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Depression treatment for children: What works?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/depression-treatment/AN00685
- With Mayo Clinic emeritus consultant
Jay L. Hoecker, M.D.
read biographyclose windowBiography of
Jay L. Hoecker, M.D.
Jay Hoecker, M.D.
Dr. Jay Hoecker, an emeritus member of the Department of Pediatric and Adolescent Medicine, brings valuable expertise to health information content on primary care pediatrics. He has a particular interest in infectious diseases of children.
He's a Fort Worth, Texas, native, certified as a pediatrician by the American Board of Pediatrics and a fellow of the American Academy of Pediatrics. He was trained at Washington University's St. Louis Children's Hospital, and in infectious diseases at MD Anderson Cancer Center in Houston. He has been with Mayo Clinic since 1989.
"The World Wide Web is revolutionizing the availability and distribution of information, including health information about children and families," Dr. Hoecker says. "The evolution of the Web has included greater safety, privacy and accuracy over time, making the quality and access to children's health information immediate, practical and useful. I am happy to be a part of this service to patients from a trusted name in medicine, to use and foster all the good the Web has to offer children and their families."
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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.
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. The treatment plan must be tailored to the severity of the child's symptoms and how they affect his or her development.
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, especially when psychotherapy is unable to effectively treat mood symptoms. Untreated mood disorders in adolescents are associated with an increased risk of suicide. Some research also 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 a family history of depression with good response to medication
- Don't have active substance abuse issues
- Don't have bipolar depression or an active psychotic illness
Even when symptoms of depression go away, continuing psychotherapy or antidepressants for a time reduces the risk that depression will recur.
Remember, depression is as common in children as it is in adults. 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.
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- Bridge JA, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: A meta-analysis of randomized controlled trials. Journal of the American Medical Association. 2007;297:1683.
- Bonin L. Depression in adolescents: Epidemiology, clinical manifestations, and diagnosis. http://www.uptodate.com/home/index.html. Accessed July 19, 2010.
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- Wall CA (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 16, 2010.
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