According to the National Alliance on Mental Illness, about 2 percent of young children have depression and one in five teens becomes depressed at some time.
Childhood depression is a serious issue. Teens affected by depression are at risk for substance abuse, suicide, and recurring episodes of depression later in life.
Depression treatment for children is very successful, with an 80 percent recovery rate. But almost half of childhood depression will recur within two years of the first episode of depression. Children also respond differently to medications than adults, so a depression treatment plan for depression in childhood needs to be carefully planned with all the risks and benefits weighed.
Treatment for Mild or Moderate Childhood Depression
If a child or a teen is showing symptoms of depression, such as persistent sadness, irritability, loss of interest in play or school, or any talk about suicide or death, the first step is a visit to the pediatrician. Your child’s doctor will rule out other illnesses that may be causing depression and may observe your child for a while.
Thinking that a child may "grow out" of depression symptoms is usually a mistake. Childhood depression may last for six to nine months and sometimes for years. Going that long without depression treatment puts a child at great risk.
A depression treatment plan for mild to moderate depression may involve:
- Referral to a health care professional. Childhood depression may be treated by a psychiatrist, a psychologist, or a licensed clinical social worker.
- Psychotherapy. Also known as talk therapy, this type of depression treatment has been shown to be effective for childhood depression. Two types of talk therapy that help are cognitive-behavioral therapy (CBT) and interpersonal therapy (ITP). CBT teaches children to change negative thoughts and behaviors, and ITP works on a child's relationships with peers and family members.
- Other support for childhood depression. Studies show that family counseling is a valuable addition to childhood depression treatment. Other types of support may include peer groups, social skills training, management of any substance abuse issues, and encouraging regular exercise.
Treatment for Moderate or Severe Childhood Depression
When depression in childhood does not respond to talk therapy and other supportive depression treatment, antidepressant medications are sometimes used. The problem is that a child's brain is still developing and children may not respond to these medications the way adults do. Since 2004 the U.S. Food and Drug Administration (FDA) has warned that some types of antidepressants may increase the risk of suicide in children. The American Academy of Child and Adolescent Psychiatry recommends using an antidepressant for children with very severe depression if talk therapy alone is not working. The only antidepressant that has been approved by the FDA for depression treatment in childhood is the drug fluoxetine (Prozac).
Treatment approaches include:
- Adding an antidepressant. Prozac is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). SSRIs work by allowing the brain chemical serotonin to circulate in the brain, which helps fight depression. Some other SSRI drugs have also been found to help childhood depression and some doctors may use these drugs, even though they are not officially approved by the FDA. This type of depression treatment is known as "off-label" prescribing.
- Combining an SSRI and talk therapy. Studies show that this type of depression treatment is better than using talk therapy or an SSRI medication alone for depression in childhood. In most cases of childhood depression, medication is combined with some other type of support therapy.
- Suicide precautions. Recent studies have shown that the overall benefits of using SSRIs in children with depression do outweigh the risks of suicide, but children and teens need to be watched very closely for any suicide risk, especially during the first few months of treatment.
An important part of the treatment plan for childhood depression is deciding how long treatment should last. To prevent a relapse, most therapists will want to continue treatment for at least six months after the child has gotten better. With recurrent depression, treatment may last for years.
Treatment of depression in children is not a one-size-fits-all approach. Each child or teen must have an individual plan that is carefully monitored. Depression treatment must take the whole child into consideration and include family relationships, living conditions, school situation, and response to treatment. Symptoms of childhood depression should never be ignored. Untreated depression in childhood can lead to a lifetime of problems. When doctors, parents, and mental health professionals work together to come up with the right depression treatment plan, most children can and do get better.
Last Updated: 7/28/2010