avoid real or perceived abandonment, such as plunging headfirst \ninto relationships—or ending them just as quickly.\n ●A pattern of intense and unstable relationships with family, friends, and loved ones.\n ●A distorted and unstable self-image or sense of self.\n ●Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating. Please note: If these behaviors happen mostly during times of elevated mood or energy, they may be symptoms of a mood disorder and not borderline personality disorder.\n ●Self-harming behavior, such as cutting.\n ●Recurring thoughts of suicidal behaviors or threats.",
    "●Self-harming behavior, such as cutting.\n ●Recurring thoughts of suicidal behaviors or threats.\n ●Intense and highly variable moods, with episodes lasting from a few hours to a few days.\n ●Chronic feelings of emptiness.\n ●Inappropriate, intense anger or problems controlling anger.\n ●Feelings of dissociation, such as feeling cut off from oneself, observing oneself from outside one’s body, or feelings of unreality.",
    "Not everyone with borderline personality disorder may experience all of these \nsymptoms. The severity, frequency, and duration of symptoms depend on the person and their illness.\nPeople with borderline personality disorder have a significantly higher rate of self-harming and suicidal behavior than the general population. \nPeople with borderline personality disorder who are thinking of harming \nthemselves or attempting suicide need help right away.\nIf you or someone you know is in immediate distress or is thinking about \nhurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website at https://suicidepreventionlifeline.org .\nWhat causes borderline personality disorder?",
    "What causes borderline personality disorder?\nResearchers aren’t sure what causes borderline personality disorder, but studies suggest that genetic, environmental, and social factors may increase the risk of developing it. These factors may include:\n ●Family history: People who have a close family member (such as a parent \nor sibling) with the illness may be at a higher risk of developing borderline personality disorder.\n ●Brain structure and function:  Research shows that people with borderline \npersonality disorder may have structural and functional changes in the brain, especially in the areas that control impulses and emotion regulation. However, the studies do not demonstrate whether these changes were risk factors for the illness or if such changes were caused by the disorder.\n ●Environmental, cultural, and social factors:  Many people with borderline",
    "●Environmental, cultural, and social factors:  Many people with borderline \npersonality disorder report experiencing traumatic life events, such as abuse, abandonment, or hardship during childhood. Others may have been exposed to unstable, invalidating relationships or conflicts.\nAlthough these factors may increase a person’s risk, it doesn’t mean it is certain that they’ll develop borderline personality disorder. Likewise, people without these risk factors may develop the disorder in their lifetime.",
    "How is borderline personality disorder diagnosed?\nA licensed mental health professional—such as a psychiatrist, psychologist, or \nclinical social worker—who is experienced in diagnosing and treating mental disorders can diagnose borderline personality disorder based on a thorough interview and a discussion about symptoms. A careful and thorough medical exam also can help rule out other possible causes of symptoms. In diagnosing the illness, providers will discuss a person’s symptoms and ask about family medical histories, including histories of mental illness. \nBorderline personality disorder is usually diagnosed in late adolescence or \nearly adulthood. Occasionally, a person younger than age 18 may be diagnosed with borderline personality disorder if symptoms are significant and last at least a year. \nWhat other illnesses can co-occur with borderline \npersonality disorder?\nBorderline personality disorder often occurs with other mental illnesses, such",
    "Borderline personality disorder often occurs with other mental illnesses, such \nas post-traumatic stress disorder (PTSD). These co-occurring disorders can make it harder to diagnose and treat borderline personality disorder, especially if symptoms of other illnesses overlap with symptoms of the disorder. For example, a person with borderline personality disorder also may be more likely to experience symptoms of major depression, PTSD, bipolar disorder, anxiety disorders, substance abuse, or eating disorders. \nHow is borderline personality disorder treated?",
    "How is borderline personality disorder treated?\nBorderline personality disorder historically has been viewed as challenging to treat. But with newer, evidence-based treatment, many people with this disorder experience fewer and less severe symptoms, improved functioning, and better quality of life. It is important for patients with borderline personality disorder to receive treatment from a licensed mental health professional. Other types of treatment, or treatment from a provider who is not appropriately trained, may be ineffective or dangerous.\nMany factors affect the length of time it takes for symptoms to improve once \ntreatment begins. It is important for people with borderline personality disorder and their loved ones to be patient and receive support during treatment. \nIt is important to seek—and stick with—treatment.",
    "Studies funded by the National Institute of Mental Health (NIMH) indicate that \nindividuals with borderline personality disorder who don’t receive adequate treatment are more likely to develop other chronic medical or mental illnesses and are less likely to make healthy lifestyle choices. \nPsychotherapy\nPsychotherapy, sometimes called “talk therapy,” is the first-line treatment for people with borderline personality disorder. Most psychotherapy occurs with a licensed, trained mental health professional in one-on-one sessions or with other individuals in group settings. Group sessions may help teach people with borderline personality disorder to interact with others and express themselves effectively.\nTwo examples of psychotherapies used to treat borderline personality \ndisorder are:",
    "Two examples of psychotherapies used to treat borderline personality \ndisorder are:\n ●Dialectical Behavior Therapy (DBT): This treatment was developed specifically for individuals with borderline personality disorder. DBT uses concepts of mindfulness or awareness of one’s present situation and emotional state. DBT also teaches skills to help people control intense emotions, reduce self-destructive behaviors, and improve relationships.\n ●Cognitive Behavioral Therapy (CBT): This treatment can help people identify and change core beliefs and behaviors that come from inaccurate perceptions of themselves and others and problems interacting with others. It may help people reduce mood swings and anxiety symptoms and may reduce the number of self-harming or suicidal behaviors.\nRead more on NIMH’s Psychotherapies health topic page at  www.nimh.nih.gov/psychotherapies .\nMedications",
    "Medications\nBecause the benefits of prescription medication for borderline personality disorder are unclear, medications aren’t typically used as the primary way to treat the illness. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms or co-occurring mental disorders such as mood swings or depression. Treatment with medications may require coordinated care from more than one medical professional. \nMedications also can sometimes cause side effects in some people.  \nTalk to your provider about what to expect from a particular medication.  \nRead more on NIMH’s Mental Health Medications health topic page at  www.nimh.nih.gov/medications .",
    "Where can I find help? \nIf you’re not sure where to get help, a health care provider can refer you to \na licensed mental health professional, such as a psychiatrist or psychologist with experience treating borderline personality disorder. If you need help starting the conversation, check out the Tips for Talking With Your Health Care Provider fact sheet at www.nimh.nih.gov/talkingtips . \nOther resources include: \n ●Substance Abuse and Mental Health Services Administration’s Behavioral Health Treatment Services Locator, a tool for finding mental health services in your area: https://findtreatment.samhsa.gov\n ●NIMH’s Help for Mental Illnesses webpage: www.nimh.nih.gov/findhelp  \n ●Agency for Healthcare Research and Quality’s website:  www.ahrq.gov/questions\nTherapy for Caregivers and Family Members\nHaving a relative or loved one with the disorder can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved one’s symptoms.",
    "Although more research is needed to determine how well family therapy helps \nwith borderline personality disorder, studies on other mental disorders show that including family members can help support a person’s treatment. Families and caregivers also can benefit from therapy. \nFamily therapy helps because:\n ●It allows the relative or loved one to develop skills to understand and \nsupport a person with borderline personality disorder.\n ●Focusing on the needs of family members helps them understand the obstacles and strategies for caring for someone with the disorder.",
    "How can I help a friend or family member with \nborderline personality disorder?\nHere are some ways to help a friend or relative with the disorder:\n ●Take time to learn about the illness to understand what your friend or \nrelative is experiencing. \n ●Offer emotional support, understanding, patience, and encouragement. Change can be difficult and frightening to people with borderline personality disorder, but things can improve over time.\n ●Encourage your loved one in treatment for borderline personality disorder to ask about family therapy.\n ●Seek counseling for yourself. Choose a different therapist than the one your relative is seeing.\nHow can I learn more about clinical trials studying \nborderline personality disorder? \nNIMH supports a wide range of research, including clinical trials that look",
    "NIMH supports a wide range of research, including clinical trials that look \nat new ways to prevent, detect, or treat diseases and conditions, including borderline personality disorder. Although individuals 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.\nResearchers at NIMH and around the country conduct clinical trials with \npatients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit  www.nimh.nih.gov/clinicaltrials .",
    "Reprints\nThis publication is in the public domain and may be reproduced or copied \nwithout permission from NIMH. We encourage you to reproduce and use NIMH publications in your efforts to improve public health. If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more \nabout using NIMH publications, refer to www.nimh.nih.gov/reprints .\nFor More Information\nNIMH website  www.nimh.nih.gov   \nwww.nimh.nih.gov/espanol  (en español)\nMedlinePlus (National Library of Medicine)  \nhttps://medlineplus.govhttps://medlineplus.gov/spanish  (en español) \nClinicalTrials.gov  \nwww.clinicaltrials.gov   \nhttps://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health Office of Science Policy, Planning, and Communications  6001 Executive Boulevard  Room 6200, MSC 9663  Bethesda, MD 20892-9663  Toll-free: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov  \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES",
    "Website: www.nimh.nih.gov  \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 22-MH-4928 Revised 2022",
    "What mental disorders can affect children?\nMany mental disorders can begin in childhood. Examples \ninclude anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), depression and other mood disorders, eating disorders, and post-traumatic stress disorder (PTSD). Early treatment can help children manage their symptoms and support their social and emotional well-being. Many adults reflect on how mental disorders affected their childhood and wish they had received help sooner.  \nWhat are the signs of mental health conditions in children?",
    "What are the signs of mental health conditions in children?  \nDistinguishing between challenging behaviors and emotions that are a part of normal development and those that may be cause for concern can be hard. Consider seeking help if your child’s behavior or emotions last for weeks or longer, cause distress for your child or your family, or interfere with your child’s functioning at school, at home, or with friends. If your child’s behavior is unsafe, or if your child talks about wanting to hurt themselves or someone else, seek help immediately.  Learn more about warning signs at  www.nimh.nih.gov/children .   \nWhen might children benefit from an evaluation?\nGet immediate help \nIf you, your child, 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 .Children and \nMental Health:  \nIs This Just a Stage?",
    "Mental Health:  \nIs This Just a Stage?\nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  \nAll children are sad, anxious, irritable, or aggressive at times, and many find it occasionally challenging \nto sit still, pay attention, or interact with others. In most cases, these are just typical developmental phases. However, such behaviors may also indicate a more serious problem in some children. \nYounger children \n● Have frequent tantrums or are irritable much of the time \n● Often seem fearful or worried \n● Complain about frequent stomachaches or headaches \nwith no known medical cause \n● Are in constant motion and cannot sit quietly (except when they are engaged in an activity they enjoy, such as watching videos or playing video games) \n● Sleep too much or too little, have frequent nightmares, or seem sleepy during the day \n● Are not interested in playing with other children or have difficulty making friends \n● Struggle academically or have experienced a recent decline in grades",
    "● Struggle academically or have experienced a recent decline in grades \n● Repeat actions or check things many times (for example, repeatedly checking to make sure a door is locked) out of fear that something bad may happenOlder children\n● Have lost interest in things that they used to enjoy \n● Have low energy \n● Sleep too much or too little or seem sleepy throughout the day \n● Have periods of highly elevated energy and activity and require much less sleep than usual \n● Spend more and more time alone and avoid social activities with friends or family \n● Diet or exercise excessively or fear gaining weight \n● Engage in self-harm behaviors (such as cutting or burning their skin) \n● Smoke, drink, or use drugs \n● Engage in risky or destructive behavior alone or with friends \n● Have thoughts of suicide \n● Say that they think someone is trying to control their mind \nor that they hear things that other people cannot hear  -",
    "Where should I start if I’m concerned about my child’s mental health?\nBeing proactive and aware of your child’s mental health is an important first step.  \nIf you have concerns about your child’s mental health, start by talking with others who frequently interact with your child. For example, ask their teacher about your child’s behavior in school, at daycare, or on the playground. \nYou can talk with your child’s pediatrician or health care provider and describe your \nchild’s behavior and what you have observed and learned from talking with others. You can also ask the health care provider for a referral to a mental health professional with experience and expertise in evaluating and treating children. Get information about finding a health care provider or accessing treatment at www.nimh.nih.gov/findhelp . \nHow is children’s mental health assessed?",
    "How is children’s mental health assessed? \nAn evaluation by a mental health professional can help understand and clarify your child’s emotions, behavior, and current situation. Based on this information, the mental health professional can decide if your child would benefit from an intervention and what intervention might work best. \nA comprehensive evaluation of a child’s mental health \nusually involves: \n● A parent interview to discuss the child’s developmental \nhistory, temperament, relationships with friends and family, medical history, interests, abilities, and any  prior treatment\n● Information gathering from the child’s school, such as standardized test scores and reports on behavior, capabilities, and difficulties \n● If needed, an interview with the child for testing and behavioral observationsAsking questions and providing information to your child’s",
    "health care provider can improve your child’s care. Talking with the health care provider builds trust and leads to better results, quality, safety, and satisfaction with care. \nHere are some questions you can ask when meeting with \nprospective treatment providers. \n● Do you use treatment approaches that are supported \nby research? \n● Do you involve parents in the treatment? If so, how are parents involved? \n● Will there be “homework” between sessions? \n● How will progress be evaluated? \n● How soon can we expect to see progress? \n● How long should treatment last?\nFor more ideas on how to start a conversation with your child’s \nhealth care provider, visit www.nimh.nih.gov/talkingtips . \nHow are childhood mental health disorders treated? \nThe mental health professional will review the evaluation results to help determine if a child’s emotions and behavior are related to changes or stresses at home or school or if they may indicate a disorder for which they would recommend treatment.",
    "There are several treatment options the mental health \nprofessional may recommend. \n● Psychotherapy (sometimes called talk therapy) , which \nincludes many different approaches such as structured \npsychotherapies directed at specific conditions. For  more information about types of psychotherapies, visit www.nimh.nih.gov/psychotherapies . Effective \npsychotherapy for children often incorporates: \n ■Parent involvement in the treatment \n ■Teaching the child skills to practice at home or school (between-session “homework assignments”) \n ■Measures of progress (such as rating scales and improvements on “homework assignments”) that are tracked over time ●Medications , which will depend on the diagnosis \nand may include antidepressants, stimulants, mood stabilizers, or other medications. For information on specific classes of medications, visit www.nimh.nih.gov/medications . Medications are often used in combination",
    "with psychotherapy. If multiple health care providers or specialists are involved, treatment information should be shared and coordinated between providers to achieve the best results. \n● Family counseling , which includes family members to \nhelp them understand how a child’s challenges may affect relationships with parents and siblings.\n● Support for parents , such as individual or group sessions \nthat include training and the opportunity to talk with  other parents. Parental support can provide new strategies for helping a child manage difficult emotions and behavior in a positive way. The therapist can also coach parents on how to work with schools to receive classroom accommodations. \nFor information about treatment options for specific disorders, \nvisit the NIMH website at www.nimh.nih.gov/health .",
    "More information and resources \nInformation on specific disorders is available on the NIMH website ( www.nimh.nih.gov/health ).  \nNote: This resource list is provided for informational purposes only. It is not comprehensive and does not constitute an \nendorsement by NIMH.\nThe following organizations and agencies have information  \non symptoms, treatments, and support for childhood mental \ndisorders. Some offer guidance for working with schools and finding mental health professionals. Participating in support groups can provide an avenue for connecting with other parents dealing with similar issues. \n ●American Academy of Child and Adolescent Psychiatry, \nFamilies and Youth ( www.aacap.org/AACAP/Families_\nYouth/AACAP/Families_and_Youth/Home.aspx )\n ●Anxiety and Depression Association of America (https://adaa.org )\n ●Association for Behavioral and Cognitive Therapies (www.abct.org )",
    "●Association for Behavioral and Cognitive Therapies (www.abct.org ) \n ●Centers for Disease Control and Prevention, Children’s Mental Health ( www.cdc.gov/childrensmentalhealth ) \n ●Child Mind Institute ( https://childmind.org/topics-a-z ) \n ●Mental Health America ( www.mhanational.org ) \n ●National Alliance on Mental Illness ( www.nami.org ) \n ●National Federation of Families ( www.ffcmh.org ) \n ●Society of Clinical Child and Adolescent Psychology, Effective Child Therapy ( https://effectivechildtherapy.org ) \n ●StopBullying.gov ( www.stopbullying.gov )How can the school support my child’s \nmental health?\nChildren who have behavioral or emotional challenges that \ninterfere with success in school may benefit from plans or accommodations provided under laws that prevent discrimination against children with disabilities. Your  \nchild’s health care providers can help you communicate with the school. \nA first step may be to ask the school whether accommodations",
    "A first step may be to ask the school whether accommodations \nsuch as an individualized education program (IEP) are appropriate for your child. Accommodations might include providing a child with a tape recorder for taking notes, allowing more time for tests, or adjusting seating in the classroom to reduce distraction. \nThe U.S. Department of Education offers information and \nresources on what schools can and, in some cases, must provide for children who would benefit from accommodations and how parents can request evaluation and services for their child. \n● The Individuals with Disabilities Education Act  \n(https://sites.ed.gov/idea ) consolidates information about \nhow states and public agencies provide early intervention, \nspecial education, and related services for infants, toddlers, children, and youth with disabilities. ● The Office for Civil Rights ( www.ed.gov/OCR ) provides",
    "information on federal laws that prohibit discrimination based on disability in public programs, such as schools. \n● The Center for Parent Information and Resources (www.parentcenterhub.org/find-your-center ) lists Parent \nTraining and Information Centers and Community Parent Resource Centers in each state. \nMany organizations listed in the “More information and \nresources” section also offer information on working with schools and more general information on disorders affecting children.",
    "For more information\nLearn more at www.nimh.nih.gov/\nhealth . For information about various \nhealth topics, visit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .Reprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as a source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .National Institute of Mental Health  Office of Science Policy, Planning, and Communications  \n6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  \nPhone: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov\nNational Instituteof Mental Health\nNIH Publication No. 24-MH-8085 \nRevised 2024What research is being done on \ndisorders affecting children? \nNIMH conducts and supports research to help find new",
    "disorders affecting children? \nNIMH conducts and supports research to help find new \nand improved ways to diagnose and treat mental disorders that occur in childhood. This research includes studies of risk factors—including genetics, experience, and the environment—which may provide clues to how these disorders develop and how to identify them early. \nNIMH also supports efforts to develop and test new \ninterventions, including behavioral, psychotherapeutic,  \nand medication treatments, and ways to improve existing treatments and make them more available in communities, doctor’s offices, and schools. Researchers are also exploring whether the benefits of treatment in childhood last into adolescence and adulthood. \nWhat are clinical trials and why  \nare they important?",
    "What are clinical trials and why  \nare they important? \nChildren are not little adults, yet they are often given medications and treatments that have been tested only in adults. Research shows that, compared to adults, children respond differently to medications and treatments, both physically and mentally. The way to get the best treatments for children is through research designed specifically for them. \nClinical trials are research studies that look at ways to prevent, \ndetect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try \ntreatments that aren’t widely available. \nNIMH supports clinical trials across the United States.",
    "treatments that aren’t widely available. \nNIMH supports clinical trials across the United States.  \nTalk to a health care provider about clinical trials and whether one is right for your child. For more information, visit www.nimh.nih.gov/clinicaltrials . \nFollow us on  \nsocial media @NIMHgov",
    "From  the NATIONAL INSTITUTE of  MENTAL HEALTH  Clinical Research Trials and You:  \nQuestions and Answers\nWhat is a clinical trial?\nA clinical trial is a research study that \ninvolves people like you. Researchers conduct clinical trials to find new or better ways to prevent, detect, or treat health conditions. \nOften, researchers want to find out if a new test, treatment, or preventive measure is safe and effective. Tests can include ways to screen for, diagnose, or prevent a disease or condition. Treatments and preventive measures can include medications, surgeries, medical devices, and behavioral therapies. \nClinical trials are important because they serve as \nthe foundation for most medical advances. Without clinical trials, many of the medical treatments and cures we have today wouldn’t exist. \nWhy should I volunteer  \nfor a clinical trial?",
    "Why should I volunteer  \nfor a clinical trial?\nPeople volunteer for clinical trials for many reasons. Some want to advance science or help doctors and researchers learn more about disease and improve health care. Others, such as \nthose with an illness, may join to try new or advanced treatments that aren’t widely available. \nWhatever your reason for joining a clinical trial, \nresearchers generally need two types of volunteers: those without specific illnesses or conditions and those with them.\nA healthy volunteer  is someone in a clinical trial \nwith no known related health problems. Researchers \nneed healthy volunteers to establish a healthy or optimal reference point. They use data from healthy volunteers to test new treatments or interventions, not to provide direct benefit to participants. A patient volunteer  is",
    "someone in a clinical trial who has the condition being studied. Researchers need patient volunteers to learn if new tests, treatments, or preventive measures are safe and effective. Not all trial participants will receive experimental medications or treatments; sometimes, participants may receive a placebo. Researchers need to vary medications and treatments so they can compare results and learn from their differences. \nWhile a study’s treatment or findings may help \npatients directly, sometimes participants will receive no direct benefit. However, in many cases, study results can still serve as building blocks that are used to help people later.\nWhat would I experience  \nduring a clinical trial? \nDuring a clinical trial, the study team will track \nyour health. Participating in a \nclinical trial may take more time than standard treatment, and you may have more tests and",
    "clinical trial may take more time than standard treatment, and you may have more tests and \ntreatments than you would if you weren’t in a clinical trial. The study team also may ask you to keep a log of symptoms or other health measures, fill out forms about how you feel, or complete other tasks. You may need to travel or reside away from home to take part in a study.",
    "What are the risks and benefits of \nmy participation in a clinical trial? \nClinical trials can provide many \nbenefits to participants and society. However, before volunteering for a clinical trial, you should talk with your \nhealth care provider and the study team about the risks and benefits.\nPotential Risks\nWhen weighing the risks of volunteering, you should consider:\n● The likelihood of any harm occurring \n● How much harm could result from your participation in the study \nResearchers try to limit patient discomfort during clinical trials. However, in some cases, volunteers have complications that require medical attention. In rare cases, volunteers have died when participating in clinical trials. \nPotential Benefits\nThe benefits of volunteering can include:\n● Treatment with study medications that may not be available elsewhere\n● Care from health care professionals who  are familiar with the most advanced  \ntreatments available",
    "treatments available \n● The opportunity to learn more about an illness and how to manage it \n● Playing an active role in your health care \n● Helping others by contributing to  \nmedical research Where can I find a mental  \nhealth clinical trial?  \nThe National Institute of Mental \nHealth (NIMH) is the lead federal agency for research on mental disorders. While NIMH supports \nresearch around the world, it also conducts many clinical trials at the National Institutes of Health (NIH) campus in Bethesda, Maryland. \nTo learn more about NIMH studies conducted \non the NIH campus, visit www.nimh.nih.gov/joinastudy . These studies enroll volunteers \nfrom the local area and across the nation. In some cases, participants receive free study-related evaluations, treatment, and transportation to NIH. \nTo learn more about NIMH-funded clinical \ntrials at universities, medical centers, and other institutions, visit www.nimh.nih.gov/clinicaltrials .\nWhat is the next step after",
    "What is the next step after  \nI find a clinical trial? \nTo learn more about a specific \nclinical trial, contact the study coordinator. You can usually find this contact information in the \ntrial’s description. \nIf you decide to join a clinical trial, let your \nhealth care provider know. They may want to talk to the study team to coordinate your care and ensure the trial is safe for you. For more tips on talking with a health care provider, visit  \nwww.nimh.nih.gov/talkingtips .",
    "How do I know if I can \njoin a clinical trial? \nPeople of all ages, ethnicities, and \nracial backgrounds can volunteer for clinical trials. If you want to join a clinical trial, you must be eligible \nto participate in that specific trial. Your eligibility can usually be determined by phone or online screening. \nAll clinical trials have eligibility guidelines \ncalled inclusion and exclusion criteria. These criteria may include: \n● Age \n● Gender \n● The type and stage of an illness \n ●Treatment history \n● Other medical conditionsResearchers  use these guidelines to find \nsuitable study participants, maximize participant safety, and ensure trial data  are accurate.\nHow is my safety protected if I choose to take part in a clinical trial?\nStrict rules and laws help protect participants in research studies, and the study team must follow these rules to conduct research. Below are some \nmeasures that can help ensure your safety.  \nEthical Guidelines",
    "measures that can help ensure your safety.  \nEthical Guidelines \nEthical guidelines protect volunteers and ensure a study’s scientific integrity. Regulators created these guidelines primarily in response to past research errors and misconduct. Federal policies and regulations require that researchers conducting clinical trials obey these ethical guidelines. \nInformed Consent",
    "Informed Consent\nBefore joining a trial, you should understand what your participation will involve. The study team will provide an informed consent document with detailed information about the study. The document will include details about the length of the trial, required visits, medications, and medical procedures. It will also explain the expected outcomes, potential benefits, possible risks, and other trial details. The study team will review the informed consent document with you and answer any questions you have. You can decide then or later if you want to take part in the trial. If you choose to join the trial, you will be asked to sign the informed consent document. This document is not a contract; it verifies you understand the study and describes what your participation will include and how your data will be used. Your consent in a clinical trial is ongoing and your participation is voluntary. You may stop participating at any time. \nInstitutional Review Board Review",
    "Institutional Review Board Review \nInstitutional review boards (IRBs) review and monitor most clinical trials in the United States. An IRB works to protect the rights, welfare, and privacy of human subjects. An IRB usually includes a team of independent doctors, scientists, and community members. The IRB’s job is to review potential studies, weigh the risks and benefits of studies, and ensure that studies are safe and ethical. \nIf you’re thinking about volunteering for a clinical \ntrial, ask if an IRB reviewed the trial.",
    "What kinds of questions should I ask \nthe study team before deciding if I want to take part in a clinical trial? \nIt can be helpful to write down any \nquestions or concerns you have. When you speak with the study team, you may want to take notes or ask to \nrecord the conversation. Bringing a supportive friend or family member may also be helpful.\nThe following topics may give you some ideas for \nquestions to ask: \n● The study’s purpose and duration\n● The possible risks and benefits\n● Your participation and care \n● Personal and cost concerns \nFor a list of specific questions, check out Questions to Ask About Volunteering for a Research Study from the U.S. Department of Health and Human Services’ Office for Human Research Protections at www.hhs.gov/about-research-participation .What happens when  \na clinical trial ends?\nWhen a clinical trial ends, researchers \nwill analyze the data to help them determine the results. After reviewing the findings, researchers often",
    "submit them to scientific journals for others to review and build on.\nBefore your participation ends, the study team \nshould tell you if and how you’ll receive the results. If this process is unclear, be sure to ask about it.\nWhere can I find  \nmore information?\nThis fact sheet covers the basics of \nclinical trials. You can find more  details and resources at  www.nimh.nih.gov/clinicaltrials . \nNIH Publication No. 23-MH-4379 \nRevised 2023Follow NIMH on  \nSocial Media @NIMHgov",
    "What Are Common Types\nof Eating Disorders?\nEating disorders are serious illnesses marked by severe disturbances to \none’s eating behaviors. Common types of eating disorders include:\nAnorexia nervosa\nPeople with anorexia nervosa severely \navoid or restrict food intake due to a distorted self-image or an intense fear of  gaining weight. Bulimia nervosa\nPeople with bulimia nervosa regularly binge eat and then engage in unhealthy behaviors to prevent weight gain, such  as forced vomiting or the use of laxatives. \nBinge-eating disorder\nPeople with binge-eating disorder regularly lose control of their eating and eat unusually large amounts of food. Avoidant restrictive food \nintake disorder (ARFID)\nPeople with ARFID limit the amount  \nand variety of food they eat due to their anxiety or fear of the consequences of eating or dislike of a food’s characteristics. \nP\neople with these types of symptoms may have an eating disorder  \nand should talk to a health care provider. Help is available.",
    "and should talk to a health care provider. Help is available.\nU.S. Department of Health and Human Services\nNational Institutes of HealthNIMH Identifier No. OM 24-4322nimh.nih.gov/eatingdisorders",
    "Depresión perinatal",
    "La depresión perinatal es un trastorno del estado de ánimo que ocurre \ndurante el embarazo y después del parto. Los síntomas pueden ir de leves a graves. En casos excepcionales, los síntomas son suficientemente graves para poner en peligro la salud y el bienestar de la madre y del bebé.\nLa depresión perinatal se puede tratar. Conozca los signos y los \nsíntomas, los factores de riesgo, los tratamientos y las formas en que usted o un ser querido pueden obtener ayuda.\n¿Qué es la depresión perinatal?\nLa depresión perinatal incluye la depresión que ocurre durante el embarazo \n(depresión prenatal) y en las semanas después del nacimiento del bebé \n(depresión posparto). La mayoría de los episodios de depresión perinatal \ncomienzan entre cuatro y ocho semanas después del nacimiento del bebé. \nMujeres embarazadas o en el periodo de posparto con depresión perinatal \nsienten tristeza, ansiedad y fatiga extremas que pueden dificultar que realicen \nsus",
    "sienten tristeza, ansiedad y fatiga extremas que pueden dificultar que realicen \nsus\n tareas diarias, incluido el cuidado de sí mismas o de los demás.\n¿Cuáles son los signos y los síntomas de  \n la depresión perinatal?\nAlgunas mujeres pueden tener unos pocos síntomas de depresión perinatal, \nmientras que otras pueden tener varios. Algunos de los síntomas más frecuentes de la depresión perinatal incluyen:\n⊲ estado de ánimo persistente de tristeza, ansiedad o “vacío” la mayor parte \ndel día, casi todos los días, durante al menos dos semanas;\n⊲ sentimientos de desesperanza o pesimismo;\n⊲ sentimientos de irritabilidad, frustración o inquietud;\n⊲ sentimientos de culpa, inutilidad o impotencia;\n⊲ pérdida de interés o de placer en pasatiempos y actividades;\n⊲ fatiga o disminución anormal de la energía;\n⊲ desasosiego o problemas para quedarse quieta;¿En qué se diferencia la depresión posparto de la tristeza posparto \n(baby blues )?",
    "(baby blues )?\nEl término tristeza posparto ( baby blues ) se usa para describir cambios leves y\nde corta duración en el estado de ánimo, así como sentimientos de preocupación, \ninfelicidad y agotamiento que muchas mujeres pueden tener durante las primeras dos semanas después de dar a luz. Los bebés recién nacidos requieren atención las 24 horas, por lo que es normal que a veces las madres se sientan cansadas e incluso abrumadas.\nSi los cambios en el estado de ánimo y los sentimientos de ansiedad o infelicidad \nson muy intensos, o si duran más de dos semanas, es posible que sean signos de depresión posparto. Por lo general, las mujeres que tienen este tipo de depresión no se sentirán mejor hasta que reciban tratamiento.",
    "⊲ dificultad para concentrarse, recordar \no tomar decisiones;\n⊲ dificultad para dormir (incluso cuando el bebé está dormido), despertarse temprano en la mañana o dormir demasiado;\n⊲ cambios anormales en el apetito o cambios de peso no planificados;\n⊲ dolores o molestias físicas, dolores de cabeza, calambres o problemas digestivos que no tienen una causa física clara y que no se alivian con tratamiento;\n⊲ problemas para establecer vínculos o un apego emocional con el bebé;\n⊲ dudas constantes sobre la capacidad de cuidar al bebé;\n⊲ pensamientos de muerte o de hacerse daño a sí misma o al bebé, o intentos de suicidio.\nLas mujeres que tienen cualquiera de estos \nsíntomas deben consultar a un proveedor de atención médica, quien puede determinar si los síntomas se deben a depresión perinatal o a otra cosa.\n¿Cuáles son los factores de riesgo de la depresión perinatal?",
    "¿Cuáles son los factores de riesgo de la depresión perinatal?\nLa depresión perinatal es una afección médica que puede afectar a cualquier mujer embarazada y en el período posparto, independientemente de su edad, raza, origen étnico, ingresos, cultura o educación. No se debe responsabilizar a la mujer de tener depresión perinatal, pues no es la culpable. Este trastorno no es el resultado de algo que haya hecho o dejado de hacer.\nLa depresión perinatal no tiene una sola causa. Las investigaciones sugieren que \nhay factores genéticos y ambientales que contribuyen al trastorno. Los factores específicos que contribuyen a la depresión perinatal pueden incluir:\n⊲ situaciones estresantes de la vida (por ejemplo, exigencias laborales o \nexperiencias traumáticas anteriores);\n⊲ exigencias físicas y emocionales del parto y de cuidar a un nuevo bebé;\n⊲ cambios hormonales que ocurren durante el embarazo y después de este.",
    "⊲ cambios hormonales que ocurren durante el embarazo y después de este.\nAdemás, una mujer tiene un mayor riesgo de sufrir depresión perinatal si tiene \nantecedentes personales o familiares de depresión o trastorno bipolar o si tuvo depresión en un embarazo anterior. Las mujeres con antecedentes de depresión perinatal deben consultar a un proveedor de atención médica para establecer un plan de seguimiento en caso de que vuelva a ocurrir un episodio depresivo.¿Qué es la psicosis posparto?\nLa psicosis posparto es una enfermedad mental grave que ocurre después de dar a luz.  Las mujeres que tienen psicosis posparto pueden tener delirios (creencias o pensamientos que no son ciertos), alucinaciones (ver, oír u oler cosas que no están allí), manía (un estado de ánimo elevado y eufórico en el que a menudo las personas parecen no estar en contacto con la realidad), paranoia y confusión. \nSe considera que la psicosis",
    "Se considera que la psicosis \nposparto es una emergencia psiquiátrica que requiere hospitalización. Las mujeres que tienen síntomas de este trastorno deben buscar ayuda de inmediato llamando al 911 o dirigiéndose a la sala de emergencias más cercana. La recuperación es posible con ayuda profesional.",
    "¿Cómo se trata la depresión perinatal?\nEs importante tratar la depresión perinatal tanto para la salud de la madre como la \ndel bebé, ya que el trastorno puede tener efectos graves en ambos. Sin embargo, con el tratamiento adecuado, la mayoría de las mujeres se sienten mejor y sus síntomas mejoran.\nPor lo general, el tratamiento para la depresión perinatal incluye terapia, medicamentos \no una combinación de ambos.\nLos investigadores continúan estudiando opciones de tratamiento para la depresión \nperinatal. Un proveedor de atención médica puede explicarle los diferentes tratamientos y ayudarla a elegir el más adecuado según sus síntomas. Puede obtener más información sobre los enfoques para tratar la depresión en www.nimh.nih.gov/depresion . \nPsicoterapia",
    "Psicoterapia\nHay varios tipos de psicoterapia (también llamada simplemente terapia o consejería) que pueden ayudar a las mujeres con depresión perinatal, enseñándoles nuevas formas de pensar y de comportarse, y ayudándolas a cambiar hábitos que contribuyen a la depresión. Las terapias basadas en evidencia para la depresión perinatal incluyen la terapia cognitivo-conductual y la terapia interpersonal.\n⊲ Terapia cognitivo-conductual. Con la terapía cognitivo-conductual, las personas \naprenden a desafiar y cambiar pensamientos y comportamientos inútiles para \nmejorar sus sentimientos depresivos y ansiosos. Las personas también aprenden diferentes formas de reaccionar ante diversas situaciones. Este tipo de terapia se puede realizar individualmente o con un grupo de personas que tengan inquietudes similares.\n⊲ Terapia interpersonal.  La terapia interpersonal se basa en la idea de que los",
    "⊲ Terapia interpersonal.  La terapia interpersonal se basa en la idea de que los \nacontecimientos interpersonales y de la vida afectan el estado de ánimo y viceversa. El propósito de este tipo de terapia es ayudar a las personas a mejorar sus habilidades de comunicación dentro de las relaciones, establecer redes de apoyo social y desarrollar expectativas realistas para afrontar mejor las crisis u otros problemas que contribuyen a su depresión.\nPara obtener más información en inglés sobre la psicoterapia, incluyendo qué \nbuscar en un terapeuta y cómo encontrar uno, visite la página del NIMH   www.nimh.nih.gov/psychotherapies .El Instituto Nacional de la Salud Mental (NIMH, por sus siglas en inglés) tiene información sobre formas de obtener ayuda y encontrar un proveedor de atención médica o de acceder a tratamiento en www.nimh.nih.gov/busqueayuda .",
    "Si usted o alguien que conoce está pasando dificultades o tiene pensamientos suicidas, llame en español o en inglés al 988,  la Línea de Prevención del \nSuicidio y Crisis. También puede chatear en 988lifeline.org . En situaciones \npotencialmente mortales, llame al 911.",
    "Medicamentos\nLos medicamentos utilizados para la depresión (antidepresivos) pueden tratar \neficazmente la depresión perinatal cuando se usan solos o en combinación con psicoterapia. Los antidepresivos actúan cambiando la forma en que el cerebro produce o utiliza ciertas sustancias químicas involucradas en el estado de ánimo o el estrés.\nLos antidepresivos requieren de tiempo para surtir efecto, generalmente entre \ncuatro y ocho semanas. A menudo, mejoran los síntomas como el sueño, el apetito y los problemas de concentración antes de que mejore el estado de ánimo. Es importante dar una oportunidad a los medicamentos para que funcionen antes de decidir si es adecuado para usted. Es posible que deba probar varios medicamentos hasta encontrar el mejor.\nLa Administración de Alimentos y Medicamentos de los Estados Unidos (FDA, por",
    "La Administración de Alimentos y Medicamentos de los Estados Unidos (FDA, por \nsus siglas en inglés) aprobó un medicamento llamado brexanolona, específicamente para tratar la depresión posparto grave. La brexanolona, que se administra por vía intravenosa durante una breve estadía en el hospital, parece funcionar de manera diferente a los antidepresivos tradicionales al alterar rápidamente una sustancia química del cerebro que puede desempeñar una función importante en la regulación de la vulnerabilidad del cuerpo a la depresión y la ansiedad.\nMás recientemente, la FDA aprobó una píldora llamada zuranolona como el primer \nmedicamento oral para la depresión posparto en mujeres adultas. De forma similar a la bexanolona, la zuranolona actúa en los receptores cerebrales. En estudios clínicos, esta píldora redujo los síntomas depresivos en mujeres con depresión posparto grave más rápidamente que los antidepresivos tradicionales.",
    "Nota:  En algunos casos, las personas menores de 25 años pueden tener un \naumento de pensamientos o comportamientos suicidas al tomar antidepresivos, \nespecialmente en las primeras semanas después de iniciarlos o cuando se les cambia la dosis. La FDA recomienda que se vigile de cerca a los pacientes de todas las edades que toman antidepresivos, especialmente durante las primeras semanas de tratamiento.\nEl riesgo de que aparezcan defectos de nacimiento y otros problemas para los \nbebés cuyas madres toman antidepresivos durante el embarazo es muy bajo. Sin embargo, las mujeres siempre deben informar a sus proveedores de atención médica si están embarazadas o amamantando y colaborar con ellos para minimizar la exposición del bebé a los medicamentos y comparar los riesgos y los beneficios de las opciones de tratamiento disponibles. Puede encontrar más información sobre los medicamentos durante el embarazo y después de este en www.fda.gov/pregnancy  (en inglés).",
    "Todos los medicamentos pueden tener efectos secundarios. Hable con un proveedor de atención médica antes de comenzar o suspender el uso de cualquier medicamento. Para obtener más información en inglés sobre los antidepresivos, visite www.nimh.nih.gov/medications . \nTambién puede obtener más información sobre medicamentos específicos, como la brexanolona y la zuranolona, incluyendo las últimas aprobaciones, los efectos secundarios, las advertencias y la información para el paciente, en el sitio web en inglés de la FDA en www.fda.gov/drugsatfda .",
    "¿Dónde puedo encontrar ayuda para la depresión perinatal?\nVisite a un profesional de la salud mental \nSi cree que tiene depresión perinatal, comience por programar una cita con un \nproveedor de atención médica. Podría ser su doctor de cabecera u otro  médico  de \natención primaria, o un profesional de salud mental que se especialice en el diagnóstico y el tratamiento de trastornos mentales (por ejemplo, un psicólogo, un psiquiatra o un trabajador social). Un proveedor de atención médica la examinará y hablará con usted sobre las opciones de tratamiento y los pasos siguientes, incluidas sus opciones si está embarazada o amamantando.\nUna buena comunicación entre usted y su proveedor de atención médica puede \nmejorar los cuidados que recibe y ayudar a que ambos tomen buenas decisiones sobre su salud. Encuentre consejos que le ayudarán a prepararse y aprovechar al máximo su visita en www.nimh.nih.gov/consejosparahablar . Para obtener",
    "recursos adicionales, incluyendo preguntas que puede hacerle a un proveedor, visite el sitio web en inglés de la Agencia para la Investigación y la Calidad de la Atención Médica (AHRQ, por sus siglas en inglés) en www.ahrq.gov/questions .\nLa Administración de Servicios de Abuso de Sustancias y Salud Mental (SAMHSA, por sus siglas en inglés) tiene un recurso en línea en inglés para ayudar a encontrar servicios de salud mental en su área: https://findtreatment.gov . \nÚnase a un grupo de apoyo o defensa\nLos grupos de apoyo o defensa pueden ser una fuente importante de ayuda e información. Un ejemplo de este tipo de grupo es Postpartum Support International. Puede encontrar otros grupos haciendo una búsqueda en línea. Para obtener más información sobre Postpartum Support International, visite www.postpartum.net/en-espanol .\nComuníquese con la Línea Nacional de Asistencia de  \nSalud Mental Materna",
    "Comuníquese con la Línea Nacional de Asistencia de  \nSalud Mental Materna\nEsta línea de asistencia ofrece apoyo de salud mental gratuito y confidencial para las madres y sus familias antes del embarazo, durante este y después del mismo. Llame o envíe un mensaje de texto al 1-833-TLC-MAMA ( 1-833-852-6262 ) para \ncomunicarse con consejeros las 24 horas del día, los 7 días de la semana. Hay consejeros que hablan inglés y español.",
    "¿Cómo pueden brindar ayuda los familiares y los \namigos para sobrellevar la depresión perinatal?\nEs fundamental comprender que la depresión perinatal es un problema médico que \nafecta a la madre, al niño y a la familia. El tratamiento es esencial para la recuperación.\nLos cónyuges, las parejas, los familiares y los amigos pueden ser los primeros en \nreconocer los signos de la depresión en una nueva madre. Los familiares y los amigos pueden brindar ayuda de muchas maneras, incluyendo:\n⊲ Fomentar la conversación con un proveedor de atención médica.\n⊲ Ayudar a llegar a las citas.\n⊲ Ofrecer apoyo emocional o práctico.\n⊲ Ayudar con las tareas diarias, como el cuidado del bebé o del hogar. \n¿Dónde puedo obtener más información sobre  \n la depresión en las mujeres?\nLas siguientes agencias tienen información adicional sobre la depresión en las mujeres:\n⊲ Plan de acción para la depresión y la ansiedad durante el embarazo y después",
    "⊲ Plan de acción para la depresión y la ansiedad durante el embarazo y después \ndel parto (Instituto Nacional de Salud Infantil y Desarrollo Humano Eunice Kennedy Shriver) www.nichd.nih.gov/ncmhep/initiatives/moms-mental-health-matters/moms/action-plan  (en inglés)\n⊲    La depresión en las mujeres www.cdc.gov/reproductive-health/depression\n(en inglés); (Centros para el Control y la Prevención de Enfermedades)\n⊲ De\npresión perinatal: intervenciones preventivas (Grupo de Trabajo de Servicios \nPr\neventivos de los Estados Unidos) www.uspreventiveservicestaskforce.org/\nuspstf/ recommendation/perinatal-depression-preventive-interventions ( en inglés)\n⊲ Depresión posparto (Oficina para la Salud de las Mujeres)  \nwww.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression  (en inglés)\n⊲ Depresión (Administración de Alimentos y Medicamentos de los Estados Unidos)  \nhttps://www.fda.gov/consumers/free-publications-women/depresion-depression-0",
    "https://www.fda.gov/consumers/free-publications-women/depresion-depression-0  \nPara información adicional sobre la depresión posparto, consulte: \n⊲ Depresión posparto (MedlinePlus, Biblioteca Nacional de Medicina)  \nhttps://medlineplus.gov/spanish/postpartumdepression.html  \n⊲ Videos: Hablemos de la depresión postparto (Oficina para la Salud de la mujer)  \nwww.womenshealth.gov/talkingPPD  (en inglés)",
    "Estudios clínicos\nLos estudios clínicos son estudios de investigación que analizan nuevas formas de \nprevenir, detectar o tratar enfermedades y afecciones. Estos estudios ayudan a determinar si un tratamiento es seguro y eficaz en las personas. Algunas personas participan en estudios clínicos para ayudar a los médicos y los investigadores a aprender más sobre una enfermedad y mejorar la atención médica. Otras personas, como las que tienen alguna afección de salud, participan para probar tratamientos que no están disponibles con facilidad. \nEl NIMH apoya estudios clínicos en diferentes áreas de los Estados Unidos. Hable con \nun proveedor de atención médica sobre estos estudios y si alguno es adecuado para usted. Para obtener más información, visite www.nimh.nih.gov/estudiosclinicos .\nPara más información\nObtenga más información en www.nimh.nih.gov/espanol . Si desea información",
    "Para más información\nObtenga más información en www.nimh.nih.gov/espanol . Si desea información \nadicional sobre diversos de temas de salud, visite el recurso MedlinePlus en español de la Biblioteca Nacional de Medicina en https://medlineplus.gov/spanish .\nComuníquese con nosotros\nInstituto Nacional de la Salud Mental Oficina de Política Científica, Planificación y Comunicaciones 6001 Executive Boulevard, MSC 9663  \nBethesda, MD 20892-9663  \nTeléfono: 1-866-615-6464  \nCorreo electrónico: nimhinfo@nih.gov   \nSitio web (inglés): www.nimh.nih.gov Sitio web (español): www.nimh.nih.gov/espanol\nReproducciones",
    "Sitio web (inglés): www.nimh.nih.gov Sitio web (español): www.nimh.nih.gov/espanol\nReproducciones \nLa información en esta publicación es de dominio público y se puede reutilizar y copiar sin necesidad de pedir permiso. Sin embargo, no puede reutilizar o copiar las imágenes. Por favor cite al Instituto Nacional de la Salud Mental como la fuente. Para obtener más información sobre el uso de las publicaciones del NIMH, consulte las pautas del NIMH para reproducir sus materiales en www.nimh.nih.gov/reproducciones .\nDEPARTAMENTO DE SALUD Y SERVICIOS HUMANOS DE \nLOS ESTADOS UNIDOS  \nInstitutos Nacionales de la Salud  \nPublicación de NIH Núm. 24-MH-8116S Revisada en 2024",
    "Depresión\nNational Institute\nof Mental Health",
    "¿Qué es la depresión?\nTodas las personas se sienten tristes o decaídas de vez en cuando, pero estos sentimientos suelen \nde\nsaparecer. L a depresión ( también l lamada d epresión m a yor, t rastorno d epresivo mayor, \nde\npresión clínica) es diferente. Puede causar síntomas graves que afectan cómo la  persona se \nsi\nente, p iensa y c oordina a ctividades d i arias c omo dorm i r, c omer o t r abajar. \nLa depresión puede afectar a cualquier persona, sin importar la edad, el género, la raz a o la etnia, \nlo\ns ingresos, la cultura o el nivel educativo. Hay investigaciones que sugiere n que los factores \nge\nnéticos, b iológicos, a mbientales y p sicológicos d es empeñan u na función e n la  depresión.\nA las mujeres se les diagnostica depresión con más frecuencia que a los hombres, per o estos \nta\nmbién p ueden s entirse de primidos. De bido a q ue e s menos p robable q ue lo s hombres \nreconozcan, h ablen y b u squen a yuda pa ra so brellevar s us sentimientos n egativos, corren un mayor",
    "riesgo de que sus síntomas de depresión no se diagnostiquen y no se traten adecuadamente. \nAdemás, l\na depresión puede ocurrir conjuntamente con otros trastornos mentales o \nenfermedades crónicas, como diabetes, cáncer, enfermedades del corazón y dolor crónico. La \ndepresión puede empeorar estas afecciones y viceversa. A veces, los medicamentos que se \ntoman para una e nfermedad causan efectos secundarios que también contribuyen a los síntomas \nde depresión.\n¿Cuáles\n son los diferentes tipos de depresión?\nHay dos tipos frecuentes de depresión:\n●Depresión mayor, que incluye síntomas de un estado de ánimo depresivo o pérdida de interés, la\nmayor parte del tiempo durante al menos dos semanas, y que interfiere en las actividades diarias.\n●Trastorno depresivo persistente (también llamado distimia o trastorno distímico), que consiste\nen síntomas de depresión menos graves que duran mucho más tiempo, generalmente por lomenos durante 2 años.\nOtros tipos de depresió n incluyen los siguientes:",
    "Otros tipos de depresió n incluyen los siguientes:\n● Trastorno afectivo estacional,  que aparece y desaparece con las estaciones del año y, por lo\ngeneral, los síntomas empiezan a finales del otoño o a principios del invierno, y desaparecen enla primavera y en el verano. Para obtener más información, visite www.nimh.nih.gov/depresionestacional .\n●Depresión con síntomas de psicosis,  que es una forma grave de depresión en la que una\npersona también muestra síntomas de psicosis, como delirios alucinaciones. Para obtener másinformación, visite www.nimh.nih.gov/psicosis .\n●Trastorno bipolar,  que incluye episodios depresivos, así como episodios maníacos (o episodios\nhipomaníacos menos graves) con un estado de ánimo inusualmente elevado, más irritabilidad o unmayor nivel de actividad. Para obtener más información, visite www.nimh.nih.gov/trastornobipolar .",
    "Hay algunos tipos adicionales de depresión que pueden ocurrir en momentos específicos de la vida de una mujer. El embarazo, el período de posparto, el ciclo menstrual y la menopausia se asocian con cambios físicos y hormonales que pueden provocar un episodio depresivo en algunas personas.\n●El trastorno disfórico premenstrual es una forma más grave del síndrome premenstrual\n(PMS,  por sus siglas en inglés), que ocurre en las semanas anteriores a la menstruación.\n●La depresión perinatal ocurre durante el embarazo o después del parto. Es más que la\n“tristeza posparto” que muchas madres nuevas sienten después de dar a luz. Para obtenermás información, visite www.nimh.nih.gov/depresionperinatal .\n●La depresión perimenopáusica  afecta a algunas mujeres durante la transición a la\nmenopausia. Las mujeres pueden tener sentimientos de irritabilidad intensa, ansiedad,tristeza o pueden dejar de disfrutar de las cosas.",
    "¿Cuáles son los signos y los síntomas de la depresión?\nEntre los signos y los síntomas frecuentes de la depresión se incluyen los siguientes:\n●sentimientos persistentes de tristeza, ansiedad o “vacío”;\n●sentimientos de desesperanza o pesimismo;\n●sentimientos de irritabilidad, frustración o intranquilidad;\n●sentimientos de culpabilidad, inutilidad o impotencia;\n●pérdida de interés o de placer en las actividades y los pasatiempos;\n●fatiga, disminución de energía o sensación de lentitud;\n●dificultad para concentrarse, recordar o tomar decisiones;\n●dificultad para dormir, despertándose muy temprano en la mañana o durmiendo demasiado;\n●cambios en el apetito o en el peso sin haberlo planificado;\n●dolores y molestias, dolor de cabeza, calambres o problemas digestivos sin una causa física\naparente, o que no se alivian ni con tratamiento;\n●pensamientos de suicidio, o intentos de suicidio.\nLa depresión también puede incluir otros cambios en el estado de ánimo o en la conducta, como:",
    "La depresión también puede incluir otros cambios en el estado de ánimo o en la conducta, como:  \n●estar más enojado o irritable;\n●sentirse inquieto o nervioso;\n●volverse retraído, negativo o desapegado;\n●participar más en actividades de alto riesgo;\n●ser más impulsivo;\n●consumir más alcohol o drogas;\n●aislarse de sus familiares y amigos;\n●no poder cumplir con sus responsabilidades o pasar por alto otras funciones importantes;\n●tener problemas con el deseo y el rendimiento sexual.\nNo todas las personas que están deprimidas presentan todos estos síntomas. Algunas personas \nsolamente tienen unos pocos síntomas, mientras que otras tienen muchos. Los síntomas de la depresión interfieren en el funcionamiento diario y causan un grado considerable de angustia a la persona que los tiene.\nSi usted muestra signos o síntomas de depresión y estos persisten o no desaparecen, hable con",
    "Si usted muestra signos o síntomas de depresión y estos persisten o no desaparecen, hable con \nsu médico u otro profesional de la salud. Si observa signos de depresión en alguien que conoce, anímelo a buscar ayuda de un profesional de la salud mental.\nSi usted o alguien que conoce está pasando dificultades o tiene pensamientos suicidas llame o envíe un mensaje de texto al 988 , la Línea de Prevención del Suicidio y Crisis. También\npuede obtener apoyo a través de su chat en vivo en 988lifeline.org . En situaciones\npotencialmente mortales, llame al 911.",
    "¿Cómo se diagnostica la depresión?\nPara diagnosticarle depresión a una persona, esta debe presentar síntomas de la enfermedad la \nmayor parte del día, casi todos los días, por lo menos durante dos semanas. Uno de los síntomas debe ser un estado de ánimo depresivo o la pérdida de interés o de placer en casi todas las actividades. Es posible que los niños y los adolescentes se muestren irritables en lugar de tristes.\nAunque para recibir un diagnóstico de depresión se requieren varios síntomas persistentes, \nademás de un estado de ánimo depresivo, las personas con solo unos pocos síntomas también pueden beneficiarse del tratamiento. La gravedad y la frecuencia de los síntomas y su duración varían según cada persona.\nSi cree que puede tener depresión, hable con un profesional de la salud, como un médico de",
    "Si cree que puede tener depresión, hable con un profesional de la salud, como un médico de \natención primaria, un psicólogo o un psiquiatra. Durante la consulta, este profesional de la salud puede preguntarle cuándo comenzaron sus síntomas, cuánto tiempo han durado, con qué frecuencia ocurren y si le impiden salir o realizar sus actividades habituales. Puede ser útil tomar algunas notas sobre sus síntomas antes de la consulta.\nAlgunos medicamentos y afecciones médicas, como virus o trastornos de la tiroides, pueden \ncausar los mismos síntomas que la depresión. Un médico u otro profesional de la salud puede descartar estas posibilidades al realizar un examen físico, hacerle una entrevista, y ordenar pruebas de laboratorio.\n¿Es igual la depresión en todas las personas?\nLa depresión puede afectar a las personas de diferentes maneras, según su edad.",
    "La depresión puede afectar a las personas de diferentes maneras, según su edad. \n●\tLos niños con depresión pueden mostrarse ansiosos, malhumorados, fingir estar enfermos, negarse a ir a la escuela, aferrarse a sus padres o preocuparse de que uno de ellos fallezca.\n●\tLos niños mayores y los adolescentes  pueden tener problemas en la escuela, enfadarse, frustrarse \nfácilmente, sentirse intranquilos, o tener una baja autoestima. También pueden tener otros trastornos, como ansiedad, problemas de alimentación, déficit de atención con hiperactividad, o consumo de drogas. Los niños más grandes y los adolescentes tienen una mayor probabilidad de tener somnolencia excesiva (llamada hipersomnia) y un aumento en el apetito (llamado hiperfagia). \n●\tLos adultos jóvenes  con depresión tienen una mayor probabilidad de estar irritables, quejarse",
    "●\tLos adultos jóvenes  con depresión tienen una mayor probabilidad de estar irritables, quejarse \nde haber aumentado de peso y tener hipersomnia, así como tener una perspectiva negativa sobre la vida y el futuro. A menudo, estos jóvenes tienen otros trastornos, como ansiedad generalizada, fobia social, trastornos de pánico o por consumo de drogas.\n●\tLos adultos de mediana edad  pueden tener más episodios depresivos, su libido se reduce, \ntienen insomnio a mitad de la noche o se despiertan en la madrugada. Es posible que  también mencionen con mayor frecuencia que tienen síntomas gastrointestinales, como  \ndiarrea o estreñimiento.\n●\tLos adultos mayores  suelen sentir tristeza o aflicción, o pueden tener otros síntomas menos",
    "●\tLos adultos mayores  suelen sentir tristeza o aflicción, o pueden tener otros síntomas menos \nevidentes. Es posible que informen que sienten una falta de emociones, en lugar de un estado de ánimo depresivo. Los adultos mayores también tienen más probabilidad de tener otras afecciones médicas o dolores que pueden causar depresión o contribuir a esta. En casos severos, los problemas de memoria y de pensamiento (llamados pseudodemencia) pueden ser muy notables.\nLa depresión también puede ser diferente en los hombres y las mujeres, con respecto a los síntomas que tienen y las conductas que muestran para afrontarlos, entre otras cosas. Por ejemplo, los hombres, así como las mujeres, pueden mostrar síntomas que no sean tristeza, sino que más bien parecen que están enojados o irritables.\nPara algunas personas, los síntomas se manifiestan como problemas físicos (por ejemplo,",
    "Para algunas personas, los síntomas se manifiestan como problemas físicos (por ejemplo, \npalpitaciones, opresión en el pecho, dolores de cabeza crónicos o problemas digestivos). Es más probable que muchos hombres consulten a un médico u otro profesional de la salud por estos síntomas físicos que por los que son emocionales. Si bien un mayor consumo de alcohol o de drogas puede ser un signo de depresión en cualquier persona, los hombres también son más propensos a utilizar estas sustancias como una estrategia de afrontamiento.",
    "¿Cómo se trata la depresión?\nPor lo general, el tratamiento de la depresión incluye psicoterapia (presencial o virtual), medicamentos \no ambos. Si estos tratamientos no disminuyen los síntomas, otra opción puede ser la terapia de estimulación cerebral.\nLa selección del plan de tratamiento adecuado debe basarse en las necesidades, las preferencias \ny la situación médica de la persona, en consulta con un profesional de salud mental o un proveedor de atención médica. Puede ser necesario intentar diferentes cosas para poder encontrar el tratamiento que funcione mejor para usted. \nEn casos más leves de depresión, el tratamiento puede empezar solo con psicoterapia y luego se \nañaden medicamentos si esta no da una buena respuesta. En el caso de una depresión moderada o grave, por lo general se recetan medicamentos como parte del plan inicial de tratamiento. \nPsicoterapia",
    "Psicoterapia\nLa psicoterapia (también llamada “terapia de diálogo” o consejería) puede ayudar a las persona con depresión al enseñarles nuevas formas de pensar y de comportarse, y también ayuda a cambiar hábitos que contribuyen a la depresión. Un profesional de salud mental debidamente autorizado y capacitado es el encargado de llevar a cabo las sesiones de psicoterapia, ya sean individuales o con otras personas en un entorno de grupo. \nLa psicoterapia puede ser eficaz cuando se realiza en persona o virtualmente a través de la \ntelesalud. Un profesional de la salud puede respaldar o complementar la terapia utilizando tecnología digital o móvil, como aplicaciones u otras herramientas.\nLas terapias basadas en evidencia para tratar la depresión incluyen la terapia cognitivo-conductual \ny la terapia interpersonal. El uso de otras formas de psicoterapia durante un tiempo limitado, como la terapia psicodinámica, también puede ayudar a algunas personas con depresión.",
    "●\tTerapia cognitivo-conductual . Con la terapia cognitivo-conductual, las personas pueden \naprender a desafiar y cambiar los patrones de pensamiento y de conducta que no son útiles, para así mejorar sus sentimientos de depresión y ansiedad. Entre los avances recientes de este tipo de terapia se incluyen la introducción de principios contemplativos y el desarrollo de formas especializada de terapias dirigidas a tratar síntomas específicos, como el insomnio.\n●\tTerapia interpersonal . Esta terapia se centra en acontecimientos interpersonales y de la vida \nque generan algún impacto en el estado de ánimo y viceversa. La finalidad es ayudar a las personas a mejorar sus destrezas de comunicación en sus relaciones, establecer redes sociales de apoyo y fijar expectativas realistas para ayudarles a sobrellevar mejor las crisis u otros problemas que pueden contribuir a la depresión o empeorarla.",
    "Para obtener más información en inglés sobre la psicoterapia, incluyendo qué buscar en un terapeuta y cómo encontrar uno, visite www.nimh.nih.gov/psychotherapies .\nMedicamentos\nLos antidepresivos son medicamentos que se usan con frecuencia para tratar la depresión. Funcionan cambiando la forma en que el cerebro produce o utiliza ciertas sustancias químicas involucradas en el estado de ánimo o el estrés.\nDebe transcurrir cierto tiempo para que los antidepresivos surtan efecto, por lo general entre  \n4 y 8 semanas, y a menudo, los síntomas como problemas para dormir, apetito o concentración mejoran antes de que mejore el estado de ánimo. Es importante darles una oportunidad al medicamento antes de decidir si es adecuado para usted o no lo es.",
    "Se dice que la depresión es resistente al tratamiento cuando una persona no mejora después  \nde intentar con al menos dos antidepresivos. La esketamina es un medicamento aprobado por  \nla Administración de Alimentos y Medicamentos de los Estados Unidos (FDA, por sus siglas en inglés) para la depresión resistente al tratamiento. Se suministra como un aerosol nasal en un consultorio médico, una clínica o un hospital y es de acción rápida, a menudo aliviando los síntomas de la depresión en unas pocas horas. Por lo general, las personas continúan tomando un antidepresivo oral para mantener la mejoría lograda en sus síntomas.\nOtra opción para la depresión resistente al tratamiento es combinar un antidepresivo con un  \ntipo diferente de medicamento que pueda hacerlo más eficaz, como un medicamento antipsicótico o anticonvulsivo.\nTodos los medicamentos pueden tener efectos secundarios. Hable con un médico u otro",
    "Todos los medicamentos pueden tener efectos secundarios. Hable con un médico u otro \nprofesional de la salud antes de comenzar o suspender el uso de cualquier medicamento. Para más información en inglés, visite www.nimh.nih.gov/medications .\nTenga presente  que, en algunos casos, los niños, los adolescentes y los adultos jóvenes menores \nde 25 años, pueden tener más pensamientos o conductas suicidas cuando toman antidepresivos, sobre todo durante las primeras semanas después de empezar a usarlos o cuando se cambian las dosis. La FDA aconseja que se vigile de cerca a los pacientes de todas las edades que estén tomando antidepresivos, especialmente durante las primeras semanas del tratamiento.\nLa información sobre los medicamentos cambia con frecuencia. Puede obtener más información",
    "La información sobre los medicamentos cambia con frecuencia. Puede obtener más información \nen inglés sobre medicamentos específicos como la esketamina, incluyendo las últimas aprobaciones, efectos secundarios, advertencias e información para el paciente, en el sitio web de la FDA en www.fda.gov/drugsatfda . \nTerapia de estimulación cerebral \nLa terapia de estimulación cerebral es una opción adicional cuando otros tratamientos para la depresión no han funcionado. Esta terapia incluye la activación o la inhibición del cerebro con electricidad u ondas magnéticas.\nAunque la terapia de estimulación cerebral se usa con menos frecuencia que la psicoterapia y los",
    "Aunque la terapia de estimulación cerebral se usa con menos frecuencia que la psicoterapia y los \nmedicamentos, puede desempeñar un papel importante en el tratamiento de la depresión en personas que no han respondido a otros tratamientos. Por lo general, la terapia se utiliza sólo después de que la persona ha intentado con la psicoterapia y medicamentos, y estos tratamientos suelen continuar. A veces, la terapia de estimulación cerebral se utiliza como una opción temprana de tratamiento cuando la depresión grave se ha vuelto potencialmente mortal, como cuando una persona ha dejado de comer o de ingerir líquidos, o tiene un alto riesgo de suicidarse.\nLa FDA ha aprobado varios tipos de terapias de estimulación cerebral. Las que más se usan son",
    "La FDA ha aprobado varios tipos de terapias de estimulación cerebral. Las que más se usan son \nla terapia electroconvulsiva (TEC) y la estimulación magnética transcraneal repetitiva (EMTr). Otras terapias de estimulación cerebral son más nuevas y, en algunos casos, todavía se considera que son experimentales. Puede obtener más información en inglés sobre estas terapias en www.nimh.nih.gov/braintherapies .\nProductos naturales \nLa FDA no ha aprobado ningún producto natural para tratar la depresión. Aunque se están llevando a cabo investigaciones y los hallazgos son inconsistentes, algunas personas informan que los productos naturales, como la vitamina D y el suplemento dietético a base de hierba de San Juan, ayudaron con sus síntomas de depresión. Sin embargo, estos productos pueden conllevar riesgos que incluyen, en algunos casos, interacciones con medicamentos recetados.\nNo use vitamina D, hierba de San Juan u otros suplementos dietéticos o productos naturales sin",
    "No use vitamina D, hierba de San Juan u otros suplementos dietéticos o productos naturales sin \nantes consultar con un proveedor de atención médica. Se deben realizar estudios rigurosos para comprobar si estos y otros productos naturales son seguros y eficaces.",
    "¿Cómo me puedo cuidar a mí mismo?\nLa mayoría de las personas con depresión se benefician del tratamiento de salud mental. Una  \nvez que comience el tratamiento, deberá comenzar a sentirse mejor poco a poco. Sea menos exigente consigo mismo durante este tiempo. Intente hacer cosas que solía disfrutar, incluso si  no tiene ganas de hacerlas. Esto puede mejorar su estado de ánimo.\nOtras cosas que podrían ayudarlo son:\n●\tTrate de hacer alguna actividad física. Tan solo 30 minutos de caminatas al día pueden mejorar \nsu estado de ánimo.\n●\tTrate de mantener una hora regular para acostarse y levantarse.\n●\tConsuma alimentos saludables con regularidad.\n●\tHaga lo que pueda y cómo pueda. Decida qué es lo que debe hacer y qué puede posponer.\n●\tTrate de interactuar con otras personas y de hablar con quienes confía sobre cómo se siente.\n●\tPosponga decisiones importantes de la vida hasta que se sienta mejor. Hable con personas que lo conozcan bien si debe tomar alguna decisión.",
    "●\tEvite el consumo de alcohol, nicotina o drogas, lo que incluye medicamentos que no le  han recetado.\n¿Cómo puedo encontrar ayuda para la depresión?\nEl Instituto Nacional de la Salud Mental (NIMH, por sus siglas en inglés) tiene información sobre formas de obtener ayuda, encontrar un proveedor de atención médica y acceder a tratamiento en www.nimh.nih.gov/busqueayuda . También puede encontrar consejos  \nque le ayudarán a prepararse y aprovechar al máximo su consulta médica en www.nimh.nih.gov/consejosparahablar .\nLa Administración de Servicios de Salud Mental y Abuso de Sustancias (SAMHSA) tiene  una herramienta en línea en inglés para encontrar servicios de salud mental en su área en https://findtreatment.gov .\n¿Cómo puedo ayudar a un ser querido que está deprimido?\nSi conoce a alguien con depresión, ayúdelo a que vea a un proveedor de atención médica o a un profesional de salud mental. Usted también puede:\n●\tOfrecerle apoyo y comprensión, animarlo y tenerle paciencia.",
    "●\tOfrecerle apoyo y comprensión, animarlo y tenerle paciencia.\n●\tInvitarlo a salir a caminar, pasear o a participar en otras actividades.\n●\tAyudarlo a seguir su plan de tratamiento, como programar recordatorios para que se tome los medicamentos que le recetaron.\n●\tAsegurarse de que tenga un medio de transporte para ir a sus citas de psicoterapia.\n●\tRecordarle que la depresión desaparecerá con el tiempo y el tratamiento.",
    "Estudios clínicos\nLos estudios clínicos son estudios de investigación que analizan nuevas formas de prevenir, \ndetectar o tratar enfermedades y afecciones. Estos estudios ayudan a determinar si un tratamiento es seguro y eficaz en las personas. Algunas personas participan en estudios  clínicos para ayudar a los médicos y los investigadores a aprender más sobre una enfermedad  \ny mejorar la atención médica. Otras personas, como las que tienen alguna afección de salud, participan para probar tratamientos que no están disponibles con facilidad. \nEl NIMH apoya estudios clínicos en diferentes áreas de los Estados Unidos. Hable con un \nproveedor de atención médica sobre estos estudios y si alguno es adecuado para usted.  Para obtener más información, visite www.nimh.nih.gov/estudiosclinicos .\nPara más información\nObtenga más información en www.nimh.nih.gov/espanol . Si desea información adicional sobre",
    "Obtenga más información en www.nimh.nih.gov/espanol . Si desea información adicional sobre \ndiversos de temas de salud, visite el recurso MedlinePlus en español de la Biblioteca Nacional de Medicina en https://medlineplus.gov/spanish .\nComuníquese con nosotros\nInstituto Nacional de la Salud Mental Oficina de Política Científica, Planificación y Comunicaciones  \n6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  \nTeléfono: 1-866-615-6464  \nCorreo electrónico: nimhinfo@nih.gov   \nSitio web (inglés): www.nimh.nih.gov  \nSitio web (español): www.nimh.nih.gov/espanol\nReproducciones",
    "Sitio web (español): www.nimh.nih.gov/espanol\nReproducciones \nLa información en esta publicación es de dominio público y se puede reutilizar y copiar sin necesidad de pedir permiso. Sin embargo, no puede reutilizar o copiar las imágenes. Por favor cite al Instituto Nacional de la Salud Mental como la fuente. Para obtener más información sobre el uso de las publicaciones del NIMH, consulte las pautas del NIMH para reproducir sus materiales en www.nimh.nih.gov/reproducciones .\nNational Instituteof Mental Health\nDEPARTAMENTO DE SALUD Y SERVICIOS HUMANOS DE LOS ESTADOS UNIDOS  \nInstitutos Nacionales de la Salud  \nPublicación de NIH Núm. No. 24-MH-8079S  Revisada en 2024",
    "From  the NATIONAL INSTITUTE of  MENTAL HEALTH  Depression  \nin Women:  \n4 THINGS TO KNOW\nDepression  is a medical condition. \nDepression is a common but serious mood disorder. \nResearch suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors. \nAll people can feel depressed, but the disorder is \nespecially common among women due to unique biological, hormonal, and social experiences. \nDepression is not brought on by anything a woman \nhas or has not done, and it is not something she  \ncan “snap out” of. Most women need treatment to feel better.Depression  has signs and  \nsymptoms to look out for.\nSadness is only one part of depression. Other common symptoms include: \n• Anxiety or irritability\n• Feelings of hopelessness, worthlessness, or \nhelplessness\n• Loss of interest or pleasure in hobbies and activities\n• Fatigue, lack of energy, or feeling slowed down\n• Difficulty concentrating, remembering, or making decisions",
    "• Difficulty concentrating, remembering, or making decisions\n• Changes in sleep or appetite\n• Physical aches or pains that do not have a clear physical cause \n• Thoughts of death or suicide or suicide attempts\nThese symptoms can make it hard to think, work, sleep, study, eat, and enjoy life. Talk to a health care provider if you experience symptoms most of the day, nearly every day, for at least 2 weeks. Depression does not look the same for everyone; some women may experience many symptoms, and others may experience only a few. Feeling sad is a normal reaction to difficult times in life. Depression is different—it is \na mood disorder that can affect how a person feels, thinks, and acts. Read this fact sheet to learn about depression in women and ways to get help.\nCommunicating well with a health care provider can improve your care. NIMH provides ways to get help, find a",
    "health care provider, and access treatment at www.nimh.nih.gov/findhelp . For tips on preparing for and getting the \nmost out of your health care visit, see www.nimh.nih.gov/talkingtips . \nIf 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 .",
    "Certain types of depression  are \nunique to women.\nCertain types of depression occur at specific stages of \na woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and perimenopause are associated with physical and hormonal changes that can bring on a depressive episode in some women.\n• Premenstrual dysphoric disorder  is a more intense \nform of premenstrual syndrome, or PMS, that occurs in \nthe weeks before menstruation. The disorder causes severe symptoms, such as depressed mood, anger or irritability, suicidal thoughts, appetite changes, bloating, breast tenderness, and joint or muscle pain.\n• Perinatal depression  occurs during pregnancy or",
    "• Perinatal depression  occurs during pregnancy or \nafter childbirth. It is more than the “baby blues” many new moms experience after giving birth. Women with perinatal depression feel extreme sadness, anxiety, and fatigue that may make it difficult to carry out daily tasks, including caring for themselves or others. Learn more about perinatal depression at www.nimh.nih.gov/perinataldepression .\n• Perimenopausal depression  affects some women \nduring the transition to menopause. Whereas abnormal periods, problems sleeping, mood swings, and hot flashes are common during the menopause transition, more extreme feelings of irritability, anxiety, sadness, or loss of enjoyment may be signs of depression.  You can get help for depression .\nEven the most severe depression can be treated. Common treatments are antidepressant medication, talk therapy (virtual or in person), or a combination of medication and therapy.\nThere is no “one-size-fits-all” for treatment. It may take",
    "There is no “one-size-fits-all” for treatment. It may take \ntrial and error to find the best one for you. A health care provider can explain the different options and help you choose the best treatment based on your symptoms. With help, you can feel better. \nFor more information on treatments for depression, \nvisit www.nimh.nih.gov/depression .  \nNIH Publication No. 23-MH-4779 \nRevised 2023Find additional resources \nThe following agencies have more information \non depression in women:\n• Depression (Office on Women’s Health)  \nwww.womenshealth.gov/mental-health/ \nmental-health-conditions/depression  \n• Depression Among Women (Centers for Disease Control and Prevention)  www.cdc.gov/reproductivehealth/depression  \n• Women and Depression (U.S. Food and  Drug Administration)  www.fda.gov/consumers/women/women-and-depression",
    "The Substance Abuse and Mental Health Services Administration provides an online resource for finding mental health services in your area at https://findtreatment.gov . \nReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. \nHowever, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .\nFollow NIMH on social media @NIMHgovwww.nimh.nih.gov\nContact: nimhinfo@nih.gov",
    "National Institute\nof Mental HealthDepression",
    "What is depression?\nEveryone feels sad or low sometimes, but these feelings usually pass. Depression (also \ncalled major depression, major depressive disorder, or clinical depression) is different.  \nIt can cause severe symptoms that affect how a person feels, thinks, and handles daily \nactivities, s uch a s sleeping, e ating, or w orking. \nD\nepression can affect anyone regardless of age, gender, race or ethnicity, income, \nculture, or education. Research suggests that genetic, biological, environmental, and \npsychological factors play a role in the disorder.\nWomen are diagnosed with depression more often than men, but men can also be \nd\nepressed. Because men may be less likely to recognize, talk about, and seek help for \ntheir negative feelings, they are at greater risk of their depression symptoms being \nundiagnosed and undertreated. \nIn addition, depression can co-occur with other mental disorders or chronic illnesses,",
    "In addition, depression can co-occur with other mental disorders or chronic illnesses, \nsuch as diabetes, cancer, heart disease, and chronic pain. Depression can make these \nconditions worse and vice versa. Sometimes, medications taken for an illness cause \nside effects that contribute to depression symptoms as well.\nWhat are the different types of depression?\nThere are two common types of depression.\n●Major depression  includes symptoms of depressed mood or loss of interest, most of\nthe time for at least 2 weeks, that interfere with daily activities.\n●Persistent depressive disorder (also called dysthymia or dysthymic disorder) consists\nof less severe depression symptoms that last much longer, usually for at least 2 years.\nOther types of depression include the following.\n●Seasonal affective disorder  comes and goes with the seasons, with symptoms\ntypically starting in the late fall and early winter and going away during the spring and",
    "typically starting in the late fall and early winter and going away during the spring and\nsummer. For more information, visit www.nimh.nih.gov/SAD .\n●Depression with symptoms of psychosis  is a severe form of depression in which a\nperson experiences psychosis symptoms, such as delusions or hallucinations. Formore information, visit www.nimh.nih.gov/psychosis .\n●Bipolar disorder  involves depressive episodes, as well as manic episodes (or less\nsevere hypomanic episodes) with unusually elevated mood, greater irritability, orincreased activity level. For more information, visit www.nimh.nih.gov/bipolardisorder .\nAdditional types of depression can occur at specific points in a woman’s life. Pregnancy, the postpartum period, the menstrual cycle, and menopause are associated with physical and hormonal changes that can bring on a depressive episode in some people.\n●Premenstrual dysphoric disorder  is a more severe form of premenstrual",
    "●Premenstrual dysphoric disorder  is a more severe form of premenstrual\nsyndrome, or PMS, that occurs in the weeks before menstruation.\n●Perinatal depression  occurs during pregnancy or after childbirth. It is more than\nthe “baby blues” many new moms experience after giving birth. For moreinformation, visit www.nimh.nih.gov/perinataldepression .\n●Perimenopausal depression  affects some women during the transition to\nmenopause. Women may experience feelings of intense irritability, anxiety,sadness, or loss of enjoyment.",
    "What are the signs and symptoms of depression?\nCommon signs and symptoms of depression include:\n●Persistent sad, anxious, or “empty” mood\n●Feelings of hopelessness or pessimism\n●Feelings of irritability, frustration‚ or restlessness\n●Feelings of guilt, worthlessness, or helplessness\n●Loss of interest or pleasure in hobbies and activities\n●Fatigue, lack of energy, or feeling slowed down\n●Difficulty concentrating, remembering, or making decisions\n●Difficulty sleeping, waking too early in the morning, or oversleeping\n●Changes in appetite or unplanned weight changes\n●Physical aches or pains, headaches, cramps, or digestive problems without a clear\nphysical cause that do not go away with treatment\n●Thoughts of death or suicide or suicide attempts\nDepression can also involve other changes in mood or behavior that include:\n●Increased anger or irritability\n●Feeling restless or on edge\n●Becoming withdrawn, negative, or detached\n●Increased engagement in high-risk activities",
    "●Becoming withdrawn, negative, or detached\n●Increased engagement in high-risk activities\n●Greater impulsivity\n●Increased use of alcohol or drugs\n●Isolating from family and friends\n●Inability to meet responsibilities or ignoring other important roles\n●Problems with sexual desire and performance\nNot everyone who is depressed shows all these symptoms. Some people experience only \na few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them.\nIf you show signs or symptoms of depression and they persist or do not go away, talk to \na health care provider. If you see signs of depression in someone you know, encourage them to seek help from a mental health professional.\nIf 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-\nthreatening situations, call 911 .",
    "How is depression diagnosed?\nTo be diagnosed with depression, a person must have symptoms most of the day, \nnearly every day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in most activities. Children and adolescents may be irritable rather than sad.\nAlthough several persistent symptoms, in addition to low mood, are required for a depression \ndiagnosis, people with only a few symptoms may benefit from treatment. The severity and frequency of symptoms and how long they last vary depending on the person.\nIf you think you may have depression, talk to a health care provider, such as a primary \ncare doctor, psychologist, or psychiatrist. During the visit, the provider may ask when your symptoms began, how long they have lasted, how often they occur, and if they keep you from going out or doing your usual activities. It may help to take some notes about your symptoms before the visit.",
    "Certain medications and medical conditions, such as viruses or thyroid disorders, can \ncause the same symptoms as depression. A provider can rule out these possibilities by doing a physical exam, interview, and lab tests.\nDoes depression look the same in everyone?\nDepression can affect people differently depending on their age.\n●Children may be anxious or cranky, pretend to be sick, refuse to go to school, cling toa parent, or worry that a parent may die.\n●Older children and teens may get into trouble at school, sulk, be easily frustrated‚\nfeel restless, or have low self-esteem. They may have other disorders, such asanxiety, an eating disorder, attention-deficit/hyperactivity disorder, or substance usedisorder. Older children and teens are also more likely to experience excessivesleepiness (called hypersomnia) and increased appetite (called hyperphagia).\n●Young adults are more likely to be irritable, complain of weight gain and hypersomnia,",
    "●Young adults are more likely to be irritable, complain of weight gain and hypersomnia,\nand have a negative view of life and the future. They often have other disorders, such asgeneralized anxiety disorder, social phobia, panic disorder, or substance use disorder.\n●Middle-aged adults may have more depressive episodes, decreased libido, middle-of-the-night insomnia, or early morning waking. They often report stomach problems,such as diarrhea or constipation.\n●Older adults often feel sadness, grief, or other less obvious symptoms. They mayreport a lack of emotions rather than a depressed mood. Older adults are also morelikely to have other medical conditions or pain that can cause or contribute todepression. Memory and thinking problems (called pseudodementia) may beprominent in severe cases.",
    "Depression can also look different in men versus women, such as the symptoms they show and the behaviors they use to cope with them. For instance, men (as well as women) may show symptoms other than sadness, instead seeming angry or irritable. \nFor some people, symptoms manifest as physical problems (for example, a racing heart, \ntightened chest, chronic headaches, or digestive issues). Many men are more likely to see a health care provider about these physical symptoms than their emotional ones. While increased use of alcohol or drugs can be a sign of depression in any person, men are also more likely to use these substances as a coping strategy.",
    "How is depression treated?\nDepression treatment typically involves psychotherapy (in person or virtual), medication, \nor both. If these treatments do not reduce symptoms sufficiently, brain stimulation therapy may be another option. \nChoosing the right treatment plan is based on a person’s needs, preferences, and medical \nsituation and in consultation with a mental health professional or a health care provider. Finding the best treatment may take trial and error. \nFor milder forms of depression, psychotherapy is often tried first, with medication added \nlater if the therapy alone does not produce a good response. People with moderate or severe depression usually are prescribed medication as part of the initial treatment plan.\nPsychotherapy",
    "Psychotherapy\nPsychotherapy (also called talk therapy or counseling) can help people with depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Psychotherapy occurs under the care of a licensed, trained mental health professional in one-on-one sessions or with others in a group setting. \nPsychotherapy can be effective when delivered in person or virtually via telehealth. A \nprovider may support or supplement therapy using digital or mobile technology, like apps or other tools.\nEvidence-based therapies to treat depression include cognitive behavioral therapy and \ninterpersonal therapy. Using other forms of psychotherapy, such as psychodynamic therapy, for a limited time also may help some people with depression.",
    "●Cognitive behavioral therapy (CBT): With CBT, people learn to challenge and changeunhelpful thoughts and behaviors to improve their depressive and anxious feelings.Recent advances in CBT include adding mindfulness principles and specializing thetherapy to target specific symptoms like insomnia.\n●Interpersonal therapy (IPT) : IPT focuses on interpersonal and life events that impact\nmood and vice versa. IPT aims to help people improve their communication skillswithin relationships, form social support networks, and develop realistic expectationsto better deal with crises or other issues that may be contributing to or worseningtheir depression.\nFor more information on psychotherapy, including what to look for in a therapist and how to find one, visit www.nimh.nih.gov/psychotherapies .\nMedication\nAntidepressants are medications commonly used to treat depression. They work by changing how the brain produces or uses certain chemicals involved in mood or stress.",
    "Antidepressants take time—usually 4−8 weeks—to work, and problems with sleep, appetite, \nand concentration often improve before mood lifts. Giving a medication a chance to work is important before deciding whether it is right for you.\nTreatment-resistant depression occurs when a person doesn’t get better after trying at \nleast two antidepressants. Esketamine is a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression. Delivered as a nasal spray in a doctor’s office, clinic, or hospital, the medication acts rapidly, typically within a couple of hours, to relieve depression symptoms. People will usually continue to take an antidepressant pill to maintain the improvement in their symptoms.",
    "Another option for treatment-resistant depression is to combine an antidepressant with \na different type of medication that may make it more effective, such as an antipsychotic or anticonvulsant medication. \nAll medications can have side effects. Talk to a health care provider before starting or \nstopping any medication. For more information, visit www.nimh.nih.gov/medications .\nNote : In some cases, children, teenagers, and young adults under 25 years may \nexperience an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. The FDA advises that patients of all ages taking antidepressants be watched closely, especially during the first few weeks of treatment.\nInformation about medication changes frequently. You can learn more about specific",
    "Information about medication changes frequently. You can learn more about specific \nmedications like esketamine, including the latest approvals, side effects, warnings, and patient information, on the FDA website at www.fda.gov/drugsatfda .\nBrain stimulation therapy\nBrain stimulation therapy is an option when other depression treatments have not worked. The therapy involves activating or inhibiting the brain with electricity or magnetic waves.\nAlthough brain stimulation therapy is less frequently used than psychotherapy and \nmedication, it can play an important role in treating depression in people who have not responded to other treatments. The therapy generally is used only after a person has tried psychotherapy and medication, and those treatments usually continue. Brain stimulation therapy is sometimes used as an earlier treatment option when severe depression has become life-threatening, such as when a person has stopped eating or drinking or is at a high risk of suicide.",
    "The FDA has approved several types of brain stimulation therapy. The most used are \nelectroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Other brain stimulation therapies are newer and, in some cases, still considered experimental. You can learn more about these therapies at www.nimh.nih.gov/braintherapies .\nNatural products \nThe FDA has not approved any natural products for treating depression. Although research is ongoing and findings are inconsistent, some people report that natural products, including vitamin D and the herbal dietary supplement St. John’s wort, helped their depression symptoms. However, these products can come with risks, including, in some cases, interactions with prescription medications.\nDo not use vitamin D, St. John’s wort, or other dietary supplements or natural products \nwithout first talking to a health care provider. Rigorous studies must test whether these and other natural products are safe and effective.",
    "How can I take care of myself?\nMost people with depression benefit from mental health treatment. Once you begin \ntreatment, you should gradually start to feel better. Go easy on yourself during this time. Try to do things you used to enjoy. Even if you don’t feel like doing them, they can improve your mood. \nOther things that may help:\n●Try to get physical activity. Just 30 minutes a day of walking can boost your mood.\n●Try to maintain a regular bedtime and wake-up time.\n●Eat regular, healthy meals.\n●Do what you can as you can. Decide what must get done and what can wait.\n●Connect with people. Talk to people you trust about how you are feeling.\n●Delay making important life decisions until you feel better. Discuss decisions with\npeople who know you well.\n●Avoid using alcohol, nicotine, or drugs, including medications not prescribed for you.\nHow can I find help for depression?\nThe National Institute of Mental Health (NIMH) has information on ways to get help, \nfind a hea",
    "The National Institute of Mental Health (NIMH) has information on ways to get help, \nfind a hea\nlth care provider, and access treatment at www.nimh.nih.gov/findhelp.  \nYou can also find tips to help prepare for and get the most out of your health care  \nvisit at www.nimh.nih.gov/talkingtips . \nThe Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to find mental health services in your area at https://findtreatment.gov .\nHow can I help a loved one who is depressed?\nIf someone you know is depressed, help them see a health care provider or mental health professional. You also can:\n●Offer support, understanding, patience, and encouragement.\n●Invite them out for walks, outings, and other activities.\n●Help them stick to their treatment plan, such as setting reminders to take\nprescri\nbed medications.\n●Make sure they have transportation or access to therapy appointments.\n●Remind them that, with time and treatment, their depression can lift.",
    "Clinical trials\nClinical trials are research studies that look at ways to prevent, detect, or treat diseases \nand conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\nNIMH supports clinical trials across the United States. Talk to a health care provider \nabout clinical trials and whether one is right for you. For more information, visit  www.nimh.nih.gov/clinicaltrials .\nFor more information\nLearn more at www.nimh.nih.gov/health . For information about various health topics, \nvisit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .\nContact us\nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications \n6001 Exe\ncutive Boulevard, MSC 9663 \nBethesda, MD 20892-9663",
    "6001 Exe\ncutive Boulevard, MSC 9663 \nBethesda, MD 20892-9663  \nPhone: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov  \nEn español: www.nimh.nih.gov/espanol\nReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .\nNational Institute\nof Mental Health\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 24-MH-8079  Revised 2024",
    "From  the NATIONAL INSTITUTE of  MENTAL HEALTH  \nWhat is disruptive mood \ndysregulation disorder?\nDisruptive mood dysregulation disorder (DMDD) is a \ncondition in which children or adolescents experience ongoing irritability, anger, and frequent, intense temper outbursts. The symptoms of DMDD go beyond a “bad mood.” DMDD symptoms are severe. \nYouth with DMDD experience significant problems at \nhome, at school, and often with peers. They also tend to require mental health care services, including doctor visits and sometimes hospitalization. Additionally, these children are at an increased risk of developing anxiety and depression in the future. \nDMDD can be treated. If you are concerned that your \nchild may have DMDD, talk to your child’s pediatrician or health care provider.\nWhat are the signs and symptoms  \nof DMDD? \nChildren or adolescents with DMDD experience: \n• Severe temper outbursts (verbal or behavioral), on \naverage, 3 or more times per week",
    "• Severe temper outbursts (verbal or behavioral), on \naverage, 3 or more times per week \n• Outbursts and tantrums that have been happening regularly for at least 12 months \n• Chronically irritable or angry mood most of the day, nearly every day \n• Trouble functioning due to irritability in more than one place, such as at home, at school, or with peersYouth with DMDD are diagnosed between the ages of 6 and 10. To be diagnosed with DMDD, a child must have experienced symptoms steadily for 12 or more months. \nOver time, as children grow and develop, the symptoms \nof DMDD may change. For example, an adolescent or young adult with DMDD may experience fewer tantrums, but they may begin to exhibit symptoms of depression or anxiety. For this reason, treatment may change over time, too. \nChildren with DMDD may have trouble in school and",
    "Children with DMDD may have trouble in school and \ndifficulty maintaining healthy relationships with family or peers. They also may have a hard time in social settings or participating in activities such as team sports. If you think your child has DMDD, seeking a diagnosis and treatment is essential.\nDid you know? \nDMDD was added to the Diagnostic and Statistical Manual of Mental Disorders  (DSM-5 ) \nin 2013. The DSM  is used to assess and diagnose \nmental disorders. For more information on DMDD, visit www.nimh.nih.gov/dmdd . What is the difference between \ntypical and severe irritability? \nAll children can become irritable sometimes. \nIt’s a normal reaction to frustration. Children experiencing severe irritability (as observed in DMDD) have difficulty tolerating frustration and have outbursts that are out of proportion to the situation at hand. These outbursts occur more often and are more severe than expected for children their age. \nFor example, a parent tells the child to stop",
    "For example, a parent tells the child to stop \nplaying a game and do their homework. Any child might be frustrated or annoyed. But a child with DMDD may become extremely upset and emotional and have an intense temper outburst with yelling or hitting. A child with DMDD experiences these intense temper outbursts a few times a week.Disruptive Mood \nDysregulation Disorder: The Basics",
    "How is DMDD diagnosed? \nIf you think your child may be experiencing symptoms \nof DMDD, talk to your child’s health care provider. Describe your child’s behavior, and report what you have observed and learned from talking with others, such as their teacher or counselor. \nAn evaluation by your child’s health care provider can \nhelp clarify problems underlying your child’s behavior, and the provider may recommend next steps. You can also ask your health care provider for a referral to a mental health professional with experience working with children and adolescents. DMDD symptoms also can occur at the same time as other disorders associated with irritability, such as attention-deficit/hyperactivity disorder (ADHD) or anxiety disorders. An accurate diagnosis is vital for effective treatment.\nFor more information about the diagnosis and \ntreatment of children, visit www.nimh.nih.gov/\nchildrenandmentalhealth . If you need help",
    "treatment of children, visit www.nimh.nih.gov/\nchildrenandmentalhealth . If you need help \nidentifying a provider in your area, call the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357). SAMHSA also has an online tool at https://findtreatment.gov  that you can \nsearch by location. For more information on how to find help for you, a friend, or a family member, visit www.nimh.nih.gov/findhelp .\nHow is DMDD treated? \nDMDD is a relatively new disorder; few DMDD-specific treatment studies have been conducted. Current treatments are primarily based on what has been helpful for other childhood disorders associated with irritability, such as ADHD, oppositional defiant disorder, and anxiety disorders. \nTreatment for DMDD generally includes certain types",
    "Treatment for DMDD generally includes certain types \nof psychotherapy (sometimes called talk therapy) and sometimes medications. In many cases, psychotherapy is considered first, with medication added later. However, at times, providers recommend that children receive both psychotherapy and medication at the start of their treatment. \nNIMH is funding studies focused on improving these \ntreatments and identifying new treatments specifically for DMDD. Parents or caregivers should work closely with their child’s health care provider to make treatment decisions that are best for their child. Psychotherapy",
    "Cognitive behavioral therapy (CBT) targets the relationship between thoughts, behaviors, and feelings and is often effective in treating anger and disruptive behavior. Researchers at NIMH are also using CBT to help children increase their ability to tolerate frustration without having an outburst. This therapy teaches coping skills for controlling anger and ways to identify and relabel the distorted perceptions that contribute to outbursts.\nParent training  teaches parents or caregivers more \neffective ways to respond to irritable behavior, such \nas anticipating events that might lead a child to temper outbursts and working ahead to avert them. Training also emphasizes the importance of predictable and consistent responses to a child’s outbursts and rewards for positive behavior.\nTo learn more about psychotherapy, visit www.nimh.\nnih.gov/psychotherapies . \nMedication",
    "To learn more about psychotherapy, visit www.nimh.\nnih.gov/psychotherapies . \nMedication \nCurrently, there are no medications approved by the U.S. Food and Drug Administration (FDA) specifically for treating children or adolescents with DMDD. However, health care providers may prescribe certain medications—such as stimulants, antidepressants, and atypical antipsychotics—to help relieve your child’s DMDD symptoms. \nAll medications have side effects. Monitor and report \nyour child’s side effects and review the medications frequently with your child’s health care provider. Visit the FDA website at www.fda.gov/drugsatfda  for the \nmost up-to-date information on medications, side effects, and warnings.",
    "•Stim ulants are often used to treat ADHD, and  \nresearch suggests that stimulant medications also  \nmay decrease irritability in youth with DMD D.\n•Antidepressants\n are sometimes used to treat  \nirritability and mood problems that children with  \nDMDD may experience. One small study suggests \nthat citalopram (a serotonin reuptake inhibitor\n \nantidepressant), combined with the stimulant  \nmethylphenidate, may decrease irritability in youth  \nwith DMDD. Please note: Antidepressants may  \nincrease suicidal thoughts and behaviors in youth,\n \nwho should be monitored closely by their health  \ncare provider.\n•medications for treating irritability associated with \nautism, and they are sometimes used to treat DMDD. However, because these medications can cause unwanted side effects, they’re usually only tried when other approaches haven’t worked.\nCertain atypical antipsychotic medications are used \nto treat children with irritability, severe outbursts, or",
    "to treat children with irritability, severe outbursts, or \naggression. The FDA has approved these\nTips for parents and caregivers \nBeing a parent or caregiver for a child or adolescent with DMDD can be stressful and overwhelming. To help build a supportive environment for you and your child, you may want to consider the following: \nLearn as much as you can about the disorder. \nTalk to your child’s health care provider or mental \nhealth professional. Ask questions about treatment options, including risks and benefits. You can find additional information about DMDD (including the latest news, videos, and information about clinical trials) at www.nimh.nih.gov/DMDD . \nTalk to your child’s teacher, counselor, or school psychologist. \nTogether, you may develop strategies, plans, and \naccommodations to help your child thrive in school. For more information, check out www.nimh.nih.gov/childrenandmentalhealth . \nFind ways to manage your stress. \nTake practical steps to manage your stress to",
    "Find ways to manage your stress. \nTake practical steps to manage your stress to \navoid the risk of negative health effects. For tips, visit www.nimh.nih.gov/stress . Seek additional support and professional help. \nParents and caregivers may be able to find \nresources and encouragement through their local chapter of the National Alliance on Mental Illness (www.nami.org/findsupport ), the National \nFederation of Families ( www.ffcmh.org ), Mental \nHealth America ( www.mhanational.org ), and \nother organizations. \nCommunicate regularly and effectively with your \nchild’s health care provider. \nFor tips to help you prepare for your child’s \nappointment, visit www.nimh.nih.gov/talkingtips . \nFor additional resources, including questions to ask your health care provider, visit the Agency  \nfor Healthcare Research and Quality website at www.ahrq.gov/questions .",
    "NIH Publication No. 23-MH-8119 \nRevised 2023Follow NIMH on  \nsocial media @NIMHgovReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright . For more information\nMedlinePlus ( National L ibrary o f Medicine)  \nhttps://medlineplus.gov   \nhttps://medlineplus.gov/spanish ( en español) \nNational Institute of Mental Health   \nO\nffice of Science Policy, Planning, and \nCommunications \n6\n001 Executive Boulevard, MSC 9663  \nBethesda, MD 20892-9663   \nToll-free: 1-866-615-6464  \nEmail: nimhinfo@nih.gov  \nw\nww.nimh.nih.gov   What are clinical trials and why are they important? \nChildren are not little adults, yet they are often given",
    "Children are not little adults, yet they are often given \nmedications and treatments that have been tested only in adults. Research shows that, compared to adults, children respond differently to medications and treatments, both physically and mentally. The way to get the best treatments for children is through research designed specifically for them. \nClinical trials are research studies that look at ways \nto prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available. \nNIMH supports clinical trials across the United States. \nTalk to a health care provider about clinical trials and whether one is right for your child. For more information, visit www.nimh.nih.gov/clinicaltrials .",
    "Eating  \nDisorders:  \nWhat You  Need  \nto Know",
    "What are eating disorders?\nEating disorders are serious illnesses marked by severe disturbances to one’s \neating behaviors. Although many people may be concerned about their health, weight, or appearance from time to time, some people become fixated or obsessed with weight loss, body weight or shape, and controlling their food intake. These may be signs of an eating disorder. \nEating disorders are not a choice. These disorders can adversely affect a person’s \nphysical and mental health, and in some cases, they can be life-threatening. With treatment, however, people can recover from eating disorders. \nWho is at risk for eating disorders?\nEating disorders can affect people of all ages, racial and ethnic backgrounds, body weights, and genders. Even people who appear healthy can have eating disorders and be extremely ill. People with eating disorders can be underweight, average weight, or overweight. \nThe exact cause of eating disorders is not fully understood. Research suggests a",
    "The exact cause of eating disorders is not fully understood. Research suggests a \ncombination of genetic, biological, behavioral, psychological, and social factors can raise a person’s risk. \nWhat are the common types of eating disorders?\nCommon types of eating disorders include:\n ●Anorexia nervosa : People with anorexia nervosa severely avoid or restrict \nfood intake due to a distorted self-image or an intense fear of gaining weight. Even when dangerously underweight, they may see themselves as overweight. Some people with anorexia nervosa may also have binge eating and purging episodes.\n ●Binge-eating disorder : People with binge-eating disorder regularly lose \ncontrol of their eating and eat unusually large amounts of food. People with binge-eating disorder are often overweight or obese.\n ●Bulimia nervosa : People with bulimia nervosa regularly binge eat and then",
    "●Bulimia nervosa : People with bulimia nervosa regularly binge eat and then \nengage in unhealthy behaviors to prevent weight gain, such as forced vomiting or the use of laxatives. People with bulimia nervosa may maintain an average weight or be overweight.\n ●Avoidant restrictive food intake disorder (ARFID) : People with ARFID limit \nthe amount and variety of food they eat due to their anxiety or fear of the consequences of eating (such as choking or vomiting) or dislike of a food’s characteristics (such as its appearance or texture). People with ARFID are frequently underweight.\nPeople exhibiting any combination of these symptoms may have an eating disorder and should talk to a health care provider.",
    "What are the signs and symptoms of anorexia nervosa?\nSigns and symptoms of anorexia \nnervosa include:\n ●Extremely restricted eating\n ●Intense and excessive exercise\n ●Extreme thinness (emaciation)\n ●A relentless pursuit of thinness and unwillingness to maintain a healthy weight\n ●Intense fear of gaining weight\n ●Distorted body image or self-image\n ●Denial of the seriousness of low body weightOver time, anorexia nervosa can lead to numerous serious health consequences, including:\n ●Thinning of the bones (osteopenia or osteoporosis)\n ●Mild anemia\n ●Muscle wasting and weakness\n ●Delayed puberty\n ●Severe constipation\n ●Low blood pressure\n ●Slowed breathing and pulse\n ●Damage to the structure and function of the heart\n ●Feeling tired all the time\n ●Infertility\n ●Brain damage\n ●Multiple organ failure",
    "●Feeling tired all the time\n ●Infertility\n ●Brain damage\n ●Multiple organ failure\nAnorexia nervosa can be fatal. It has an extremely high death rate compared with other mental disorders. People with anorexia nervosa are at risk of dying from medical complications associated with starvation. Suicide is a leading cause of death for people diagnosed with anorexia nervosa. \nIf 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 \nlife-threatening situations, call 911 .",
    "What are the signs and symptoms of binge-eating disorder?\nSigns and symptoms of binge-\neating disorder include:\n ●Eating unusually large amounts of food in a short amount of time, for example, within two hours\n ●Eating rapidly during binge episodes\n ●Eating even when full or not hungry\n ●Eating until uncomfortably full\n ●Eating alone or in secret to avoid embarrassment\n ●Feeling distressed, ashamed, or guilty about eating\n ●Dieting frequently, possibly without weight lossOver time, binge eating can lead to serious health consequences, including:\n ●Obesity\n ●Type 2 diabetes\n ●Cardiovascular problems\n ●Sleep problems\n ●Gastrointestinal symptoms (such as acid reflux, bloating, and diarrhea)",
    "What are the signs and symptoms of bulimia nervosa?\nThe signs and symptoms of bulimia \nnervosa include the same signs and symptoms as binge eating. They also include the following, which aim to get rid of food after binge eating:\n ●Throwing up\n ●Taking laxatives\n ●Exercising excessively\n ●FastingOver time, bulimia nervosa can lead to serious health consequences, including: \n ●Chronically inflamed and sore throat\n ●Swollen salivary glands in the neck and jaw area\n ●Worn tooth enamel and increasingly sensitive and decaying teeth\n ●Acid reflux disorder and other gastrointestinal problems\n ●Intestinal distress and irritation\n ●Severe dehydration\n ●Electrolyte imbalance\nWhat are the signs and symptoms of avoidant restrictive \nfood intake disorder?\nSigns and symptoms of ARFID \ninclude: \n ●Severe restriction of types or amount of food eaten\n ●Lack of appetite or interest in food \n ●Dramatic weight loss",
    "●Lack of appetite or interest in food \n ●Dramatic weight loss \n ●Upset stomach, abdominal pain, or other gastrointestinal issues with no other known cause\n ●Limited range of preferred foods that becomes even more limited (“picky eating” that gets progressively worse)Over time, ARFID can lead to serious health consequences, including: \n ●Unhealthy weight loss\n ●Malnutrition\n ●Changes to physical growth \n ●Functional impairments associated with academic performance, work, and relationships",
    "What mental illnesses can co-occur with eating disorders?\nPeople with eating disorders are at risk for co-occurring mental illnesses, which \nmost often include depression, anxiety, and substance use disorders. People with eating disorders are also at a higher risk for suicide. It’s critical to treat any co-occurring conditions as part of the treatment plan. \nHow are eating disorders treated?\nEating disorders can be treated successfully. Early detection and treatment are important for recovery. Treatment plans for eating disorders include:\n ●Individual, group, or family psychotherapy  to identify and change troubling \nemotions, thoughts, and behaviors about food. For general information about psychotherapies, visit www.nimh.nih.gov/psychotherapies .\n ●Medical care and monitoring to treat the health consequences of an eating disorder and monitor overall well-being.\n ●Nutritional counseling  to help people eat well and reach and maintain a \nhealthy weight.",
    "●Nutritional counseling  to help people eat well and reach and maintain a \nhealthy weight.\n ●Medication to treat the symptoms of some eating disorders, including bulimia nervosa and binge-eating disorder, and to reduce symptoms of co-occurring anxiety or depression. There are currently no medications approved by the U.S. Food and Drug Administration (FDA) to treat the symptoms of anorexia nervosa or ARFID.  \nSome people with a severe eating disorder may need to be in a hospital or residential treatment program. \nA person’s family can play a crucial role in treatment. They can encourage a family member with eating or body image issues to seek help and can provide support during treatment. Research suggests that family-based treatment can improve eating disorder treatment outcomes, particularly  for adolescents.",
    "How can I find help?\nIf you have concerns about your eating behavior or mental health, talk to a primary \ncare provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure \nout the next steps. Find tips for talking with a health care provider about your \nmental health at www.nimh.nih.gov/talkingtips .\nYou can learn more about getting help at www.nimh.nih.gov/findhelp . The \nSubstance Abuse and Mental Health Services Administration (SAMHSA) provides information about finding support at https://findsupport.gov  and locating mental \nhealth services in your area at https://findtreatment.gov .\nWhat are clinical trials and why are they important?",
    "What are clinical trials and why are they important?\nClinical trials are research studies that look at ways to prevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions , join to try treatments that aren’t widely available. \nNIMH supports clinical trials across the United States. Talk to a health care provider about clinical trials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .",
    "For more information\nLearn more at www.nimh.nih.gov/health . For information about various  \nhealth topics, visit the National Library of Medicine’s MedlinePlus resource at \nhttps://medlineplus.gov . \nContact us\nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications 6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  \nPhone: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov  \nEn español: www.nimh.nih.gov/espanol\nReprints\nThe information in this publication is in the public domain and may be reused  or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright . \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health NIH Publication No. 24-MH-4901 Revised 2024",
    "¡Entusiásmate\nlas investigcon aiocne\nbre la salud mseontal s !\nUn libro para colorear \ncon actividades\nPARA NIÑOS DE 8 A 12 AÑOS\nDel INSTITUTO NACIONAL de la SALUD MENTAL  \n\nDel INSTITUTO NACIONAL de la SALUD MENTAL  \n¡Entusiásmate\nlas investig anc\ncoione\nbre la salud msentso al!\nUn libro para colorear \ncon actividades\nPARA NIÑOS DE 8 A 12 AÑOS\nEl Instituto Nacional de la Salud Mental (NIMH, por sus siglas en inglés) es la agencia federal que dirige \nlas investigaciones sobre los trastornos mentales. El NIMH es uno de los 27 institutos y centros que \nconstituyen los Institutos Nacionales de la Salud (NIH, por sus siglas en inglés), la agencia más grande \nde la nación en el campo de las investigaciones médicas. Los NIH forman parte del Departamento de \nSalud y Servicios Humanos de los Estados Unidos.",
    "¿QUÉ ES LA SALUD MENTAL?\ndato curioso \nLa salud mental incluye cómo nos sentimos, pensamos y actuamos. Tus genes, la forma en que \nfunciona tu cerebro y las cosas que suceden en tu vida pueden afectar tu salud mental. Los cambios en la forma de pensar, sentir o actuar que hacen más difícil que hagas las tareas escolares o que estés con tus familiares y amigos podrían ser un signo de algún trastorno mental.  Al igual que cuando tienes \nuna infección de oído o gripe, es posible que necesites ayuda para que te sientas mejor.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 1\n\n¿QUÉ SON LAS \nINVESTIGACIONES SOBRE LA \nSALUD MENTAL?\ndato curioso \nLos investigadores en este campo estudian la salud mental, las causas de los trastornos mentales y nuevas \nformas de tratarlos. \n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL!2",
    "EL INSTITUTO NACIONAL \nDE LA SALUD MENTAL\ndato curioso\nEl Instituto Nacional de la Salud Mental (NIMH) es una de las muchas agencias que forman parte del \ngobierno de los Estados Unidos. El NIMH apoya a los investigadores que estudian los trastornos mentales. El NIMH tiene laboratorios en el estado de Maryland y también apoya a investigadores de todos los Estados Unidos y el resto del mundo. Si llegas a ser investigador de salud mental, ¡podrías terminar trabajando o recibiendo apoyo del NIMH!\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 3",
    "ESTUDIOS CLÍNICOS\ndato curioso \nLos estudios clínicos son un tipo de investigación sobre la salud mental. En los estudios clínicos, los \ninvestigadores ponen a prueba nuevos tratamientos para ver si funcionan y son seguros para las personas. La razón por la que las personas se ofrecen como voluntarias para participar en estudios clínicos es para ayudar a encontrar tratamientos nuevos y mejores para los trastornos mentales.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL!4",
    "EL MÉTODO CIENTÍFICO\ndato curioso \nTodos los investigadores usan el método científico para hacer preguntas, realizar pruebas y resolver \nproblemas. A veces, la investigación no responde a la pregunta original, ¡y eso también está bien! Los nuevos conocimientos que se adquieren pueden resultar en nuevas preguntas y respuestas.\nObservación: \nAlgo que has \nvisto o notado \nque te ha \ndespertado la \ncuriosidad.Pregunta:   \n“Me pregunto qué pasaría si…”\nResultado:  Podrías compartir lo que aprendiste o cambiar tuhipótesis y volvera intentarlo.Hipótesis:  \nLo que \nsupones \nque podría \nsuceder en tu \nexperimento.\nConclusión:  \nLo que \naprendiste de \ntu experimento.Experimento: Llevas a cabo investigaciones para probar su hipótesis.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 5",
    "¿PUEDES ENCONTRAR LAS DIFERENCIAS?\n¿Puedes encontrar las ocho (8) diferencias entre las dos imágenes?\nLas respuestas están en la página 13.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL!6",
    "LABERINTO\n¡Ayuda al estudiante a convertirse en investigador!\nAyuda al estudiante a encontrar la manera de convertirse en un investigador de salud mental. Aunque se \npuede elegir solo una vía para este estudiante, ¡hay muchos caminos que se pueden tomar! \na.Toma clases de ciencia y psicología que te interesen o te entusiasmen.\nb.Considera oportunidades para hacer voluntariado, como darse consejos entre compañeros o trabajar\nen un asilo de ancianos.\nc.Gradúate de la escuela secundaria.\nd.Asiste a la universidad y explora algunas áreas más emocionantes de la ciencia, la salud y la psicología.\ne.Encuentra un mentor (una persona o amigo con más experiencia) que ayude a guiarte en tu camino.\nf.Busca pasantías u otro tipo de oportunidades para trabajar en laboratorios y ayudar a los\ncientíficos a realizar sus investigaciones.",
    "científicos a realizar sus investigaciones.\ng.Explora oportunidades de voluntariado, como darse consejos entre compañeros, trabajarpara una línea directa que atiende llamadas de personas que necesitan ayuda con susalud mental o ser voluntario en un hospital.\nh.Considera obtener un título avanzado, como una maestría, un título de doctor enmedicina (M.D.) o un doctorado en otras áreas (Ph.D.).\ni.Piensa en la posibilidad de estudiar para ser enfermero, terapeuta o trabajador social.\nj.Contribuye a que el mundo sea un lugar más saludable mentalmente.\nab\nc\ndi\nh\nf eg\nLas respuestas están en la página 13.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 7",
    "PRUEBA TUS CONOCIMIENTOS  \nACERCA DE LAS INVESTIGACIONES  \nSOBRE LA SALUD MENTAL\nUsa el banco de palabras para resolver las siguientes pistas del crucigrama.\n1 2\n3\n4\n5\n6  7\n8\n9\n10\n11\n12banco de palabras \nClínico\nDiagnósticoHipótesisRevista \nprofesionalAprendizaje\nMemoriaMétodoTrastornosInvestigacionesLaboratorioMentorTratamiento\nhorizontal\n3.El _________  científico\n7. Donde se podría publicar un artículo de\ninvestigación científica\n8. Atención médica por una enfermedad o lesión\n9. Donde el cerebro almacena y recuerda\ninformación\n10. Una persona o un amigo con experiencia que\npuede guiar tu carrera\n11. Espacio físico donde se lleva a cabo\nuna investigación\n12. La depresión y la ansiedad son dos tipos de estosvertical\n1. Una suposición sobre lo que podría suceder\nen tu experimento\n2. Identificar una enfermedad al observar los\nsíntomas\n4. Adquirir conocimientos o habilidades al\nexperimentar algo, estudiarlo o si alguien\nte lo enseña\n5. Estudio cuidadoso para descubrir nueva\ninformación",
    "te lo enseña\n5. Estudio cuidadoso para descubrir nueva\ninformación\n6. Investigación que incluye probar nuevos\ntratamientos en un grupo de personas:estudio  ________\nLas respuestas están en la página 13.   \n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL!8",
    "TODO ACERCA DE LAS INVESTIGACIONES \nSOBRE LA SALUD MENTAL \nBusca hacia arriba, hacia abajo, hacia adelante, hacia atrás y en diagonal para encontrar las palabras ocultas.\nD L T R A T A M I E N T O S I\nI E E I V T H O U G H T S T N\nA E S V O S A T J A L W S A V\nG D E C L T C E R E B R O R E\nN R N I U A B R O T S P O L S\nÓ O T E N B E A I L D T Z F T\nS S I N T N R P S C N D U D I\nT I M C A Y A I P E X E T A G\nI D I A R N I A M S E S R C A\nC N E N I C H M S I P R H B C\nO D N O O S G R S O E S X G I\nE U T S K D I S C O V N R Y O\nM P O I O N R O T S A R T S N\nV L S S G N I L E E F K S O E\nS T R P E N S A M I E N T O S\nCEREBRO\nCIENCIA \nDESCUBRIMIENTOS \nDIAGNÓSTICO  INVESTIGACIONES\nMENTOR \nPENSAMIENTOS\nSENTIMIENTOSTERAPIA \nTRASTORNO \nTRATAMIENTO\nVOLUNTARIO\nLas respuestas están en la página 14.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 9",
    "UN MENSAJE CRÍPTICO \nSOBRE TU FUTURO\nResuelve los problemas de matemáticas y luego usa las letras debajo de tus respuestas \npara decodificar el mensaje oculto en los siguientes espacios en blanco.\n12 + 12 5 x 0 8 + 8 16 + 16 6 + 6 1 x 9 30 - 2 25 + 8 5 + 1 90 - 9 55 + 8 60 + 20 10 + 8\nA B C D E F G H I J K L M\n4 + 4 15 + 15 30 - 5 9 + 6 50 + 6 2 x 1 2 + 2 30 - 3 10 + 10 3 x 1 3 + 4 7 + 7 24 + 2\nN O P Q R S T U V W X Y Z\nmensaje oculto\n2 6 456 24 024 81 24 2 32 27 56 30 14\n2 6 28 27 12 2 427 2 6 8 4 1256 12 212 2\n25 30 32 56 624 2 1630 8201256 4 6 56 412\n12 8 27 8 6 8 20 12 2 4 6 28 24 32 30 56 32 12\n224 80 27 32 18 12 8 4 24 80 14 32 12 216 27 056 656\n80 24 1680 24 20 12 15 27 12 830 2 24 14 27 32 12 24\n32 12 2 0 80 30 15 27 12 24 56 80 30 2\n18 6 2 4 1256 630 2 32 1280 16 1256 12 056 30.\nLas respuestas están en la página 14.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL!10",
    "¡LLEVA A CABO TU PROPIO EXPERIMENTO! \n¡Ahora es tu turno de ser el investigador! Este experimento rápido te ayudará a comprender  \nun poco más sobre cómo el cerebro recuerda las cosas.\nPrimero, comencemos con una hipótesis. Vas a poner a prueba la idea de que es más fácil recordar \nuna lista de palabras si tienen algo en común. Puedes realizar este experimento solo o con un \npequeño grupo de familiares o amigos como voluntarios.\nLo que necesitarás: \n•Tú o algunos voluntarios\n•Los cuadros de palabras de abajo y en la página siguiente•Una hoja de papel\n•Un reloj o cronómetro\nPaso 1:\n1.Fija tu cronómetro en 2 minutos.\n2.Mira el cuadro de palabras A durante 2 minutos e intenta memorizar tantas palabras como puedas.\n3.Cuando ya hayan pasado los 2 minutos, tapa el cuadro de palabras y escribe tantas palabras en\nlos espacios vacíos como puedas recordar.\n4.Cuenta cuántas palabras recordaste y escribe ese número en el cuadro de datos de la\npágina siguiente.\ncuadro de palabras a:",
    "página siguiente.\ncuadro de palabras a:\nNueve Gato Rostro Anillo Jugar\nTapones Lámpara Manzana Mesa Carro\nEjército Banco Fuego Sostener Teléfono\nReloj Caballo Color Bebé Espada\nEscritorio Agarrar Televisión Pájaro Piedra\nAunque tuviste 2 minutos para memorizar las palabras, es posible que te haya resultado difícil recordar \nincluso un par de palabras.\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 11",
    "¡LLEVA A CABO TU PROPIO EXPERIMENTO! \n(continuación)\nPaso 2:\n1.Fija tu cronómetro en 2 minutos.\n2.Mira el cuadro de palabras B durante 2\nminutos. Lee las palabras en cada fila deizquierda a derecha e intenta memorizar tantaspalabras como puedas.3.Cuando ya hayan pasado los 2 minutos, tapael cuadro de palabras y escribe tantas palabrasen los espacios vacíos como puedas recordar.\n4.Cuenta cuántas palabras recordaste y escribeese número en el cuadro de datos de lapágina siguiente.\ncuadro de palabras b:\nCaballo Gato Perro Pescado Pájaro\nNaranja Amarillo Azul Verde Negro\nMesa Silla Escritorio Librero Cama\nMaestra Escuela Estudiante Tarea Aula\nManzana Banano Kiwi Uva Pera\ncuadro de datos\nTotal de palabras que recordaste del cuadro de palabras A\nTotal de palabras que recordaste del cuadro de palabras B\nObservaciones y conclusiones\n¿Qué observaste acerca de cuántas palabras recordaste del cuadro de palabras A y del cuadro de",
    "¿Qué observaste acerca de cuántas palabras recordaste del cuadro de palabras A y del cuadro de \npalabras B? Aunque tuviste 2 minutos para memorizar las palabras, es posible que te haya resultado difícil recordar incluso un par de palabras del cuadro de palabras A porque todas eran diferentes.\nProbablemente recordaste más palabras del cuadro de palabras B. Las palabras del cuadro de \npalabras B están “agrupadas” para que sea más fácil ponerlas en categorías.\n¡Esta idea de “agrupar” elementos en grupos, como animales o colores, puede ser una herramienta útil \npara memorizar información!\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 12",
    "RESPUESTAS A LAS \nPÁGINAS DE ACTIVIDADES\nrespuestas a “¿puedes encontrar las diferencias?”\nrespuestas al \n“laberinto”\nei\nh\nfgab\nc\ndrespuestas a “prueba tus conocimientos \nacerca de las investigaciones sobre la salud mental”\n9IH\nRLARM\nISTA7I\nP\nI\nSÓ\nNA\nP\nE\nD43T O E D\nT\nE\nEV PRO\nT A TORNO121\nIC\nL\nÍ\nN\nC6  D\nI\nG\nN\nTS2\nO11ZI\nM10NTOI\nMEMO IA\nT IM ENT8\nRAI FEÓ\nL ONA\nC\nO\nJ\nERAR TA\nATV\nE\nS\nI\nG5\nSOC\nI\nN\nERATOR O B\nShorizontal\n3.Methód\n7.Revista profesional\n8.Tratamiento\n9.Memoria\n10.Mentor\n11.Laboratorio\n12.Trastornosvertical\n1.Hipótesis\n2.Diagnóstico\n4.Aprendizaje\n5.Investigaciones\n6.Clínico\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 13",
    "RESPUESTAS A “TODO \nACERCA DE LAS INVESTIGACIONES SOBRE LA SALUD MENTAL”D L T R A T A M I E N T O S I\nI E E I V T H O U G H T S T N\nA E S V O S A T J A L W S A V\nG D E C L T C E R E B R O R E\nN R N I U A B R O T S P O L S\nÓ O T E N B E A I L D T Z F T\nS S I N T N R P S C N D U D I\nT I M C A Y A I P E X E T A G\nI D I A R N I A M S E S R C A\nC N E N I C H M S I P R H B C\nO D N O O S G R S O E S X G I\nE U T S K D I S C O V N R Y O\nM P O I O N R O T S A R T S N\nV L S S G N I L E E F K S O E\nS T R P E N S A M I E N T O S\nrespuestas a “un mensaje críptico sobre tu futuro”\n12 + 12 5 x 0 8 + 8 16 + 16 6 + 6 1 x 9 30 -2 25 + 8 5 + 1 90 - 9 55 + 8 60 + 20 10 + 8\n24 0 16 32 12 9 28 33 6 81 63 80 18\nA B C D E F G H I J K L M\n4 + 4 15 + 15 30 - 5 9 + 6 50 + 6 2 x 1 2 + 2 30 - 3 10 + 10 3 x 1 3 + 4 7 + 7 24 + 2\n8 30 25 15 56 2 4 27 20 3 7 14 26\nN O P Q R S T U V W X Y Z\nS i t r a b a j a sd u r o y\n2 6 4 56 24 0 24 81 24 2 32 27 56 30 14\ns i g u e s t u s i n t e r e s e s",
    "2 6 4 56 24 0 24 81 24 2 32 27 56 30 14\ns i g u e s t u s i n t e r e s e s\n2 6 28 27 12 2 4 27 2 6 8 4 12 56 12 2 12 2\np o d r i a s c o n v e r t i r t e\n25 30 32 56 6 24 2 16 30 8 20 12 56 4 6 56 4 12\ne n  u n i n v e s t i g a d o r d e\n12 8 27 8 6 8 20 12 2 4 6 28 24 32 30 56 32 12\ns a l u d m e n t a l y d e s c u b r i r\n2 24 80 27 32 18 12 8 4 24 80 14 32 12 2 16 27 0 56 6 56\nl a c l a v e q u e n o s a y u d e a\n80 24 16 80 24 20 12 15 27 12 8 30 2 24 14 27 32 12 24\nd e s b l o q u e a r l o s\n32 12 2 0 80 30 15 27 12 24 56 80 30 2\nm i s t e r i o s d e l c e r e b r o .\n18 6 2 4 12 56 6 30 2 32 12 80 16 12 56 12 0 56 30\n¡ENTUSIÁSMATE CON LAS INVESTIGACIONES SOBRE LA SALUD MENTAL! 14",
    "DEPARTAMENTO DE SALUD Y SERVICIOS \nHUMANOS DE LOS ESTADOS UNIDOS\nInstitutos Nacionales de la SaludPublicación de NIH Núm. 24-MH-8197S\nPara obtener más información sobre la salud mental, visite los \nsitios web del NIMH en www.nimh.nih.gov/espanol  (español)  \nowww.nimh.nih.gov  (inglés). Para obtener información sobre\nuna amplia variedad de temas de salud, visite el servicioMedlinePlus en español de la Biblioteca Nacional de Medicinaen https://medlineplus.gov/spanish .\nReproducciones\nLa información en esta publicación es de dominio público y se puede reutilizar y copiar sin necesidad de pedir permiso. Por favor cite al Instituto Nacional de la Salud Mental como  \nla fuente. Para obtener más información sobre el uso de las  \npublicaciones del NIMH, consulte las pautas del NIMH para reproducir sus materiales en www.nimh.nih.gov/reproducciones .¡Entusiásmate\nconlasinvestigaciones\nsobrelasaludmental!\n\nGeneralized \nAnxiety Disorder:\nWhen Worry Gets \nOut of Control",
    "Do you often find yourself worrying about everyday \nissues for no obvious reason? Are you always waiting for disaster to strike or excessively worried about things such as health, money, family, work, or school?\nIf so, you may have a type of anxiety disorder called \ngeneralized anxiety disorder (GAD). GAD can make daily life feel like a constant state of worry, fear, and dread. The good news is GAD is treatable. Learn more about the symptoms of GAD and how to find help.\nWhat is generalized anxiety disorder?\nOccasional anxiety is a normal part of life. Many people may worry about",
    "Occasional anxiety is a normal part of life. Many people may worry about \nthings such as health, money, or family problems. But people with GAD feel extremely worried or nervous more frequently about these and other things—even when there is little or no reason to worry about them. GAD usually involves a persistent feeling of anxiety or dread that interferes with how you live your life. It is not the same as occasionally worrying about things or experiencing anxiety due to stressful life events. People living with GAD experience frequent anxiety for months, if not years.\nGAD develops slowly. It often starts around age 30, although it can occur \nin childhood. The disorder is more common in women than in men.\nWhat are the signs and symptoms of  \ngeneralized anxiety disorder?\nPeople with GAD may:\n ●Worry excessively about everyday things\n ●Have trouble controlling their worries or feelings of nervousness\n ●Know that they worry much more than they should",
    "●Know that they worry much more than they should\n ●Feel restless and have trouble relaxing\n ●Have a hard time concentrating\n ●Startle easily\n ●Have trouble falling asleep or staying asleep",
    "●Tire easily or feel tired all the time \n ●Have headaches, muscle aches, stomachaches, or unexplained pains\n ●Have a hard time swallowing\n ●Tremble or twitch\n ●Feel irritable or “on edge”\n ●Sweat a lot, feel lightheaded, or feel out of breath\n ●Have to go to the bathroom frequently\nChildren and teens with GAD often worry excessively about: \n ●Their performance in activities such as school or sports\n ●Catastrophes, such as earthquakes or war\n ●The health of others, such as family members\nAdults with GAD are often highly nervous about everyday circumstances, \nsuch as: \n ●Job security or performance\n ●Health \n ●Finances\n ●The health and well-being of their children or other family members\n ●Being late\n ●Completing household chores and other responsibilities\nBoth children and adults with GAD may experience physical symptoms such as pain, fatigue, or shortness of breath that make it hard to function and that interfere with daily life.",
    "Symptoms may fluctuate over time and are often worse during times of \nstress—for example—with a physical illness, during school exams, or during a family or relationship conflict.\nWhat causes generalized anxiety disorder?\nRisk for GAD can run in families. Several parts of the brain and biological processes play a key role in fear and anxiety. By learning more about how the brain and body function in people with anxiety disorders, researchers may be able to develop better treatments. Researchers have also found that external causes, such as experiencing a traumatic event or being in a stressful environment, may put you at higher risk for developing GAD.",
    "How is generalized anxiety disorder treated?\nIf you think you’re experiencing symptoms of GAD, talk to a health care \nprovider. After discussing your history, a health care provider may conduct  \na physical exam to ensure that an unrelated physical problem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional. \nGAD is generally treated with psychotherapy (sometimes called “talk \ntherapy”), medication, or both. Speak with a health care provider about the best treatment for you.\nPsychotherapy",
    "Psychotherapy\nCognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat GAD. CBT teaches you different ways of thinking, behaving, and reacting to situations that help you feel less anxious and worried. CBT has been well studied and is the gold standard for psychotherapy.\nAnother treatment option for GAD is acceptance and commitment therapy \n(ACT). ACT takes a different approach than CBT to negative thoughts and uses strategies such as mindfulness and goal setting to reduce your discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data are available on its effectiveness. However, different therapies work for different types of people, so it can be helpful to discuss what form of therapy may be right for you with a mental health professional.\nFor more information on psychotherapy, visit www.nimh.nih.gov/\npsychotherapies .\nMedication",
    "For more information on psychotherapy, visit www.nimh.nih.gov/\npsychotherapies .\nMedication\nHealth care providers may prescribe medication to treat GAD. Different types of medication can be effective, including: \n ●Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)\n ●Anti-anxiety medications, such as benzodiazepines",
    "SSRI and SNRI antidepressants are commonly used to treat depression, \nbut they also can help treat the symptoms of GAD. They may take several weeks to start working. These medications also may cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe for most people, especially if the dose starts off low and is increased slowly over time. Talk to your health care provider about any side effects that you may experience.\nBenzodiazepines, which are anti-anxiety sedative medications, also can be \nused to manage severe forms of GAD. These medications can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time if you need them.\nBuspirone is another anti-anxiety medication that can be helpful in treating",
    "Buspirone is another anti-anxiety medication that can be helpful in treating \nGAD. Unlike benzodiazepines, buspirone is not a sedative and has less potential to be addictive. Buspirone needs to be taken for 3–4 weeks for it to be fully effective.\nBoth psychotherapy and medication can take some time to work. Many \npeople try more than one medication before finding the best one for them. A health care provider can work with you to find the best medication, dose, and duration of treatment for you. \nFor basic information about these and other mental health medications, \nvisit www.nimh.nih.gov/medications . Visit the Food and Drug \nAdministration’s website ( www.fda.gov/drugsatfda ) for the latest \nwarnings, patient medication guides, and information on newly approved medications.\nSupport Groups",
    "warnings, patient medication guides, and information on newly approved medications.\nSupport Groups\nSome people with anxiety disorders might benefit from joining a self-help or support group and sharing their problems and achievements with others. Support groups are available both in person and online. However, any advice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider.",
    "Healthy Habits\nPracticing a healthy lifestyle also can help combat anxiety, although this \nalone cannot replace treatment. Researchers have found that implementing certain healthy choices in daily life—such as reducing caffeine intake and getting enough sleep—can reduce anxiety symptoms when paired with standard care—such as psychotherapy and medication. \nStress management techniques, such as exercise, mindfulness, and \nmeditation, also can reduce anxiety symptoms and enhance the effects of psychotherapy. You can learn more about how these techniques benefit your treatment by talking with a health care provider. \nTo learn more ways to take care of your mental health, visit www.nimh.\nnih.gov/mymentalhealth .\nHow can I support myself and others  \nwith generalized anxiety disorder?\nEducate Yourself\nA good way to help yourself or a loved one who may be struggling with",
    "Educate Yourself\nA good way to help yourself or a loved one who may be struggling with \nGAD is to seek information. Research the warning signs, learn about treatment options, and keep up to date with current research.\nCommunicate\nIf you are experiencing GAD symptoms, have an honest conversation about how you’re feeling with someone you trust. If you think that a friend or family member may be struggling with GAD, set aside a time to talk with them to express your concern and reassure them of your support.\nKnow When to Seek Help\nIf your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as at school, at work, or with friends and family—it’s  time to seek professional help. Talk to a health care provider about your mental health.",
    "Are there clinical trials studying  \ngeneralized anxiety disorder?\nNIMH supports a wide range of research, including clinical trials that look \nat new ways to prevent, detect, or treat diseases and conditions—including GAD. Although individuals 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.\nResearchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nFinding Help\nBehavioral Health Treatment Services Locator",
    "Finding Help\nBehavioral Health Treatment Services Locator \nThis online resource, provided by the Substance Abuse and Mental Health Services Administration, helps you locate mental health treatment facilities and programs. Find a facility in your state at https://findtreatment.samhsa.gov. For additional resources, visit www.nimh.nih.gov/findhelp . \nTalking to a Health Care Provider About Your Mental Health \nCommunicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at www.nimh.nih.gov/talkingtips . For \nadditional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website at www.ahrq.gov/questions .",
    "If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide \nPrevention Lifeline website at https://suicidepreventionlifeline.org .",
    "Reprints\nThis publication is in the public domain and may be reproduced or copied \nwithout permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH \nInformation Resource Center at 1-866-615-6464, email nimhinfo@nih.gov , \nor refer to NIMH’s reprint guidelines at www.nimh.nih.gov/reprints .\nFor More Information\nNIMH website  \nwww.nimh.nih.gov   \nwww.nimh.nih.gov/espanol  (en español)\nMedline Plus (National Library of Medicine) \nhttps://medlineplus.gov   \nhttps://medlineplus.gov/spanish  (en español)\nClinicalTrials.gov  \nwww.clinicaltrials.gov  \nhttps://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health \nOffice of Science Policy, Planning, and Communications 6001 Executive Boulevard  \nRoom 6200, MSC 9663 Bethesda, MD 20892-9663 Toll-free: 1-866-615-6464  \nEmail: nimhinfo@nih.gov  \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES",
    "Email: nimhinfo@nih.gov  \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 22-MH-8090 Revised 2022",
    "Get Excited\nAbout the Brain!\nA Coloring &  \nActivity Book\nFor Kids Ages 8–12\nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  \n\nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  \nGet Excited\nAbout the Brain!\nA Coloring &  \nActivity Book\nFor Kids Ages 8–12\nThe National Institute of Mental Health (NIMH) is the lead federal agency for research \non mental disorders. NIMH is one of the 27 Institutes and Centers that make up the \nNational Institutes of Health (NIH), the nation’s largest medical research agency.  \nNIH is part of the U.S. Department of Health and Human Services.",
    "GET EXCITED ABOUT THE BRAIN! 1Parts of the Brain\nparietal lobe\nHelps you understand language \nand process information from \nyour five sensesFrontal lobe\nAids in complex \nthinking, learning, and problem-solving\nOccipital lobe\nReceives and makes \nsense of visual \ninformation, such as \nrecognizing faces  \nand objectstemporal lobe\nResponsible for  \nhearing and understanding sounds\ncerebellum\nResponsible for balance \nand coordination\nbrain stem\nControls your basic body functions, such as breathing, temperature, and heart rate\n\n2 GET EXCITED ABOUT THE BRAIN!The Cerebral Cortex \nfun fact \nThe cerebral cortex  is the wrinkly outer \nlayer of the brain. As you think and learn \nnew things, the outer layer folds up and gets wrinklier.\n\nGET EXCITED ABOUT THE BRAIN! 3Your Brain and Memory\nfun fact\nHuman brains can hold tons of \ninformation. There are around 2,500,000 gigabytes of storage space in your brain. The top-of-the-line smartphone has 1,000 gigabytes!",
    "4 GET EXCITED ABOUT THE BRAIN!Neurons in the Brain \nFun fact\nNeurons are cells that send information in your brain. There are three main  types of neurons:  sensory \nneurons , motor neurons , and interneurons.  All three have different roles and play an important \npart in communicating with the rest of the body. Your brain has about 100 billion neurons (that’s \n100,000,000,000!), which is about the same as the number of stars in the Milky Way galaxy.\n\nGET EXCITED ABOUT THE BRAIN! 5Brain Growth\nFun fact \nThe human brain grows a lot between birth and the teenage years. Everyone’s brain grows and \nmatures at different rates. Our brains reach their largest size when we are between 11 and 14 years old. Of course, the size of your brain doesn’t determine how smart you are!",
    "6 GET EXCITED ABOUT THE BRAIN!Brain Power\nFun fact \nOne of the ways neurons talk \nto each other is with electrical signals. Neurons are sending these signals all the time. At any moment, your brain is generating enough electricity to power a small lightbulb!\n\nGET EXCITED ABOUT THE BRAIN! 7Water in Your Brain\nFun fact \nAn adult human brain weighs \naround 3 pounds and is made up of about 73% water!",
    "8 GET EXCITED ABOUT THE BRAIN!Test Your Knowledge of Common \nMental Health Disorders and Terms\nUse the word bank to solve the crossword clues below.\n2\n6\n81\n43\n5\n7\nWord bank \nAnxiety\nDepressionNeuroscience PsychotherapyRecoverResilience SchizophreniaTreatment\nacross\n2.Another word for talk therapy, which can help people with a variety of mental disorders and\nemotional difficulties\n4.A general word for getting medical care for a physical or mental illness\n6.A mood disorder that causes people to feel extremely sad or hopeless\n8.The field of study that researches how the brain works, diseases, and disorders\ndown\n1.A disorder that could make people see, hear, or believe things that are not really there\n3.A ge\nneral word that means to heal or get better\n5.The ability to handle and recover from tough times or situations\n7.A feeling of being really worried or fearful\nAnswers can be found on page 12.",
    "GET EXCITED ABOUT THE BRAIN! 9A Cryptic Message About the Blood \nVessels in Your Brain\nSolve the math problems, then use the letters below your answers to decode \nthe hidden message in the blanks below. \n32 1890 21 4 24 25 090 24 24 2 60 21 4 42190 4\n1825 30 24 12 90 28 18 2 24 1266 28 90 90 66 35 21\n090 24 24 2 60 21 4 42190 4 18 3 30 24 1240\n040 28 18 3 21 3 2 66 24 21 3 2 66 35 2130\n1424 1290 2 466 40 2166 56 35 35 28 90 25 1428 30\n66 24 66 35 21 32 24 24 3hidden message\n30 24 12 40 040 28 18 3 35 28 4 28 024 1266120,000\n.\n!,\nAnswers can be found on page 13.30 - 2 3 x 0 50 + 6 2 x 1 25 - 4 27 - 2 6 x 1 30 + 5 20 - 2 10 + 6 1 x 5 100 - 10 30 + 2\nA B C D E F G H I J K L M\n 3 x 1 15 + 9 60 - 3 1 x 1 50 - 10 2 x 2 60 + 6 8 + 4 40 + 20 2 x 7 25 - 5 50 - 20 90 - 9\nN O P Q R S T U V W X Y Z",
    "10 GET EXCITED ABOUT THE BRAIN!Faster Than a Speeding Neuron! \nUnscramble the words below by rearranging the order of the letters. Then use those \nwords to fill in the blanks in the paragraph below, and learn more about how fast the \nneurons in your brain work!\nT R O O M\nR U N N E O S\nL A N G I S S\nA F S TN A I R T\nS A G E M E S S\nL I O N S M I L\nL C M E H A C I\nThere are  ————————————  of  ————————————  in your brain that \ntell your whole body what to do. These neurons use electrical and  \n———————————— signals to send billions of  ————————————  every \nday that help you think, feel, and do amazing things. They send information \nto and from your brain at more than 150 miles per hour, which is as fast as a  \n————————————— . But if you need to act quickly,  ————————————  \nneurons can send —————————————  at more than 200 miles per hour. \nThat’s  ———————— !\nAnswers can be found on page 14.",
    "GET EXCITED ABOUT THE BRAIN! 11All About the Brain \nSearch up, down, forward, backward, and diagonally to find the hidden words.  \n  Put your brain to the test, and see how many you can find!\nJ B T N G Z O T E H V X S X S\nC Q R A C N O C X C S L E R P\nB K E O S U I U C S N T B U K\nW M S W C T V K E I R A M M L\nQ C E H E Q E P N O P B L A C\nP R A J U L X E C I Q I N A T\nC E R E B E L L U M H G T L B\nP N C B R A I N U H U T A A H\nQ V H B Q C J C E A Z R N T L\nG N I R A E H Z G S O B E E A\nC R O I V A H E B P S T U I T\nE M O T I O N S M L M P R R N\nE B O L G Z H E P S E A O A O\nW A Z P G W T X X N L T N P R\nG B P E J S X V C W L R S B F\nBALANCE\nCEREBELLUM\nFRONTAL\nLOBE\nPARIETAL\nTASTE\nTOUCHBEHAVIOR\nCORTEX\nHEARING\nNEURONS\nRESEARCH\nTEMPORAL\nWELLNESSBRAIN\nEMOTIONS\nLANGUAGE\nOCCIPITAL\nSMELL\nTHINKING\nAnswers can be found on page 14.",
    "12 GET EXCITED ABOUT THE BRAIN!Answers to  \nActivity Puzzles\naNSWERs to “test your knowledge of common \nmental health disorders and terms” \nAcross \n2. Psychotherapy\n4. Treatment\n6. Depression\n8. Neuroscience Down \n1. Schizophrenia\n3. Recover\n5. Resilience\n7. Anxiety\nPSYCHOTHERAPY2S\nC\nI\nZ\nO\nH\nR\nE\nI\nADEPRESSION6\nNEUROSCIENCE8E\nS\nI\nL\nI\nE\nC\nEA\nN\nX\nI\nT\nYTREATMENTR\nC\nO\nV\nE\nR43\n5\n71",
    "GET EXCITED ABOUT THE BRAIN! 13aNSWERs to “a cryptic message about \nthe blood vessels in your brain” \nHidden message\nY o u r b r a in h a s a b o u t\n30 24 1240 040 28 18 3 35 28 4 28 024 1266120,000\n32 1890 21 4 24 25 090 24 24 2 60 21 4 42190 4m i le s o f b lo o d v e s s e l s\n1825 30 24 12 90 28 18 2 24 1266 28 90 90 66 35 21I f y o u la id o u t a l l th e\n090 24 24 2 60 21 4 42190 4 18 3 30 24 1240b lo o d v e s s e l s in y o u r\n040 28 18 3 21 3 2 66 24 21 3 2 66 35 2130b r a in e n d to e n d th e y\n1424 1290 2 466 40 2166 56 35 35 28 90 25 1428 30w o u ld s t r e t c h h a l fw a y\n66 24 66 35 21 32 24 24 3to th e m o o n.\n,\n!30 - 2 3 x 0 50 + 6 2 x 1 25 - 4 27 - 2 6 x 1 30 + 5 20 - 2 10 + 6 1 x 5 100 - 10 30 + 2\n28 0 56 2 21 25 6 35 18 16 5 90 32\nA B C D E F G H I J K L M\n 3 x 1 15 + 9 60 - 3 1 x 1 50 - 10 2 x 2 60 + 6 8 + 4 40 + 20 2 x 7 25 - 5 50 - 20 90 - 9\n3 24 57 1 40 4 66 12 60 14 20 30 81\nN O P Q R S T U V W X Y Z",
    "14 GET EXCITED ABOUT THE BRAIN!J B T N G Z O T E H V X S X S\nC Q R A C N O C X C S L E R P\nB K E O S U I U C S N T B U K\nW M S W C T V K E I R A M M L\nQ C E H E Q E P N O P B L A C\nP R A J U L X E C I Q I N A T\nC E R E B E L L U M H G T L B\nP N C B R A I N U H U T A A H\nQ V H B Q C J C E A Z R N T L\nG N I R A E H Z G S O B E E A\nC R O I V A H E B P S T U I T\nE M O T I O N S M L M P R R N\nE B O L G Z H E P S E A O A O\nW A Z P G W T X X N L T N P R\nG B P E J S X V C W L R S B FThere are millions of neurons  in your brain that  \ntell your whole body what to do. These neurons use electrical and  \nchemical  signals to send billions of messages  every  \nday that help you think, feel, and do amazing things. They send information to and from your brain at more than 150 miles per hour, which is as fast as a train . But if you need to act quickly, motor   \nneurons can send signals  at more than 200 miles per hour. \nThat’s fast !",
    "neurons can send signals  at more than 200 miles per hour. \nThat’s fast !\nanswers to “all about the brain”aNSWERs to “faster than a speeding neuron!”\nunscrambled words\nMotor  \nNeurons  \nSignals  \nFastTrain  \nMessages  \nChemical  \nMillions",
    "National Institute\nof Mental Health\nU.S. DEPARTMENT OF HEALTH  \nAND HUMAN SERVICES National Institutes of HealthNIH Publication No. 23-MH-8117\nFor more information about mental health, visit \nthe NIMH website at www.nimh.nih.gov\n. For \ninformation on a wide variety of health topics,  visit the National Library of Medicine’s MedlinePlus service at \nhttps://medlineplus.gov .\nReprints  \nThe information in this publication is in the public domain and may be reused or copied without permission. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at \nwww.nimh.nih.gov/copyright .\n\nGet Excited\nAbout Mental Health\nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  A Coloring &  \nActivity Book\nFor Kids Ages 8–12Research!",
    "The National Institute of Mental Health (NIMH) is the lead federal agency for research \non mental disorders. NIMH is one of the 27 Institutes and Centers that make up the \nNational Institutes of Health (NIH), the nation’s largest medical research agency.  \nNIH is part of the U.S. Department of Health and Human Services.From  the NATIONAL INSTITUTE of  MENTAL HEALTH  \nA Coloring &  \nActivity Book\nFor Kids Ages 8–12Get Excited\nAbout Mental HealthResearch!\n\n\nGET EXCITED ABOUT MENTAL HEALTH RESEARCH!  1What Is Mental Health? \nfun fact \nMental health includes how we feel, think, and act. Your genes, the way your brain works, and things \ngoing on in your life can affect your mental health. Changes in the way you think, feel, or act that make it harder to do your schoolwork or be with family and friends could be a sign of a mental disorder.  Just \nlike when you have an ear infection or the flu, you may need help to get better.",
    "2 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! Mental Health Research\nfun fact \nMental health researchers study mental health, the causes of mental disorders, and new ways to treat them. \n\nGET EXCITED ABOUT MENTAL HEALTH RESEARCH!  3The National Institute \nof Mental Health\nfun fact\nThe National Institute of Mental Health (NIMH) is one of many agencies that are part of the United \nStates government. NIMH supports researchers who study mental disorders. NIMH has labs in Maryland, and NIMH also supports researchers all over the country and the world. If you become a mental health researcher, you could wind up working for or being supported by NIMH! \n\n4 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! Clinical Trials\nFun fact\nClinical trials are one type of mental health research. In clinical trials, researchers try new treatments to \nsee if they work and are safe for people. People volunteer to take part in clinical trials to help find new and better treatments for mental disorders.",
    "GET EXCITED ABOUT MENTAL HEALTH RESEARCH!  5\nThe Scientific Method\nFun fact \nAll researchers use the scientific method to ask questions, perform tests, and solve problems. \nSometimes the research doesn’t answer the original question, and that’s okay too! New knowledge can lead to new questions and answers. \nResult:  Sharing what you learned or changing your hypothesis and trying again! Observation: \nSomething \nyou’ve seen \nor noticed that  \nhas made  \nyou curious. Question:   \n“I wonder what would happen if…?”\nHypothesis:   \nA guess about \nwhat might \nhappen in your \nexperiment.\nExperiment:  \nConducting \nresearch to test your hypothesis. Conclusion:  \nWhat you \nlearned \nfrom your \nexperiment.\n\n6 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! Can You Spot the Differences?\nCan you find all eight (8) differences between them? \nAnswers can be found on page 13.",
    "GET EXCITED ABOUT MENTAL HEALTH RESEARCH!  7ab\nc\ndi\nh\nf egMaze\nHelp the student become a researcher!\nHelp the student find their way along the path to becoming a mental health researcher. \nThough you can pick just one path for this student, there are many paths you can take! \na. Take classes about science and psychology that interest or excite you.\nb. Consider volunteer opportunities, like peer counseling or working at a nursing home.\nc. Graduate high school. \nd. Go to college and explore more exciting areas of science, health, and psychology. \ne. Find a mentor—a person or friend with more experience—to help guide you along your path.\nf. Look for internships or opportunities in laboratories to help scientists conduct their research. \ng. Explore volunteer opportunities like peer counseling, working for a hotline that takes calls  \nfrom people who need help with their mental health, or volunteering at a hospital.",
    "from people who need help with their mental health, or volunteering at a hospital.\nh. Consider getting an advanced degree, like a master’s, medical (M.D.),  \nor doctoral (Ph.D.) degree.\ni. Consider becoming a nurse, therapist, or social worker.\nj. Contribute to making the world a more mentally healthy place.\nAnswers can be found on page 13.",
    "8 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! 1 0Test Your Knowledge ABOUT \nCONDUCTING MENTAL HEALTH RESEARCH\nUse the word bank to solve the crossword clues below.\nword bank \nClinical\nDiagnosisHypothesis JournalLearningMemory MethodDisorderResearchLabMentorTreatment\nacross\n 1. The scientific _________\n 4. Where a scientific research paper might  \nbe published\n 6. Medical care for an illness or injury 7. How the brain stores and remembers \ninformation\n 8. Depression and anxiety are types of these 11. A person or friend with experience who can \nguide you in your career\n 12. Physical space where research is conducteddown\n 2. A guess about what might happen in  \nyour experiment\n 3. Identifying an illness by looking at symptoms\n 5. Gaining knowledge or skills by experiencing \nsomething, studying, or being taught\n 9. Careful study and investigation to discover \nnew information\n 10. Research that involves trying new treatments \non a group of people: _________ trials",
    "10. Research that involves trying new treatments \non a group of people: _________ trials\nAnswers can be found on page 13.4\n82\n3\n1295\n111\n76",
    "GET EXCITED ABOUT MENTAL HEALTH RESEARCH!  9B L E M Y Q U V A K P E D S Y\nP R E I N T H O U G H T S T M\nG E A V T S A L J A L W S A P\nE D A I R T C U P Z Z O W S Y\nF R I V N A B N O T S L R L P\nI O R D O L E T I L D O Z F A\nE S C I E N C E S C T O U D R\nR I F A V Y A E P N X H T A E\nI D L G K N I R E S E A R C H\nJ N J N I C H M S U P R H B T\nI D W O F S G R S O F S X G T\nE U T S K D I S C O V E R Y C\nM P B I N O H M N O I D D S P\nV L A S G N I L E E F K S V I\nS T R E A T M E N T C N I B LAll About Mental Health Research \nSearch up, down, forward, backward, and diagonally to find the hidden words.\nAnswers can be found on page 14.BRAIN  \nDISORDER  \nRESEARCH  \nTHOUGHTSDISCOVERY  \nFEELINGS  \nSCIENCE  \nTREATMENTDIAGNOSIS  \nMENTOR  \nTHERAPY  \nVOLUNTEER",
    "10 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! 18 12 8 424 80 33 12 24 80 433 56 12 212 24 56 16 33 1256A Cryptic Message About \nYour Future \nSolve the math problems, then use the letters below your answers to decode  \nthe hidden message in the blanks below. \n12 + 12 5 x 0 8 + 8 16 + 16 6 + 6 1 x 9 30 - 2 25 + 8 5 + 1 90 - 9 55 + 8 60 + 20 10 + 8\nA B C D E F G H I J K L M\n4 + 4 15 + 15 30 - 5 9 + 6 50 + 6 2 x 1 2 + 2 30 - 3 10 + 10 3 x 1 3 + 4 7 + 7 24 + 2\nN O P Q R S T U V W X Y Z\nAnswers can be found on page 14.hidden message\n6 9 1430 27 330 56 63 33 24 5632 24 832\n1430 27 1630 27 80 32 012 1630 18 12 24\n433 24 4 33 1280 25 2 27 2 27 880 30 1663 433 12930 80 80 30 3 1430 27 56 6 8 41256 12 2 4 2\n24 832 32 6 21630 20 1256 433 12 63 12 14\n18 14 2 41256 612 2 30 9 433 12 056 24 6 8,\n.",
    "GET EXCITED ABOUT MENTAL HEALTH RESEARCH!  11Conduct Your Own Experiment! \nNow it’s your turn to be the researcher! This quick experiment will help you understand  \na little bit more about how the brain remembers things. \nFirst, let’s start with a hypothesis! You’re going to test the idea that it’s easier to remember  \na list of words if they have something in common. You can do this experiment on your own or with  \na small group of family members or friends as volunteers.\nWhat you’ll need: \n• You or some volunteers\n• The word boxes below and on the next page• A piece of paper• A watch or timer \nStep 1:  \n1. Set your timer for 2 minutes. \n2. Look at Word Box A for 2 minutes and try to memorize as many words as you can. \n3. When the 2 minutes are over, cover the Word Box and write down as many words in the empty spaces as you can remember. \n4. Count how many words you remembered and write that number in the Data Box on the next page.  \nword box a:\nNine Cat Face Ring Play",
    "word box a:\nNine Cat Face Ring Play\nPlugs Lamp Apple Table Car\nArmy Bank Fire Hold Phone\nClock Horse Color Baby Sword\nDesk Grab TV Bird Rock\nEven though you had 2 minutes to memorize the words, you might have found it hard to remember even a couple of the words.",
    "12 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! Conduct Your Own Experiment! (Cont.)\nStep 2:  \n1.  Set your timer for 2 minutes. \n2. Look at Word Box B for 2 minutes. Read the \nwords across each row from left to right and try to memorize as many of the words as you can. 3. When the 2 minutes are over, cover the Word Box and write down as many words in the empty spaces as you can remember. \n4. Count how many words you remembered and write that number in the Data Box. \nword box b:\nHorse Cat Dog Fish Bird\nOrange Yellow Blue Green Black\nTable Chair Desk Bookshelf Bed\nTeacher School Student Homework Class\nApple Banana Kiwi Grape Pear\nObservations and Conclusions \nWhat did you observe about how many words you remembered from Word Box A and Word Box B? Even though you had 2 minutes to memorize the words, you might have found it hard to remember even a couple of the words from Word Box A because they were all different.",
    "You probably remembered more words from Word Box B. The words in Word Box B are “chunked” to \nmake them easy to group based on categories. \nThis idea of “chunking” or “clustering” items in groups, like animals or colors, can be a helpful tool for \nmemorizing information! Total words remembered from Word Box A\nTotal words remembered from Word Box BData box:",
    "GET EXCITED ABOUT MENTAL HEALTH RESEARCH!  13answers to “test your knowledge about \nconducting mental health research” Answers to  \nActivity Puzzles\nM\nJOURNAL4\nDI ORDER8SY\nP\nT\nH\nE\nI\nSH2\nLIC\nL\nI\nN\nC\nA10D\nI\nG\nN\nIS3\nL B12HAE\nS\nE\nR\nC9\nGNL\nA\nR\nI\nN5\nM11E TOS1T D E\nMEMO7YOO\nT AE TM T6R Nanswers to “can you spot the differences?”\n across\n1. Method\n4. Journal6. Treatment7. Memory8. Disorder11. Mentor12. Labdown\n2. Hypothesis3. Diagnosis4. Learning9. Research10. Clinicalanswers to “maze” \nab\nc\ndi\nh\nf eg",
    "14 GET EXCITED ABOUT MENTAL HEALTH RESEARCH! answers to “all about mental health research”\nanswers to “a cryptic message about your future” B L E M Y Q U V A K P E D S Y\nP R E I N T H O U G H T S T M\nG E A V T S A L J A L W S A P\nE D A I R T C U P Z Z O W S Y\nF R I V N A B N O T S L R L P\nI O R D O L E T I L D O Z F A\nE S C I E N C E S C T O U D R\nR I F A V Y A E P N X H T A E\nI D L G K N I R E S E A R C H\nJ N J N I C H M S U P R H B T\nI D W O F S G R S O F S X G T\nE U T S K D I S C O V E R Y C\nM P B I N O H M N O I D D S P\nV L A S G N I L E E F K S V I\nS T R E A T M E N T C N I B L\n12 + 12 5 x 0 8 + 8 16 + 16 6 + 6 1 x 9 30 -2 25 + 8 5 + 1 90 - 9 55 + 8 60 + 20 10 + 8\n24 0 16 32 12 9 28 33 6 81 63 80 18\nA B C D E F G H I J K L M\n4 + 4 15 + 15 30 - 5 9 + 6 50 + 6 2 x 1 2 + 2 30 - 3 10 + 10 3 x 1 3 + 4 7 + 7 24 + 2\n8 30 25 15 56 2 4 27 20 3 7 14 26\nN O P Q R S T U V W X Y Z\n6 9 1430 27 330 56 63 33 24 56 32 24 832I f y o u w o r k h a r d and",
    "N O P Q R S T U V W X Y Z\n6 9 1430 27 330 56 63 33 24 56 32 24 832I f y o u w o r k h a r d and\n1430 27 1630 27 80 32 012 1630 18 12 24y o u c o u ld b e c om e a\n18 12 8 424 80 33 12 24 80 433 56 12 212 24 56 16 33 1256m e n ta l h e a l th re s e a r c h e r\n24 832 32 6 21630 20 1256 433 12 63 12 14a n d d is c o v e r th e k e y\n433 24 4 33 1280 25 2 27 2 27 880 30 1663 433 12th a t h e lp s u s u n lo c k th e930 80 80 30 3 1430 27 56 6 8 41256 12 2 4 2fo l lo w y o u r in te re s t s,\n18 14 2 41256 612 2 30 9 433 12 056 24 6 8m y s te r ie s o f th e b r a in.",
    "Get Excited\nAbout Mental Health\nFor more information about mental health, visit \nthe NIMH website at www.nimh.nih.gov . For \ninformation on a wide variety of health topics,  visit the National Library of Medicine’s MedlinePlus service at \nhttps://medlineplus.gov .\nReprints  \nThe information in this publication is in the public domain and may be reused or copied without permission. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .U.S. DEPARTMENT OF HEALTH  AND HUMAN SERVICES National Institutes of HealthNIH Publication No. 23-MH-8197Research!",
    "Helping Children and  \nAdolescents Cope With  \nTraumatic Events\nEvery year, children and adolescents experience disasters and other \ntraumatic events. Family, friends, and trusted adults play an essential role in helping youth cope with these experiences.\nHow do children and adolescents respond to traumatic events? \nIt is typical for children and adolescents to have a range of reactions after experiencing or witnessing a traumatic \nevent, such as a natural disaster, an act of violence, or a serious accident.\nRegardless of age, children and \nadolescents may: \n ●Report having physical  problems such as stomachaches or headaches.\n ●Have nightmares or other sleep problems, including refusing to  go to bed. \n ●Have trouble concentrating. \n ●Lose interest in activities they normally enjoy.\n ●Have feelings of guilt for not preventing injuries or deaths.\n ●Have thoughts of revenge.Young children (age 5 and younger) may:\n ●Cling to caregivers and/or cry and be tearful.",
    "●Cling to caregivers and/or cry and be tearful.\n ●Have tantrums, or be irritable  or disruptive.\n ●Suddenly return to behaviors such as bed-wetting and  thumb-sucking.\n ●Show increased fearfulness (for example, fear of the dark, monsters, or being alone).\n ●Incorporate aspects of the traumatic event into imaginary play.Older children (age 6 and older) and adolescents may:\n ●Have problems in school. \n ●Withdraw or become isolated from family and friends.\n ●Avoid reminders of the event.\n ●Use drugs, alcohol, or tobacco.\n ●Be disruptive, disrespectful,  \nor destructive.\n ●Be angry or resentful.\nMany of these reactions are \nnormal and will lessen with time. If these symptoms last for more than a month, the family should reach out to a health care provider.",
    "What can adults do to help?\nHow adults respond to trauma can strongly influence \nhow children and adolescents react to trauma. When caregivers and family members take steps to support their own ability to cope, they can provide better care for others. \nCaregivers and family members can help by creating \na safe and supportive environment, remaining as calm as possible, and reducing stressors. Children and adolescents need to know that their family members love them and will do their best to take care of them. \nDo:\n ●Ensure children and adolescents are safe and that\ntheir basic needs are addressed.\n ●Allow them to be sad or cry.\n ●Let them talk, write, or draw pictures about the eventand their feelings.\n ●Limit their exposure to repetitive news reports abouttraumatic events.\n ●Let them sleep in your room (for a short time) or sleepwith a light on if they are having trouble sleeping.\n ●Try to stick to routines, such as reading bedtimestories, eating dinner together, and playing games.",
    "●Help them feel in control by letting them make somedecisions for themselves, such as choosing theirmeals or picking out their clothes.\n ●Pay attention to sudden changes in behaviors,speech, language use, or strong emotions.\n ●Contact a health care provider if new problemsdevelop, particularly if any of the following symptomsoccur for more than a few weeks:\n■Having flashbacks (reliving the event)\n■Having a racing heart and sweating\n■Being easily startled\n■Being emotionally numb\n■Being very sad or depressed\nDon’t:\n ●Expect children and adolescents to be brave or tough.\n ●Make them discuss the event before they are ready.\n ●Get angry if they show strong emotions.\n ●Get upset if they begin bed-wetting, acting out, orthumb-sucking.\n ●Make promises you can’t keep (such as “You will beOK tomorrow” or “You will go home soon.”)\nNIH Publication No. 22-MH-8066Follow NIMH on  \nSocial Media @NIMHgovwww.nimh.nih.gov Where can I find help?",
    "Social Media @NIMHgovwww.nimh.nih.gov Where can I find help?\nThe Substance Abuse and Mental Health Services Administration (SAMHSA) offers a Disaster Distress Helpline , which provides immediate crisis counseling for \npeople who are experiencing emotional distress related to any natural or human-caused disaster. The helpline is free, multilingual, confidential, and available 24 hours a \nday, 7 days a week. You can call or text the helpline at 800-985-5990 or visit the helpline website at https://\ndisasterdistress.samhsa.gov .\nSAMHSA also provides the Behavioral Health Treatment Services Locator , an online tool for finding \nmental health services in your area. Find treatment programs in your state at https://findtreatment.samhsa.gov . For additional resources, visit  \nwww.nimh.nih.gov/findhelp .",
    "www.nimh.nih.gov/findhelp . \nIf you, your child, or someone you know is in immediate distress or is thinking about hurting themselves, call 911 or call the National Suicide Prevention Lifeline  toll-free at 1-800-273-TALK \n(8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website at https://suicidepreventionlifeline.org .\nWhere can I find more resources?\nNational Institute of Mental Health: Coping With Traumatic Events www.nimh.nih.gov/copingwithtrauma\nN\national Institute of Mental Health:  \nChild and Adolescent Mental Health www.nimh.nih.gov/children  \nCenters for Disease Control and Prevention: \nC\naring for Children in a Disaster  \nwww.cdc.gov/childrenindisasters  \nNational Child Traumatic Stress Network www.nctsn.org",
    "Let’s Talk About Eating Disorders\nThe way we talk about eating disorders matters.  \nHere are some facts to help you discuss them.\n“Eating disorders are serious and can be fatal.”\nEating disorders often involve serious medical complications that can \ncause permanent damage or death. People with eating disorders also have an increased risk of dying by suicide.\n“Eating disorders are caused by a variety of factors.”\nSeveral factors can increase a person’s risk of developing an eating disorder, including biological, psychological, and social factors. An eating disorder is not a lifestyle choice.\n“Eating disorders can affect anyone.”\nEating disorders do not discriminate. They affect people of all ages, races, ethnicities, and genders.\n“You can’t tell if someone has an eating disorder by \nlooking at them.”\nPeople with eating disorders can be underweight, average weight, or overweight.\n“Family members can be a patient’s best ally during \ntreatment.”",
    "“Family members can be a patient’s best ally during \ntreatment.”\nFamily members can encourage a family member with eating or body image issues to seek help and provide support during treatment.\n“It is possible to recover from an eating disorder.”\nRecovery is possible with treatment and time.\nnimh.nih.gov/eatingdisorders \nNIMH Identifier No. OM 24-4317",
    "What are genes?\nGenes are segments of deoxyribonucleic acid \n(DNA), the biological “blueprint” for proteins that form the building blocks of our cells. Your DNA is passed down from your biological parents and varies a little from person to person. These variations contribute to differences in appearance, personality, and health. Certain genes, along with biological and environmental factors, can be associated with mental disorders, which are health conditions that can affect how you think, feel, and cope with life.\nHow do genes affect your \nmental health? \nCommon mental disorders like depression and \nanxiety are likely the result of a combination of life experiences, environment, and genetic variation. These variations can impact how your genes are turned “on” and “off” throughout life and play a role in the onset of some diseases. \nMost genetic variants don’t directly cause",
    "Most genetic variants don’t directly cause \nmental disorders. However, in rare cases, some uncommon gene variants can increase the risk of developing mental disorders. If you or a relative has one of these rare variants, it’s a good idea to talk to a health care provider about the risks. Should I visit a genetic counselor? \nGenetic counseling can give you information about how genetic conditions might affect you or your family. A geneticist or genetic counselor will collect your personal and family health history to determine how likely it is that you or a family member has a genetic condition. They can then help you decide whether a genetic test might be right for you or your relative. Genetic testing is often done before or during pregnancy, soon after birth, or if your health care provider suspects you may have a genetic disease. \nTo learn more about genetic counseling, visit the",
    "To learn more about genetic counseling, visit the \nGenetic Counseling FAQ page of the National Human Genome Research Institute website at www.genome.gov/FAQ/Genetic-Counseling  and \nthe Centers for Disease Control and Prevention’s Genetic Counseling webpage at www.cdc.gov/\ngenomics/gtesting/genetic_counseling.htm . \nLooking at My Genes:\nWHAT CAN THEY TELL ME  \nABOUT MY MENTAL HEALTH?\nFrom the NATIONAL INSTITUTE of  MENTAL HEALTH",
    "Can genetic testing help predict my risk of developing a mental disorder? \nCurrently, genetic tests cannot accurately \npredict your risk of developing a mental disorder. Although research is underway, researchers are still learning about the ways genes can contribute to mental disorders— or protect against them. Of those genes that are linked to mental disorders, most raise the risk by tiny amounts. \nWhile recent studies have begun to identify \nthe genetic markers associated with certain mental disorders and eventually may lead to better screening and more individualized treatment, it is still too early to use genetic tests to diagnose or treat mental disorders.\nWhat is the difference between clinical genetic testing \nand direct-to-consumer genetic reports?\nClinical or diagnostic genetic testing",
    "and direct-to-consumer genetic reports?\nClinical or diagnostic genetic testing \nClinical genetic testing can help predict the risk of some diseases, such as cancer, but is not yet very useful for predicting the risk for mental disorders.  Health care providers may order genetic testing for people who may have a high risk for rare genetic diseases. During testing, health care providers may search for a single gene or a few genes that are strongly associated with a specific disease. \nThere are many different types of genetic tests that \nmay help to: \n ⊲Identify genetic variants that may increase the risk of developing a disease\n ⊲Diagnose disease \n ⊲Guide health care providers in deciding on the best medicine or treatment for certain people \nIf a disease runs in your family, your health care provider can tell you if it’s detectable with genetic testing. For more information about clinical or genetic testing, visit www.genome.gov/FAQ/Genetic-Testing .Direct-to-consumer genetic reports",
    "The purpose and audiences of direct-to-consumer genetic reports differ from clinical or diagnostic genetic testing.\nFor a fee, anyone can mail a saliva sample to companies \nthat sell a direct-to-consumer genetic report. While advertisements may say that the company can provide information based on a person’s genetic variation about their risks of developing specific diseases, these reports typically cannot help predict one’s risk for developing mental disorders. \nBecause direct-to-consumer genetic reports for",
    "Because direct-to-consumer genetic reports for \nmental disorders are not accompanied by a health care provider’s guidance, their results should be interpreted cautiously. These reports have varying levels of scientific support, may or may not be approved by the U.S. Food and Drug Administration, and can be misleading. If you decide to undergo direct-to-consumer genetic testing, the results should be discussed with your health care provider or genetic counselor before taking any action, such as changing your medications. For more information about direct-to-consumer tests, visit www.fda.gov/medical-devices/in-vitro-diagnostics/direct-consumer-tests .",
    "What research is NIMH doing on genetics? \nThe National Institute of Mental Health (NIMH) funds \nand conducts research to help answer important scientific questions about mental disorders. NIMH is currently studying and supporting research on the human genetic variations that contribute to the risk of different mental disorders. These include but are not limited to the following: \n ⊲Eating disorders, such as anorexia nervosa, binge eating disorders, and bulimia nervosa\n ⊲Mood disorders, such as anxiety disorders, bipolar disorder, and depression\n ⊲Neurodevelopmental disorders, such as autism spectrum disorder and intellectual disability ⊲Obsessive-compulsive disorder \n ⊲Post-traumatic stress disorder\n ⊲Psychosis and schizophrenia",
    "⊲Post-traumatic stress disorder\n ⊲Psychosis and schizophrenia\nResearch investigating these topics will help the field take steps toward better screening and personalized treatment. Basic research efforts enhance our understanding of the underlying causes of disease and might result in improved clinical treatments. You can learn more about ongoing research efforts by visiting www.nimh.nih.gov/news/science-news/science-news-about-genetics .Some mental disorders run in families, and your family’s mental health history may be an important clue for determining your risk of developing a mental disorder. Having a close relative with a mental disorder could mean you are at a higher risk, but it doesn’t necessarily mean you will develop that disorder. Many other factors play a role. \nKnowing your family’s mental health history can help \nyou and your health care provider look for early warning signs and help your health care provider recommend ways to reduce your risk. \nTalk to your relatives",
    "Talk to your relatives\nThe first step in creating a family health history is to talk to your relatives. The most helpful information comes from “first-degree” relatives—parents, brothers, sisters, and children. Health histories from “second-degree” relatives—such as nieces, nephews, half-brothers, half-sisters, grandparents, aunts, and uncles—also can be helpful but are less informative for your own risk. \nDon’t worry if you can’t get complete information for \nevery relative. Some people may not want to talk,  and others may be unable to remember information accurately. That’s okay. Whatever information you  can collect will be helpful. \nKeep a record of your family history \nFree programs like the Surgeon General’s “My Family Health Portrait” can help you create a family health history. You can use the program to record information about your family’s health and share it with your health care provider or family members. You can find the program at https://cbiit.github.io/FHH/html .",
    "New or updated information can be added as a family grows or family members are diagnosed with health conditions. It may take a little time and effort, but this record can improve your family’s health for generations. \nTalk with a mental health professional \nIf mental disorders run in your family, consider talking with a mental health professional who can help you understand the illness’ risk and ways to prevent or treat it. Asking questions and providing information to your health care provider can improve your care and results and increase safety and satisfaction. For tips and information about speaking with your health care provider, visit www.nimh.nih.gov/talkingtipsand the Agency for Healthcare Research Quality at www.ahrq.gov/questions .\nHow can my family health history help me \nunderstand my health risks?",
    "NIH Publication No. 24-MH-4298 \nRevised 2024Follow us on  \nsocial media @NIMHgovWhere can I find more information \nabout genetics?\nFor information about how genes affect your risk \nfor developing a disease or disorder, visit: \n⊲ Centers for Disease Control and Prevention: Family Health History:  www.cdc.gov/genomics/famhistory  \n⊲ National Human Genome Research Institute: www.genome.gov/health  \n⊲ MedlinePlus: Genetics: https://medlineplus.gov/genetics\nHow can I find help for \nmental disorders? \nNIMH has information on ways to get help  \nand find a health care provider or access treatment at www.nimh.nih.gov/findhelp . In \naddition, the Substance Abuse and Mental  Health Services Administration has an online \ntool at https://findtreatment.gov  to help you  \nfind mental health services in your area.What are clinical trials and why are \nthey important?  \nClinical trials are research studies that look at",
    "they important?  \nClinical trials are research studies that look at  \nnew ways to prevent, detect, or treat diseases and conditions. These studies help researchers determine if a new treatment is safe and effective in people. The main purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future. \nPeople volunteer for clinical trials for many reasons. \nSome people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try new or advanced treatments that aren’t widely available. \nNIMH supports clinical trials at the National Institutes \nof Health campus in Bethesda, Maryland, and across the United States. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nFor more information",
    "For more information\nLearn more at www.nimh.nih.gov/\nhealth . For information about various \nhealth topics, visit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .Reprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as a source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .National Institute of Mental Health  Office of Science Policy, Planning,  and Communications  \n6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  \nPhone: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov",
    "My Mental Health: Do I Need Help?\nFirst, determine how much your symptoms interfere with your daily life.\nIf so, here are some self-care activities that can help:\n• Exercising (e.g., aerobics, yoga)\n• Engaging in social contact (virtual or in person)\n• Getting adequate sleep on a regular schedule• Eating healthy\n• Talking to a trusted friend or family member\n• Practicing meditation, relaxation,  \nand mindfulness\nIf the symptoms above do not improve or seem to be worsening despite self-care efforts,  \ntalk to your health care provider.\nDo I have severe symptoms that have lasted 2 weeks or more?\n• Difficulty sleeping\n• Appetite changes that result in unwanted weight \nchanges\n• Struggling to get out of bed in the morning because of mood• Difficulty concentrating \n• Loss of interest in things you usually find enjoyable\n• Unable to perform usual daily functions and responsibilities\n• Thoughts of death or self-harm",
    "• Unable to perform usual daily functions and responsibilities\n• Thoughts of death or self-harm \nIf you are in crisis, call or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org,  \nor text the Crisis Text Line (text HELLO to 741741).\nSeek professional help:\n• Psychotherapy (talk therapy)—virtual or in person; individual, group, or family• Medications\n• Brain stimulation therapies\nFor help finding treatment, visit nimh.nih.gov/findhelp .\nDo I have mild symptoms that have lasted for less than 2 weeks?\n• Feeling a little down\n• Feeling down, but still able to do job, schoolwork, or housework• Some trouble sleeping\n• Feeling down, but still able to take care of yourself or take care of others\nNIH Publication No. 22-MH-8134Follow NIMH on  \nSocial Media @NIMHgovwww.nimh.nih.gov",
    "Obsessive-  \nCompulsive  \nDisorder:  \nWhen Unwanted Thoughts or \nRepetitive Behaviors Take Over",
    "What is OCD?\nObsessive-compulsive disorder (OCD) is a long-lasting disorder in which a \nperson experiences uncontrollable and recurring thoughts (obsessions), engages in repetitive behaviors (compulsions), or both. People with OCD have time-consuming symptoms that can cause significant distress or interfere with daily life. However, treatment is available to help people manage their symptoms and improve their quality of life.\nWhat are the signs and symptoms of OCD?\nPeople with OCD may have obsessions, compulsions, or both. Obsessions  are \nrepeated thoughts, urges, or mental images that are intrusive, unwanted, and make most people anxious. Common obsessions include:\n ●Fear of germs or contamination\n ●Fear of forgetting, losing, or misplacing something\n ●Fear of losing control over one’s behavior\n ●Aggressive thoughts toward others or oneself\n ●Unwanted, forbidden, or taboo thoughts involving sex, religion, or harm\n ●Desire to have things symmetrical or in perfect order",
    "●Desire to have things symmetrical or in perfect order\nCompulsions  are repetitive behaviors a person feels the urge to do, often in \nresponse to an obsession. Common compulsions include:\n ●Excessive cleaning or handwashing\n ●Ordering or arranging items in a particular, precise way\n ●Repeatedly checking things, such as that the door is locked or the oven is off\n ●Compulsive counting\n ●Praying or repeating words silently\nOCD symptoms may begin anytime but usually start between late childhood and young adulthood. Most people with OCD are diagnosed as young adults. \nThe symptoms of OCD may start slowly and can go away for a while or worsen \nas time passes. During times of stress, the symptoms often get worse. A person’s obsessions and compulsions also may change over time. \nPeople with OCD might avoid situations that trigger their symptoms or use",
    "People with OCD might avoid situations that trigger their symptoms or use \ndrugs or alcohol to cope. Many adults with OCD recognize that their compulsive behaviors do not make sense. However, children may not realize that their behavior is out of the ordinary and often fear that something terrible will happen if they do not perform certain compulsive rituals. Parents or teachers typically \nrecognize OCD symptoms in children.",
    "Recognizing OCD: How to know if your symptoms are OCD\nEveryone rethinks or double-checks things sometimes. Not all repeated \nthoughts are obsessions, and not all rituals or habits are compulsions. However, people with OCD generally:\n ●Can’t control their obsessions or compulsions, even when they know they’re excessive.\n ●Spend more than 1 hour a day on their obsessions or compulsions. \n ●Don’t get pleasure from their compulsions but may feel temporary  relief from their anxiety. \n ●Experience significant problems in daily life due to these thoughts  or behaviors.",
    "●Experience significant problems in daily life due to these thoughts  or behaviors. \nSome people with OCD also have a tic disorder involving repetitive movements or sounds. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Vocal tics include things like repetitive throat-clearing, sniffing, or grunting sounds. It is common for people with OCD to also have a diagnosed mood disorder or anxiety disorder.\nIf you think you or your child may have OCD, talk to a health care provider. If left untreated, OCD symptoms can become severe and interfere with daily life.\nWhat are the risk factors for OCD?\nAlthough the exact causes of OCD are unknown, various risk factors increase the chances of developing the disorder.",
    "●Genetics: Studies have shown that having a first-degree relative (parent or sibling) with OCD is associated with an increased chance of developing the disorder. Scientists have not identified any one gene or set of genes that definitively leads to OCD, but studies exploring the connection between genetics and OCD are ongoing.\n ●Biology: Brain imaging studies have shown that people with OCD often have differences in the frontal cortex and subcortical structures of the brain, areas of the brain that impact the ability to control behavior and emotional responses. Researchers also have found that several brain areas, brain networks, and biological processes play a key role in obsessive thoughts, compulsive behavior, and associated fear and anxiety. Research is underway to better understand the connection between OCD symptoms and parts of the brain. This knowledge can help researchers develop and adapt treatments targeted to specific brain locations.",
    "●Temperament: Some research has found that people who exhibit more \nreserved behaviors, experience negative emotions, and show symptoms of anxiety and depression as children are more likely to develop OCD.\n ●Childhood trauma: Some studies have reported an association between childhood trauma and obsessive-compulsive symptoms. More research is needed to understand this relationship.\nChildren who suddenly develop OCD symptoms or experience a worsening of OCD symptoms after a streptococcal infection may be diagnosed with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). You can learn more about PANDAS at www.nimh.nih.gov/pandas .\nHow is OCD diagnosed?",
    "How is OCD diagnosed?\nDiagnosing OCD can be difficult because symptoms such as worry, anxiety, and low mood—which are often people’s most distressing concerns—can be similar to those of other mental illnesses. Also, people with OCD may not tell their health care provider about their obsessions and compulsions out of fear of judgment. \nIf you are experiencing symptoms, the first thing you should do is speak with a \nhealth care provider. They will examine you and ask about your health history to ensure other illnesses or conditions are not causing your symptoms. A health care provider may refer you to a mental health professional for further evaluation or treatment.\nHow is OCD treated?\nTreatment helps many people, even those with the most severe forms of OCD. Mental health professionals treat OCD with medications, psychotherapy, or a combination of treatments. A mental health professional can help you decide which treatment option is best for you and explain the benefits and risks of",
    "each. \nFollowing your treatment plan is important because psychotherapy and \nmedication can take some time to work. Although there is no cure for OCD, treatments help people manage their symptoms, engage in day-to-day activities, and lead full, active lives.\nFind tips for talking with a health care provider to improve your care and get the most out of your visit at www.nimh.nih.gov/talkingtips .",
    "Psychotherapy\nPsychotherapy can be an effective treatment for adults and children with OCD. \nResearch shows that certain types of psychotherapy, including cognitive behavioral therapy and other related therapies, can be as effective as medication for many people. For others, psychotherapy may be most effective when combined with medication.\n ●Cognitive behavioral therapy (CBT): CBT is a type of talk therapy that helps people recognize harmful or untrue ways of thinking so they can more clearly view and respond to challenging situations. CBT helps people learn to question these negative thoughts, determine how they impact their feelings and actions, and change self-defeating behavior patterns. CBT has been well studied and is considered the “gold standard” of psychotherapy for many people. CBT works best when customized to treat the unique characteristics of specific mental disorders, including OCD.\n ●Exposure and response prevention therapy (ERP): Research shows that ERP,",
    "●Exposure and response prevention therapy (ERP): Research shows that ERP, \na specific type of CBT, effectively reduces compulsive behaviors, even for people who do not respond well to medication. With ERP, people spend time in a safe environment that gradually exposes them to situations that trigger their obsession (such as touching dirty objects) and prevent them from engaging in their typical compulsive behavior (such as handwashing). Although this approach may initially cause anxiety, creating a risk of dropping out of treatment prematurely, compulsions decrease for most people as they continue treatment.\nChildren with OCD may need additional help from family members and health care providers to recognize and manage their OCD symptoms. Mental health professionals can work with young children to identify strategies for managing stress and increasing support so they can control their OCD symptoms.\nYou can learn more about psychotherapies, including CBT, at www.nimh.nih.",
    "You can learn more about psychotherapies, including CBT, at www.nimh.nih.\ngov/psychotherapies . \nMedication\nHealth care providers may prescribe medication to help treat OCD. The most \ncommon medications prescribed for OCD are antidepressants that target serotonin, a chemical transmitter in the brain involved in depression and OCD. The largest category of antidepressants is called selective serotonin reuptake inhibitors. \nAntidepressant treatment can take 8–12 weeks before symptoms begin to \nimprove, and treatment for OCD may require higher doses than are typically used to treat depression. For some people, these medications may cause side effects such as headaches, nausea, or difficulty sleeping. Most people with OCD find that medication, often in combination with psychotherapy, can help them manage their symptoms.",
    "Your health care provider can adjust medication doses over time to minimize \nside effects or withdrawal symptoms. Do not stop taking your medication without first talking to your health care provider. They can work with you to monitor your health and adjust your treatment plan safely and effectively.\nThe most up-to-date information on medications, side effects, and warnings  \nis available on the U.S. Food and Drug Administration (FDA) website at  www.fda.gov/drugsatfda .\nOther treatments\nIn 2018, the FDA approved using a deep form of repetitive transcranial magnetic stimulation (rTMS)—along with medication, psychotherapy, or a combination of both—to treat people with severe OCD who did not respond to other treatments. In 2022, this approval was extended to standard TMS devices.\nMost commonly used to treat depression, rTMS is a noninvasive therapy that",
    "Most commonly used to treat depression, rTMS is a noninvasive therapy that \nuses a magnet to deliver repeated low-intensity pulses to stimulate a particular part of the brain. Unlike most treatments, rTMS can target specific brain areas associated with OCD.\nDeep brain stimulation (DBS) is a surgical procedure that uses electricity to \ndirectly stimulate sites in the brain. Health care providers may use DBS to treat people with severe OCD when other treatments have not worked. However, this therapy is considered experimental. \nAlthough DBS has received FDA approval to treat certain neurological disorders",
    "Although DBS has received FDA approval to treat certain neurological disorders \nsuch as Parkinson’s disease, its effectiveness for treating mental disorders is still being actively researched. The FDA has approved using DBS to treat severe cases of OCD under a Humanitarian Device Exemption. This exemption allows the use of a medical device, such as DBS, for rare diseases or conditions that affect a relatively small number of people, making it challenging to gather enough evidence to establish the device’s effectiveness.\nYou can learn more about brain stimulation therapies, including rTMS and DBS, \nat www.nimh.nih.gov/braintherapies . Visit www.fda.gov/medical-devices for \nthe latest information and guidance on brain stimulation devices. \nEffective strategies for managing stress and anxiety \nYou can do several things to manage the stress and anxiety associated  \nwith OCD. \n ●Create a consistent sleep schedule.\n ●Make regular exercise a part of your routine.",
    "with OCD. \n ●Create a consistent sleep schedule.\n ●Make regular exercise a part of your routine.\n ●Eat a healthy, balanced diet.\n ●Seek support from trusted family and friends.",
    "How can I find help?\nIf you’re unsure where to get help, a health care provider is an excellent place \nto start. They can refer you to a qualified mental health professional who has experience treating OCD and can evaluate your symptoms.\nYou can learn more about getting help and finding a health care provider on \nthe NIMH website at www.nimh.nih.gov/findhelp . The Substance Abuse and \nMental Health Services Administration (SAMHSA) has an online tool at https://findtreatment.gov  to help you find mental health services in your area.\nWhat are clinical trials and why are they important? \nClinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. These studies help researchers determine if a new treatment is safe and effective in people. The main purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.",
    "People volunteer for clinical trials for many reasons. Some people join clinical \ntrials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try new or advanced treatments that aren’t widely available.\nNIMH supports clinical trials at the National Institutes of Health campus in \nBethesda, Maryland, and across the United States. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .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.",
    "Reprints \nThe information in this publication is in the public domain and may be reused \nor copied without permission. However, you may not reuse or copy the images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright . \nWhere can I learn more? \nNIMH website  www.nimh.nih.gov www.nimh.nih.gov/espanol (en español) \nMedlinePlus (National Library of Medicine)  https://medlineplus.gov https://medlineplus.gov/spanish ( en español) \nClinical Trials.gov \nwww.clinicaltrials.gov https://salud.nih.gov/investigacion-clinica (en español) \nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications 6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  Toll-free: 1-866-615-6464  Email: nimhinfo@nih.gov \nWebsite: www.nimh.nih.gov \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES",
    "Website: www.nimh.nih.gov \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES \nNational Institutes of Health NIH Publication No. 23-MH-4676 Revised 2023",
    "PANDAS —Questions and Answers\nOverview\nWhat is PANDAS?\nPANDAS is short for Pediatric Autoimmune \nNeuropsychiatric Disorders Associated with Streptococcal Infections. A child may be diagnosed with PANDAS when:\n ⊲Obsessive-compulsive disorder (OCD) , tic \ndisorder, or both suddenly appear following a streptococcal (strep) infection, such as strep throat or scarlet fever.\n ⊲The symptoms of OCD or tic symptoms suddenly become worse following a strep infection.\nThe symptoms are usually dramatic, happen “overnight and out of the blue,” and can include motor or vocal tics or both and obsessions, compulsions, or both. In addition to these symptoms, children may become moody or irritable, experience anxiety attacks, or show concerns about separating from parents or loved ones. What causes PANDAS?",
    "Strep bacteria are very ancient organisms that survive in the human host by hiding from the immune system as long as possible. They hide themselves by putting molecules on their cell wall so that they look nearly identical to molecules found on the child’s heart, joints, skin, and brain tissues. This hiding is called “molecular mimicry” and allows the strep bacteria to evade detection for a long time.\nHowever, the molecules on the strep bacteria are \neventually recognized as foreign to the body and the child’s immune system reacts to the molecules by producing antibodies. Because of the molecular mimicry by the bacteria, the immune system reacts not only to the strep molecules but also to the human host molecules that were mimicked; antibodies “attack” the mimicked molecules in the child’s own tissues. These antibodies that react to both the molecules on the strep bacteria and to similar molecules found on other parts of the body are an example of “cross-reactive” antibodies.",
    "National Institute\nof Mental Health",
    "Studies at the National Institute of Mental Health \n(NIMH) and elsewhere have shown that some cross-reactive antibodies target the brain—causing OCD, tics, and the other neuropsychiatric symptoms of PANDAS.\nCould an adult develop PANDAS?\nPANDAS is considered a pediatric disorder and typically first appears in childhood from age\n 3 to \npuberty. Reactions to strep infections are rare after age 12, but researchers recognize that PANDAS could occur, though rarely, among adolescents. It is unlikely that someone would experience these post-strep neuropsychiatric symptoms for the first time as an adult, but it has not been fully studied.\nIt is possible that adolescents and adults may have \nimmune-mediated OCD, but this is not known. \nSigns and Symptoms\nHow is PANDAS diagnosed?",
    "immune-mediated OCD, but this is not known. \nSigns and Symptoms\nHow is PANDAS diagnosed?\nThe diagnosis of PANDAS is a clinical diagnosis, which means that there are no lab tests that can diagnose PANDAS. Instead, health care providers use diagnostic criteria for the diagnosis of PANDAS (see below). At the present time, the clinical features of the illness are the only means of determining whether a child might have PANDAS.\nThe diagnostic criteria are:\n ⊲Presence of OCD, a tic disorder, or both\n ⊲Pediatric onset of symptoms (i.e., age 3 to puberty)\n ⊲Episodic course of symptom severity ⊲Association with group A Beta-hemolytic strep \ninfection, such as a positive throat culture for strep or history of scarlet fever\n ⊲Association with neurological abnormalities, such as physical hyperactivity or unusual, jerky movements that are not in the child’s control\n ⊲Very abrupt onset or worsening of symptoms",
    "⊲Very abrupt onset or worsening of symptoms\nIf the symptoms have been present for more than a week, blood tests may be done to document a preceding strep infection.\nAre there any other symptoms \nassociated with PANDAS episodes?\nYes. Children with PANDAS often experience one \nor more of the following symptoms in conjunction with their OCD or tic disorder:\n ⊲Symptoms of attention-deficit/hyperactivity disorder (ADHD), such as hyperactivity, inattention, or fidgeting\n ⊲Separation anxiety (e.g., child is “clingy” and has difficulty separating from his or her caregivers; for example, the child may not want to be in a different room in the house from his or her parents)\n ⊲Mood changes, such as irritability, sadness,  or emotional lability (i.e.,\n tendency to laugh  \nor cry unexpectedly at what might seem the wrong moment)\n ⊲Trouble sleeping\n ⊲Nighttime bed-wetting, frequent daytime urination, or both\n ⊲Changes in motor skills, such as changes  in handwriting\n ⊲Joint pains",
    "⊲Changes in motor skills, such as changes  in handwriting\n ⊲Joint pains\nWhat is an episodic course \nof symptoms?\nChildren with PANDAS seem to have dramatic ups \nand downs in the severity of their OCD and tics. OCD or tics that are almost always present at a relatively consistent level do not represent an episodic course. Many children with OCD or tics have good days and bad days, or even good weeks and bad weeks. However, children with PANDAS have a",
    "very sudden onset or worsening of their symptoms, \nfollowed by a slow, gradual improvement. If children with PANDAS get another strep infection, their symptoms suddenly worsen again. The increased symptom severity usually persists for at least several weeks but may last for several months or\n longer.\nMy child has had strep throat before, \nand he has tics, OCD, or both. Does that mean he has PANDAS?\nNo. Many children have OCD, tics, or both, and \nalmost all school-aged children get strep throat at some point. In fact, the average grade-school student will have two or three strep throat infections each year.\nPANDAS is considered as a diagnosis when there is \na very close relationship between the abrupt onset or worsening of OCD, tics, or both, and a strep infection. If strep is found in conjunction with two or three episodes of OCD, tics, or both, then the child may have PANDAS.\nWhat does an elevated anti-strep \nantibody titer mean? Is this bad for my\n child?",
    "What does an elevated anti-strep \nantibody titer mean? Is this bad for my\n child?\nThe anti-strep antibody titer (i.e., the number of \nmolecules in blood that indicate a previous infection) is a test that determines whether the child has had a previous strep infection.\nAn elevated anti-strep titer means the child has had \na strep infection sometime within the past few months, and his or her body created antibodies to fight the strep bacteria.\nSome children create lots of antibodies and have very",
    "Some children create lots of antibodies and have very \nhigh titers (up to 2,000), while others have more modest elevations. The height of the titer elevation doesn’t matter, and elevated titers are not necessarily bad for your child. The test measures a normal, healthy response—the production of antibodies to fight off an infection. The antibodies stay in the body for some time after the infection is gone, but the amount of time that the antibodies persist varies greatly between individuals. Some children have “positive” antibody titers for many months after a single infection.When is a strep titer considered to be \nabnormal, or “elevated”?\nThe lab at the National Institutes of Health considers \nstrep titers between 0 and 400 to be normal. Other labs set the upper limit at 150 or 200. Because each lab measures titers in different ways, it is important to know the range used by the lab where the test was done—just ask where the lab draws the line between negative or positive titers.",
    "What if my child’s doctor does not \nunderstand or does not want to consider PANDAS?\nContact the International OCD Foundation ( www.\niocdf.org/find-help ) or the PANDAS Physicians \nNetwork ( www.pandasppn.org ) to find a doctor \nwho may be knowledgeable about PANDAS.\nPLEASE NOTE: NIMH does not evaluate the \nprofessional qualifications and competence of individual health care providers listed on these websites. The resources are provided for general informational purposes only. NIMH does not intend to provide specific medical advice on its websites, but rather to help visitors better understand mental health and disorders. NIMH will not provide specific medical advice and urges you to consult with a qualified mental health or health care provider for diagnosis and answers to your personal questions.\nTreatment\nWhat are the treatment options for \nchildren with PANDAS?\nTreatment with Antibiotics\nThe best treatment for acute episodes of PANDAS",
    "children with PANDAS?\nTreatment with Antibiotics\nThe best treatment for acute episodes of PANDAS \nis to treat the strep infection causing the symptoms, if it is still present, with antibiotics.",
    "⊲A throat culture should be done to document \nthe presence of strep bacteria in the  throat.\n ⊲If the throat culture is positive, a single course of antibiotics usually will get rid of the strep infection and allow the PANDAS symptoms \nt\no subside.\nIf a properly obtained throat culture is negative, the clinician should make sure that the child doesn’t have an occult (hidden) strep infection, such as a sinus infection (often caused by strep bacteria) or strep bacteria infecting the anus, vagina, or urethral opening of the penis. Although the latter infections are rare, they have been reported to trigger PANDAS symptoms in some patients and can be particularly problematic because they will linger for longer periods of time and continue to provoke the production of cross-reactive antibodies.\nThe strep bacteria can be harder to eradicate in the \nsinuses and other sites, so the course of antibiotic treatment may need to be longer than that used for strep throat.",
    "Tips for Parents or Caregivers\nSterilize or replace toothbrushes during and \nfollowing the antibiotics treatment to make sure that the child isn’t re-infected with strep.\nIt also might be helpful to ask a health care \nprovider to perform throat cultures on the child’s family members to make sure that none are “strep carriers,” who could serve as a source of the strep bacteria.\nHow can you manage neuropsychiatric \nsymptoms of PANDAS?\nChildren with PANDAS-related obsessive-compulsive \nsymptoms will benefit from standard medications; behavioral therapies, such as cognitive behavioral therapy (CBT); or both. OCD symptoms are treated best with a combination of CBT and a selective serotonin reuptake inhibitor (SSRI) medication, and tics respond to a variety of medications.\nChildren with PANDAS appear to be unusually",
    "Children with PANDAS appear to be unusually \nsensitive to the side effects of SSRIs and other medications, so it is important to “start low and go slow” when using these medications. In other words, clinicians should prescribe a very small starting dose of the medication and increase it slowly enough that the child experiences as few side effects as possible. If PANDAS symptoms worsen, the SSRI dosage should be decreased promptly. However, SSRIs and other medications should not be stopped abruptly, as that also could cause difficulties.\nFor more information about mental health \nmedications, please visit the NIMH website at www.nimh.nih.gov/health .\nWhat about treating PANDAS \nwith plasma exchang\ne or \nimmunoglobulin (IVIG)?",
    "What about treating PANDAS \nwith plasma exchang\ne or \nimmunoglobulin (IVIG)?\nPlasma exchange or immunoglobulin (IVIG) may be a consideration for acutely and severely affected children with PANDAS. Research suggests that both active treatments can improve global functioning, depression, emotional ups and downs, and obsessive-compulsive symptoms. However, there may be side effects associated with the treatments, including nausea, vomiting, headaches, and dizziness.\nIn addition, there is a risk of infection with any \ninvasive procedure, such as these. Thus, the treatments should be reserved for severely  ill patients and administered by a qualified team of health care professionals . \nShould an elevated strep titer be \ntr\neated with antibiotics?\nNo. Elevated titers indicate that a patient has had a past strep exposure, but the titers can’t tell you precisely when the strep infection occurred. Children may have “positive” titers for many months after",
    "one infection. Because these elevated titers are \nmerely a marker of a prior infection and not proof of an ongoing infection, it is not appropriate to give antibiotics for elevated titers. Antibiotics are recommended only when a child has a positive  rapid strep test or positive strep throat culture.\nCan penicillin be used to treat \nPANDAS or prevent future PANDAS symptom exacerbations?\nPenicillin does not specifically treat the symptoms \nof PANDAS. Penicillin and other antibiotics treat the sore throat caused by the strep by getting rid of the bacteria. In PANDAS, research suggests that it is the antibodies produced by the body in response to the strep infection that may cause PANDAS symptoms, not the bacteria itself.\nResearchers at NIMH have been investigating the \nuse of antibiotics as a form of prophylaxis to prevent future problems. However, there isn’t enough evidence to recommend the long-term use of antibiotics at this time.\nMy child has PANDAS. Should he have",
    "My child has PANDAS. Should he have \nhis tonsils removed?\nCurrent research does not suggest that \ntonsillectomies for children with PANDAS are helpful. If a tonsillectomy is recommended because of frequent episodes of tonsillitis, it would be useful to discuss the pros and cons of the procedure with your child’s health care provider because of the role that the tonsils play in fighting strep infections.Participating in  \nC\nlinical R e search\nC\nlinical trials are research studies that look at new \nways to prevent, detect, or treat diseases and \nconditions. The goal of clinical trials is to \ndetermine if a new test or treatment works and is \nsafe. Although individual participants may benefit \nfrom being part of a clinical trial, participants \nshould be aware that the primary purpose of a \nclinical trial is to gain new scientific knowledge so \nthat others may be better helped in the future.\nResearchers at NIMH and around the country \nconduct many studies with patients and healthy",
    "Researchers at NIMH and around the country \nconduct many studies with patients and healthy \nvolunteers. We have new and better treatment \noptions today because of what clinical trials \nuncovered years ago. Be part of tomorrow’s medical \nbreakthroughs. Talk to your doctor about clinical \ntrials, their benefits and risks, and whether one is \nright for you.\nFor more information about clinical research and \nhow to find clinical trials being conducted around \nthe countr y, visit ww w.nimh.nih.go v/health/trials .\nFinding Help\nBehavioral Health Treatment \nServices Locator\nThe Substance Abuse and Mental Health Services \nAdministration provides this online resource for locating mental health treatment facilities and programs. Find a facility in your state at ht t ps://findtreatment.samhsa.gov . For additional resources, \nvisit www.nimh.nih.gov/findhelp .\nQuestions to Ask Your Doctor",
    "visit www.nimh.nih.gov/findhelp .\nQuestions to Ask Your Doctor\nAsking questions and providing information to your doctor or health care provider can improve your care. Talking with your doctor builds trust and leads to better results, quality, safety, and satisfaction. Visit the Agency for Healthcare Research and Quality website for tips at www.ahrq.gov/patients-consumers .",
    "For More Information\nNIMH website  \nwww.nimh.nih.gov  \nMedlinePlus (National Library of Medicine) \nhttps://medlineplus.gov   \n(En español: https://medlineplus.gov/spanish )\nClinicalTrials.gov  \nwww.clinicaltrials.gov  \n(En español: https://salud.nih.gov/investigacion-clinica )Reprints\nThis publication is in the public domain and  may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH Information \nResource Center at  866-615-6464 , email  \nnimhinfo@nih.gov , or refer to our reprint \nguidelines at https://www.nimh.nih.gov/health/publications/reprinting-and-reusing-nimh-publications.shtml .\nNational Institute of Mental Health Office of Science Policy, Planning,   and Communications  \nScience Writing, Press, and Dissemination Branch \n6001 Executive Boulevard \nRoom 6200, MSC 9663 Beth\nesda, MD 20892-9663 \nPhone: 301-443-4513 or  \nToll-free: 866-615-6464",
    "Room 6200, MSC 9663 Beth\nesda, MD 20892-9663 \nPhone: 301-443-4513 or  \nToll-free: 866-615-6464  \nTTY: 301-443-8431 or  \nTTY Toll-free: 866-415-8051 Fax:\n 301-443-4279  \nEmail: nimhinfo@nih.gov  \nWebsite:  www.nimh.nih.govNational Institute\nof Mental Health\nU.S. DEPARTMENT OF HEALTH \nAND HUMAN SERVICES \nNational Institutes of Health \nNIH Publication No. 19-MH-8092  \nRevised 2019",
    "Panic  \nDisorder: \nWhen Fear  \nOverwhelms",
    "Do you sometimes have sudden attacks of anxiety \nand overwhelming fear that last for several minutes? Maybe your heart pounds, you sweat, and you feel like you can’t breathe or think clearly. Do these attacks occur at unpredictable times with no apparent trigger, causing you to worry about the possibility of having another one at any time?\nAn untreated panic disorder can affect your quality \nof life and lead to difficulties at work or school. The good news is panic disorder is treatable. Learn more about the symptoms of panic disorder and how to find help.\nWhat is panic disorder?\nPeople with panic disorder have frequent and unexpected panic attacks. \nThese attacks are characterized by a sudden wave of fear or discomfort or a sense of losing control even when there is no clear danger or trigger. Not everyone who experiences a panic attack will develop panic disorder. \nPanic attacks often include physical symptoms that might feel like a heart",
    "Panic attacks often include physical symptoms that might feel like a heart \nattack, such as trembling, tingling, or rapid heart rate. Panic attacks can occur at any time. Many people with panic disorder worry about the possibility of having another attack and may significantly change their life to avoid having another attack. Panic attacks can occur as frequently as several times a day or as rarely as a few times a year.\nPanic disorder often begins in the late teens or early adulthood. Women \nare more likely than men to develop panic disorder.",
    "What are the signs and symptoms  \nof panic disorder?\nPeople with panic disorder may have:\n ●Sudden and repeated panic attacks of overwhelming anxiety and fear\n ●A feeling of being out of control, or a fear of death or impending doom \nduring a panic attack\n ●An intense worry about when the next panic attack will happen\n ●A fear or avoidance of places where panic attacks have occurred in the past\n ●Physical symptoms during a panic attack, such as:\n ▪Pounding or racing heart\n ▪Sweating\n ▪Chills\n ▪Trembling\n ▪Difficulty breathing \n ▪Weakness or dizziness\n ▪Tingly or numb hands\n ▪Chest pain\n ▪Stomach pain or nausea \nWhat causes panic disorder?",
    "▪Chest pain\n ▪Stomach pain or nausea \nWhat causes panic disorder?\nPanic disorder sometimes runs in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain and certain biological processes may play a crucial role in fear and anxiety. Some researchers think panic attacks are like “false alarms” where our body’s typical survival instincts are active either too often, too strongly, or some combination of the two. For example, someone with panic disorder might feel their heart pounding and assume they’re having a heart attack. This may lead to a vicious cycle, causing a person to experience panic attacks seemingly out of the blue, the central feature of panic disorder. Researchers are studying how the brain and body interact in people with panic disorder to create more specialized treatments. In addition, researchers are looking at the ways stress and environmental factors play a role in the disorder.",
    "How is panic disorder treated? \nIf you’re experiencing symptoms of panic disorder, talk to a health care \nprovider. After discussing your history, a health care provider may conduct a physical exam to ensure that an unrelated physical problem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.\nPanic disorder is generally treated with psychotherapy (sometimes called \n“talk therapy”), medication, or both. Speak with a health care provider about the best treatment for you.\nPsychotherapy",
    "Psychotherapy\nCognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat panic disorder. CBT teaches you different ways of thinking, behaving, and reacting to the feelings that happen during or before a panic attack. The attacks can become less frequent once you learn to react differently to the physical sensations of anxiety and fear during a panic attack. \nExposure therapy is a common CBT method that focuses on confronting \nthe fears and beliefs associated with panic disorder to help you engage in activities you have been avoiding. Exposure therapy is sometimes used along with relaxation exercises.\nFor more information on psychotherapy, visit www.nimh.nih.gov/\npsychotherapies .\nMedication\nHealth care providers may prescribe medication to treat panic disorder. Different types of medication can be effective, including:",
    "●Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)\n ●Beta-blockers\n ●Anti-anxiety medications, such as benzodiazepines",
    "SSRI and SNRI antidepressants are commonly used to treat depression, \nbut they also can help treat the symptoms of panic disorder. They may take several weeks to start working. These medications also may cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe, especially if the dose starts off low and is increased slowly over time. Talk to your health care provider about any side effects that you may experience. \nBeta-blockers can help control some of the physical symptoms of panic \ndisorder, such as rapid heart rate, sweating, and tremors. Although health care providers do not commonly prescribe beta-blockers for panic disorder, the medication may be helpful in certain situations that precede a panic attack.\nBenzodiazepines, which are anti-anxiety sedative medications, can be",
    "Benzodiazepines, which are anti-anxiety sedative medications, can be \nvery effective in rapidly decreasing panic attack symptoms. However, some people build up a tolerance to these medications and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time if you need them. \nBoth psychotherapy and medication can take some time to work. Many \npeople try more than one medication before finding the best one for them. A health care provider can work with you to find the best medication, dose, and duration of treatment for you. A healthy lifestyle also can help combat panic disorder. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust for support. To learn more ways to take care of your mental health, visit www.nimh.nih.\ngov/mymentalhealth .",
    "gov/mymentalhealth . \nFor more information about medications used to treat panic disorder, visit www.nimh.nih.gov/medications . Visit the Food and Drug Administration’s \nwebsite ( www.fda.gov/drugsatfda ) for the latest warnings, patient \nmedication guides, and information on newly approved medications.",
    "How can I support myself and others  \nwith panic disorder? \nEducate Yourself\nA good way to help yourself or a loved one who may be struggling with \npanic attacks or panic disorder is to seek information. Research the warning signs, learn about treatment options, and keep up to date with current research.\nCommunicate\nIf you are experiencing panic disorder symptoms, have an honest conversation about how you’re feeling with someone you trust. If you think that a friend or family member may be struggling with panic disorder, set aside a time to talk with them to express your concern and reassure them of your support.\nKnow When to Seek Help\nIf your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as at school, at work, or with friends and family—it’s time to seek professional help. Talk to a health care provider about your mental health.\nAre there clinical trials studying panic disorder?",
    "Are there clinical trials studying panic disorder?\nNIMH supports a wide range of research, including clinical trials that look  at new ways to prevent, detect, or treat diseases and conditions—including panic disorder. Although individuals 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.\nResearchers at NIMH and around the country conduct clinical trials with \npatients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you.  For more information, visit www.nimh.nih.gov/clinicaltrials .",
    "Finding Help\nBehavioral Health Treatment Services Locator \nThis online resource, provided by the Substance Abuse and Mental Health \nServices Administration, helps you locate mental health treatment facilities and programs. Find a facility in your state at https://findtreatment.samhsa.gov . For additional resources, visit www.nimh.nih.gov/findhelp . \nTalking to a Health Care Provider About Your Mental Health \nCommunicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at www.nimh.nih.gov/talkingtips . For \nadditional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website at www.ahrq.gov/questions .",
    "If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide \nPrevention Lifeline website at https://suicidepreventionlifeline.org .",
    "Reprints\nThis publication is in the public domain and may be reproduced or copied \nwithout permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH \nInformation Resource Center at 1-866-615-6464, email nimhinfo@nih.gov , \nor refer to NIMH’s reprint guidelines at www.nimh.nih.gov/reprints .\nFor More Information\nNIMH website  \nwww.nimh.nih.gov   \nwww.nimh.nih.gov/espanol  (en español)\nMedline Plus (National Library of Medicine) \nhttps://medlineplus.gov  \nhttps://medlineplus.gov/spanish  (en español)\nClinicalTrials.gov  \nwww.clinicaltrials.gov  \nhttp://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health \nOffice of Science Policy, Planning, and Communications 6001 Executive Boulevard  \nRoom 6200, MSC 9663 Bethesda, MD 20892-9663 Toll-free: 1-866-615-6464  \nEmail: nimhinfo@nih.gov  \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES",
    "Email: nimhinfo@nih.gov  \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 22-MH-8077 Revised 2022",
    "Perinatal Depression",
    "Perinatal depression is a mood disorder that occurs during pregnancy \nand after childbirth. The symptoms can range from mild to severe. In rare cases, the symptoms are severe enough that a mother and her baby’s health and well-being may be at risk. \nPerinatal depression can be treated. Learn about the signs and symptoms, \nrisk factors, treatments, and ways you or a loved one can get help.\nWhat is perinatal depression?\nPerinatal depression includes depression that occurs during pregnancy (prenatal  \ndepression) and in the weeks after childbirth (postpartum depression). Most \nepisodes of perinatal depression begin within 4−8 weeks after the baby is \nborn. Pregnant and postpartum women  with perinatal depression experience \nextreme sadness, anxiety, and fatigue that may make it difficult to carry out \ndaily tasks, including caring for themselves or others.\nWhat are the signs and symptoms of perinatal depression?\nSome women experience a few symptoms of perinatal depression, while others",
    "Some women experience a few symptoms of perinatal depression, while others \nexperience several symptoms. Some of the more common symptoms include:\n⊲ Persistent sad, anxious, or “empty” mood most of the day, nearly every day, for at least 2 weeks\n⊲ Feelings of hopelessness or pessimism\n⊲ Feelings of irritability, frustration, or restlessness\n⊲ Feelings of guilt, worthlessness, or helplessness\n⊲ Loss of interest or pleasure in hobbies and activities\n⊲ Fatigue or abnormal decrease in energy\n⊲ Being restless or having trouble sitting stillHow is postpartum depression different from “baby blues”?\n“Baby blues” is a term used to describe mild and short-lasting mood changes and feelings of worry, unhappiness, and exhaustion that many women experience in the first 2 weeks after giving birth. Babies require around-the-clock care, so it’s normal for new mothers to feel tired or overwhelmed sometimes. \nMood changes and feelings of anxiety or unhappiness that are severe",
    "Mood changes and feelings of anxiety or unhappiness that are severe \nor last longer than 2 weeks after childbirth may be signs of postpartum depression. Women with postpartum depression generally will not feel better without treatment.",
    "⊲ Difficulty concentrating, \nremembering, or making decisions\n⊲ Difficulty sleeping (even when the baby is asleep), waking early in the morning, or oversleeping\n⊲ Abnormal changes in appetite or unplanned weight changes\n⊲ Physical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatment\n⊲ Trouble bonding or forming an emotional attachment with the baby\n⊲ Persistent doubts about the ability to care for the baby\n⊲ Thoughts of death or harming oneself or the baby or suicide attempts\nWomen who experience any of these symptoms should see a health care provider. A provider can determine whether the symptoms are due to perinatal depression or something else.\nWhat are the risk factors for perinatal depression?\nPerinatal depression is a medical condition that can affect any pregnant or \npostpartum woman, regardless of age, race, ethnicity, income, culture, or",
    "postpartum woman, regardless of age, race, ethnicity, income, culture, or \neducation. A woman is not to blame or at fault for having perinatal d epress ion: \nIt is not caused by anything she has  or has not done. \nPerinatal depression does not have a single cause. Research suggests that \ngenetic and environmental factors contribute to the disorder. Specific factors \ncontributing to perinatal depression can include:\n⊲ Life stress (for example, demands at work or experiences of past trauma)\n⊲ Physical and emotional demands of childbirth and caring for a new baby\n⊲ Changes in hormones that occur during and after pregnancy \nIn addition, women are at increased risk for perinatal depression if they have a",
    "In addition, women are at increased risk for perinatal depression if they have a \npersonal or family history of depression or bipolar disorder or if they experienced depression with a previous pregnancy. Women with a history of perinatal depression should consult a health care provider to develop a plan for follow-up care in case a depressive episode reoccurs.What is postpartum psychosis?\nPostpartum psychosis is a serious mental illness that can occur after childbirth. Women with postpartum psychosis may experience delusions (thoughts or beliefs that are not true), hallucinations (seeing, hearing, or smelling things that are not there), mania (a high, elated mood that often seems out of touch with reality), paranoia,  and confusion. \nPostpartum psychosis is a",
    "Postpartum psychosis is a \npsychiatric emergency that requires hospitalization. Women experiencing symptoms of postpartum psychosis should seek immediate help by calling 911 or going to the nearest emergency room. Recovery is possible with professional help.",
    "How is perinatal depression treated?\nTreating perinatal depression is critical for the health of the mother and her \nbaby, as the disorder can have serious effects on both. However, with proper treatment, most women feel better and their symptoms improve.\nTreatment for perinatal depression usually includes therapy, medication, or a \ncombination of therapy and medication. \nResearchers continue to study treatment options for perinatal depression. A \nhealth care provider can explain the different treatments and help you choose the best one based on your symptoms. You can learn more about approaches for treating depression at www.nimh.nih.gov/depression .\nPsychotherapy",
    "Psychotherapy\nSeveral types of psychotherapy (also called talk therapy or counseling) can help women with perinatal depression by teaching them new ways of thinking and behaving and helping them change habits that contribute to depression. Evidence-based therapies for perinatal depression include cognitive behavioral therapy and interpersonal therapy.\n⊲ Cognitive behavioral therapy (CBT) : With CBT, people learn to challenge \nand change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. People also learn different ways of reacting to situations. CBT can be conducted individually or with a group of people who have similar concerns.\n⊲ Interpersonal therapy (IPT) : IPT is based on the idea that interpersonal and",
    "⊲ Interpersonal therapy (IPT) : IPT is based on the idea that interpersonal and \nlife events impact mood and vice versa. IPT aims to help people improve their communication skills within relationships, form social support networks, and develop realistic expectations to better deal with crises or other issues contributing to their depression.\nFor more information on psychotherapy, including what to look for in a therapist and how to find one, visit www.nimh.nih.gov/psychotherapies . The National Institute of Mental Health (NIMH) has information on ways to get help and find a health care provider or access treatment at www.nimh.nih.gov/findhelp .\nIf 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 . \nIn life-threatening situations, call 911 .",
    "Medication\nMedications used for depression (antidepressants) can effectively treat \nperinatal depression when used alone or in combination with psychotherapy. Antidepressants work by changing how the brain produces or uses certain chemicals involved in mood or stress. \nAntidepressants take time—usually 4−8 weeks—to work. Problems with sleep, \nappetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it is right for you. You may need to try several medications to find the best one.\nThe U.S. Food and Drug Administration (FDA) has approved a medication \ncalled brexanolone specifically to treat severe postpartum depression. Brexanolone, which is administered through an IV during a brief hospital stay, appears to work differently than traditional antidepressants by rapidly altering a brain chemical that may play an important role in regulating the body’s vulnerability to depression and anxiety.",
    "More recently, the FDA approved a pill called zuranolone as the first oral \nmedication for postpartum depression in adults. Zuranolone acts on similar brain receptors to brexanolone. In clinical trials, the pill reduced depressive symptoms in women with severe postpartum depression more quickly than traditional antidepressants. \nNote : In some cases, people under 25 years may experience an increase\nin suicidal thoughts or behavior when taking antidepressants, especially  in \nthe first few weeks after starting or when the dose is changed. The FDA \nadvises that patients of all ages taking antidepressants be watched closely, \nespecially during the first few weeks of treatment.\nThe r\nisk of birth defects and other problems for babies of mothers who take \nantidepressants during pregnancy is very low. However, women should always",
    "antidepressants during pregnancy is very low. However, women should always \nlet a health care provider know if they are pregnant or nursing and work with the provider to minimize the baby’s exposure to medication and weigh the risks and benefits of available treatment options. More information on medications during and after pregnancy can be found at www.fda.gov/pregnancy .\nAll medications can have side effects. Talk to a health care provider before starting or stopping any medication. For more information on antidepressants, visit www.nimh.nih.gov/medications . \nYou can also learn more about specific medications like brexanolone and zuranolone, including the latest approvals, side effects, warnings, and patient information, on the FDA website at www.fda.gov/drugsatfda .",
    "How can I find help for perinatal depression?\nVisit a mental health professional \nIf you think you have perinatal depression, start by making an appointment \nwith a health care provider. This could be a primary care doctor or a mental health professional who specializes in diagnosing and treating mental disorders (for example, a psychologist, psychiatrist, or social worker). A health care provider will examine you and talk to you about treatment options and next steps, including options if you are pregnant or nursing. \nCommunicating well with a health care provider can improve your care and \nhelp you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at www.nimh.nih.gov/talkingtips . For \nadditional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality at www.ahrq.gov/questions .",
    "The Substance Abuse and Mental Health Services Administration provides  an online resource for finding mental health services in your area at  https://findtreatment.gov . \nJoin a support or advocacy group\nSupport or advocacy groups can be an important source of help and information. One example of this type of group is Postpartum Support International; you can find others through online searches. For more information about Postpartum Support International, visit www.postpartum.net . \nContact the National Maternal Mental Health Hotline\nThis hotline offers free, confidential mental health support for mothers and their families before, during, and after pregnancy. Call or text 1-833-9-TLC-MAMA (1-833-852-6262 ) to connect with counselors 24 hours a day, 7 days a week. \nEnglish- and Spanish-speaking counselors are available.",
    "How can family and friends provide help for \nperinatal depression?\nIt is essential to understand that perinatal depression is a medical condition that \nimpacts the mother, the child, and the family. Treatment is central to recovery. \nSpouses, partners, family members, and friends may be the first to recognize \nsigns of depression in a new mother. Family and friends can provide help in many ways that include: \n⊲ Encouraging discussion with a health care provider \n⊲ Helping get to appointments \n⊲ Offering emotional or practical support\n⊲ Assisting with daily tasks such as caring for the baby or home\nWhere can I learn more about depression in women?\nThe following agencies have additional information on depression in women:\n ⊲Action Plan for Depression and Anxiety During Pregnancy and After \nBirth ( Eunice Kennedy Shriver  National Institute of Child Health and\nHuman Development) www.nichd.nih.gov/ncmhep/initiatives/moms-\nmental-health-matters/moms/action-plan",
    "mental-health-matters/moms/action-plan\n⊲   Depression Among Women (Centers for Disease Control and Prevention) \nwww.cdc.gov/reproductive-health/depression\n⊲ Pe\nrinatal Depression: Preventive Interventions (U.S. Preventive Services \nTask Force)  www.uspreventiveservicestaskforce.org/uspstf/recommendation/perinatal-depression-preventive-interventions\n ⊲Postpartum Depression (Office on Women’s Health) www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression\n ⊲Women and Depression (U.S. Food and Drug Administration)  www.fda.gov/consumers/women/women-and-depression\nFor more information on postpartum depression, also see:\n ⊲Postpartum Depression (MedlinePlus, National Library of Medicine) https://medlineplus.gov/postpartumdepression.html\n ⊲Talking Postpartum Depression videos (Office on Women’s Health) www.womenshealth.gov/talkingPPD",
    "What are clinical trials and why are they important?\nClinical trials are research studies that look at ways to prevent, detect, or  \ntreat diseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available. \nNIMH supports clinical trials across the United States. Talk to a health care \nprovider about clinical trials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials . \nFor more information\nMedlinePlus (National Library of Medicine)  https://medlineplus.gov  \nhttps://medlineplus.gov/spanish  (en español)",
    "https://medlineplus.gov/spanish  (en español)\nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications  6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663 Toll-free: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov  \nEn espanol: www.nimh.nih.gov/espanol  \nReprints \nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 23-MH-8116 Revised 2023",
    "Post-Traumatic \nStress Disorder",
    "What is post-traumatic stress disorder, or PTSD?\nIt is natural to feel afraid during and after a traumatic situation. Fear is a part  \nof the body’s “fight-or-flight” response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma,  \nand most will recover from their symptoms over time. Those who continue  to experience symptoms may be diagnosed with post-traumatic stress  disorder (PTSD). \nWho develops PTSD?\nAnyone can develop PTSD at any age. This includes combat veterans and people who have experienced or witnessed a physical or sexual assault, abuse, an accident, a disaster, a terror attack, or other serious events. People who have PTSD may feel stressed or frightened, even when they are no longer in danger.\nNot everyone with PTSD has been through a dangerous event. Sometimes, \nlearning that a relative or close friend experienced trauma can cause PTSD.\nAbout 6 of every 100 people will experience PTSD at some point in their",
    "About 6 of every 100 people will experience PTSD at some point in their \nlifetime, according to the National Center for PTSD, a U.S. Department of Veterans Affairs program. Women are more likely than men to develop PTSD. Certain aspects of the traumatic event and biological factors (such as genes) may make some people more likely to develop PTSD.\nWhat are the symptoms of PTSD?\nSymptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.\nThe course of the disorder varies. Although some people recover within \n6 months, others have symptoms that last for 1 year or longer. People with PTSD",
    "6 months, others have symptoms that last for 1 year or longer. People with PTSD \noften have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.\nAfter a dangerous event, it is natural to have some symptoms. For example, \nsome people may feel detached from the experience, as though they are observing things as an outsider rather than experiencing them. A mental health professional—such as a psychiatrist, psychologist, or clinical social worker—can determine whether symptoms meet the criteria for PTSD.",
    "To be diagnosed with PTSD, an adult must have all of the following for at \nleast 1 month:\n ●At least one re-experiencing symptom\n ●At least one avoidance symptom\n ●At least two arousal and reactivity symptoms\n ●At least two cognition and mood symptoms\nRe-experiencing symptoms\n ●Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating\n ●Recurring memories or dreams related to the event\n ●Distressing thoughts\n ●Physical signs of stress\nThoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.\nAvoidance symptoms\n ●Staying away from places, events, or objects that are reminders of the experience\n ●Avoiding thoughts or feelings related to the traumatic event\nAvoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.\nArousal and reactivity symptoms\n ●Being easily startled",
    "Arousal and reactivity symptoms\n ●Being easily startled\n ●Feeling tense, on guard, or on edge\n ●Having difficulty concentrating\n ●Having difficulty falling asleep or staying asleep\n ●Feeling irritable and having angry or aggressive outbursts\n ●Engaging in risky, reckless, or destructive behavior\nArousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping or eating.\nCognition and mood symptoms\n ●Trouble remembering key features of the traumatic event\n ●Negative thoughts about oneself or the world\n ●Exaggerated feelings of blame directed toward oneself or others\n ●Ongoing negative emotions, such as fear, anger, guilt, or shame\n ●Loss of interest in previous activities\n ●Feelings of social isolation\n ●Difficulty feeling positive emotions, such as happiness or satisfaction",
    "●Difficulty feeling positive emotions, such as happiness or satisfaction\nCognition and mood symptoms can begin or worsen after the traumatic event. They can lead people to feel detached from friends or family members.",
    "How do children and teens react to trauma?\nChildren and teens can have extreme reactions to traumatic events, but their \nsymptoms may not be the same as those seen in adults. In children younger than age 6, symptoms can include:\n ●Wetting the bed after having learned to use the toilet\n ●Forgetting how to talk or being unable to talk\n ●Acting out the scary event during playtime\n ●Being unusually clingy with a parent or other adult\nOlder children and teens usually show symptoms more like those seen in adults. They also may develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilt over not preventing injury or death, or have thoughts of revenge.\nFor more information on helping children and adolescents cope with traumatic \nevents, see www.nimh.nih.gov/helpchildrencope .\nWhy do some people develop PTSD and other people \ndo not?\nNot everyone who lives through a dangerous event develops PTSD—many",
    "do not?\nNot everyone who lives through a dangerous event develops PTSD—many \nfactors play a part. Some of these factors are present before the trauma; others play a role during and after a traumatic event.\nRisk factors that may increase the likelihood of developing PTSD include:\n ●Exposure to previous traumatic experiences, particularly during childhood\n ●Getting hurt or seeing people hurt or killed\n ●Feeling horror, helplessness, or extreme fear\n ●Having little or no social support after the event\n ●Dealing with stressors after the event, such as the loss of a loved one, pain \nand injury, or loss of a job or home\n ●Having a personal history or family history of mental illness or substance use\nResilience factors  that may reduce the likelihood of developing PTSD include:\n ●Seeking out and receiving support from friends, family, or support groups\n ●Learning to feel okay with one’s actions in response to a traumatic event",
    "●Learning to feel okay with one’s actions in response to a traumatic event\n ●Having a coping strategy for getting through and learning from a  traumatic event\n ●Being prepared and able to respond to upsetting events as they occur, despite feeling fear",
    "How is PTSD treated?\nIt is important for people with PTSD symptoms to work with a mental health \nprofessional who has experience treating PTSD. The main treatments are psychotherapy, medications, or a combination of psychotherapy and medications. An experienced mental health professional can help people find the best treatment plan for their symptoms and needs.\nSome people with PTSD, such as those in abusive relationships, may be living \nthrough ongoing trauma. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms of PTSD. People who experience traumatic events or who have PTSD may also experience panic disorder, depression, substance use, or suicidal thoughts. Treatment for these conditions can help with recovery after trauma. Research shows that support from family and friends also can be an essential part of recovery.\nFor tips to help prepare and guide you in talking to your health care provider",
    "For tips to help prepare and guide you in talking to your health care provider \nabout your mental health, visit www.nimh.nih.gov/talkingtips .\nPsychotherapy\nPsychotherapy, sometimes called talk therapy, includes a variety of treatment techniques that mental health professionals use to help people identify and change troubling emotions, thoughts, and behaviors. Psychotherapy can provide support, education, and guidance to people with PTSD and their families. Treatment can take place one on one or in a group setting and usually lasts 6 to 12 weeks but can last longer.\nSome types of psychotherapy target PTSD symptoms, while others focus on \nsocial, family, or job-related problems. Effective psychotherapies often emphasize a few key components, including learning skills to help identify triggers and manage symptoms.\nA common type of psychotherapy called cognitive behavioral therapy can \ninclude exposure therapy and cognitive restructuring.",
    "include exposure therapy and cognitive restructuring.\n ●Exposure therapy  helps people learn to manage their fear by gradually \nexposing them, in a safe way, to the trauma they experienced. As part of exposure therapy, people may think or write about the trauma or visit the place where it happened. This therapy can help people with PTSD reduce symptoms that cause them distress.\n ●Cognitive restructuring  helps people make sense of the traumatic event. \nSometimes people remember the event differently from how it happened, or \nthey may feel guilt or shame about something that is not their fault. Cognitive restructuring can help people with PTSD think about what happened in a realistic way.\nLearn more about psychotherapy at www.nimh.nih.gov/psychotherapies .",
    "Medications\nThe U.S. Food and Drug Administration (FDA) has approved two selective \nserotonin reuptake inhibitors (SSRIs), a type of antidepressant medication, for the treatment of PTSD. SSRIs may help people manage PTSD symptoms, such as sadness, worry, anger, and feeling emotionally numb. Health care providers may prescribe SSRIs and other medications along with psychotherapy. Some medications may help treat specific PTSD symptoms, such as sleep problems and nightmares.\nPeople should work with their health care providers to find the best medication \nor combination of medications and the right dose. Read the latest medication warnings, patient medication guides, and information on newly approved medications on the FDA website at www.fda.gov/drugsatfda .\nHow can I find help?\nThe Substance Abuse and Mental Health Services Administration (SAMHSA) provides an online resource for finding mental health services",
    "in your area at https://findtreatment.gov . For additional resources, visit  \nwww.nimh.nih.gov/findhelp .\nIf 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  \nat 988lifeline.org . In life-threatening situations, call 911.\nWhat can I do to help myself?\nYou can get better with treatment. Here are some things you can do to  help yourself:\n ●Talk with your health care provider about treatment options and follow your treatment plan.\n ●Engage in exercise, mindfulness, or other activities that help reduce stress.\n ●Try to maintain routines for meals, exercise, and sleep.\n ●Set realistic goals and focus on what you can manage.\n ●Spend time with trusted friends or relatives and tell them about things that may trigger symptoms.\n ●Expect your symptoms to improve gradually, not immediately.\n ●Avoid the use of alcohol or drugs.",
    "How can I help a loved one with PTSD?\nIf you know someone who may be experiencing PTSD, the most important \nthing you can do is to help that person get the right diagnosis and treatment. Some people may need help making an appointment with their health care provider; others may benefit from having someone accompany them to their health care visits.\nIf a close friend or relative is diagnosed with PTSD, you can encourage them to \nfollow their treatment plan. If their symptoms do not improve after 6 to 8 weeks, you can encourage them to talk about it with their health care provider. You  \nalso can:\n ●Offer emotional support, understanding, patience, and encouragement.\n ●Learn about PTSD so you can understand what your friend is experiencing.\n ●Listen carefully. Pay attention to the person’s feelings and the situations that may trigger PTSD symptoms.\n ●Share positive distractions, such as walks, outings, and other activities.\nWhere can I find more information on PTSD?",
    "Where can I find more information on PTSD?\nThe National Center for PTSD, a program of the U.S. Department of Veterans Affairs, is the leading federal center for research and education on PTSD and traumatic stress. You can find information about PTSD, treatment options, getting help, and additional resources for families, friends, and providers at www.ptsd.va.gov .\nAre there clinical trials studying PTSD?\nNIMH supports a wide range of research, including clinical trials that look at new ways to prevent, detect, or treat diseases and conditions—including PTSD. Although individuals 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.\nResearchers at NIMH and around the country conduct clinical trials with patients",
    "Researchers at NIMH and around the country conduct clinical trials with patients \nand healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .",
    "Reprints\nThe information in this publication is in the public domain and may be reused or \ncopied without permission. However, you may not reuse or copy the images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .\nFor more information\nNIMH website  \nwww.nimh.nih.gov  \nwww.nimh.nih.gov/espanol  (en español)\nMedlinePlus  (National Library of Medicine)  \nhttps://medlineplus.gov  \nhttps://medlineplus.gov/spanish  (en español)\nClinicalTrials.gov   \nwww.clinicaltrials.gov  \nhttps://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health Office of Science Policy, Planning, and Communications 6001 Executive Boulevard  \nRoom 6200, MSC 9663 Bethesda, MD 20892-9663 Toll-free: 1-866-615-6464  \nEmail: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health",
    "U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 23-MH-8124 Revised 2023",
    "National Institute\nof Mental Health\nSchizophrenia",
    "What is schizophrenia?\nSchizophrenia is a serious mental illness that affects how a person thinks, \nfeels, and behaves. People with schizophrenia may appear to have lost touch with reality, which can be distressing for them and their family and friends. The symptoms of schizophrenia can make it difficult to participate in usual, everyday activities, but effective treatments are available. Treatment can help people remain in school, maintain employment, achieve independence, and enjoy personal relationships.\nWhat are the signs and symptoms of schizophrenia?",
    "What are the signs and symptoms of schizophrenia?\nIt’s important to recognize the symptoms of schizophrenia and seek help as early as possible. People with schizophrenia are usually diagnosed between the ages of 16 and 30, after the first episode of psychosis. Starting treatment as soon as possible following the first episode of psychosis is an important step toward recovery. However, research shows that gradual changes in thinking, mood, and social functioning often appear before the first episode of psychosis. Schizophrenia is rare in younger children.\nSchizophrenia symptoms can differ from person to person, but they generally \nfall into three main categories: psychotic, negative, and cognitive.\nPsychotic symptoms",
    "fall into three main categories: psychotic, negative, and cognitive.\nPsychotic symptoms\nPsychotic symptoms include changes in the way a person thinks, acts, and experiences the world. A person experiencing psychotic symptoms often has disrupted thoughts and perceptions, and they may have difficulty recognizing what is real and what is not. For some people, these symptoms come and go. For others, the symptoms become stable over time. Psychotic symptoms include hallucinations, delusions, and thought disorder.\n ►Hallucinations  are when a person sees, hears, smells, tastes, or feels \nthings that are not there. Hearing voices is common among people with schizophrenia. People who hear voices may hear them for a long time before family or friends notice a problem.\n ►Delusions  are when a person has strong beliefs that are not objectively",
    "►Delusions  are when a person has strong beliefs that are not objectively \ntrue and may seem irrational to others. For example, individuals experiencing delusions may believe that people on the radio and television are sending special messages that require a certain response, or they may believe that they are in danger or that others are trying to hurt them.",
    "►Thought disorder is when a person has ways of thinking that are unusual \nor illogical. People with thought disorder may have trouble organizing their thoughts and speech. They may stop talking in the middle of a thought, jump from topic to topic, or make up words that have no meaning.\nNegative symptoms\nNegative symptoms include loss of motivation, loss of interest or enjoyment in daily activities, withdrawal from social life, difficulty showing emotions, and difficulty functioning normally. Negative symptoms include:\n ►Having trouble planning and sticking with routine activities, such as grocery shopping\n ►Having trouble anticipating and being motivated by pleasure in  everyday life\n ►Talking in a dull voice and showing limited facial expression\n ►Avoiding social interaction or interacting in socially awkward ways",
    "►Avoiding social interaction or interacting in socially awkward ways\n ►Having very low energy and spending a lot of time in passive activities. In extreme cases, a person might stop moving or talking for periods of time, which is a rare condition called catatonia.\nThese negative symptoms are sometimes mistaken for symptoms of depression or other mental illnesses.\nCognitive symptoms\nCognitive symptoms include problems with attention, concentration, and memory. These symptoms can make it hard to follow a conversation, learn new things, or remember appointments. A person’s level of cognitive functioning is one of the best predictors of their day-to-day functioning. Health care providers use specific tests to evaluate cognitive functioning. Cognitive symptoms include:\n ►Having trouble processing information to make decisions\n ►Having trouble using information immediately after learning it\n ►Having trouble focusing or paying attention",
    "Risk of violence\nMost people with schizophrenia are not violent. Overall, people with \nschizophrenia are more likely than those without the illness to be harmed by others. For people with schizophrenia, the risk of self-harm and violence to others is most significant when the illness is untreated or co-occurs with alcohol or substance misuse. It is important to help people who are showing symptoms get treatment as quickly as possible.\nSchizophrenia vs. dissociative identity disorder\nAlthough some of the symptoms may seem similar on the surface, schizophrenia is not dissociative identity disorder (which used to be called multiple personality disorder or split personality). People with dissociative \nidentity disorder have two or more independent identities  with distinct \nbehaviors and memories.\nWhat causes schizophrenia?\nSeveral factors may contribute to a person’s risk of developing schizophrenia.\nGenes\nSchizophrenia sometimes runs in families. However, just because one family",
    "Genes\nSchizophrenia sometimes runs in families. However, just because one family \nmember has schizophrenia, it does not mean that other members of the family also will have it. Studies suggest that many different genes may increase a person’s chances of developing schizophrenia and that no single gene causes the disorder by itself.\nEnvironment \nResearch suggests that a combination of genetic factors and aspects of a person’s environment and life experiences may play a role in the development of schizophrenia. These environmental factors may include poverty, stressful or dangerous surroundings, and exposure to viruses or nutritional problems before birth.\nBrain structure and function",
    "Brain structure and function \nResearch shows that people with schizophrenia may be more likely to have subtle differences in the size of certain brain areas and in connections between brain areas. Some of these brain differences may develop before birth. Researchers are working to better understand how brain structure and function may relate to schizophrenia.",
    "How is schizophrenia treated?\nCurrent treatments for schizophrenia focus on helping individuals manage \ntheir symptoms, improve day-to-day functioning, and achieve personal  life goals, such as completing education, pursuing a career, and having fulfilling relationships.\nAntipsychotic medication\nAntipsychotic medication can help make psychotic symptoms less intense and less frequent. This type of medication is usually taken every day in a pill or liquid form. Some forms may be given as an injection once or twice a month. To learn more about antipsychotic medication, visit www.nimh.nih.gov/medications .\nIf a person’s symptoms do not improve with usual antipsychotic medication, they may be prescribed 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 patients.\nPeople respond to antipsychotic medication in different ways. It is important",
    "People respond to antipsychotic medication in different ways. It is important \nto report any side effects to a health care provider. Many people taking antipsychotic medication experience side effects such as weight gain, dry mouth, restlessness, and drowsiness when they start taking these medications. Some side effects may go away over time, while others may last.\nDo not stop taking a medication without first talking to a health care \nprovider.  They can work with you to monitor your health and adjust your \ntreatment plan safely and effectively. Some people may need to try several medications before finding the one that works best.\nRead the most up-to-date information on medications, side effects, and \nwarnings on the U.S. Food and Drug Administration (FDA) website at  \nwww.fda.gov/drugsatfda .\nPsychosocial treatments",
    "www.fda.gov/drugsatfda .\nPsychosocial treatments\nPsychosocial treatments help people find solutions to everyday challenges and manage symptoms while attending school, working, and forming relationships. These treatments are often used together with antipsychotic medication. People who participate in regular psychosocial treatment are less likely to have symptoms reoccur or to be hospitalized.",
    "Examples of this kind of treatment include cognitive behavioral therapy, \nbehavioral skills training, supported employment, and cognitive remediation interventions.\nLearn more about psychosocial treatments and therapies at  \nwww.nimh.nih.gov/psychotherapies .\nFamily education and support\nEducational programs can help family and friends learn about symptoms  of schizophrenia, treatment options, and strategies for helping loved ones with the illness. These programs can help friends and family manage their own distress, boost their coping skills, and strengthen their ability to  provide support.\nCoordinated specialty care",
    "Coordinated specialty care\nCoordinated specialty care (CSC) programs are recovery-focused programs for people with first episode psychosis, an early stage of schizophrenia. Health professionals and specialists work together as a team to provide CSC, which includes psychotherapy, medication, case management, employment and education services, and family education and support. The treatment team works collaboratively with the individual to make treatment decisions, \ninvolving family members as much as possible.\nCompared with typical care, CSC is more effective in reducing symptoms, \nimproving quality of life, and increasing involvement in work or school.\nAssertive community treatment\nAssertive community treatment is designed to help individuals with schizophrenia who are likely to experience multiple hospitalizations or homelessness. This type of treatment is usually delivered by a team of  health care providers who work together to provide care to patients in  the community.",
    "Treatment for drug and alcohol misuse \nPeople with schizophrenia may also have problems with drugs and alcohol. A treatment program that includes treatment for both schizophrenia and substance use is important for recovery because substance use can interfere with treatment for schizophrenia.",
    "How can I find help?\nIf you have concerns about your mental health, talk to a primary care provider. \nThey can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find tips for talking with a health care provider about your mental health at www.nimh.nih.gov/talkingtips .\nYou can learn more about getting help at www.nimh.nih.gov/findhelp . The \nSubstance Abuse and Mental Health Services Administration (SAMHSA) provides information about finding support at https://findsupport.gov  and \nlocating mental health services in your area at https://findtreatment.gov .\nIf 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 \n988lifeline.org . In life-threatening situations, call 911.\nHow can I help a friend or relative \nwith schizophrenia?",
    "How can I help a friend or relative \nwith schizophrenia?\nIt can be difficult to know how to help someone who is experiencing \npsychosis. Here are some things you can do:\n ►Help them get treatment and encourage them to stay in treatment.\n ►Remember that their beliefs or hallucinations seem very real to them.\n ►Be respectful, supportive, and kind without tolerating dangerous or inappropriate behavior.\n ►Look for support groups and family education programs, such as  those offered by the National Alliance on Mental Illness at  www.nami.org/Support-Education .",
    "Clinical trials\nClinical trials are research studies that look at ways to prevent, detect, or treat \ndiseases and conditions. These studies help show whether a treatment is safe and effective in people. Some people join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available.\nNIMH supports clinical trials across the United States. Talk to a health care \nprovider about clinical trials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nFor more information\nLearn more by visiting NIMH’s website at www.nimh.nih.gov/health . For \ninformation on a wide variety of health topics, visit the National Library of Medicine’s MedlinePlus resource at https://medlineplus.gov .\nContact us",
    "Contact us\nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications 6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663 Phone: 1-866-615-6464  \nEmail: n imhinfo@nih.gov\n \nWebsite: www.nimh.nih.gov  \nEn español: www.nimh.nih.gov/espanol\nReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 24-MH-8082 Revised 2024National Instituteof Mental Health",
    "Seasonal  \nAffective  \nDisorder\nWhat is seasonal affective disorder?\nMany people go through short periods when they feel sad or \nunlike their usual selves. Sometimes, these mood changes begin and end when the seasons change. Many people feel “down” or have the “winter blues” when the days get shorter in the fall and winter and feel better in the spring when longer daylight hours return.\nSometimes, these mood changes are more serious and can \naffect how a person feels, thinks, and behaves. If you have noticed significant changes in your mood and behavior when the seasons change, you may be experiencing seasonal affective disorder (SAD).\nIn most cases, SAD symptoms start in the late fall or early \nwinter and go away during the spring and summer, known as winter-pattern SAD or winter depression. Other people experience depressive symptoms during the spring and summer months, known as summer-pattern SAD or summer depression. Summer-pattern SAD is less common.",
    "What are the signs and symptoms  \nof SAD?\nSAD is a type of depression characterized by a recurrent \nseasonal pattern, with symptoms lasting about 4−5 months out of the year. The signs and symptoms of SAD include those associated with depression as well as disorder-specific symptoms that differ for winter-pattern versus summer-pattern SAD. \nNot every person with SAD experiences all the symptoms \nlisted below. Learn more about signs and symptoms of depression at  www.nimh.nih.gov/depression . \nSymptoms of depression can include:\n ●Persistent sad, anxious, or “empty” mood most of the day, nearly every day, for at least 2 weeks\n ●Feelings of hopelessness or pessimism\n ●Feelings of irritability, frustration, or restlessness\n ●Feelings of guilt, worthlessness, or helplessness\n ●Loss of interest or pleasure in hobbies and activities \n ●Decreased energy, fatigue, or feeling slowed down ●Difficulty concentrating, remembering, or making decisions",
    "●Changes in sleep or appetite or unplanned weight changes\n ●Physical aches or pains, headaches, cramps, or digestive problems that do not have a clear physical cause and do not go away with treatment\n ●Thoughts of death or suicide or suicide attempts\nFor winter-pattern SAD, additional symptoms can include:\n ●Oversleeping (hypersomnia)\n ●Overeating, particularly with a craving for carbohydrates, leading to weight gain\n ●Social withdrawal (feeling like “hibernating”)\nFor summer-pattern SAD, additional symptoms can include:\n ●Trouble sleeping (insomnia)\n ●Poor appetite, leading to weight loss\n ●Restlessness and agitation\n ●Anxiety\n ●Violent or aggressive behavior",
    "●Restlessness and agitation\n ●Anxiety\n ●Violent or aggressive behavior\nWinter-pattern SAD should not be confused with “holiday blues”—feelings of sadness or anxiety brought on by stresses at certain times of the year. The depression associated with SAD is related to changes in daylight hours, not the calendar, so stresses associated with the holidays or predictable seasonal changes in work or school schedules, family visits, and so forth are not the same as SAD.\nThe National Institute of Mental Health (NIMH) has information on ways to get help and find a health care provider or access treatment at www.nimh.nih.gov/findhelp . \nIf 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  \nlife-threatening situations, call 911 .",
    "life-threatening situations, call 911 .\nThe Substance Abuse and Mental Health Services Administration has an online tool to help you  find mental health services in your area at  https://findtreatment. gov.From  the NATIONAL INSTITUTE of  MENTAL HEALTH",
    "How is SAD diagnosed?\nIf you or someone you know is showing symptoms of SAD, \ntalk to a health care provider or a mental health specialist about your concerns. They may have you fill out a questionnaire to determine if your symptoms meet the criteria for SAD.\nTo be diagnosed with SAD, a person must meet the \nfollowing criteria:\n ●They have the symptoms of depression or the more specific \nsymptoms of winter- or summer-pattern SAD listed above.\n ●Their depressive episodes occur during specific seasons (winter or summer) for at least 2 consecutive years. However, not all people with SAD experience symptoms every year.\n ●Their depressive episodes during the specific season are more frequent than depressive episodes experienced at other times of the year.\nWho develops SAD?\nIt is estimated that millions of Americans experience SAD, although many may not know they have this common disorder. In most cases, SAD begins in young adulthood.\nSAD occurs much more often in women than in men.",
    "SAD occurs much more often in women than in men. \nWinter-pattern SAD also occurs more often than summer-pattern SAD. Therefore, SAD is more common in people living farther north, where there are shorter daylight hours in the winter. For example, people in Alaska or New England are more likely to develop SAD than people in Texas or Florida. \nSAD is more common in people with depression or bipolar \ndisorder, especially bipolar II disorder, which involves repeated depressive episodes and hypomanic episodes (less severe than the typical manic episodes of bipolar I disorder). Additionally, people with SAD tend to have other mental disorders, such as attention-deficit/hyperactivity disorder, eating disorder, anxiety disorder, or panic disorder. Learn more about these disorders at www.nimh.nih.gov/health .\nSAD sometimes runs in families and may be more common in people who have relatives with other mental illnesses, such as depression or schizophrenia.What causes SAD?",
    "Researchers are still determining what causes SAD. Most research to date has investigated potential causes of winter-pattern SAD because it is more common and easier to study. As a result, less is known about summer-pattern SAD, and more research is needed.\nStudies indicate that people with SAD, especially winter-\npattern SAD, have reduced levels of the brain chemical serotonin, which helps regulate mood. Research also suggests that sunlight affects levels of molecules that help maintain normal serotonin levels. Shorter daylight hours may prevent these molecules from functioning properly, contributing to decreased serotonin levels in the winter.\nVitamin D deficiency may exacerbate these problems in",
    "Vitamin D deficiency may exacerbate these problems in \npeople with winter-pattern SAD because vitamin D is believed to promote serotonin activity. In addition to vitamin D consumed in food, the body produces vitamin D when exposed to sunlight on the skin. With less daylight in the winter, people with SAD may have lower vitamin D levels, further reducing serotonin activity.\nOther studies suggest that both forms of SAD relate to \naltered levels of melatonin—a hormone important for maintaining the normal sleep−wake cycle. People with winter-pattern SAD produce too much melatonin, which can increase sleepiness and lead to oversleeping. \nIn contrast, people with summer-pattern SAD may have \nreduced melatonin levels, consistent with long, hot days worsening sleep quality and leading to depression symptoms. Longer daylight hours, shorter nights, and high temperatures can also cause sleep disruptions. However, these theories have not been systematically tested.",
    "Both serotonin and melatonin help maintain the body’s daily \nrhythm tied to the seasonal night−day cycle. In people with SAD, changes in serotonin and melatonin disrupt normal daily rhythms. As a result, they can no longer adjust to seasonal changes in day length, leading to sleep, mood, and behavior changes.\nNegative thoughts and feelings about the winter or summer \nand its associated limitations and stresses are also common among people with SAD (as well as others). It is unclear, however, whether these thoughts are causes or effects of the mood disorder, but they can be a useful focus of treatment.",
    "How is SAD treated?\nTreatments are available to help people with SAD. They fall \ninto four main categories that can be used alone or in combination:\n ●Light therapy\n ●Psychotherapy  ●Antidepressant medication\n ●Vitamin D\nLight therapy and vitamin D are treatments for winter-pattern SAD, whereas psychotherapy and antidepressants are used to treat depression in general, including winter- and summer-pattern SAD. There are no treatments specific to summer-pattern SAD. \nTalk to a health care provider about the potential benefits \nand risks of different treatment options and which treatment is best for you. NIMH has tips for talking with a health care provider at www.nimh.nih.gov/talkingtips .\nLight therapy\nSince the 1980s, light therapy has been a mainstay for treating winter-pattern SAD. It aims to expose people with SAD to a bright light to make up for the diminished natural sunlight in darker months.\nFor this treatment, the person sits in front of a very bright",
    "For this treatment, the person sits in front of a very bright \nlight box (10,000 lux) every day for about 30−45 minutes, usually first thing in the morning, from fall to spring. The light box, which is about 20 times brighter than ordinary indoor light, filters out the potentially damaging UV light, making this a safe treatment for most. However, people with certain eye diseases or people taking certain medications that increase sensitivity to sunlight may need to use alternative treatments or use light therapy under medical supervision.\nPsychotherapy\nPsychotherapy (also called talk therapy or counseling) can help people with SAD by teaching them new ways of thinking and behaving and changing habits that contribute to depression. \nCognitive behavioral therapy (CBT) is a type of psychotherapy",
    "Cognitive behavioral therapy (CBT) is a type of psychotherapy \naimed at helping people learn to challenge and change unhelpful thoughts and behaviors to improve their depressive and anxious feelings. CBT has been adapted for people with SAD (known as CBT-SAD). CBT-SAD is typically conducted in two weekly group sessions for 6 weeks that focus on replacing negative thoughts related to the season, such as thoughts about the darkness of winter or the heat of summer, with more positive thoughts. CBT-SAD also uses a process called behavioral activation, which helps people identify and schedule pleasant, engaging indoor or outdoor activities to offset the loss of interest they typically experience in the winter or summer.\nWhen researchers directly compared CBT-SAD with light",
    "When researchers directly compared CBT-SAD with light \ntherapy, both treatments were equally effective in improving SAD symptoms—although some symptoms got better slightly faster with light therapy than CBT. However, a long-term study that followed SAD patients for two winters found that the positive effects of CBT seemed to last longer. \nLearn more about psychotherapy at www.nimh.nih.gov/\npsychotherapies . \nAntidepressant medication\nMedications used to treat depression (antidepressants) can be effective for SAD when used alone or in combination with talk therapy. Antidepressants work by changing how the brain produces or uses certain chemicals involved in mood or stress. \nAntidepressants take time—usually 4−8 weeks—to work. \nProblems with sleep, appetite, and concentration often improve before mood lifts. It is important to give a medication a chance to work before deciding whether it is right for you. You may need to try several medications to find the one that works best.",
    "Because SAD, like other types of depression, is associated with \ndisturbances in serotonin activity, antidepressant medications called selective serotonin reuptake inhibitors are sometimes used to treat symptoms. These medications can significantly enhance a person’s mood. \nThe U.S. Food and Drug Administration (FDA) has approved \nan antidepressant called bupropion in an extended-release form designed to last longer in the body. For many people, bupropion can prevent the recurrence of seasonal depressive episodes when taken daily from the fall through early spring.\nAll medications can have side effects. Talk to a health care \nprovider before starting or stopping any medication. Learn more about antidepressants at www.nimh.nih.gov/medications . \nYou can also learn about specific medications like bupropion, including the latest approvals, side effects, warnings, and patient information, on the FDA website at www.fda.gov/drugsatfda . \nVitamin D",
    "Vitamin D\nBecause many people with winter-pattern SAD have vitamin D deficiency, vitamin D supplements may help improve symptoms. However, studies testing vitamin D as a treatment for SAD have produced mixed results, with some studies indicating that it is as effective as light therapy and other studies finding no effect.\nTalk to a health care provider about any dietary supplements \nand prescription or over-the-counter medications you are taking. Vitamin D can interact with some medications.",
    "For more information\nMedlinePlus (National Library of \nMedicine)  \nhttps://medlineplus.gov    \nhttps://medlineplus.gov/spanish  \n(en español)\nClinicalTrials.gov   \nwww.clinicaltrials.gov   \nhttps://salud.nih.gov/investigacion-\nclinica  (en español)Reprints\nNIH Publication No. 23-MH-8138  \nRevised 2023Follow NIMH on  \nSocial Media @NIMHgovCan SAD be prevented?\nBecause the onset of SAD is so predictable, people with a \nhistory of the disorder might benefit from starting the treatments mentioned above before the fall (for winter-pattern SAD) or spring (for summer-pattern SAD) to help prevent or reduce depression symptoms. To date, few studies have investigated whether SAD can be prevented. \nIt is helpful to discuss a personalized treatment plan with \na health care provider. A provider can help you decide not only the best treatment option but the best timing to help prevent SAD depressive episodes. What are clinical trials and why are \nthey important?",
    "they important?\nClinical trials are research studies that look at new ways to \nprevent, detect, or treat diseases and conditions. These studies help researchers determine if a new treatment is safe and effective in people. The main purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.\nPeople volunteer for clinical trials for many reasons. Some \npeople join clinical trials to help doctors and researchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try new or advanced treatments that aren’t widely available.\nNIMH supports clinical trials at the National Institutes of \nHealth campus in Bethesda, Maryland, and across the United States. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nThe information in this publication",
    "The information in this publication \nis in the public domain and may be reused or copied without permission. However, you may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy  to learn more about our guidelines  for reusing NIMH content at  www.nimh.nih.gov/copyright .National Institute of Mental Health  Office of Science Policy, Planning,  and Communications  \n6001 Executive Boulevard, MSC 9663 Bethesda, MD 20892-9663  \nToll-free: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov",
    "Do you have mild symptoms that \nhave lasted less than 2 weeks?\n●Feeling down but still able\nto take care of yourself andothers\n●Having some trouble sleeping\n●Having less energy than usualbut still able to do your job,schoolwork, or houseworkThese activities can make you feel better:\n●Doing something you enjoy\n ●Going outside in the sunlight\n●Spending time with familyand friends\n●Eating healthy and avoidingfoods with lots of sugarSeasonal Affective Disorder (SAD):\nMore Than the Winter Blues\nAs the days get shorter and there is less daylight, you may start to feel sad. While many \npeople experience the “winter blues,” some people may have a type of depression called seasonal affective disorder (SAD). \nThe first step is to determine how much your symptoms interfere with your daily life.\nFor help finding treatment, visit nimh.nih.gov/findhelp . \nIf you or someone you know is in immediate distress or is thinking about hurting themselves,",
    "If you or someone you know is in immediate distress or is thinking about hurting themselves, \ncall or text the 988 Suicide & Crisis Lifeline at 988 or chat at 988lifeline.org .Do you have more severe symptoms that have lasted more than 2 weeks?\n●Social withdrawal\n●Oversleeping\n●Gaining weight\n●Craving foods with lots of\nsugar like cakes, candies,and cookiesSeek professional help:\n●Light therapy\n●Psychotherapy (talk therapy)\n●Medications\n●Vitamin D supplements\nIf these activities do not help or your symptoms are getting worse, talk to a \nhealth care provider.\nnimh.nih.gov/ sad\nNIMH Identification No. OM 22-4320",
    "• Generally is a response to an \nexternal  cause, such as taking \na big test or arguing with  a friend.\n• Goes away once the situation is resolved. \n• Can be positive or negative. For example, it may inspire you to meet a deadline, or it may cause you to lose sleep. • Generally is internal,  meaning \nit’s your reaction to stress.\n• Usually involves a \npersistent feeling of \napprehension or \ndread that doesn’t go \naway, and that interferes \nwith how you live your life.\n• Is constant, even if there is no \nimmediate threat. Both stress and anxiety \ncan affect your mind and \nbody. You may experience \nsymptoms such as: \n• Excessive worry\n• Uneasiness\n• Tension\n• Headaches or body pain\n• High blood pressure\n• Loss of sleep\nnimh.nih.gov/stressandanxiety Find Help\nIf you are struggling to cope, or the symptoms of  \nyour stress or anxiety begin to interfere with your \neveryday life, it may be time to talk to a professional.  Find more information about getting help on the",
    "National Institute of Mental Health website at  www.nimh.nih.gov/findhelp .Ways to Cope\n• Keep a journal. \n• Download an app with relaxation exercises.\n• Exercise and eat healthy.\n• Get regular sleep. \n• Avoid excess caffeine. \n• Identify and challenge your negative thoughts. \n• Reach out to your friends or family.\nNIMH Identifier No. OM 20-4319 Is it stress or anxiety?I’M SO  STRESSED  \nOUT! \nStressBoth Stress  \nand Anxiety Anxiety",
    "Social \nAnxiety Disorder:  \nMore Than \nJust Shyness",
    "Are you afraid of being judged by others? Are you \nself-conscious in everyday social situations? Do you avoid meeting new people due to fear or anxiety? If \nyou have been feeling this way for at least 6 months \nand these feelings make it hard for you to do everyday tasks—such as talking to people at work or school—you may have social anxiety disorder.\nSocial anxiety disorder is an intense, persistent fear \nof being watched and judged by others. This fear can affect work, school, and other daily activities. It can even make it hard to make and keep friends. The good news is social anxiety disorder is treatable. Learn more about the symptoms of social anxiety disorder and how to find help.\nWhat is social anxiety disorder?\nSocial anxiety disorder is a common type of anxiety disorder. A person",
    "Social anxiety disorder is a common type of anxiety disorder. A person \nwith social anxiety disorder feels symptoms of anxiety or fear in situations where they may be scrutinized, evaluated, or judged by others, such as speaking in public, meeting new people, dating, being on a job interview, answering a question in class, or having to talk to a cashier in a store. Doing everyday things, such as eating or drinking in front of others or using a public restroom, also may cause anxiety or fear due to concerns about being humiliated, judged, and rejected. \nThe fear that people with social anxiety disorder have in social situations",
    "The fear that people with social anxiety disorder have in social situations \nis so intense that they feel it is beyond their control. For some people, this fear may get in the way of going to work, attending school, or doing everyday things. Other people may be able to accomplish these activities but experience a great deal of fear or anxiety when they do. People with social anxiety disorder may worry about engaging in social situations for weeks before they happen. Sometimes, they end up avoiding places or events that cause distress or generate feelings of embarrassment.",
    "Some people with the disorder do not have anxiety related to social \ninteractions but have it during performances instead. They feel symptoms of anxiety in situations such as giving a speech, competing in a sports game, or playing a musical instrument on stage.\nSocial anxiety disorder usually starts during late childhood and may resemble \nextreme shyness or avoidance of situations or social interactions. It occurs more frequently in females than in males, and this gender difference is more pronounced in adolescents and young adults. Without treatment, social anxiety disorder can last for many years, or even a lifetime.\nWhat are the signs and symptoms of \nsocial anxiety disorder?\nWhen having to perform in front of or be around others, people with social \nanxiety disorder may: \n ●Blush, sweat, or tremble. \n ●Have a rapid heart rate. \n ●Feel their “mind going blank,” or feel sick to their stomach.\n ●Have a rigid body posture, or speak with an overly soft voice.",
    "●Have a rigid body posture, or speak with an overly soft voice.\n ●Find it difficult to make eye contact, be around people they don’t know, or talk to people in social situations, even when they want to.\n ●Feel self-consciousness or fear that people will judge them negatively.\n ●Avoid places where there are other people.\nWhat causes social anxiety disorder?\nRisk for social anxiety disorder may run in families, but no one knows for sure why some family members have it while others don’t. Researchers have found that several parts of the brain are involved in fear and anxiety and that genetics influences how these areas function. By studying how the brain and body interact in people with social anxiety disorder, researchers may be able to create more targeted treatments. In addition, researchers are looking at the ways stress and environmental factors play a role in the disorder.",
    "How is social anxiety disorder treated?\nIf you’re concerned you may have symptoms of social anxiety disorder, talk \nto a health care provider. After discussing your history, a health care provider may conduct a physical exam to ensure that an unrelated physical \nproblem is not causing your symptoms. A health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, or clinical social worker. The first step to effective treatment is to get a diagnosis, usually from a mental health professional.\nSocial anxiety disorder is generally treated with psychotherapy (sometimes \ncalled “talk therapy”), medication, or both. Speak with a health care provider about the best treatment for  you. \nPsychotherapy",
    "Psychotherapy\nCognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful. CBT also can help  you learn and practice social skills, which is very important for treating social anxiety disorder. CBT has been well studied and is the gold standard for psychotherapy. \nExposure therapy is a CBT method that focuses on progressively \nconfronting the fears underlying an anxiety disorder to help you engage  in activities you have been avoiding. Exposure therapy is sometimes used along with relaxation exercises. CBT delivered in a group therapy format also can offer unique benefits for social anxiety disorder. \nAnother treatment option for social anxiety disorder is acceptance and",
    "Another treatment option for social anxiety disorder is acceptance and \ncommitment therapy (ACT). ACT takes a different approach than CBT to negative thoughts and uses strategies such as mindfulness and goal setting to reduce your discomfort and anxiety. Compared to CBT, ACT is a newer form of psychotherapy treatment, so less data are available on its effectiveness. However, different therapies work for different types of people, so it can be helpful to discuss what form of therapy may be right for you with a mental health professional.\nFor more information on psychotherapy, visit www.nimh.nih.gov/\npsychotherapies .",
    "Medication\nHealth care providers may prescribe medication to treat social anxiety \ndisorder. Different types of medication can be effective in treating this disorder, including:\n ●Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)\n ●Beta-blockers\n ●Anti-anxiety medications, such as benzodiazepines\nSSRI and SNRI antidepressants are commonly used to treat depression, but they also can help treat the symptoms of social anxiety disorder. They may take several weeks to start working. Antidepressants may also cause side effects, such as headaches, nausea, or difficulty sleeping. These side effects are usually not severe, especially if the dose starts off low and is increased slowly over time. Talk to your health care provider about any side effects that you may experience.\nBeta-blockers can help control some of the physical symptoms of social",
    "Beta-blockers can help control some of the physical symptoms of social \nanxiety disorder, such as rapid heart rate, sweating, and tremors. Beta-blockers are commonly the medication of choice for the “performance anxiety” type of social anxiety disorder.\nBenzodiazepines, which are anti-anxiety sedative medications, are \npowerful and begin working right away to reduce anxious feelings. These medications can be very effective in rapidly decreasing anxiety, but some people build up a tolerance to them and need higher and higher doses to get the same effect. Some people even become dependent on them. Therefore, a health care provider may prescribe them only for brief periods of time if you need them.\nBoth psychotherapy and medication can take some time to work. Many",
    "Both psychotherapy and medication can take some time to work. Many \npeople try more than one medication before finding the best one for them. A health care provider can work with you to find the best medication, dose, and duration of treatment for you. People with social anxiety disorder usually obtain the best results with a combination of medication and CBT or other psychotherapies. \nFor basic information about these and other mental health medications, \nvisit www.nimh.nih.gov/medications . Visit the Food and Drug Administration’s \nwebsite ( www.fda.gov/drugsatfda ) for the latest warnings, patient \nmedication guides, and information on newly approved medications.",
    "Support Groups\nMany people with social anxiety find support groups helpful. In a group of \npeople who all have social anxiety disorder, you can receive unbiased, honest feedback about how others in the group see you. This way, you can learn that your thoughts about judgment and rejection are not true or are distorted. You also can learn how others with social anxiety disorder approach and overcome the fear of social situations.\nSupport groups are available both in person and online. However, any \nadvice you receive from a support group member should be used cautiously and does not replace treatment recommendations from a health care provider. \nBoth psychotherapy and medication can take some time to work. A healthy \nlifestyle also can help combat anxiety. Make sure to get enough sleep and exercise, eat a healthy diet, and turn to family and friends who you trust  for support. To learn more ways to take care of your mental health, visit www.nimh.nih.gov/mymentalhealth .",
    "How can I support myself and others with social \nanxiety disorder?\nEducate Yourself\nA good way to help yourself or a loved one who may be struggling with \nsocial anxiety disorder is to seek information. Research the warning signs, learn about treatment options, and keep up to date with current research.\nCommunicate\nIf you are experiencing social anxiety disorder symptoms, have an honest conversation about how you’re feeling with someone you trust. If you think that a friend or family member may be struggling with social anxiety disorder, set aside a time to talk with them to express your concern and reassure them of your support.\nKnow When to Seek Help\nIf your anxiety, or the anxiety of a loved one, starts to cause problems in everyday life—such as avoiding social situations at school, at work, or with friends and family—it’s time to seek professional help. Talk to a health care provider about your mental health.",
    "Are there clinical trials studying  \nsocial anxiety disorder?\nNIMH supports a wide range of research, including clinical trials that look \nat new ways to prevent, detect, or treat diseases and conditions—including social anxiety disorder. Although individuals 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.\nResearchers at NIMH and around the country conduct clinical trials with \npatients and healthy volunteers. Talk to a health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nFinding Help\nBehavioral Health Treatment Services Locator",
    "Finding Help\nBehavioral Health Treatment Services Locator \nThis online resource, provided by the Substance Abuse and Mental Health Services Administration, helps you locate mental health treatment facilities and programs. Find a facility in your state at https://findtreatment.samhsa.gov . For additional resources, visit www.nimh.nih.gov/findhelp . \nTalking to a Health Care Provider About Your Mental Health \nCommunicating well with a health care provider can improve your care and help you both make good choices about your health. Find tips to help prepare for and get the most out of your visit at www.nimh.nih.gov/talkingtips . For \nadditional resources, including questions to ask a provider, visit the Agency for Healthcare Research and Quality website at www.ahrq.gov/questions . \nIf you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline",
    "toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website at https://suicidepreventionlifeline.org .",
    "Reprints\nThis publication is in the public domain and may be reproduced or copied \nwithout permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH \nInformation Resource Center at 1-866-615-6464, email nimhinfo@nih.gov , \nor refer to NIMH’s reprint guidelines at www.nimh.nih.gov/reprints .\nFor More Information\nNIMH website  \nwww.nimh.nih.gov   \nwww.nimh.nih.gov/espanol  (en español)\nMedline Plus (National Library of Medicine) \nhttps://medlineplus.gov   \nhttps://medlineplus.gov/spanish  (en español)\nClinicalTrials.gov  \nwww.clinicaltrials.gov  \nhttps://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health \nOffice of Science Policy, Planning, and Communications 6001 Executive Boulevard  \nRoom 6200, MSC 9663 Bethesda, MD 20892-9663 Toll-free: 1-866-615-6464  \nEmail: nimhinfo@nih.gov  \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES",
    "Email: nimhinfo@nih.gov  \nWebsite: www.nimh.nih.gov\nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES  \nNational Institutes of Health \nNIH Publication No. 22-MH-8083 Revised 2022",
    "Stand Up to stress!\nA Coloring &  \nActivity Book\nFor Kids Ages 8–12\nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  \n\nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  \nStand Up to stress!\nA Coloring &  \nActivity Book\nFor Kids Ages 8–12\nThe National Institute of Mental Health (NIMH) is the lead federal agency for research \non mental disorders. NIMH is one of the 27 Institutes and Centers that make up the \nNational Institutes of Health (NIH), the nation’s largest medical research agency.  \nNIH is part of the U.S. Department of Health and Human Services.",
    "STAND UP TO STRESS! 1What Is Stress?\nStress is how the brain and body respond to any type of challenge, such as a test in school \nor a difficult talk with a friend. Stress can lead to good or bad things. For example, it might help you meet an important deadline, or it might make it harder to get a good night’s sleep.\nEveryone experiences stress from time to time, and that is okay. But too much stress over a \nlong time can be bad for your health. Learn about the causes of stress and how to handle it!\n\n2 STAND UP TO STRESS!What Causes Stress? \nstress fact\nLots of things in your life can cause stress. Sometimes, you might feel overwhelmed because there’s so \nmuch going on at once—like having a lot of homework or activities. Other times, it might be because something is making you feel nervous or worried, like an upcoming test or a tricky situation with friends or family. The good news is there are ways to help your body calm down and handle stress.",
    "STAND UP TO STRESS! 3Sleep\nstress fact\nSleep can affect how well you think, react, work, learn, and get along with others. Try to have a healthy \nbedtime routine. Going to bed and waking up at the same time each day and turning off your phone, tablet, or laptop before bed can help you sleep better and may reduce your stress.\n\n4 STAND UP TO STRESS!Be Active!\nstress fact\nGetting 30 minutes of exercise each day helps your body and brain stay healthy and strong. Even  \n5–10 minutes of being active can help you feel better and reduce stress!\n\nSTAND UP TO STRESS! 5Friends and Famil y \nstress fact\nTalking to your friends and family—in person, on the phone, or online—can make you feel happier and \nhealthier. You can also talk to a trusted adult, like a parent or teacher, if you start to feel overwhelmed. Talking about your feelings with friends and family can remind you that you’re not alone and help you feel better.",
    "6 STAND UP TO STRESS!Eating Well\nstress fact \nEating healthy food fuels your body! Making healthy food \nchoices helps reduce stress by keeping your heart and brain healthy and giving you the energy to stay active.\n\nSTAND UP TO STRESS! 7Mindfulness \nstress fact \nMindfulness is like giving your brain a little break to focus on what’s happening right now. You can \npractice mindfulness in different ways, like paying attention to your breathing, feeling the warmth of the sun on your skin, or listening carefully to the sounds in nature. Paying attention to positive feelings and thinking about the good things in your life can help you develop a positive mindset, which helps reduce stress.",
    "8 STAND UP TO STRESS!Let’s Relax!\nstress fact \nTaking time to relax is important because it helps your body and mind rest. Quiet activities like reading \na book, coloring, taking a bath, or cuddling a pet can also help you feel calm and less worried. Try the activity below to help you relax and handle stressful feelings. \ntense and Relax \nStress can make your muscles feel tight. Your whole body might feel stiff like an uncooked spaghetti noodle. Because the body and mind are connected, relaxing tight muscles can help you feel calmer. You can do this activity before bed or anywhere. Be sure to practice it often! Afterwards, you will notice how much more relaxed your body feels. \n1. S\ntart by tensing your feet and curling your toes. \nImagine you’re digging your toes into the sand \nor wet, squishy mud. Relax your toes and take a deep breath in and out. 2.   Pretend you’re a puppet with strings attached to your feet. Relax your legs and take a deep breath in and out.",
    "STAND UP TO STRESS! 93. Tense your stomach. Imagine that a puppy is \nabout to jump on you. Relax your stomach and take a deep breath in and out.4.  Tense your hands by making fists. Pretend you’re trying to squeeze all the juice out of a lemon. Relax your hands and take a deep breath in and out.\n5. Tense your shoulders by pulling them up to your ears. Think of yourself as a turtle going into its shell. Relax your shoulders, bring your head out of its shell, and take a deep breath in and out.6.  Tense your face by scrunching it up. Pretend you’re eating a really sour candy. Relax your face and take a deep breath in and out",
    "10 STAND UP TO STRESS!Can you find these Signs of stress?\nYour mind and your body are connected.  \nToo much stress in your brain can cause your body to feel bad.  \nSearch up, down, forward, and diagonally to find the hidden words.\nN Y L S S J O N T S B X J C T O H N P L\nY Y M O T H P E L Z U U K A F F O H X A\nO H H D Q O A B B R S W E A T I N G T K\nL T Z J A Y M K T B Y G Z M S Q J C V W\nF K S A L P Q A I Z T N R N S B N C M S\nH E A D A C H E C N F U E L C Q E X C M\nQ M X V P F F K M H G T X K I G R V S J\nN V E F T J A D P B A P V M N D V R G T\nJ K E W Q E L P F G D C D I A I O X B S\nI G   R U M P Y I L I T Y H N W Z U U I L\nT I R E D U X O G J N A X E O Z S Z Y S\nV Z V Q R T V V T X E N R Q R I H O I Q\nO G V N W P I R S W I S G F R N H K R R\nD N L A F E F Z S R X Y G W Y E S M V Z\nA C H V Z G M K S U E A G K U S S P F B\nB N O W W V X C P M S U Q K A S N U D T\nT K G Z IW X F T R K G B M X I B G R O\nT G N E L D IW D D F P Z P A B Q J F H\nA F W V R G A B O C R X Z P H Y V G U B",
    "T G N E L D IW D D F P Z P A B Q J F H\nA F W V R G A B O C R X Z P H Y V G U B\nB G C L A D A W G D L V F G L X R R W Y\nANGER  \nH\nEADACHE  \nSHAKING  \nTENSION  DIZZINESS  \nNERVOUS\nSTOMACHACHE\nTIREDGRUMPY \nPAIN\nSWEATING\nWORRY\nAnswers can be found on page 13.",
    "STAND UP TO STRESS! 11Test Your Knowledge of  \nHealthy Coping Skills\nUse the word bank to solve the crossword clues below.\n1\n4\n62 1\n5\n7\n8 Word bank \nAdult\nBreathExerciseFoodMindfulness MindsetRelaxRoutine \nacross\n1. To help calm your body, take a deep __________, count to 5, and let it out slowly. \n3. Activities like drawing, coloring, or reading can help you __________. \n6. Pay attention to positive feelings so you can develop a positive __________. \n7. Choosing healthy __________ fuels your body and your brain!\n8. Not getting enough sleep can increase your stress, so it’s important to have a good bedtime \n__________. \nDOWN\n2. Even 10 minutes a day of __________, like walking or running, can help you feel better. \n4. If you start to feel overwhelmed, you can always talk to a trusted __________. \n5. Slowing down and paying attention to the warmth of the sun on your skin is an example of __________.\nAnswers can be found on page 14.3",
    "12 STAND UP TO STRESS!Check Your Emotion Temperature \nSometimes your emotions feel like they might boil over! Write down some situations that might cause \nstress, like moving to a new house or school, or arguing with a friend. Then, starting at the bottom on \nthe left side, name some emotions you might feel in those situations, from most calm (1) to most upset \n(5). On the right side, fill in actions that might help you cope when you have those emotions. You can \nuse the words in the word banks or come up with your own ideas.\nMy situations: \n 1. _______________________________\n 2. _______________________________\n 3. _______________________________ 4. _______________________________\n 5. _______________________________\nemOtiOn ThermOmeter\n0emOtiOns actiOns5\n4\n3\n2\n1\nemOtiOns WORD BANK\nAngry\nAnnoyed\nBothered\nCalm\nDisappointedFrustrated\nFurious\nGrumpy\nUpset\nNervousactiONS word bank\nAppreciate the \nmoment\nCount to 10\nFind something funny\nImagine a beautiful \nplace\nListen to or play",
    "moment\nCount to 10\nFind something funny\nImagine a beautiful \nplace\nListen to or play \nmusic Sit somewhere quiet\nTake a deep breath \nTake a walk\nTalk with a trusted \nadult or friend\nTense and relax \nexercise\nWrite in a journal",
    "STAND UP TO STRESS! 13Answers to  \nActivity Puzzles\nanswers to “can you find these signs of stress?” (from page 10)\nN Y LSS J O N T S B X J C T O HN P L\nY Y M OTH P E L Z U U K A F FO H X A\nO H H D QOA B B RSWEATING T K\nL T Z J A YMK T B Y G Z MS Q J C V W\nF K S A L P QAI Z T N RN S BN C M S\nHEADACHECN F UE L C QE X C M\nQ M X V P F F K MHGT X K I GR V S J\nN V E F T J A D P BA P V M NDV R G T\nJ K E W Q E L P F G DC D I AIO X B S\nIGRUMPY I L I T YH NWZU U I L\nTIRED U X O G J N A XEOZS Z Y S\nV Z V Q R T V V T X E N R QRI H O I Q\nO G V N W P I R S W I S G FRN H K R R\nD N L A F E F Z S R X Y G WYE S M V Z\nA C H V Z G M K S U E A G K US S P F B\nBN O W W V X C P M S U Q K ASN U D T\nT KG Z IW X F T R K G B M XI B G R O\nT G NE L D IW D D F P Z PA B Q J F H\nA F W VR G A B O C R X ZP H Y V G U B\nB G C L A D A W G D L V F G L X R R W Y",
    "14 STAND UP TO STRESS!answers to “test your knowledge of healthy coping skills” \n(from page 11) \nacross \n1. Breath\n3. Relax\n6. Mindset\n7. Food\n8. Routinedown \n2. Exercise\n4. Adult\n5. Mindfulness\nOM1\nR UT I O EELA\nUXX\nE\nR\nC\nI\nS\nEE\nD\nL\nT4\nN\nD\nF\nU\nL\nN\nS\nSM\n6BR AT\nEH2 1\nT DS NI5\nO F7\n8 3\n\nStand Up to stress!\nU.S. DEPARTMENT OF HEALTH  \nAND HUMAN SERVICES National Institutes of HealthNIH Publication No. 24-MH-8156Revised 2024\nFor more information about mental health, visit \nthe NIMH website at  www.nimh.nih.gov . For \ninformation on a wide variety of health topics,  \nvisit the National Library of Medicine’s MedlinePlus service at https://medlineplus.gov .\nReprints  \nThe information in this publication is in the public domain and may be reused or copied without permission. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .",
    "Suicide is a leading cause of death in the United States \nand a major public health concern. When a person dies  \nby suicide, the effects are felt by family, friends, and communities. This brochure can help you, a friend, or a family member learn more about the warning signs of suicide, ways to help prevent suicide, and effective treatment options.\nIF YOU OR SOMEONE YOU KNOW IS IN CRISIS: \nCall or text the 988 Suicide & Crisis Lifeline at 988  or chat at \n988lifeline.org . The Lifeline provides free and confidential support to \npeople in suicidal crisis or emotional distress 24 hours a day,  \n7 days a week, across the United States.\nCall 911  in life-threatening situations.\nFREQUENTLY ASKED QUESTIONS \nAbout Suicide",
    "What is suicide?\nSuicide  is when people harm themselves with the goal of ending their life, and \nthey die as a result. \nA suicide attempt is when people harm themselves with the goal of ending \ntheir life, but they do not die.\nAvoid using terms such as “committing suicide,” “successful suicide,” or “failed \nsuicide” when referring to suicide and suicide attempts, as these terms often carry negative meanings.\nWho is at risk for suicide?\nPeople of all genders, ages, and ethnicities can be at risk for suicide.\nThe main risk factors for suicide are:\n ●A history of suicide attempts\n ●Depression, other mental disorders, or substance use disorder\n ●Chronic pain\n ●Family history of a mental disorder or substance use\n ●Family history of suicide\n ●Exposure to family violence, including physical or sexual abuse\n ●Presence of guns or other firearms in the home\n ●Having recently been released from prison or jail\n ●Exposure, either directly or indirectly, to others’ suicidal behavior, such as",
    "●Exposure, either directly or indirectly, to others’ suicidal behavior, such as \nthat of family members, peers, or celebrities\nMost people who have risk factors for suicide 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.\nStressful life events (such as the loss of a loved one, legal troubles, or financial \ndifficulties) 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.",
    "What are the warning signs of suicide?\nWarning signs that someone may be at immediate risk for attempting  \nsuicide include:\n ●Talking about wanting to die or wanting to kill themselves\n ●Talking about feeling empty or hopeless or having no reason to live\n ●Talking about feeling trapped or feeling that there are no solutions\n ●Feeling unbearable emotional or physical pain\n ●Talking about being a burden to others\n ●Withdrawing from family and friends\n ●Giving away important possessions\n ●Saying goodbye to friends and family\n ●Putting affairs in order, such as making a will\n ●Taking great risks that could lead to death, such as driving extremely fast\n ●Talking or thinking about death often\nOther serious warning signs that someone may be at risk for attempting \nsuicide include:\n ●Displaying extreme mood swings, suddenly changing from very sad to very calm or happy",
    "●Displaying extreme mood swings, suddenly changing from very sad to very calm or happy\n ●Making a plan or looking for ways to kill themselves, such as searching for lethal methods online, stockpiling pills, or buying a gun\n ●Talking about feeling great guilt or shame\n ●Using alcohol or drugs more often\n ●Acting anxious or agitated\n ●Changing eating or sleeping habits\n ●Showing rage or talking about seeking revenge",
    "What treatment options and therapies are available?\nEffective, evidence-based interventions are available to help people who are \nat risk for suicide: \n ●Cognitive Behavioral Therapy (CBT) : CBT is a type of psychotherapy that \ncan help people learn new ways of dealing with stressful experiences. CBT helps people learn to recognize their thought patterns and consider alternative actions when thoughts of suicide arise.\n ●Dialectical Behavior Therapy (DBT) : DBT is a type of psychotherapy that \nhas been shown to reduce suicidal behavior in adolescents. DBT also has \nbeen shown to reduce the rate of suicide attempts in adults with borderline",
    "been shown to reduce the rate of suicide attempts in adults with borderline \npersonality disorder, a mental illness characterized by an ongoing pattern of varying moods, self-image, and behavior that often results in impulsive actions and problems in relationships. A therapist trained in DBT can help a person recognize when their feelings or actions are disruptive or unhealthy and teach the person skills that can help them cope more effectively with upsetting situations.",
    "●Brief Intervention Strategies: Research has shown that creating a safety plan or crisis response plan—with specific instructions for what to do and how to get help when having thoughts about suicide—can help reduce a person’s risk of acting on suicidal thoughts. Staying connected and following up with people who are at risk for suicide also has been shown to help lower the risk of future suicide attempts. Research also has shown that increasing safe storage of lethal means can help reduce suicide attempts and deaths by suicide. In addition, collaborative assessment and management of suicide risk can help to reduce suicidal thoughts.\n ●Collaborative Care : Collaborative care is a team-based approach to mental \nhealth 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.",
    "What should I do if I am struggling or someone I \nknow is having thoughts of suicide?\nIf you notice warning signs of suicide—especially a change in behavior or \nnew, concerning behavior—get help as soon as possible. \nFamily and friends are often the first to recognize the warning signs of  \nsuicide, and they can take the first step toward helping a loved one find mental health treatment. \nIf someone tells you that they are going to kill themselves, do not leave them \nalone. Do not promise that you will keep their suicidal thoughts a secret—tell a trusted friend, family member, or other trusted adult. \nCall 911  if there is an immediate life-threatening situation.\nYou also can contact: 988 Suicide & Crisis Lifeline \n988lifeline.org",
    "You also can contact: 988 Suicide & Crisis Lifeline \n988lifeline.org  \nCall or text 988; Llame al 988 (para ayuda en español) 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. Support is also available in English via chat at 988lifeline.org .\nWhat if I see suicidal messages on social media?\nKnowing how to get help when someone posts suicidal messages can help save a life. Many social media sites have a process to get help for the person posting the message. To learn more, visit the 988 Suicide & Crisis Lifeline’s webpage about safety and support on social media at https://988lifeline.org/\nhelp-someone-else/safety-and-support-on-social-media .\nIf you see messages or live streaming content that suggests someone is actively engaging in suicidal behavior,  you can contact safety teams at the",
    "social media company. They will reach out to connect the person with the help they need.",
    "Does asking someone about suicide  \nput the idea in their head?\nNo. Studies have shown that asking people about suicidal thoughts and \nbehaviors does not cause or increase such thoughts. Asking someone directly, “Are you thinking of killing yourself?” can be the best way to identify someone at risk for suicide.\nDo people “threaten” suicide to get attention?\nSuicidal thoughts or actions are a sign of extreme distress and an indicator that someone needs help. Talking about wanting to die by suicide is not a typical response to stress. All talk of suicide should be taken seriously and requires immediate attention. \nHow do suicide rates differ among groups of people? \nData show that the rates of suicide attempts and suicide deaths vary \naccording to characteristics such as age, gender, race, ethnicity, and \ngeographic location. The most recent statistics and information on suicide  \nrisk are available on the Centers for Disease Control and Prevention website",
    "risk are available on the Centers for Disease Control and Prevention website \nat www. cdc.gov/suicide and the National Institute of Mental Health’s  \nwebsite at www.nimh.nih.g ov/suicidestats. \nHow can I find help for mental health concern s?\nIf you have concerns about your mental health, tell your health care provider. \nYour health care provider will listen to your concerns and can help you figure out next steps. Find tips for talking with your doctor about mental health concerns at www.nimh.nih.gov/talkingtips .\nTo find mental health treatment facilities in your area, call the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-662-4357, visit their website at https://findtreatment.gov , or text your\nZIP code to 435748.",
    "Where can I learn about NIMH research on suicide?\nNIMH supports promising research that is likely to have an impact on reducing \nsuicide in the United States. Research is helping improve our ability to identify people at risk for suicide and to develop and improve effective treatments. NIMH researchers continue to study suicide and how to best implement suicide prevention and intervention programs in different settings, including health care, community, school, and the justice system. \nTo learn more about NIMH research priorities and recent research on suicide \nprevention, visit the NIMH website at www.nimh.nih.gov . \nFor additional information about suicide prevention efforts, visit the National Action Alliance for Suicide Prevention at https://theactionalliance.org  and \nZero Suicide at http://zerosuicide.sprc.org . \nWhat should I know about clinical trials?",
    "Zero Suicide at http://zerosuicide.sprc.org . \nWhat should I know about clinical trials?\nClinical trials are research studies that look at new ways to prevent, detect,  or treat diseases and conditions. Although individuals 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.\nTalk to your health care provider about clinical trials, their benefits and  \nrisks, and whether one is right for you. For more information, visit  \nwww.nimh.nih.gov/clinicaltrials .",
    "Reprints\nThis publication is in the public domain and may be reproduced or copied \nwithout permission from NIMH. We encourage you to reproduce and use NIMH publications in your efforts to improve public health. If you do use our materials, we request that you cite the National Institute of Mental Health. To learn more about using NIMH publications, refer to www.nimh.nih.gov/reprints . \nFor More Information\nNIMH website  www.nimh.nih.gov   \nwww.nimh.nih.gov/espanol  (en español)\nMedlinePlus (National Library of Medicine)  https://medlineplus.gov   \nhttps://medlineplus.gov/spanish  (en español)\nClinicalTrials.gov  \nwww.clinicaltrials.gov   \nhttps://salud.nih.gov/investigacion-clinica  (en español)\nNational Institute of Mental Health  Office of Science Policy, Planning, and Communications  6001 Executive Boulevard  Room 6200, MSC 9663  Bethesda, MD 20892-9663  Toll-free: 1-866-615-6464  Email: nimhinfo@nih.gov   \nWebsite: www.nimh.nih.gov",
    "Website: www.nimh.nih.gov  \nU.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health NIH Publication No. 23-MH-6389\nRevised 2023",
    "Brain development is related to social \nexperiences during adolescence.\nChanges to the areas of the brain responsible for social processes can \nlead teens to focus more on peer relationships and social experiences. The emphasis on peer relationships, along with ongoing prefrontal cortex development, might lead teens to take more risks because the social benefits outweigh the possible consequences of a decision. These risks could be negative or dangerous, or they could be positive, such as talking to a new classmate or joining a new club or sport.\nAdolescence is an important  \ntime for brain development.\nAlthough the brain stops growing in size by early adolescence,",
    "time for brain development.\nAlthough the brain stops growing in size by early adolescence, \nthe teen years are all about fine-tuning how the brain works. The brain finishes developing and maturing in the mid-to-late 20s. The part of the brain behind the forehead, called the prefrontal cortex, is one of the last parts to mature. This area is responsible for skills like planning, prioritizing, and making good decisions.The Teen Brain: 7 Things to Know\nThe teen brain is ready to learn  \nand adapt.\nThe teen brain has an amazing ability to adapt and respond to \nnew experiences and situations. Taking challenging classes, exercising, and engaging in creative activities like art or music can strengthen brain circuits and help the brain mature.\nTeen brains may respond differently to stress.",
    "Teen brains may respond differently to stress.\nBecause the teen brain is still developing, teens may respond to stress differently than adults. This could increase teens’ chances of developing stress-related mental illnesses such as anxiety and depression. Recognizing possible triggers and practicing effective coping techniques can help teens deal with stress. More information on managing stress is available at www.nimh.nih.gov/stress .1\n2\n3From the NATIONAL INSTITUTE of  MENTAL HEALTH\nDid you know that big  and important changes  happen in the brain during \nadolescence? Here are  seven things to know about the teen brain :\n4",
    "If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & \nCrisis Lifeline at  988  or chat at  988lifeline.org. In life-threatening situations, call 911. The teen brain is resilient.\nDespite the stresses and challenges that come with adolescence, most teens go on to become healthy adults. Some changes in the brain during this critical phase of development actually help support resilience and mental health over the long term.\nFinding help\nIf you or someone you know has a mental illness, is struggling emotionally, or has concerns about their  \nmental health, there are ways to get help. Find more information at  www.nimh.nih.gov/findhelp .\nTalking openly with your doctor or other health care provider can improve your care and help you both  \nmake good choices about your health. Find tips to help prepare for and get the most out of your visit at  \nwww.nimh.nih.gov/talkingtips.\n \nNIH Publication No. 23-MH-8078",
    "www.nimh.nih.gov/talkingtips.\n \nNIH Publication No. 23-MH-8078\nRevised 2023www.nimh.nih.govMost teens do not get enough sleep.\nResearch shows that the sleep hormone melatonin works \ndifferently in teens than in children and adults. In adolescence, melatonin levels stay high later at night and drop later in the morning, which may explain why teens may stay up late and struggle with waking up early. Many teens do not get enough sleep, making it harder to pay attention, control impulses, and do well at school. Getting good sleep at night can help support mental health.  5\n6Mental illnesses may begin to appear  \nduring adolescence.\nOngoing changes in the brain, along with physical, emotional, and  \nsocial changes, can make teens more likely to experience mental  \nhealth problems. The fact that all these changes happen at one  \ntime may explain why many mental illnesses—such as schizophrenia, anxiety, depression, bipolar disorder, and eating disorders—emerge during adolescence. \n7",
    "Tips for Talking With a \nHealth Care Provider  \nAbout Your Mental Health\nDon’t wait for a health care provider to ask about your mental health. \nStart the conversation. Here are five tips to help prepare and guide you on talking to a health care provider about your mental health and getting the most out of your visit.\n1. Talk to a primary care provider.\nIf you don’t know where to start for help, you may want to consider bringing up your mental \nhealth concerns during your appointment with a primary care provider (PCP) . A PCP is a health \ncare practitioner people see for common medical problems, and this person is often a doctor. However, a PCP may be a physician assistant or a nurse practitioner. \nMental health is an integral part of health, and people with mental disorders can often be at risk \nfor other medical conditions , such as heart disease or diabetes. In many primary care settings,",
    "for other medical conditions , such as heart disease or diabetes. In many primary care settings, \nyou may be asked if you’re feeling anxious or depressed, or if you have had thoughts of suicide. Even if your PCP doesn’t ask you first, take this opportunity to talk to your PCP, who can help \nrefer you to a mental health professional. You also can visit the NIMH Find Help for Mental \nIllnesses  webpage for help finding a health care provider or treatment.\n2. Prepare ahead of your visit.\nHealth care providers have a limited time for each appointment, so it may be helpful to think of \nyour questions or concerns beforehand.\n ●Prepare your questions.  Make a list of what you want to discuss and any questions or concerns\nyou might have. This worksheet  may help you prepare your questions or concerns.",
    "you might have. This worksheet  may help you prepare your questions or concerns.\n● Prepare a list of your medications. It’s important to tell your health care provider about all themedications you’re taking, including over-the-counter (nonprescription) drugs, herbal remedies,vitamins, and supplements. This worksheet  can help you track your medications.\n● Review your family history.  Certain mental illnesses tend to run in families and having a relative\nwith a mental disorder could mean you’re at higher risk. Knowing your family mental healthhistory  can help determine your risk for certain disorders. It can also help your health care\nprovider recommend actions for reducing your risk and enable you and your provider to lookfor early warning signs.",
    "NIH Publication No. 22-MH-8094Follow NIMH on  \nSocial Media @NIMHgovwww.nimh.nih.gov 3. Consider bringing a friend or relative.\nIt can be difficult to absorb all the information your health care provider shares, especially if \nyou are not feeling well. Sometimes it’s helpful to bring a close friend or relative to your \nappointment. A companion can be there for support, help you take notes, and remember what \nyou and the provider discussed. They also might be able to offer input to your provider about \nhow they think you are doing. Some people like having a friend or family member there \nthroughout an appointment, while other s pref er to first meet alone with a health care provider \nand then have a trusted friend or relative join them w hen recommendati ons for treatments \nare discussed.\n4. Be honest.\nYour health care provider can help you get better only if you have open and honest",
    "4. Be honest.\nYour health care provider can help you get better only if you have open and honest \ncommunication. It is important to remember that discussions between you and a health care provider are private and cannot be shared with anyone without your expressed permission. Describe all your symptoms to your provider and be specific about when they started, how severe they are, and how often they occur. You should also share any major stressors or recent life changes that could be triggering or exacerbating your symptoms.\nSymptoms of mental illnesses may include:\n● Persistent sad, anxious, or “empty” mood\n● Feelings of hopelessness or pessimism\n● Irritability\n● Feelings of guilt, worthlessness, or helplessness\n● Loss of interest or pleasure in hobbies and activities\n● Decreased energy or fatigue\n● Moving or talking more slowly\n● Feeling restless or having trouble sitting still\n● Difficulty concentrating, remembering, or making decisions",
    "● Difficulty concentrating, remembering, or making decisions\n● Difficulty sleeping, early-morning awakening, or oversleeping\n● Appetite or weight changes (or both)\n● Thoughts of death or suicide, or suicide attempts\n● Aches or pains, headaches, cramps, or digestive problems without a clear\np\nhysical cause and/or that do not ease even with treatment\n5. Ask questions.\nIf you have questions or concerns, ask the health care provider for more information about the mental health diagnosis or treatment. If a provider suggests a treatment option that you’re not comfortable or familiar with, express your concerns and ask if there are other options. You may decide to try a combination of treatment approaches and want to consider getting another opinion from a different health care provider. It’s important to remember that there is no “one-size-fits-all” treatment. To find one that works best for you, you may need to talk to a few",
    "other health care providers to find someone you are comfortable with and try several different treatments or a combination of treatments.",
    "What is a chronic disease?\nA chronic disease is a condition that lasts at least \none year and requires ongoing medical attention or limits activities of daily living or both. Examples of chronic diseases include autoimmune diseases, diabetes, cancer, epilepsy, heart disease, HIV/AIDS, hypothyroidism, multiple sclerosis, and pain.\nCan chronic disease lead  \nto depression?\nPeople who have a chronic disease are at a higher risk of developing depression. Depression can be triggered by:\n• Anxiety, stress, or other challenges caused by a \nchronic disease\n• Brain changes from a chronic disease (such as Parkinson’s disease or stroke)\n• Medication used to treat a chronic disease\n• A personal or family history of depression or suicide\nResearch suggests that people who have a chronic disease and depression tend to have more severe symptoms of both illnesses. \nCan depression lead to  \nchronic disease?\nPeople who have depression are at higher risk of",
    "Can depression lead to  \nchronic disease?\nPeople who have depression are at higher risk of \ndeveloping certain chronic diseases, including heart disease, diabetes, stroke, pain, osteoporosis, and Alzheimer’s disease. This may be due to:\n• Challenges completing tasks that are good for health, \nsuch as eating well and exercising, due to symptoms like fatigue\n• Challenges accessing medical care that could help prevent, detect, or treat physical health issues early and avoid the progression of a chronic disease\n• Changes in the way the body functions due to depression, such as increased inflammation, reduced blood circulation and heart rate control, and abnormalities in stress hormonesWhat are the signs and symptoms  \nof depression?\nCommon signs and symptoms of depression include:\n• Persistent sad, anxious, or “empty” mood\n• Feelings of hopelessness or pessimism\n• Feelings of irritability, frustration‚ or restlessness \n• Feelings of guilt, worthlessness, or helplessness",
    "• Feelings of guilt, worthlessness, or helplessness\n• Loss of interest or pleasure in hobbies and activities\n• Fatigue, lack of energy, or feeling slowed down\n• Difficulty concentrating, remembering, or  \nmaking decisions\n• Difficulty sleeping, waking too early in the morning,  or oversleeping\n• Changes in appetite or unplanned weight changes\n• Physical aches or pains, headaches, cramps, or digestive problems without a clear physical cause that do not go away with treatment\n• Thoughts of death or suicide or suicide attempts\nNot everyone who is depressed experiences all of these symptoms. Some people may only experience a few symptoms, while others experience many. Depression symptoms interfere with day-to-day functioning and cause significant distress for the person experiencing them. \nIf you show signs or symptoms of depression and they \npersist or do not go away, talk to a health  care provider. \nFrom  the NATIONAL INSTITUTE of  MENTAL HEALTH  Understanding",
    "From  the NATIONAL INSTITUTE of  MENTAL HEALTH  Understanding \nthe Link Between Chronic Disease and Depression\nIf you or someone you know is struggling or having \nthoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org . In life-\nthreatening situations, call 911.",
    "How is depression treated? \nDepression is treatable—even if you have a  \nchronic disease.\nDepression treatment typically involves psychotherapy \n(in person or virtual), medication, or both. \nA health care provider can help you choose the right \ntreatment plan based on your needs, preferences, and existing medical conditions. Tell the provider about the medications you take and treatments you undergo to avoid multiple medications interfering with one another.\nIf you cannot or do not wish to take antidepressant \nmedication, other evidence-based treatments are available, including psychotherapy, brain stimulation therapy, and light therapy. \nYou may have to try a few treatments to find the best  \none for you. With treatment, you can feel better. For  more information on treatments for depression, visit www.nimh.nih.gov/depression .How can I find help?",
    "If you have concerns about your mental health, talk to a primary care provider. They can refer you to a qualified mental health professional, such as a psychologist, psychiatrist, or clinical social worker, who can help you figure out the next steps. Find tips for talking with a health care provider about your mental health at  www.nimh.nih.gov/talkingtips .\nYou can learn more about getting help at www.nimh.nih.gov/findhelp . The Substance Abuse and Mental Health \nServices Administration (SAMHSA) provides information about finding support at https://findsupport.gov and locating mental health services in your area at  https://findtreatment.gov .\nWhat are clinical trials and why are \nthey important?\nClinical trials are research studies that look at ways to \nprevent, detect, or treat diseases and conditions. These studies help show whether a treatment is safe and effective in people. \nSome people join clinical trials to help doctors and",
    "Some people join clinical trials to help doctors and \nresearchers learn more about a disease and improve health care. Other people, such as those with health conditions, join to try treatments that aren’t widely available. \nNIMH supports clinical trials across the United States. \nTalk to a health care provider about clinical trials and whether one is right for you. For more information, visit www.nimh.nih.gov/clinicaltrials .\nNIH Publication No. 24-MH-8015 \nRevised 2024Follow us on social media @NIMHgovwww.nimh.nih.gov\nContact: nimhinfo@nih.govReprints\nThe information in this publication is in the public domain and may be reused or copied without permission. However, \nyou may not reuse or copy images. Please cite the National Institute of Mental Health as the source. Read our copyright policy to learn more about our guidelines for reusing NIMH content at www.nimh.nih.gov/copyright .Research suggests that a “collaborative care approach”",
    "can improve the overall health of people with depression. In this approach, primary care providers, care managers, and psychiatric consultants work together to provide mental and physical health care at the same location. Collaborative care is not yet available in all primary care offices or clinics—ask your health care provider if it’s an option for you.",
    "From  the NATIONAL INSTITUTE of  MENTAL HEALTH  \nTelemental health is the use of telecommunications or videoconferencing technology \nto provide mental health services. It is sometimes referred to as telepsychiatry or telepsychology. Research suggests that telemental health services can be effective for many people, including, but not limited to those with attention-deficit/hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), depression, and anxiety. What Is \nTelemental Health?\nAs the need for providing virtual mental health care \nservices has increased, providers are finding ways to use phone and videoconferencing technology to bring therapy, evaluations, interventions, and medication management to individuals where they are. Although the practice has become much more common, especially as a result of the coronavirus (COVID-19) pandemic, more research is needed to understand when and how telemental health services should be used. \nPotential Benefits",
    "Potential Benefits \n ⊲Convenience: Telemental health appointments \ndon’t require travel and often mean less time off work and smoother logistics coordination for things like transportation or childcare. Patients also can schedule appointments with less advance notice and at more flexible hours.\n ⊲Broader reach:  The technology is available to people \nwho may not have had access to mental health services previously, including those in remote areas and emergency care situations.\n ⊲Fewer barriers:  For those who may have been \nhesitant to look for mental health care in the past, telemental health services might be an easier first step than traditional mental health services.\n ⊲Advances in technology: As telemental health services have increased, providers have become more familiar with evolving videoconferencing technology, with some switching to entirely  \nvirtual practices.Potential Drawbacks\n ⊲Access to technology: Services may be limited by lack of internet connection and devices.",
    "⊲Access to technology: Services may be limited by lack of internet connection and devices. \n ⊲Quality issues: Varying levels of technological quality can affect how services are provided and received. \n ⊲Cost:  Evolving technology means updating \nequipment, platforms, and networks for patients.\n ⊲Privacy:  Cameras in users’ homes and virtual online \nplatforms pose privacy considerations. Individuals also might be more hesitant to share sensitive personal information with a provider in a situation where others might hear. \n ⊲Insurance coverage:  The rise in telehealth during \nthe COVID-19 pandemic has led to policy changes to make services accessible to more people. However, it is not known how long such flexibilities will stay in place, and understanding what services are available can be complicated. Coverage and provider licensure requirements vary from state to state.Learn about factors to consider when using telemental health.",
    "If you are in immediate distress or are \nthinking about hurting yourself, call the National Suicide Prevention Lifeline toll-free at 1-800-273-TALK (8255)  or the toll-free TTY number at  1-800-799-4TTY ( 4889). You also can\ntext the Crisis Text Line (HELLO to741741) or go to the National SuicidePrevention Lifeline  website at\nhttps://suicidepreventionlifeline.org .\nMore Resources\n ⊲MedlinePlus: Telehealth  \n(https://medlineplus.gov/telehealth.html )\n ⊲Department of Health and Human Services: Telehealth  \n(https://www.telehealth.hhs.gov )Finding a Telemental Health Services Provider\nMany of the same considerations for finding a provider for in-person mental health services apply to finding a telemental health services provider. Considerations specific to telemental health include:\n⊲ Security:  As videoconferencing platforms continue to \nevolve, most providers use secure platforms through  \nwhich recording isn’t possible . Industry best practices",
    "which recording isn’t possible . Industry best practices  \nfor videoconferencing for telemental health services  providers suggest selecting platforms with appropriate verification, confidentiality, and security features. \n⊲ Introductory sessions: Meeting a provider for the first time in a virtual environment may make it more challenging to determine comfort level. Initial free consultations may make it easier to determine if a telemental health services provider feels like a good fit. \nLearn more about getting help and finding a health care provider on the National Institute of Mental Health (NIMH) website at www.nimh.nih.gov/findhelp . The Substance Abuse \nand Mental Health Services Administration (SAMHSA) offers  the Behavioral Health Treatment Services Locator at  https://findtreatment.samhsa.gov . Use this online tool to  \nhelp you find mental health services in your area and to  learn whether providers offer telemental health services. \nNational Institute\nof Mental Health",
    "National Institute\nof Mental Health\nNIH Publication No. 21-MH-8155Follow NIMH on  \nSocial Media @NIMHgovwww.nimh.nih.gov"
]