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What is the Best Treatment for Teenage Depression?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Depression is a serious mental health condition.

However, the word depression has become a catch-all, informal word that people use all the time to mean something other than the class of mental health disorders known by mental health professionals by their clinical designation, depressive disorders.

When you talk with friends, acquaintances, and family members, you might hear sentences like this:

I am so depressed.

It’s enough to make you depressed.

I’ve been a little depressed lately.

What a depressing movie!

And when you talk to teenagers or read their texts, you’ll probably hear or see this one:

OMG. *fml* I’m depressed.

In all those sentences – and in the context(s) in which most are used – the word depressed functions as a synonym for the word sad. Which is fine. And in most cases, mostly harmless. Mostly harmless, though, is not totally harmless.

The reason we start here, talking about the informal use of the word, is that it’s one of the reasons significant stigma around mental health disorders like depression still exists – and stigma around mental health disorders is not harmless.

It causes people who need treatment to avoid treatment, it causes people in treatment to feel shame about their treatment, and it causes the general public to dismiss both the clinical phenomenon of depression and therefore, dismiss depression treatment and minimize the pain and suffering of people with depression.

Stigma, to put it simply, is not harmless – and the way we throw around the word depression is partly to blame for the harm caused by stigma. The constant informal use of the word as a stand in for sad trivializes clinical depression by equating it with the typical, run-of-the-mill, day-to-day sadness we all feel at times.

Depression is not sadness: depression is a serious mental health condition.

Understanding Teen Depression and Treatment for Teen Depression

If you’re the parent of a teen who recently received a diagnosis for a depressive disorder, finding appropriate treatment is one of the most important steps you and your family will take on the journey back to total health, harmony, and wellbeing.

This article will help you understand what a depression diagnosis means. We’ll talk about the history of depression treatment, offer a list of signs and symptoms of depression in teens, present the latest data on the prevalence of depression among teens, and then share the types of treatment that – according to the latest scientific research – are most effective for treating depression in teens.

Here’s a quick primer on the history of depression:

Prehistory (Mesopotamia, Babylon, etc.)

Depression was considered a form of spiritual malady or possession by demons or evil spirits. Treatments sometimes included beatings and things like starvation, thought to drive out the demons or spirits.

The Classical Era

In Greek and Roman civilizations, many people still believed depression – known then as melancholia – was caused by evil spirits. The famous Greek physician Hippocrates – famous for the Hippocratic Oath that all modern doctors take  – believed depression was caused by an imbalance in the humours, i.e. their word for various bodily fluids. Later in the classical era, the Roman philosopher Cicero proposed that emotions such as fear, anger, or grief cause depression. It’s interesting to note that during this time, physicians prescribed things like massage, changes in diet, exercise, music, and medication derived from the opium poppy to treat depression. That’s interesting because, after almost a thousand years, these approaches – excluding opioid drugs – are now recognized as effective complementary supports for depression treatment, and are often included in the best treatment plans for teenage depression.

The Renaissance and Enlightenment

This period, despite its many advances in science and art, is when the idea of depression as a personal weakness or moral failure became prevalent. It became common to shun people with depression, or worse, lock them up. However, the idea that depression may be inherited – predating the discovery of genetic contributions to depression by hundreds of years – was first proposed during this era.

The 20th Century

This period defined the landscape for what we think of as modern approaches to treatment for depression. During the 20th century, doctors and therapists defined many of the terms we’re familiar with today. Psychoanalysis – the origin of modern talk therapy – was invented by Sigmund Freud and expanded by thinkers like Carl Jung. Theorists like B.F. Skinner proposed a behaviorist theory of and approach to mental illness. Researchers like Aaron Beck proposed cognitive explanations for depression, which led to effective treatments that we use today, such as cognitive behavioral therapy (CBT) and its host of derivatives.

While the 20th century brought significant advances and formed the foundation for the contemporary medical model of mental illness, it also struggled under the weight of centuries of stigma. Isolation, shunning, and minimizing depression – core elements of stigma – were common in 20th-century culture. These ideas persisted well into the 1990s, and crept into the first part of the 21st century.

Depression in the 21st Century: Expanded Understanding Grounded in Medical Science

In the 21st century, the medical model of mental illness became the most widely accepted theoretical framework for understanding and treating mental health disorders, including depression. Here’s a basic definition of the medical model of mental illness published by the American Psychological Association (APA). The medical model is:

“…the concept that mental and emotional problems are analogous to biological problems—that is, they have detectable, specific, physiological causes (e.g., an abnormal gene or damaged cell) and are amenable to cure or improvement by specific treatment.”

During the 20th century, researchers and therapists also recognized the contributions of environment, genetics, and personal experience to the development of depression. All these factors are consistent with the medical model because clinicians recognize their effect on brain function, which is, by definition, physiological. In turn, they recognize the impact of physiological brain function on mental health.

And, specifically germane to this article, depression.

This level of understanding gives us our contemporary, working definition of depression, found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the go-to reference manual mental health professionals use every day to diagnose patients with mental health disorders. The DSM-V refers to depression as major depressive disorder and defines it as “…an overwhelming feeling of sadness, isolation, and despair that last two weeks or longer at a time.”

In the 21st century, we recognize the following symptoms of depression.

Symptoms of Teen Depression

  • Persistent sad or empty mood
  • Loss of interest in or inability to enjoy favorite hobbies, sports, and activities
  • Persistent or daily crying
  • Frequent or daily feelings of hopelessness or pessimism
  • Frequent or daily irritability, hostility, or anger
  • Persistent feelings of guilt or worthlessness
  • Decreased energy or fatigue
  • Social isolation and impaired communication
  • Persistent boredom and low energy
  • Extreme restlessness and agitation
  • Difficulty concentrating, remembering things, or making decisions
  • Insomnia or excessive sleeping
  • Extreme loss or gain of weight
  • Thinking about, talking about, or attempting suicide*
  • Physical symptoms such as headaches or stomach aches without a clear physical cause, which typical treatment does not help

*If you think your teen is in imminent danger, please call 911 or go to the nearest emergency room immediately.

It’s important to understand that a clinical diagnosis of depression only requires an individual to experience one of the first two symptoms, but they must persist daily for two weeks or more to meet the criteria for clinical depression.

Those are the signs and symptoms of depression. If your teen has depression and you’re seeking the best treatment for teenage depression, it’s helpful to know you’re not alone, and that many teens and families face and overcome depression every year.

Here’s the data from the  2019 National Survey on Drug Use and Health (NSDUH) on rates of depression and mental health treatment.

Prevalence of Teen Depression and Treatment: United States (2019)

  • 8 million adolescents diagnosed with major depressive disorder (MDE)
  • 6 million adolescents received treatment for MDE
  • 601,000 adolescents received treatment for a MDE with severe impairment

Prevalence of Teen Depression: United States (2019) By Age

  • 13-14: 8.4%
  • 15-16: 12.6%
  • 17-18: 15.4%
  • Females age 13-18: 15.9%
  • Males age 13-18: 7.7%
  • With severe impairment, female and male, age 13-18: 8.7%

We provide these numbers so you know that you aren’t alone – and neither is your teenager. Millions of adolescents have depression, over a million seek and receive treatment each year, and many of those learn to manage their depression and live full and productive lives.

Now, as promised, we’ll move on to our discussion of depression treatment, which, by the way, does not involve the damaging – and admittedly barbaric – practices of the past, but rather, relies on compassion, empathy, and human-to-human understanding, grounded in solid scientific evidence, peer-review, and best practices established by clinicians and researchers around the world.

Treatment for Teenage Depression: Data-Driven, Compassionate, and Effective

Research shows that the most effective treatment for teenage depression follows the integrated treatment model. The best treatment centers for teenage depression apply this model, which includes a combination of individual therapy, group therapy, family therapy, medication (as needed), lifestyle modifications, and complementary supports like mindfulness, expressive therapies, experiential activities, and community support.

At the best treatment center for teens with depression, these therapies above typically occur in various combinations across different levels of care. The different levels of care correspond to the specific amount of supervision, monitoring, treatment immersion, and treatment intensity a teen with depression needs. The common levels of care include outpatient treatment (OP), intensive outpatient treatment (IOP), partial hospitalization treatment (PHP), and residential treatment (RTC).

To learn more about levels of care, please read our introductory article “Teenage Rehab Centers in California: How to Choose the Right Program for Your Child.”

Integrated Treatment for Teenage Depression: Practical Skills for Managing Symptoms

The primary objective of depression treatment for teens – or for anyone at any age – is to give them the tools to process their emotions, manage their symptoms, and live a life that’s not dominated by their depression.

These tools include, but are not limited to:

  1. Learning to identify, talk about, and process their emotions.
  2. Validating their own experiences and emotions
  3. Understanding how these emotions affect their thoughts and patterns of thought.
  4. Realizing how these thoughts or patterns of thought affect their behavior.
  5. Using this knowledge to process and manage the patterns of behavior, thought, and emotion that disrupt life and cause pain and/or discomfort.
  6. Believing they have the power to manage their depression through practical action guided by reflective thought, the support of mental health professionals, and the compassion and love of their family and peers.

Teenagers who receive evidence-based, integrated treatment for depression learn that they’re more than their diagnosis. They understand they can live a full and productive life. They learn that with treatment and support, they can live a life they create, rather than a life defined by their mental health condition. The skills they learn – when they receive the best depression treatment available – are theirs for life. They can apply them at home, at work, at school, and in their social lives.

The best treatment for teens empowers them to be themselves. It allows them to learn, grow, enjoy their lives, and enables them to navigate the tricky – and sometimes challenging – transition from youth to adulthood and beyond.

To learn about how to find the best treatment center for your teenager with depression, please read our article Mental Health Treatment for Adolescents: An Overview or read and download this helpful guide: How to Find the Best Treatment Programs for Teens.

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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