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    Jay L. Hoecker, M.D.

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Question

Depression treatment for children: What works?

What's the most effective depression treatment for children?

Answer

from Jay L. Hoecker, M.D.

Many years ago, doctors didn't believe that children could experience depression. But mental health experts now know that depression is as common in children as it is in adults.

For children, depression treatment may include psychotherapy either alone or in combination with antidepressant medication. Although opinions vary about which depression treatment should be tried first, a growing body of evidence indicates that the best approach for most children is a combination of both. Treatment is most often provided in an outpatient setting. Sometimes hospital care may be needed.

Many types of psychotherapy are available. For depression treatment, cognitive behavioral therapy may be especially effective. Children who are depressed often have an unhealthy, negative view of themselves and their experiences. With cognitive behavioral therapy, children learn to develop a healthier, more positive outlook — which can help relieve depression. Sometimes it's helpful for families to be involved in therapy as well.

Antidepressant medication is another option for childhood depression treatment. Some research indicates a link between antidepressants and increased suicidal thoughts and behaviors in children being treated with these drugs, so it's important for doctors to carefully weigh the risks and benefits before prescribing antidepressants to children. Still, for many kids, the benefits of antidepressants outweigh the risks.

Antidepressants may be particularly helpful for children who:

  • Have severe symptoms that likely won't respond to therapy alone
  • Don't have convenient or timely access to therapy
  • Have chronic or recurring depression
  • Have psychosis or bipolar disorder

Even when symptoms of depression go away, continuing psychotherapy or antidepressants for a time reduces the risk that depression will recur.

Remember, early detection and treatment of depression is important at any age — and family support is essential. If you suspect that your child is depressed, contact your child's doctor or a mental health provider.

Next question
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References
  1. Bridge JA, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment. Journal of the American Medical Association. 2007;297(15):1683-1696.
  2. Bonin L. Depression in adolescents: Epidemiology, clinical manifestations, and diagnosis. http://www.uptodate.com/home/index.html. Accessed Aug. 14, 2008.
  3. Bonin L, et al. Overview of treatment for adolescent depression. http://www.uptodate.com/home/index.html. Accessed Aug. 14, 2008.
  4. Bonin L, et al. Psychosocial treatment for adolescent depression. http://www.uptodate.com/home/index.html. Accessed Aug. 14, 2008.
  5. Moreland CS, et al. Psychopharmacological treatment for adolescent depression. http://www.uptodate.com/home/index.html. Accessed Aug. 14, 2008.
  6. The use of medication in treating childhood and adolescent depression: Information for patients and families. American Psychiatric Association. American Academy of Child and Adolescent Psychiatry. http://www.parentsmedguide.org/parentsmedguide.pdf. Accessed Aug. 15, 2008.

AN00685

Oct. 9, 2008

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