Treatment:

Treatment options for adolescents with depression include:

• Supportive care from a medical provider
• Talk therapy
• Antidepressant medications (possibly)

Treatment should be tailored to the teenager, and the symptoms. Families often help in treating adolescent depression.

MEDICATION

The first medication tried is usually a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). Fluoxetine (Prozac) and escitalopram (Lexapro) are the only SSRIs approved for treating major depression in adolescents (ages 12 - 17). Fluoxetine is also approved for children age 8 and older.

NOTE: SSRIs and other antidepressants carry a warning that they may increase the risk of suicidal thoughts and actions in children and adolescents. Other evidence has not showed that these drugs increase suicide risk in children.

Doctors are still prescribing SSRIs and other antidepressant medications to adolescents with depression. Several important facts about taking any antidepressants include:

• Children and adolescents who take medications should be followed by a doctor for side effects. Parents or caregivers should watch for suicidal thoughts or behaviors, nervousness, irritability, moodiness, or sleeplessness that is getting worse. Get medical help for these symptoms right away.
• Do not stop taking medications without talking to your health care provider first.

Not all antidepressants are approved for use in children and teens. For example, tricyclic antidepressants are not approved for use in teens.

TALK THERAPY

Almost all adolescents 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.

Types of talk therapy include:

• Cognitive-behavioral therapy teaches depressed people ways of fighting negative thoughts. It makes people more aware of their symptoms, helps them learn what makes their depression worse, and teaches them problem-solving skills.
• Family therapy may be helpful if family conflict is contributing to the depression. Support from family or teachers may help with school problems.
• Talk therapy (psychotherapy) can help adolescents understand issues that may be causing their behavior, thoughts, or feelings.
• Joining a support group of people who are experiencing problems like yours can also help. Ask your therapist or doctor for recommendations.

Sometimes people with severe depression, or those who are suicide risks may need to stay in the hospital for treatment.

Adolescents with depression should learn to:

• Take medications correctly and manage their side effects
• Watch for early signs that depression is getting worse, and react when it happens
• Exercise more and seek out other activities that they enjoy
• Avoid alcohol and drugs (whether or not they have been prescribed). These substances affect the brain and make the depression worse over time. They may also affect judgment about suicide.
• When you are struggling, talk to someone you trust about how you are feeling. Try to be around people who are caring and positive.

Expectations (prognosis):

Depression usually responds to treatment. Getting the right treatment as early as possible may prevent further episodes. However, about half of very depressed teens will keep having problems with depression as adults.

Complications:

• Drug, alcohol, and tobacco abuse
• Effects on school performance and relationships
• Other mental health problems, such as anxiety disorders
• Teenage suicide
• Violence and reckless behavior

Adolescents with other mental health problems usually need longer and more intensive treatment.

Calling your health care provider:

There are numbers you can call from anywhere in the United States, 24 hours a day, 7 days a week: 1-800-SUICIDE or 1-800-999-9999.

Call your health care provider right away if you notice one or more of these suicide warning signs:

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

See: Suicide and suicidal behavior for more information

Call your health care provider if you notice:

• Depression that is not improving or is getting worse
• Nervousness, irritability, moodiness, or sleeplessness that is new or getting worse
• Side effects of medications

NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!