When Teens Are Depressed

About 5 percent of children become clinically depressed at some point during the transition to adulthood. Depression is a burden both for the adolescents and their families and carries a number of risks, including teen suicide. Results of a major clinical study, funded by the National Institute of Mental Health (NIMH), appear in the October 2007 Archives of General Psychiatry.

The study concludes that combining antidepressant medication and cognitive behavioral therapy is the fastest and safest way to treat depression. Medication alone can be quick and easy, but may elevate the risk of suicide even as it is improving depression.

Cognitive behavioral therapy alone can be very effective, but on average the teens stay depressed longer before improvement.

Combining the two delivers the fastest results, without increased suicide risk, and teaches teens the behavioral tools to handle future stresses. These results came from boys and girls 12 to 17 years old, from 13 different medical centers, and from a variety of ethnic and social backgrounds. The best treatment for an individual teen may depend on many factors, but for all teens I believe the option for both of these treatments should be readily available.

Too often medications aren’t considered and too often therapy isn’t adequately covered by payment systems. Now that an evidence-based approach to teen depression is gaining strength, perhaps more teens will get the support they need.

The TADS Team. The Treatment for Adolescents with Depression Study (TADS): Long-term Effectiveness and Safety Outcomes. Arch Gen Psychiatry. 2007;64:1132-1143.