Studies have shown a combination of therapy and medication to be useful in treating children and teens who are depressed. However, all treatment options have risks and benefits, and treatment may vary based on other factors, such as whether or not your child or teen is impacted by another condition or disorder, such as ADHD, OCD, or an anxiety disorder. When making these difficult decisions, the best strategy is to adopt a team approach. Make sure to enlist at least some of the following “team members” in your decision-making process:
• Those in your immediate family, including yourself and your child or teen
• Your child’s educational care providers
• Your child’s medical care providers
• Any trusted friends who have gone through similar experiences
When depression is first identified in a child or teen, the first decision many parents have to make is how to access psychosocial treatments. Psychosocial treatments include individual therapies, psycho-education, self-help and support groups and are helpful in providing guidance, support and education to children and adolescents living with depression and their families.
There are a wide array of individual and group therapies available in most communities, and if your child is a student at a school with Title I funding, they may be able to access free therapy at school or reduced-cost therapy after school. Cognitive behavioral therapy (CBT), which is based on a theory that if the client can concentrate on changing the negative attributional bias (seeing every cup as half-empty) associated with major depression, depressive tendencies will be significantly reduced. Interpersonal therapy (IPT) is also effective and focuses on a patient’s self-concept and relationships with peers and family.
Psycho-education and family psycho-education have also proven to be beneficial for children 8 to12 years old with depression. The NAMI Basics education program is an example of psycho-education designed for children and families. The program focuses on strengthening, supporting and empowering caregivers. Psycho-education can also be provided through behaviorists, licensed school psychologists, or school-based psychologists and may be available through parent trainings provided by your child’s school district or through private companies or providers.
Medication can be an effective treatment option for child and adolescent depression, but it also carries risks. Fluoxetine (Prozac) is the only antidepressant specifically approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in children ages 8 and older. Doctors can prescribe other antidepressant medications “off label” (not specifically approved by the FDA for the condition). If a doctor suggests another medication, it is a good idea to ask questions regarding the safety of the drug, the purpose of the drug, and the side effects in children your child’s age.
How long a young person may need treatment is determined by the improvement and severity of symptoms. Typically, therapists see youth for eight to 12 sessions to address a specific concern (such as a phobia or conflict resolution issues). Many therapists will decrease the frequency of psychotherapy sessions but continue some maintenance therapy longer than the initial eight to 12 weeks of treatment. Medical treatment for a first episode of depression is likely to last at least six to 12 months with either treatment but may be longer. For recurring depression, many doctors will recommend a person stay on medication for considerably longer periods to prevent a recurrence.
As a parent or caregiver, there are many options to support youth living with depression. Here are some important steps:
• Help your young person stick to their treatment plan. Make sure they get to appointments and take medication as prescribed. Many young people will question if they still need the medication when they have a period of improvement or are unhappy with some side effects.
• Learn about depression. Knowledge will help you and your child overcome many aspects of the illness.
• Communicate openly. Listen to your child or teenagers by allowing them space to express how they feel without judging them.
• Pay attention to warning signs. Working with your child and the treatment team find ways to identify, avoid and handle triggers.
• Engage in a healthy lifestyle. Exercise or physical activity help to lift mood. Sleeping well and eating nutritious foods are important to wellness and reduce symptoms.
• Help your teen avoid alcohol and other drugs. Some teens feel like alcohol or drugs lessen depression symptoms, but in the long run they only worsen their depression and make it harder to treat.
Taking care of yourself and the rest of the family is also critically important; depression is a challenging mental health condition and everyone may experience a wide range of emotions and move through different stages of acceptance. It helps to know that you are not alone. The National Alliance on Mental Illness (NAMI) provides education programs and family support groups that are offered nationwide. If you are interested in these supports, you can reach the NAMI helpline by calling 1 (800) 950-NAMI (6264), Monday through Friday, 10 a.m.- 6 p.m., EST or by email at email@example.com.