Treatment:

Treatment options for adolescents with depression include supportive care from a medical provider, psychotherapy, and antidepressant medications. It is important that treatment be customized to the adolescent and the severity of depression symptoms. Families often participate in the treatment of adolescent depression.

MEDICATION

The first medication considered is usually a type of antidepressant called selective serotonin reuptake inhibitors (SSRI). NOTE: SSRIs carry a warning that they may increase the risk of suicidal thoughts and actions in children and adolescents. Teens and families should be alert for sudden changes or increased suicidal thoughts. Talk to your doctor about the benefits and risks of this type of medicine.

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

THERAPY

Family therapy may be helpful if family conflict is contributing to the depression. Support from family or teachers may also be needed to help with school problems. Occasionally, hospitalization in a psychiatric unit may be required for individuals with severe depression, or those who are suicide risks.

Because of the behavior problems that often occur with adolescent depression, many parents are tempted to send their child to a "boot camp," "wilderness program," or "emotional growth school." These programs often use non-medical staff, confrontational therapies, and harsh punishments. There is no scientific evidence to support such programs. In fact, there is a growing body of research suggesting they can actually harm sensitive teens with depression.

Depressed teens who act out may also become involved with the criminal justice system. Parents are often advised not to intervene, but to "let them experience consequences." This can harm teens by exposing them to more deviant peers and reducing their educational opportunities. A better solution is to get the best possible legal advice and search for treatment on your own. This gives parents more control over treatment techniques and options.

Though a large percentage of teens in the criminal justice system have mental disorders such as depression, few juvenile prisons, "boot camps," or other "alternative to prison" programs provide adequate treatment.

Expectations (prognosis):

Depressive episodes usually respond to treatment. Early and appropriate treatment of depression in adolescence may prevent further episodes. However, about half of seriously depressed teens are likely to have continued problems with depression as adults.

Complications:

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

Adolescents with additional psychiatric problems usually require longer and more intensive treatment.

Calling your health care provider:

Call your health care provider if you notice one or more suicide warning signs:

• Giving most cherished possessions to others
• Moodiness
• Personality change
• Threat of suicide
• Withdrawal, urge to be alone, isolation

NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!