Learn which depression treatment option is right for you.

Outpatient Depression Treatment for Teens

Depression treatment for teens has focused on pharmaceuticals rather than on newer, drug-free options commonly used in adults, like transcranial magnetic stimulation (TMS). This is demonstrated by recent statistics provided by Express Scripts, a mail-order pharmacy, which reported that between 2015 and 2019, prescriptions of antidepressants for teenagers rose 38 percent, compared with 12 percent for adults.

Parents observing signs of depression in teens may struggle with understanding the difference between normal, teenage awkwardness and major depression. When confronted with major depression in teens, many are tempted to place their child into in-patient treatment to resolve the condition, only to find that finding such a setting may be difficult in a state that ranks 27th in the nation for youths experiencing at least one major depressive episode.

Adolescence can be a tumultuous time, filled with hormonal changes, academic pressures, social challenges, and identity formation. When coupled with the lingering trauma of the pandemic, underlying mental health issues, and social media, teenagers can be left with feelings of sadness, hopelessness, and worthlessness in teenagers.

This page aims to provide a comprehensive guide to recognizing the signs of depression in teens, treatment options, coping strategies, and accessing professional assistance. While there is a time and a place for in-patient treatment, many teens with major depressive disorder may benefit from outpatient care and innovative approaches like transcranial magnetic stimulation (TMS).

Depression What are the Symptoms?

Major depression in a teen is a mental health condition characterized by persistent feelings of sadness, hopelessness, and despair that significantly interfere with a teenager's daily life and functioning. It goes beyond the typical mood swings or occasional feelings of sadness commonly experienced during adolescence.

Signs of depression to look for in teens

Changes in Appetite: Depressed teenagers may experience significant changes in appetite, leading to either noticeable weight loss or weight gain. This change is not due to intentional dieting but rather a manifestation of their emotional state.

Changes in Sleep Patterns: Sleep disorders are common among teenagers with depression. This can manifest as difficulty falling asleep, staying asleep throughout the night, or excessive sleeping (hypersomnia). Conversely, some teens may experience insomnia, struggling to get adequate sleep despite feeling exhausted.

Feelings of Guilt or Worthlessness: Teens with depression often harbor intense feelings of guilt, self-blame, or worthlessness, even when there is no logical reason for such feelings. They may constantly criticize themselves and perceive themselves as inadequate or unlovable.

Loss of Interest in Activities: A noticeable lack of interest or pleasure in activities that were once enjoyable or engaging is a common sign of teenage depression. This can include hobbies, socializing with friends, or participating in school or extracurricular activities.

Persistent Sadness: Teens with depression often experience prolonged periods of deep sadness or emptiness, which may seem disproportionate to their circumstances.

These symptoms can vary in intensity and duration but typically persist for an extended period, lasting for weeks or months, and significantly impairing the teenager's ability to function normally in various aspects of their life, including academics, social interactions, and personal relationships. It's essential for parents, caregivers, and educators to recognize these signs of a teen with depression and seek professional help as early as possible. The longer a teen lives with depression, the harder it is to resolve.

Risk factors for depression in teens

Genetic Predisposition: Research suggests that genetics play a significant role in the development of depression, with teenagers having a family history of depression being at a higher risk. Certain genetic variations may make individuals more vulnerable to developing depressive symptoms when exposed to stressors.

Environmental Stressors: Adolescence is a period marked by numerous stressors, including academic pressure, social expectations, family conflicts, and peer relationships. These stressors can overwhelm teenagers and contribute to the onset or exacerbation of depression.

Trauma: Exposure to traumatic events such as abuse, neglect, violence, or loss can significantly increase the risk of depression in teenagers. Traumatic experiences during childhood or adolescence can disrupt normal emotional development and increase vulnerability to mental health issues.

Social Influences: Social factors, such as bullying, peer pressure, social rejection, or feelings of loneliness and isolation, can contribute to teenage depression. Adolescents may struggle to navigate complex social dynamics, leading to feelings of inadequacy or social anxiety, which can contribute to depression.

Social Media: Research found that excessive social media use among adolescents was associated with higher levels of depression and anxiety symptoms. In addition, The British Medical Journal (2019) reported that exposure to idealized images and unrealistic beauty standards on social media platforms can contribute to negative body image and low self-esteem among children and adolescents.

We also know that excessive screen time can cause sleep disturbances and disrupted circadian rhythms which can contribute to mood disturbances and cognitive impairments. [Source: American Academy of Pediatrics. (2016). Media and Young Minds. Pediatrics, 138(5), e20162591.]

In summary, research suggests that excessive use of social media platforms is associated with various negative outcomes, including depression, anxiety, negative self-perception, cyberbullying, sleep disturbances, among other issues. It's essential for parents, educators, and policymakers to be aware of these risk factors and take proactive steps to support children's mental well-being.

Teen Depression: How to Recognize When to Seek Professional Help

Recognizing signs indicating the need for professional depression treatment for teens is crucial for ensuring that individuals receive timely support and treatment for their mental health concerns. The sooner a teen gets help, the easier it is to recover and prevent long-term damage. Some common signs that may indicate the need for professional intervention include:

  1. Persistent Depressive Symptoms: If an individual experiences persistent feelings of sadness, hopelessness, or despair that last for an extended period (typically two weeks or more) and significantly impact their daily functioning, it may indicate clinical depression. Other symptoms may include changes in appetite or sleep patterns, fatigue, difficulty concentrating, and feelings of worthlessness or guilt.
  2. Thoughts of Self-Harm or Suicide: Teenagers who express thoughts of self-harm, suicide ideation, or engage in self-destructive behaviors should be taken seriously and provided with immediate professional intervention. Signs may include talking about feeling hopeless, having no reason to live, giving away cherished possessions, expressing thoughts of being a burden to others, or making plans for suicide.
  3. Impaired Functioning: If an individual's mental health symptoms significantly impair their ability to perform daily tasks, fulfill responsibilities, or engage in activities they once enjoyed, it may indicate the need for professional help. This can include difficulties at school or work, social isolation, withdrawal from friends and family, or neglect of personal hygiene and self-care.
  4. Social Withdrawal: Withdrawal from social activities, hobbies, and relationships can be a sign of underlying mental health issues, such as depression or anxiety. If an individual consistently avoids social interactions, isolates themselves from others, or exhibits changes in their social behavior, it may warrant professional intervention to address their emotional well-being.

It's essential to approach these signs with empathy, understanding, and non-judgmental support. Provide teenagers with options from qualified mental health professionals, such as therapists, counselors, psychologists, or psychiatrists, who can provide assessment, diagnosis, and appropriate treatment options tailored to their needs and include them in the decision-making process.

If your teen expresses immediate thoughts of self-harm or suicide, it's crucial to take immediate action by contacting emergency services or calling the Colorado Crisis Hotline or NAMI.

Options for Teenage Depression Treatment

Depression treatment for teens typically involves a combination of therapy, medication, lifestyle changes, and support from family and peers. Here are some common approaches to depression treatment for teens:

Traditional Depression Treatment for Teens

  1. Therapy (Psychotherapy):
    • Cognitive Behavioral Therapy (CBT): CBT is a widely used therapeutic approach for treating depression in teenagers. It focuses on identifying and challenging negative thought patterns and behaviors, teaching coping skills, and promoting problem-solving strategies.
    • Interpersonal Therapy (IPT): IPT focuses on improving communication and relationship skills, addressing interpersonal conflicts, and resolving issues related to grief, loss, or life transitions.
    • Dialectical Behavior Therapy (DBT): DBT combines elements of CBT with mindfulness techniques to help teenagers regulate emotions, manage distress, and develop healthy coping mechanisms.
    • Family Therapy: Family therapy involves working with the entire family to improve communication, resolve conflicts, and address family dynamics that may contribute to depression in teenagers.
  2. Medication:
    • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and other antidepressant medications may be prescribed to teenagers with moderate to severe depression. These medications help regulate neurotransmitters in the brain associated with mood regulation.
    • Many parents ask us "What is a good antidepressant for a teenager?" Currently, there are only two FDA-approved antidepressants for teens – Lexapro and Prozac, although doctors may prescribe for off-label use. Genetic testing may also result in a certain medication being prescribed over another, even if it is off-label.
    • Teenagers need to be monitored closely by a healthcare provider, and preferably, a mental health specialist when taking antidepressants, as they may have side effects and require adjustments to dosage or medication. It is also advisable to have a mental health specialist prescribing to avoid polypharmacy situations where teens can easily become overmedicated without the proper oversight.
    • Here are a few questions you should ask for Better Mental Health Medication Management

Intensive Depression Treatment for Teens

  1. Intensive Outpatient Program (IOP):
    • IOP is a level of care that offers more intensive treatment than traditional outpatient therapy but is less restrictive than inpatient or residential programs.
    • IOP typically involves attending therapy sessions and group sessions several times a week, usually for three to five days, while allowing individuals to return home in the evenings or on weekends.
    • Treatment in an IOP may include individual therapy, group therapy, family therapy, psychoeducation, medication management, and experiential therapies.
    • IOPs are suitable for teenagers who require more structured and intensive treatment than traditional outpatient therapy but do not require 24-hour supervision or medical monitoring.
    • We often serve as a step-down facility to manage medications for patients after they leave an IOP program so patients can maintain progress.
  1. Partial Hospitalization Program (PHP):
    • PHP is a more intensive level of care that provides comprehensive treatment during the day while allowing individuals to return home or to a supervised living environment in the evenings.
    • PHP typically involves attending treatment sessions five days a week, for several hours each day, often resembling a full-day school schedule.
    • Treatment in a PHP may include individual therapy, group therapy, family therapy, medication management, psychiatric evaluation and monitoring, psychoeducation, and various therapeutic activities.
    • PHPs are suitable for teenagers who require structured and intensive treatment but do not require 24-hour medical supervision or inpatient hospitalization. PHPs offer a higher level of support and supervision than IOPs and are appropriate for individuals who may be at risk of self-harm or require more intensive intervention.
    • We can also support teens leaving a PHP program to manage medications or add on additional services like TMS.

Both IOPs and PHPs provide a supportive and therapeutic environment where teenagers can receive comprehensive treatment for depression while continuing to maintain connections with their families, schools, and communities. These programs are often part of a continuum of care, with individuals transitioning to less intensive levels of treatment as they progress in their recovery journey. It's essential for teenagers and their families to work closely with mental health professionals to determine the most appropriate level of care and develop a personalized treatment plan that meets their needs and goals.

You can also read our Insider's Guide to Mental Health Resources for Students to get a more general overview about Colorado's mental health system and the levels of care summarized in the table below.

SymptomsLevel of CareReasons to Use FacilityTreatment EnvironmentWho to Contact
Anxiety/DepressionOutpatient•Initial Assessment
•Mild to moderate symptoms
•Step-down from higher levels of care
Outpatient ClinicAxis Integrated Mental Health
Moderate Anxiety/DepressionIntensive Outpatient Program (IOP)•Structured treatment
•Increased support needed
IOP FacilityNorthstar Transitions
Severe Anxiety/DepressionPartial Hospitalization Program (PHP)•Severe symptoms
•Need for medical supervision
PHP FacilityNorthstar Transitions
Suicidal ThoughtsInpatient Hospitalization•Immediate danger to self/others
•Need 24/7 supervision
Inpatient HospitalBoulder Community Health
Unstable Bipolar Disorder Mania/HypomaniaInpatient Hospitalization•Stabilization of manic symptoms
•Need for medication adjustment
Inpatient HospitalCentennial Peaks
Schizophrenia/Psychotic SymptomsInpatient Hospitalization•Acute Symptoms
•Need for intensive monitoring
Inpatient HospitalCentennial Peaks
Substance AbuseInpatient/Outpatient•Need for structured program
•Medical supervision
Rehabilitation CenterSandstone Care
Eating DisordersInpatient/Outpatient•Need for medical monitoring
•Nutritional Counseling
Eating Disorder ClinicLa Luna Center

It's essential for teenagers with depression to work closely with a qualified mental health professional to develop a personalized treatment plan tailored to their individual needs and preferences. Collaboration between teenagers, their families, healthcare providers, and other support systems is crucial for achieving positive outcomes in depression treatment.

Drug-Free Depression Treatments for Teens

The increase in the number of psychotropic drugs being prescribed to adolescents and teens is concerning as many of these drugs have not been studied for their impact on a developing brain, or their impacts when used together. While we are not against using medications in teens, we also believe in a conservative approach until more clinical data can prove the efficacy and safety of a polypharmacy approach, especially when non-pharmacological approaches exist.

Transcranial Magnetic Stimulation (TMS)

TMS Treatment uses magnets to stimulate the parts of the brain involved with depression and anxiety. No pharmaceuticals are used during the treatment. The treatment has been FDA-approved and covered by insurance for depression in adults, but is not currently approved for use in children under 18. However, research has shown that off-label use of the treatment is safe in children as young as 9. Please read TMS Treatment for Teenage Depression and Advantages of TMS for more information about this innovative treatment option.

Lifestyle Changes

  • Regular Exercise: Physical activity can help alleviate symptoms of depression by releasing endorphins, reducing stress, and improving mood. Encourage teenagers to engage in regular exercise, such as walking, jogging, swimming, or participating in sports.
  • Healthy Eating: A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can support overall well-being and help regulate mood. We can provide nutritional psychiatry coaching as part of a holistic mental health treatment plan.
  • Sufficient Sleep: Adequate sleep is essential for mental health. Encourage teenagers to establish a regular sleep schedule and practice good sleep hygiene habits, such as avoiding screens before bedtime and creating a relaxing bedtime routine.
  • We also highly endorse social prescribing to support patients with their mental health.

Support Groups and Peer Support

  • Support groups and peer support networks can provide teenagers with a sense of belonging, understanding, and validation from others who have experienced similar struggles with depression. These groups may be led by mental health professionals or peers and can offer encouragement, empathy, and shared coping strategies.
  • WiseMind Counseling in Denver has a few Teen Groups and they take insurance.

School-Based Support

Many schools offer counseling services, support groups, and mental health resources to help students cope with depression and other mental health issues. School counselors and mental health professionals can provide individual counseling, academic accommodations, and referrals to outside resources as needed.

Alternative Therapies

Some teenagers may benefit from complementary and alternative therapies such as mindfulness meditation, yoga, art therapy, or acupuncture. These approaches can help reduce stress, promote relaxation, and enhance overall well-being when used with traditional treatment methods.

Should you Consider Ketamine Infusions for Teens?

While ketamine infusions can be incredibly useful for adults and can be prescribed off-label for teens, we believe that a certain level of maturity is needed for teenagers to understand the mechanism by which the treatment works, rather than being focused on the disassociative experience. We have observed in our clinic that even adults can become hyperfixated on the disassociation from reality rather than working on creating a reality they don't need to disassociate from.

This is to not to say that we would never prescribe ketamine infusions for teens. For suicidal ideation, it may be the best option for getting immediate relief before moving to a non-pharmacological approach like TMS. However, two prescribers need to be in agreement that ketamine is the proper course of action and no other treatment would be appropriate. We hope that teens get help before they get into this phase, but that isn't always possible.

How to Find Professional Depression Treatment for Teens

Finding a qualified mental health professional for teenagers and their families can be a crucial step toward addressing mental health concerns effectively. Here's some guidance on how to locate and choose the right mental health services:

  1. Ask for Referrals: Seek recommendations from trusted sources such as family members, friends, teachers, school counselors, or primary care physicians. They may be able to provide valuable insights and referrals to qualified mental health professionals in your area.
  2. Check with Insurance Providers: If you have health insurance, check your provider's directory of mental health professionals who are covered under your plan. This can help narrow down your options and ensure that you have access to affordable mental health services.
  3. Use Online Directories: Utilize online directories and resources to search for licensed therapists, psychologists, psychiatrists, and counseling centers in your area. Websites such as Psychology Today, GoodTherapy, or the American Psychological Association's Psychologist Locator allow you to search for mental health professionals based on location, specialty, and insurance coverage.
  4. Consult Professional Organizations: Explore professional organizations and associations for mental health professionals, such as the American Psychological Association (APA), the American Psychiatric Association (APA), or the National Association of Social Workers (NASW). These organizations often have directories or referral services to help you find qualified professionals.
  5. Research Credentials and Specialties: When considering potential mental health professionals, research their credentials, experience, and areas of specialty. Look for professionals who are licensed, credentialed, and experienced in treating the specific mental health concerns or issues that you or your teenager are facing.
  6. Consider Teletherapy Options: In addition to traditional in-person therapy, consider teletherapy options, which provide remote mental health services through video conferencing or phone calls. Teletherapy can offer convenience, accessibility, and flexibility, especially for individuals who may have difficulty accessing in-person services.
  7. Schedule Consultations: Once you've identified potential mental health professionals, schedule initial consultations or appointments to discuss your needs, concerns, and treatment goals. Use this opportunity to ask questions, discuss treatment approaches, and determine if the professional fits your teenager.
  8. Trust Your Instincts: Ultimately, trust your instincts and intuition when selecting a mental health professional. Choose someone who makes you feel comfortable, understood, and respected, and who demonstrates empathy, expertise, and professionalism in their interactions.

Don't Forget to Help Yourself Before Seeking Depression Treatment for Teens

You are the single most important member of your child's care team. But you cannot continue to give from an empty cup. Supporting a loved one with a mental illness requires strength and patience. Giving yourself the emotional resources to survive and thrive during this time is the best thing you can give to your teen. Don't hesitate to reach out to Axis Integrated Mental Health for help and support when needed.

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