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