If your teenager has been struggling with depression and antidepressants have not helped, or have helped but come with side effects your teen cannot live with, you are not out of options. You are at the start of a different set of options. This guide is for parents in the Denver area who want to understand the full picture of depression treatments for teenagers. From therapy and medication to advanced treatments like Deep TMS, helping families understand the full range of evidence-based options available.
What Are the Signs That My Teenager Is Depressed?
Teen depression looks different from adult depression, and it can be easy to mistake for typical teenage behavior. Here is what parents are most commonly seeing before they bring their teen to Axis:
- Persistent sadness or irritability that lasts more than two weeks
- Loss of interest in things your teen used to love, sports, music, friends, gaming
- A drop in grades or increasing school refusal
- Sleeping far more than usual or struggling to sleep at all
- Withdrawing from friends and family
- Talking about feeling worthless, hopeless, or like a burden
- Physical complaints with no medical cause: headaches, stomachaches, fatigue
- Increased irritability or outbursts that seem out of proportion
Teen depression is not a character flaw or a parenting failure. According to a 2025 Colorado Healthy Kids Survey, 22% of Colorado’s youth experienced persistent feelings of sadness or hopelessness. Among LGBTQ youth, 41% have seriously considered suicide according to the Trevor Project. If your teen is struggling, they are far from alone, and there are effective treatments available right here in the Denver area.
Why Do Some Teenagers Not Respond to Antidepressants?
Antidepressants are often the first step, and they work well for many teens. But they do not work for everyone. Only two antidepressants are FDA-approved for use in children and adolescents: fluoxetine (Prozac) and escitalopram (Lexapro). Many others are used off-label, which means they have not been studied in children for short-term or long-term use.
There are several reasons a teenager may not respond to antidepressants:
- Side effects that are hard to tolerate: Weight gain, sexual side effects, emotional blunting, and increased anxiety in the early weeks are common reasons teens stop taking medication. Medication side effects can sometimes interfere with a teen’s everyday functioning, affecting attention, academic performance, social interactions, motivation, and overall quality of life.
- Incomplete response: The medication takes the edge off but does not get your teen back to feeling like themselves
- Treatment-resistant depression: Some teens’ brains simply do not respond to antidepressant chemistry the way the research predicts
- Developing brain sensitivity: Parents often have legitimate concerns about introducing psychiatric medications to a brain that is still developing
When two or more antidepressants have not produced meaningful relief, a teenager is considered to have treatment-resistant depression. This is the moment when most families begin asking whether there is something else.
What Are All the Depression Treatment Options for Teenagers?
Here is a plain-language overview of the full treatment spectrum for teen depression, from first-line options through advanced treatments:
| Treatment | How It Works | Best For | Limitations |
|---|---|---|---|
| Therapy (CBT, DBT) | Teaches skills for managing thoughts, emotions, and behaviors | First-line; mild to moderate depression | May not be enough for severe or treatment-resistant depression |
| Antidepressants | Adjusts serotonin and norepinephrine in the brain | Moderate depression; works for many teens | Side effects; only 2 FDA-approved for teens; does not work for everyone |
| Combination (therapy + meds) | Addresses both brain chemistry and behavior patterns | Most common recommended approach | Same limitations if the medication does not work |
| Deep TMS | Magnetic pulses stimulate the mood-regulation areas of the brain; no drugs, no anesthesia | Treatment-resistant depression; teens who cannot tolerate meds | Requires daily sessions for 4-6 weeks; must meet insurance criteria |
| Spravato (esketamine) | Nasal spray that creates new brain connections; rapid results | Severe or treatment-resistant depression; suicidal ideation | Not covered for teenagers younger than 18. |
At Axis Integrated Mental Health, we offer all of these except IV ketamine. Our approach is to find the right combination for your teenager’s specific situation, not to push one treatment over another.
What Is Deep TMS and Is It Safe for Teenagers?
This is the question most parents ask first, and it is the right question to ask. Deep TMS is a non-invasive treatment that uses gentle magnetic pulses to stimulate the areas of the brain that control mood. Your teenager sits in a chair and wears a cushioned helmet. There is no anesthesia, no needles, no drugs, and no recovery time. Most sessions take about 20 minutes, and your teen can drive themselves or go straight back to school afterward.
In November 2025, the FDA granted clearance to the BrainsWay Deep TMS system specifically for adolescents ages 15 to 21, based on real-world evidence from 1,120 adolescents treated across 35 TMS centers in the United States. Psychiatric Times reported that after 36 sessions, depressive symptoms improved by an average of 12 points on the PHQ-9, a clinically significant improvement. Patients also showed meaningful reductions in co-occurring anxiety symptoms.
Axis is one of the only Denver-area practices using the BrainsWay H-Coil system, the same technology behind this FDA clearance. This matters because not all TMS devices are the same. The BrainsWay H-Coil reaches deeper and wider areas of the brain than standard figure-8 coil devices used at most TMS-only clinics in Colorado.
Side effects are generally mild: a headache or scalp tenderness during or after treatment. There is a very rare risk of seizure (less than 0.1%). Most teens tolerate it well from the first session.
What Happens to a Teenager’s Brain During Deep TMS? (And Why That Matters More Than Pills)
This is the section that most parents tell us was the turning point for them.
Antidepressants work by changing levels of certain chemicals in the brain. To do that, the medication circulates throughout your teenager’s entire body, affecting many different systems at once. This is why side effects such as weight gain, fatigue, and sexual side effects are common. The treatment is systemic rather than targeted.
Deep TMS works differently. It uses targeted magnetic pulses to stimulate the brain circuits involved in mood regulation. The primary target is the left prefrontal cortex, an area that often shows reduced activity in people with depression. Deep TMS helps reactivate these underactive networks and restore healthier brain function. Because Deep TMS is not a medication, it does not enter the bloodstream or circulate throughout the body. It does not affect hormones, metabolism, or other organ systems. The treatment is focused on the brain regions associated with depression, which is why it avoids many of the body-wide side effects commonly associated with antidepressant medications.
For parents who have been concerned about putting a developing brain on long-term psychiatric medication, this distinction is meaningful. TMS can also support deprescribing, meaning that many patients who respond well to TMS are eventually able to reduce or eliminate their medication with their prescriber’s guidance.
Many Axis families choose to do both TMS and Spravato together for teenagers 18 years old and over for the strongest possible outcome. In our clinical experience, the combination produces the best results and often allows teens to significantly reduce their medication load over time.
Does Insurance Cover Deep TMS for My Teenager?
Yes, in many cases. The insurance landscape for teen TMS has changed significantly in 2025 and 2026. Here is where each major carrier stands:
| Carrier | Minimum Age | Medication Trials Required | Therapy Required? | Key Notes |
|---|---|---|---|---|
| UnitedHealthcare / Optum | Age 15+ (as of Jan 1, 2026) | 2 trials; no class restriction for ages 15-17 | Helpful but not required | Most flexible criteria for teens |
| Cigna / Evernorth | Age 15+ | 2 trials; no class restriction for ages 15-17 | Yes – psychotherapy required | No prior auth needed as of March 2026 for contracted providers |
| Aetna | Age 15+ | 2 trials from 2 different classes, 8 weeks each; plus augmentation trial | Not required but asked | Stricter criteria; most documentation needed |
| Anthem BCBS Colorado | Age 18+ only | Not applicable for teens under 18 | N/A | Does not currently cover TMS for teenagers |
| Medicare | Age 18+ only | Not applicable for teens under 18 | N/A | Does not currently cover TMS for teenagers under 18 |
Colorado Medicaid does not cover Deep TMS for any age. If you have a Denver Health Medicaid plan, TMS is not covered. If you have a Denver Health POS+ commercial plan, coverage depends on your specific plan design.
Axis handles the entire insurance verification and prior authorization process for your family. You do not need to call your insurance company or navigate the approval process alone. Check your teen’s coverage here.
What Documentation Does My Teen’s Insurance Need to Approve TMS?
The most common reason a prior authorization is delayed or denied is incomplete documentation. Here is what Axis collects on your behalf before submitting:
- Your teen’s diagnosis (typically major depressive disorder, moderate to severe)
- Names, doses, and durations of antidepressants tried and the outcome of each
- Documentation of any therapy your teen has participated in
- A standardized depression rating scale score from your teen’s psychiatric evaluation
- A clinical summary written by your Axis provider supporting medical necessity
Most approvals through UHC, Cigna, and Aetna come through within two weeks of submission. Cigna patients have an additional advantage: as of March 6, 2026, Cigna no longer requires prior authorization at all for TMS at contracted behavioral health practices. Axis is a contracted Cigna provider.
What Does Deep TMS Cost for a Teenager with Insurance?
With insurance, most families at Axis pay a specialist copay per session. Here are general guidelines from our historical data on what to expect:
- Aetna: $20 to $50 per session after prior authorization
- Cigna: Approximately $30 per session based on 200+ Axis patients; no prior auth required as of March 2026
- UnitedHealthcare: As low as $10 per session depending on plan design
Without insurance, the standard 36-session protocol at Axis costs $5,500. An accelerated 6-day protocol is available for $7,000. HSA and FSA funds can be applied to any out-of-pocket costs.
Use the Axis TMS cost calculator to get a personalized estimate based on your specific plan. Enter your deductible, out-of-pocket max, and copay and get an estimate in under 60 seconds. No phone calls. No waiting on hold.
Where Can My Teenager Get Deep TMS in the Denver Area?
Axis Integrated Mental Health offers Deep TMS at four Front Range locations. All locations use the BrainsWay H-Coil system and accept Aetna, Cigna, UnitedHealthcare, Medicare, and Tricare. New patients are typically seen within 7 days.
- Denver (Aurora) – 1444 South Potomac Street, Suite 220, Aurora, CO 80012
- Denver Tech Center (Greenwood Village) – 6950 East Belleview Avenue, Suite 300, Denver, CO 80111
- Boulder (Louisville) – 400 South McCaslin Boulevard, Suite 111, Louisville, CO 80027
- Westminster – 8758 Wolff Court, Suite 205, Westminster, CO 80031
To schedule a free insurance check or to find out if your teenager qualifies for Deep TMS, schedule online here or call or text us at 720-400-7025.
Meet Dr. Kartiki Churi, MD – Axis CMO and Adolescent Psychiatry Specialist
If your teenager is struggling with depression and you are not sure where to start, Dr. Kartiki Churi is one of the Denver area’s leading psychiatrists specializing in adolescent mental health. As Chief Medical Officer at Axis Integrated Mental Health, Dr. Churi brings both clinical depth and a personal commitment to making advanced depression treatments accessible to teens who have not found relief through medication alone.
Dr. Churi sees adolescent patients in person at the Axis Boulder location at 400 South McCaslin Boulevard, Suite 111, Louisville, CO 80027, and via telehealth for families anywhere in Colorado. She oversees the clinical standards behind Axis’s Deep TMS and Spravato programs and works directly with teens to find the right treatment path, whether that means medication management, Deep TMS, Spravato, or a combination of all three.
Her approach starts with listening. She takes the time to understand your teenager’s full history before recommending any next steps, and she is experienced in navigating the specific ways depression shows up in adolescents, including when a drug-free option like Deep TMS is the right call.
To schedule an appointment with Dr. Churi in Boulder or via telehealth, call or text Axis at 720-400-7025. New patients are typically seen within 7 days.
What the Research Says About Teen Depression Treatment
- 19.2% of adolescents ages 12-19 experience depression in any given two-week period, with teen girls reaching 26.5%. From 2013-2014 to 2023, depression prevalence in adolescents and adults increased from 8.2% to 13.1%. Source: CDC NCHS Data Brief No. 527, April 2025.
- In 2025, 63,000 Colorado Adolescents had serious thoughts of suicide. But there is only 1 school psychologist for every 918 students in Colorado’s K-12 public schools. The recommended ration is 1 school psychologist for every 500 students. National Alliance for Mental Illness (NAMI), March 2025
- In November 2025, BrainsWay received FDA clearance for Deep TMS as an adjunct therapy for adolescents ages 15-21. Real-world evidence from 1,120 adolescents across 35 US TMS centers showed an average 12-point improvement on the PHQ-9 after 36 sessions. Source: Psychiatric Times, November 2025.
- Randomized controlled trials of TMS in adolescent depression have shown response rates of 89% to 98% for active TMS. Multiple peer-reviewed RCTs (Liu et al. 2022, Fu et al. 2022, Jiao et al. 2024) reported 89-98% response rates for active TMS versus 69-80% for sham. Source: Molecular Psychiatry, Nature, February 2026.
Frequently Asked Questions
Category 1: Understanding Teen Depression
How do I know if my teenager is depressed or just going through a phase?
The key difference between typical teenage moodiness and depression is duration and impairment. All teens have hard days. Depression means a persistent low mood, loss of interest, or significant behavior change lasting two weeks or more that is getting in the way of daily life, school, friendships, or sleep. If your teen has been struggling for more than two weeks and things are not improving, that is worth a professional evaluation. Learn more about teen depression and when to seek help at axismh.com.
What should I do first if I think my teenager is depressed?
Start with a visit to your teen’s pediatrician or a child and adolescent psychiatrist for a formal evaluation. Axis also has providers who see teens. If your teen is already in therapy and still struggling, or has tried medication without success, ask about advanced treatment options like Deep TMS. You can also call or text Axis at 720-400-7025 for a free insurance check. Most new patients at Axis are seen within 7 days. No referral is needed.
Category 2: TMS for Teenagers
Is TMS safe for teenagers?
Yes. Deep TMS is non-invasive: no drugs, no anesthesia, no needles. In November 2025, the FDA granted specific clearance for the BrainsWay Deep TMS system for adolescents ages 15 to 21, based on data from 1,120 teens treated across 35 US centers. The most common side effects are mild: a headache or scalp tenderness during or after a session. There is a very rare risk of seizure (less than 0.1%). Patients do not need recovery time and can return to school or normal activities immediately after each session. For more information on what to expect, visit axismh.com/tms/.
How is Deep TMS different from standard TMS for teenagers?
Standard TMS uses a figure-8 coil that stimulates a narrow, shallow area of the brain. Deep TMS, which is the only type used at Axis, uses the BrainsWay H-Coil, which reaches deeper and wider areas of the brain linked to mood regulation. Insurance companies reimburse both at the same rate, so your out-of-pocket cost is identical. The difference shows up in outcomes: Deep TMS has demonstrated higher response and remission rates in clinical data than older TMS technologies. Read our comparison at axismh.com for a deeper look.
Category 3: Insurance and Cost
What insurance plans cover TMS for teenagers in Colorado?
UnitedHealthcare, Cigna, and Aetna all cover Deep TMS for patients age 15 and older in Colorado. Anthem BCBS Colorado and Medicare currently cover TMS for adults age 18 and older only. Colorado Medicaid does not cover TMS for any age. Your teen typically needs to have tried two or more antidepressants without meaningful improvement to qualify. Axis handles all insurance verification and prior authorization at no extra charge. Check your teen’s coverage here.
How much does TMS cost for my teenager with insurance?
With insurance, most families pay a specialist copay per session. Cigna patients at Axis average about $30 per session. UHC patients may pay as little as $10 per session. Aetna patients typically pay $20 to $50 per session after prior authorization. Without insurance, the standard protocol at Axis is $5,500 for 36 sessions. HSA and FSA funds can be applied. Use the free Axis TMS cost calculator to get a personalized estimate for your teen’s specific plan in under 60 seconds.
Category 4: What to Expect
What does a TMS session look like for my teenager?
Your teenager sits comfortably in a chair and wears a cushioned helmet. The treatment delivers gentle magnetic pulses for about 20 minutes. Most teens listen to music or use the time to relax. There is no sedation. Your teen can drive themselves to and from sessions, go to school before or after, and participate in sports, work, or other activities on the same day. The standard course is 36 sessions over about six weeks. Axis also offers a 6-day accelerated protocol. Most teens begin to notice improvement within 3 to 4 weeks. Visit axismh.com/tms/ for a full walkthrough of what to expect.
