Adolescent depression

Alternative Names

Treatment

Treatment options for adolescents with depression are similar to those for used to treat depression in adults. Treatments may include psychotherapy and antidepressant medications.

MEDICATION

The first medication considered is usually a type of antidepressant called a selective serotonin reuptake inhibitors (SSRI). Prozac is most often the first choice. NOTE: SSRI's 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 such 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 to help with school problems may also be needed. Occasionally, hospitalization in a psychiatric unit may be required for individuals with severe depression, or if they are at risk of suicide.

Because of the behavior problems that often co-exist 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 which suggests that 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."

Unfortunately, this can also harm teens through exposure to more deviant peers and reduction in educational opportunities. A better solution is to get the best possible legal advice and search for treatment on your own, which gives parents more control over techniques used and options.

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

Outlook (Prognosis)

Depressive episodes usually respond to treatment, and early and comprehensive 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.

Possible Complications

Teenage suicide is associated with depression as well as many other factors. Depression frequently interferes with school performance and interpersonal relationships. Teens with depression often have other psychiatric problems, such as anxiety disorders.

Depression is also commonly associated with violence and reckless behavior. Drug, alcohol, and tobacco abuse frequently coexist with depression. Adolescents with additional psychiatric problems usually require longer and more intensive treatment.

When to Contact a Medical Professional

Call your health care provider if one or more warning signs of potential suicide are present.

Be alert to the following signs:

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

NEVER IGNORE A SUICIDE THREAT OR ATTEMPT!

References

MacKenzie DL, Gover AR,  Armstrong GS, Mitchell O. A National Study Comparing the Environments of Boot Camps With Traditional Facilities for Juvenile Offenders. Washington, DC. National Institute of Justice, US Dept. of Justice; 2001.

Borque B, Han M, Hill S. A National Survey of Aftercare Provisions for Boot Camp Graduates. Washington, DC. National Institute of Justice, US Dept. of Justice; 1996.

Bottcher J, Isorena T. First-year evaluation of the California Youth Authority Boot Camp. In: D MacKenzie, E Herbert, eds. Correctional Boot Camps: A Tough Intermediate Sanction. Washington, DC: National Institute of Justice, US Dept of Justice; 1995.

MacKenzie D, Souryal C. Multi-site Evaluation of Shock Incarceration. Washington, DC: National Institute of Justice, US Dept of Justice; 1994.

Peters M, Thomas D, Zamberlan C. Boot Camps for Juvenile Offenders Program Summary. Washington, DC: Office of Juvenile Justice and Delinquency Prevention, US Dept of Justice; 1997.