Treatment

Treatment depends on the type and severity of your teenager's depression symptoms. A combination of talk therapy (psychotherapy) and medication can be very effective for most teens with depression.

If your teen has severe depression or is in danger of self-harm, he or she may need a hospital stay or may need to participate in an outpatient treatment program until symptoms improve.

Here's a closer look at depression treatment options.

Medications

The Food and Drug Administration (FDA) has approved two medications for teen depression — fluoxetine (Prozac) and escitalopram (Lexapro). Talk with your teen's doctor about medication options and possible side effects, weighing the benefits and risks.

FDA alert

Most antidepressants are generally safe, but the FDA requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teens and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when first beginning a new medication or with a change in dosage. If your teen has suicidal thoughts while taking an antidepressant, immediately contact your doctor or get emergency help.

For most teens, the benefits of taking an antidepressant likely outweigh any risks. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Finding the right medication

Everyone's different, so finding the right medication or dose for your teen may take some trial and error. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as the body adjusts. Encourage your teen not to give up.

Inherited traits play a role in how antidepressants affect different people. In some cases, where available, results of genetic tests (done by blood test or cheek swab) may offer clues about how the body may respond to a particular antidepressant. However, other variables besides genetics can affect response to medication.

Managing medications

Carefully monitor your teen's use of medications. To work properly, antidepressants need to be taken consistently at the prescribed dose. Because overdose can be a risk for teens with depression, the doctor may prescribe only small supplies of pills at a time, or recommend that you dole out medication so that your teen does not have a large amount of pills available at once.

If your teen has bothersome side effects, he or she shouldn't stop taking an antidepressant without talking to the doctor first. Some antidepressants can cause withdrawal symptoms unless the dose is slowly tapered off — quitting suddenly may cause a sudden worsening of depression.

Antidepressants and pregnancy

If your teen is pregnant or breast-feeding, some antidepressants may pose an increased health risk to the unborn or nursing child. If your teen becomes pregnant or plans to become pregnant, make certain your teen talks to the doctor about antidepressant medications and managing depression during pregnancy.

Psychotherapy

Psychotherapy, also called psychological counseling or talk therapy, is a general term for treating depression by talking about depression and related issues with a mental health professional. Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy.

Psychotherapy may be done one-on-one, with family members or in a group. Through regular sessions, your teen can:

• Learn about the causes of depression
• Learn how to identify and make changes in unhealthy behaviors or thoughts
• Explore relationships and experiences
• Find better ways to cope and solve problems
• Set realistic goals
• Regain a sense of happiness and control
• Help ease depression symptoms such as hopelessness and anger
• Adjust to a crisis or other current difficulty

Hospitalization and other treatment programs

In some teens, depression is so severe that a hospital stay is needed, especially if your teen is in danger of self-harm or hurting someone else. Getting psychiatric treatment at a hospital can help keep your teen calm and safe until symptoms are better managed.

Day treatment programs also may help. These programs provide the support and counseling needed while your teen gets depression symptoms under control.