Helping your teen with depression

Treatment Options for Your Teenager

You, your teen, and your medical provider should discuss what might help your teen the most. The most effective treatments for depression are:

• Talk therapy
• Antidepressant medicines

If your teen might have a problem with drugs or alcohol, talk with their doctor. 

If your teen has severe depression or is at risk for suicide, your teen may need to stay in the hospital for treatment.

Find a Good Therapist or Counselor

Talk to your doctor about finding a therapist for your teen.

• Most teens with depression benefit from some type of talk therapy.
• Talk therapy is a good place to talk about their feelings and concerns, and to learn ways to deal with them. Your teen can learn to understand issues that may be causing their behavior, thoughts, or feelings.
• Your teen will most likely need to see a therapist at least once a week to start.

There are many different kinds of talk therapy, such as:

• Cognitive-behavioral therapy teaches your teen to reason through negative thoughts. Your teen will be more aware of their symptoms, and will learn what makes their depression worse and problem-solving skills. 
• Family therapy is helpful when family conflict is contributing to the depression. Support from family or teachers may help with school problems. 
• Group therapy can help teens learn from the experiences of others who are struggling with the same type of problems. 

Your primary care provider can help you understand what your health insurance will cover.

Learn about Anti-depressant Medicines

You, your teen, and your doctor should discuss whether antidepressant medicine might help your teen. Medicine is more important if your teen is severely depressed. In these cases, talk therapy alone cannot be effective.

If you decide that medicine would help, your doctor will most likely prescribe a type of anti-depressant medicine called a selective serotonin reuptake inhibitor (SSRI) for your teen.

The two most common SSRI medicines are fluoxetine (Prozac) and escitalopram (Lexapro). These are approved to treat depression in teenagers. Prozac isalso approved for children age 8 and older.

Another type of antidepressants, called tri-cyclics, is not approved for use in teens.

There are risks and side effects with taking antidepressant medicines. Your teen’s doctor can help manage these side effects. In a small number of teens, these medicines can make them more depressed and give them more suicidal thoughts. If this happens, you or your teen should talk to the doctor right away.

If you, your teen, and your doctor decide that your teen will take an antidepressant, make sure that: 

• You give it time. Finding the right drug and dose can take time. It could take 4 to 6 weeks to get to full effect. 
• A psychiatrist, or other medical doctor, who treats depression in teens is watching for side effects. 
• You and other caregivers watch your teen for suicidal thoughts or behaviors, and for nervousness, irritability, moodiness, or sleeplessness that is getting worse. Get medical help for these symptoms right away. 
• Your teen does not stop taking the antidepressant on their own. Talk to your teen’s health care provider first. If your team decides to stop taking the antidepressant, your teen may be instructed to lower the dose slowly before stopping altogether. 
• Keep your teen going to talk therapy. 
• If your teen is depressed in the fall or winter, ask your doctor about light therapy. It uses a special lamp that acts like the sun.

You Can Help Your Teenager

Keep talking with your teen.

• Give your support. Let your teen know that you are there for them. 
• Listen. Try not to give too much advice and do not try to talk your teen out of being depressed. Try not to overwhelm your teen with questions or lectures. Teens often shut down with that kind of approach.

Help or support your teen with daily routines.

• Schedule your family life to help your teen get enough sleep. 
• Create a healthy diet for your family. 
• Give gentle reminders for your teen to take their medicine. 
• Watch for signs that depression is getting worse. Have a plan if it does. 
• Encourage your teen to exercise more and to do activities they like. 
• Talk to your teenager about alcohol and drugs. Let your teen know that alcohol and drugs make depression worse overtime.

Keep your home safe for teens.

• Do not keep alcohol in the home, or keep it securely locked. 
• If your teen is depressed, it is best to remove any guns from the home. If you feel you must have a gun, lock up all guns and keep ammunition separate. 
• Lock up all prescription medications.

When to Contact a Medical Professional

Call your health care provider right away if you notice any signs of suicide. For immediate help, go to the nearest emergency room or call the suicide hotline: 1-800-SUICIDEor 1-800-999-9999. The hotline is open 24/7. Warning signs of suicide include:

• Giving possessions away
• Personality change
• Risk-taking behavior
• Threat of suicide or plans to hurt oneself
• Withdrawal, urge to be alone, isolation

References

US Preventive Services Task Force. Screening and treatment for major depressive disorder in children and adolescents: US Preventive Services Task Force Recommendation Statement. Pediatrics. 2009;123:1223-1228.

Zuckerbrot RA, Cheung AH, Jenson PS, Stein REK. Identification, assessment, and initial management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1299-e1312.

Cheung AH, Zuckerbrot RA, Jenson PS, Ghalib K. Treatment and ongoing management guidelines for adolescent depression in primary care. Pediatrics. 2007;120:e1313-e1326.

Bostic JQ, Prince JB. Child and adolescent psychiatric disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier;2008:chap 69.

Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. National Institute of Mental Health (NIMH). January 13, 2010. Accessed March 25, 2012.

Update Date: 11/5/2012

Updated by: David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.