Depression and Teens:
Treatment Options
How is depression treated?
There are many different kinds of treatment for depression. Deciding on the right treatment depends on how much difficulty your teenager is having, what treatments are available to her, and personal preference.
- Counseling or Psychotherapy. Counseling or psychotherapy is something that can help with depression, and often the first treatment recommended by health care providers. It involves talking about thoughts, feelings, and behaviors in a confidential setting. Therapy can create a safe environment for your teen to discuss painful or frightening issues without feeling judged. It can teach your teen strategies for coping with situations in her life and with her feelings. It can also help her to understand herself better and provide an opportunity for her to learn how to solve problems more effectively.
It is extremely important that your teen feel comfortable with her mental health provider. It is worth the extra effort it can take to find someone with whom she feels she can have a trusting relationship. She will probably be able to tell if it is a good match within a few sessions.
Therapy can be done in a few different settings. Individual therapy is when your teen meets with the therapist alone. Often there is an opportunity for the parent to meet with the therapist either at the beginning or end of sessions, or occasionally as the sessions continue. Group therapy puts your teen in touch with others her age who are experiencing similar problems, and may be supportive and reassuring in addition to, or instead of individual therapy. Sometimes, when a teenager is depressed, family therapy is useful because members of families are often unclear about how to help. The purpose of family therapy is to be supportive of a family’s attempt to communicate better and support each other more skillfully.
- Medication. If depression is significantly interfering with your teenager's life, or if you or she feel that therapy alone isn't helping, your teenager's health care provider or therapist may suggest medication. The levels of certain chemicals in the brain are directly related to depression. Taking medication can help these chemicals become more balanced and help a person feel less depressed.
Medication does not take the place of therapy. The primary goal of medication in treating depression is to reduce a person’s debilitating symptoms. This can enable your teen, with her therapist’s help, to understand the causes of her depression and make the necessary behavioral changes she needs to move beyond this period in her life.
A doctor, a psychiatrist, or a nurse practitioner can prescribe medications. There are some primary care doctors and nurses who are familiar with current trends in anti-depressant medication. When possible, however, it is useful to use a prescriber who is skilled in mental health issues with adolescents, such as an adolescent psycho-pharmacologist or psychiatrist who works with teens. There are many different medications that treat depression and the prescriber will choose one based on your child’s symptoms, age, medical history and other individual factors. Parents often have concerns about their children taking medication for depression, so it is helpful to ask about both the benefits and possible side effects. Anti-depressant medication has generally been shown to be safe when used as prescribed. Both your teen and you should feel comfortable talking with the prescriber and have a direct way in which to contact them as needed. Additionally, it is important that there be a clear line of communication between the prescriber and the treating therapist.
When your teen is feeling better, she may want to stop taking the medication, but most medications need to be decreased gradually. You and your teen should always talk with her health care provider before making any changes with the medication.
- Day Programs, Overnight Programs, and Hospitals. If your teen becomes so depressed that she has trouble with her every day life, or she is having thoughts about hurting herself, she needs more help than outpatient visits. In day programs at counseling centers or hospitals, patients arrive in the morning and spend all day in counseling, group discussions, and activities with mental health professionals and other teens who are experiencing similar issues. Overnight treatment programs are usually at hospitals where patients receive professional care all-day and are supervised overnight.
Both treatments are used for teens who are severely depressed. Sometimes when a teen is in a crisis due to depression she may require in-hospital care. She may also be hospitalized if the depression has been going on for a long time and there are no signs of improvement. A person can be hospitalized against her will only if she is medically deemed to be harmful to herself or others. If this is the case with your teen, she cannot sign herself out of an in-patient program until she is considered to be medically and emotionally stable and safe.
Written by the CYWH Staff at Children's Hospital Boston
Updated: 2/23/2010
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