Teenology 101

Mental Health in Teens: What to expect from at the Doctor’s Office

Mental health disorders afflict many teens (nearly 1 in 3 will have thoughts of sadness). In this post, guest Dr. Laura Richardson provides information on making the diagnosis of depression and what types of treatment your doctor may discuss.

  • How will my teen’s doctor diagnose depression?

The diagnosis of depression is usually based on the symptoms that your teen reports feeling such as depressed mood, loss of interest in doing things, low energy and difficulty concentrating. Some doctors make this diagnosis based on talking with your teen and you and some might use tools, like paper questionnaires, to help them make the diagnosis.

  • How common is depression in teens?

Depression is one of the most common health issues in teenagers. Estimates of how many teens have depression at any given time range from 5-8%. Over the course of adolescence (up to age 18), about one in five teens will experience an episode of major depression.

  • Will my teen need medication?

Not necessarily. It depends on how severe your teen’s symptoms are and how long they have been going on. Some teens with milder symptoms are able to feel better by making changes to improve their mood such as improving their sleep, increasing their exercise, increasing activities that they enjoy, or spending more time with people who care about them. Teens with more severe symptoms, symptoms that have lasted a long time, or who have tried to make changes but their symptoms aren’t better would probably benefit from some type of treatment like psychotherapy and/or medications. Studies show that both medication and psychotherapy are helpful in treating depression. The rates that teens get better are similar between both types of treatment but psychotherapy may take longer to improve symptoms than medications. We often recommend that teens start with one treatment and if that isn’t helping the second can be added.

  • What are alternatives (and/or adjuncts) to medication for the treatment of depression in my teen?

Even if a teen does receive therapy or medications, it is still important that they don’t give up on other changes (such as sleep, or spending time with friends) that will help them to improve their mood.

  • What are the side effects of medication?

The main side effects of medication happen in the first week and include feeling a little “jittery” and having an upset stomach. Some people find that the medication makes them a little anxious. The effects on sleep are variable. Some teens find that the medications make it easier to sleep and others find that they make it harder. Antidepressants can also cause an increase in suicidal thoughts during the period right after the medication is started or when the dose is increased. Although this is very rare, it is something we always let teens and families know about and we emphasize that if teens are having these thoughts that they need to let someone know. It is not something we would want to miss.

  • If we start medication, will my teen be on it forever?

No. The average length of an episode of depression without treatment is about 9 months. We usually recommend that if a teen finds medication helpful that they continue it for at least 6 to 12 months. Since depressive symptoms can recur if the medication is stopped too quickly, we recommend that when the teen is ready to come off of the medications that they do it slowly and under a physician’s guidance. We also encourage them to pick a time when, if the depression did recur, they aren’t too stressed out. For example, we wouldn’t recommend that a teen stops their medication during finals.

Resources for teens:



My teen just came out, now what

young loveI have the privilege of working with teens around many aspects of their lives including sexuality and reproductive health. While my professional focus is on the health and well-being of teens, adolescents live with and are accompanied by parents. My day to day encounters often include a significant amount of conversation with parents. Now most parents are a bit uncomfortable discussing their teens reproductive health. Add in sexuality that differs from the majority, and the conversation becomes even more challenging. These terms may change, but all of them mean their teen is disclosing they are a sexual minority. Read full post »

Preventing Gun Violence: Don’t Ignore the Signs

teeninjailThis week marks the one year anniversary of the tragic Marysville Pilchuck High School shooting. As I reflect on the events of the previous year, gun violence comes up in multiple settings: The school shooting in my own state, the shooting of people gathering at a church in the South, and other incidents that occurred around the nation with less media coverage, but with equally devastating consequences for families and friends. As a provider in Snohomish County, I also think about many of my patients who were affected by this tragedy. My patients and their parents have described the feelings of helplessness, frustration, anger, and fear that something like this will happen again. This reflection leaves me with a sense of urgency that we as a community need to do more. We must answer questions to understand what brings a youth to the breaking point, how do we know if someone is having homicidal and/or suicidal thoughts and, most importantly, how can we prevent future tragedies? Read full post »

Transition After High School Post 4 – Clery Act

Guest Post by Laura Burkhart, MD

“Safety doesn’t happen by accident”

When talking with your teen about making the transition to college, we often focus on the positive, as it is definitely an amazing life changing event.  You want your teen to successfully adapt in making more responsible choices, while remaining safe and protected inside the walls of a college campus.  However, there is a very important topic that often gets missed in that crucial time before they start classes.  That is the subject of campus crimes and security.   I am not writing this to send you running to lock your teen in their room, ensuring their safety by never letting them out and feeding them through the door!   This post is meant to open the dialogue between you and your teen about personal safety.

College campuses were once thought of as “Ivory Towers”, protected from the dangerous individuals and violent acts of the rest of the world.  It is the hope that every student has an affirmative college experience, but we know from numerous stories and statistics that is not always the case. So how can you find out about the safety of the college campuses your teen is looking at? Its actually easier then you think, but that was not always the case. It is important to respect the history and personal tragedy that allows us to access this information so readily today. Read full post »

The Impact of Implicit Bias

Think about the encounters you have with strangers every day. When you stop by the grocery store and notice people in the check out line, what comes to mind? Does the young parent with multiple very small children bring up any emotions or thoughts? What do you think of the food items being purchased by the person who is underweight or overweight? How do you react when a group of teens with darkly dyed hair, piercings, and tattoos is standing in the doorway? Now consider a group of clean-cut teens? Everyone has biases: those subconscious perceptions of people around us. They shape our actions and judgements. But, biases are often incorrect. They are generalizations about a group based on our cultural norms or expectations, but may have no actual basis in reality. For example, the parent with multiple young children in the check out line may be a nanny not a single parent. The clean-cut teens in the doorway may be waiting for a peer who is stealing alcohol while the pierced and tattooed teens are trying to advocate for ending childhood hunger. Read full post »

Powdered Caffeine Dangers

Coffee cup illustrationIt’s the Fall. With this season comes the return of cable knit sweaters, closed toed shoes, pumpkin spice, and early mornings as school starts again. Oh those early mornings! Getting up for school is hard and teens may be tempted to use some outside help to not only wake up in the mornings, but to stay up late to finish homework projects. One substance that is making headlines (again) is caffeine. It’s in our coffee, tea, chocolate milk. Adults use this substance quite a lot (just look at all the coffee carts, cafes, & break rooms that are bustling by 8am!) and companies have found a new way to supply consumers with their daily fix of the substance. Unfortunately, the new product can be dangerous. Read full post »

Transition after high school Post 3 – College Health Services

college studentGuest Post by Laura Burkhart, MD

“You can never cross the ocean until you have the courage to lose sight of the shore.”

In the part of this series, I will go into a little further into the details of visiting a campus and what you need to have ready from a health standpoint. If you and your teen are still finding yourself stuck on where to even start looking to apply, you can refer back to the previous post.

Now that you and your teen have decided on what campuses to visit (great job by the way, that can be the toughest part!), it is time to discuss what is often the most exciting part for your teen…the tour. A campus tour is a great way to become familiar with the institution, not only for the physical elements, but also for the health resources offered. It is important for your teen to have a support system on campus of caring professionals that can offer assistance if needed. Read full post »

Transition after high school Post 2 – University versus College

Guest Post: Laura Burkhart, MD

“There are two gifts we should give our children: one is roots and the other is wings.”

As summer winds to an end, one of the most exciting times for a teen is figuring out what they are going to do after high school graduation. The last year in high school can be filled with both anticipation and anxiety, and as a parent it can be a difficult task to help them navigate the momentous next steps along a path filled with opportunity. College might not be right for all, but if you and your teen think it might be a good fit, you should know about all the options out there. First of all, take a deep breath…you and your teen will get through this! Here are a few tips to help you get started and make the big unknown of the college universe a little clearer.

There are more options now then the traditional 4 year college, and each one can have unique differences to help everyone obtain an education no matter their life situation or learning style. Read full post »

Transition after high school Post 1 What are Our Options

A note from Dr. Evans: I often find myself discussing life plans with my patients. Some teens have no clue what to do after high school, others are set on going to medical school (eventually), some just want to work, and some think they may want to join the military. In this series, I’ve asked guest authors to talk a bit about some of the options available. This is not an all inclusive list at all and if readers have topics they’d like discussed, please add those ideas in the comments.

We’ll start with some general options in the first post, then go on to discuss more details about the different between university, college, and community college in the coming posts of this series.

Guest Author: Emily Winn – University of Washington School of Nursing

Transition after high school – What are our options? Read full post »

Music and brain power

African American teen plays an acoustic guitar.

African American teen plays an acoustic guitar.

I was a musician from junior high through college. My athletic abilities left much to be desired, but as a 4th grader, an astute music teacher assigned me to the cello. This instrument became the fuel that drove me to push past my shyness, embrace being on stage, and forge friendships that I still have to this day.  Learning to read music was a similar experience to learning a second language: frustrating at times, challenging, but so rewarding when I was able to put it into practice and result in something that was easily understandable to another human being. Read full post »