Treatment for depression in young people is similar to treatment for depression in adults and includes counseling and medicines. Although antidepressant medicines can be effective in treating depression, the safety and long-term effects of these medicines in children are not yet fully understood. But for many young people with depression, experts believe the benefits of the medicines outweigh the risks.

Less than one-third of children or teens with depression receive treatment.⁴ This may be due, in part, to the old belief that young people do not get depression or that feeling depressed is normal for their age. Also, teens often do not seek help for depression, because they may think feeling bad is normal, they may blame something else (or themselves) for their symptoms, or they may not know where to go for help. Tell your child to ask for help if he or she feels bad, and let your child know who to go to for help with depression or other problems.

Initial treatment

The type of treatment your child requires depends on whether it is his or her first episode of depression, the severity of the depression, and issues related to the cause of the depression, such as family conflict or academic problems.⁸ If your child is suicidal or is severely depressed and is out of touch with reality (psychotic) or unable to function, a stay in the hospital may be needed.

Treatment of depression in children and teens generally includes professional counseling, medicines, and education about depression for your child and your family.

Professional counseling for depression may include:

• Cognitive-behavioral therapy, which focuses on changing certain thinking and behavior patterns.
• Interpersonal therapy, which focuses on social and personal relationships and related problems.
• Problem-solving therapy, a type of cognitive therapy that helps you find practical solutions to problems.
• Family therapy, which can help educate and comfort the whole family.
• Play therapy, for very young children.

Medications used to treat childhood depression include:

• Selective serotonin reuptake inhibitors (called SSRIs), such as fluoxetine (Prozac). SSRIs are the medicines most often used for childhood or teen depression. Fluoxetine is currently the only SSRI approved by the U.S. Food and Drug Administration (FDA) for use in children, although other SSRIs are sometimes used.
• Atypical antidepressant medications, such as bupropion (for example, Wellbutrin) In some cases, these may be used to treat childhood or teen depression.
• Monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil). MAOIs are rarely given due to potentially serious side effects and dietary restrictions.
• Tricyclic antidepressants such as amitriptyline (Elavil, for example). Tricyclic antidepressants have been used in the past for childhood depression, but recent studies have found limited evidence that these medicines are effective.¹⁵ Tricyclics also carry the risk of overdose and other serious consequences, such as heart problems.