Treatment Options for Adolescent Depression
Statistics for adolescents and young adults who seek treatment for their depression are very low- only about 25% of teenagers with symptoms of depression will actively seek out any kind of treatment (Tanielian et al., 2009).
It is important to see a doctor if depression is suspected, so that any possible medical causes can be ruled out. Some conditions, such as hypothyroidism, can cause symptoms that are similar to depression.
The Guidelines for Adolescent Depression in Primary Care (Cheung et. al, 2007) suggest increasing active social support for teens experiencing mild depressive symptoms for 6-8 weeks, as well as keeping a close eye on the child to notice what changes are happening before beginning treatment.
Psychotherapy
For moderate to severe symptoms, anti-depressant medications are often recommended in conjunction with psychotherapy such as Cognitive Behavior Therapy (CBT). A study conducted by Bradley, McGrath, Brannen, and Bagnell (2010) found that the majority of adolescents (92% of boys and 95% of girls) preferred psychotherapy as a form of treatment for depression over antidepressants.
Antidepressants
Selective Serotonin Reuptake Inhibitors (SSRIs) are the most widely used and accepted medication treatment for adolescent depression. Fluoxetine (aka Prozac, Sarafem, and Fontax) is the only SSRI currently approved by the FDA for adolescent use (Cheung et. al, 2007).The YouTube video below gives an explanation of exactly how these antidepressants work in the brain. SSRIs help ease depression symptoms, but they can also cause unpleasant side effects such as weight gain and headaches. It is recommended by the FDA that patients see their primary care provider or nurse practitioner at least once per week for the first four weeks of treatment, biweekly for the next twelve weeks, and then as needed from then on (Cheung et. al, 2007). These professionals will monitor the adolescent and help him or her adjust to the medication safely.
How do SSRIs work?
Physical Activity
Physical exercise has also been found to be a beneficial complement to depression treatments-- some studies have found that its effects on depression symptoms are comparable to traditional treatments such as psychotherapy and medication. Regular exercise decreases levels of cortisol (the "stress hormone"), and increases neurotransmission of monoamines and beta-endorphins, which can result in higher feelings of overall well-being (Knapen et. al, 2009). Exercise can also provide an increased sense of control over the body and its functions, as well as providing a social outlet with fitness classes and programs. A professional such as a physical therapist can work with the adolescent to create an exercise plan with goals based on the teen's fitness level and preferences.
Depressed teens often have physical ailments such as muscle aches and pains. Regular physical exercise may improve a variety of physiological and psychological factors in depressed individuals. Studies have shown that exercise is effective in improving depressive states. (Nabkasorn 2005).
There are several psychological and emotional benefits to be gained from exercise. Exercise boosts self-confidence, making individuals feel better about appearance and improving self esteem. Exercise promotes effective coping and can provide a distraction and get your mind off of your problems and eases the physical symptoms of depression. Studies have shown that exercise releases a "feel good" chemical in the brain that can last for several hours after exercise has been completed. The productions of these endorphins also improve natural immunity and reduces perceptions of pain and improves mood. It has also been suggested that an increase in body temperature during exercise has a calming effect on the body.
Physical Therapy plays an important role in recovery from depression. A physical therapist can use their skills to assist individuals in optimal care by evaluating the individual needs of their clients. They individualize therapy and exercise programs to promote endurance, strength building and improve flexibiity and range of motion. They promote safety with exercise and improve well being in their patients offering encouragement and providing support through education and demonstration of exercise programs.
Suicide
The risk of suicide attempts or ideation becomes higher in adolescents who struggle with depression. Keep an eye out for these signs that your child may be contemplating suicide (www.helpguide.org):
Throughout depression treatment, be aware of the emergence any of these signs, or any drastic changes in behavior or symptoms. If you suspect that a teen you know may be having suicidal thoughts, don't be afraid to talk with them about it, or suggest that they find a professional to speak with. There is no evidence that talking with someone about suicide will increase their likelihood of suicidal thoughts. If the child confirms that they are having suicidal thoughts and have a plan in place, seek help and hospitalization immediately-- stay with them until a professional is present to help stabilize the child.
It may be helpful to develop a written 'safety plan' for the child when he or she is feeling hopeless. The plan may include contact information for friends, family members, and/or suicide hotlines. See the "Coping and Support" page of this site to find helpful information on a few of these hotlines.
- Talking about or romanticizing death (saying things such as: "people would be better off if I were dead"; "I wish I could disappear forever."
- Giving away personal belongings
- Saying goodbye to friends or family
- Engaging in dangerous or reckless behavior that could result in an injury or death
Throughout depression treatment, be aware of the emergence any of these signs, or any drastic changes in behavior or symptoms. If you suspect that a teen you know may be having suicidal thoughts, don't be afraid to talk with them about it, or suggest that they find a professional to speak with. There is no evidence that talking with someone about suicide will increase their likelihood of suicidal thoughts. If the child confirms that they are having suicidal thoughts and have a plan in place, seek help and hospitalization immediately-- stay with them until a professional is present to help stabilize the child.
It may be helpful to develop a written 'safety plan' for the child when he or she is feeling hopeless. The plan may include contact information for friends, family members, and/or suicide hotlines. See the "Coping and Support" page of this site to find helpful information on a few of these hotlines.