Treatment of Teen Depression
There may be a variety of precipitating factors in the development of teen depression (see Contributing Factors To Teen Depression), but there are also many possible intervention points in its treatment.
Psychotherapy For The Treatment of Teen Depression
Studies on the effectiveness of psychotherapy in the treatment of teen depression have shown that it is moderately to highly effective. Many recent studies have shown that the ability of the therapist to empathically connect with the teen and guide him or her through a course of treatment is more important than the specific treatment procedures used by the therapist. This factor indicates that it is important to pay attention to the quality of the relationship your teen is developing (or not developing) with his or her therapist, and to intervene if necessary.
Studies have also indicated that follow-up sessions (after the initial course of treatment is completed) are useful and sometimes necessary in order to maintain the benefits of psychotherapy. Such studies support the belief held by some clinicians that depression should be viewed as a chronic condition and that clients should be taught how to live with it, as well as how to self-monitor mood changes and be aware of when help is needed. It should be noted that not all clinicians share belief in the chronic nature of depression, but most will agree that the complete resolution of depression is difficult to achieve.
Medication For The Treatment of Teen Depression
As noted previously, studies have shown a link between genetics and depressive tendencies, and antidepressants can be an effective treatment for the biological aspect of depression. However, both England and the US have issued warnings pertaining to the use of antidepressants with children and adolescents as a result of studies that have shown an increased risk for suicide. At this time, Fluoxetine (Prozac and its generic equivalent) is the only antidepressant approved by the FDA for use with the children and adolescents, but prescribing physicians are given leeway to use their own judgment in prescribing other drugs if they believe conditions warrant. Fluoxetine acts to increase the amount of serotonin available to the brain, and generally has a positive effect on mood. Serious and sometimes fatal results have occurred when Fluoxetine is used in combination with drugs known as MAO inhibitors, such as Nardil and Parnate (also antidepressants). Users should always consult with a qualified prescriber before taking antidepressants of any kind. Antidepressant medications must generally be taken regularly for at least two weeks before significant results are evidenced, and in some cases up to 12 weeks may be required.
If the teen taking an antidepressant becomes uncharacteristically agitated, negative, is heard to make comments about harming him or herself or others, or displays any other new and worrisome behaviors, he or she should be taken to the prescribing professional immediately for follow-up and evaluation. Once medication is begun, it should not be discontinued without the advice of a qualified prescriber.
It is the experience of this writer that it is useful to consider medication used in the treatment of depression as a temporary and helpful support for the adolescent, just as one would use a cast to support a broken arm during its healing, rather than as the beginning of a lifetime requirement for medication. Many studies have shown that medication and psychotherapy combined create the greatest benefit in the treatment of depression, particularly in the prevention of relapse. While medication is sometimes necessary, it has the disadvantage of giving the user the belief that something outside of him or herself can can create an almost magical change, and without requiring personal effort. Therapy, on the other hand, while requiring more effort and time, has the potential of awakening in the patient the knowledge that he or she can help him or herself.
Family Interventions For The Treatment of Teen Depression
Family intervention has the benefit of viewing depression as a problem for the family to solve together, rather than identifying the teen as the sole patient who has to be "cured."
Some of the goals of family interventions are the following:
Improving interpersonal relationships and reducing conflictual communication styles among family members
Decreasing high levels of anger by improving communications
Empowering the teen to be more assertive
Helping the teen establish more autonomy from parents while simultaneously maintaining positive relationships with them
Decreasing perfectionist demands of parents in order to reduce teen frustration
Decreasing excessive emotional dependency among family members can be helpful in treating depression.
Increasing positive family interactions
Encouraging the affected teen to assist in finding solutions can also be helpful, but it is important to differentiate between helpful and unhelpful ideas. For example, a depressed teen may ask for more time alone, but such a request has to be evaluated in light of a depressed teen's proclivity for social isolation.
Family interventions require the assistance of a skilled family therapist, as well a degree of willingness on the part of all family members to examine their role in the problem being expressed by the "identified patient." When these necessary components exist, a family intervention can be very useful in the treatment of teen depression.
Leon Pyle, PhD
For additional information, see: Supporting Your Teen's Mental Health.
