Teen Depression

Diagnosis

Diagnosing teen depression typically includes several steps to understand symptoms, rule out other conditions and determine the most accurate diagnosis. A physical exam is often the first step. During this exam, the doctor may ask detailed questions about your teenager’s overall health to uncover any medical issues that could be contributing to depression. Lab tests, such as a complete blood count or thyroid test, may also be done to rule out physical causes of depressive symptoms.

A psychological evaluation is an essential part of the diagnostic process. A doctor or mental health professional discusses your teen’s thoughts, emotions and behaviors, and may use questionnaires to help identify patterns. This evaluation also helps pinpoint the type of depression involved. Different specifiers may be used, such as anxious distress, melancholic features or atypical features, each representing specific symptom patterns.

Depression symptoms can also overlap with other disorders. Conditions such as bipolar disorder, cyclothymic disorder, disruptive mood dysregulation disorder, persistent depressive disorder and premenstrual dysphoric disorder may present with depression-like symptoms. Some cases of depression are linked to substance use, medications or underlying medical conditions. A thorough evaluation helps determine if depression is a primary diagnosis or a symptom of another condition.

Treatment

Treatment for teen depression varies based on the type and severity of symptoms. Many teenagers benefit from a combination of talk therapy and medication. If your teen has severe depression or risks self-harm, a hospital stay or outpatient treatment program may be needed until symptoms become more manageable.

Medication options approved for teen depression include fluoxetine and escitalopram. These medicines may take time to work, and finding the right dose may require patience. A black box warning on all antidepressants highlights the rare possibility of increased suicidal thoughts in people under 25 during the early treatment period or after dose changes. Careful monitoring is essential, particularly in the first few weeks. Most teens who take antidepressants experience more benefits than risks, especially as symptoms improve over time.

Managing medications involves ensuring they are taken consistently. To lower overdose risk, doctors may prescribe smaller quantities or advise parents to control access to all medications at home. Teens should not stop antidepressants suddenly, as this could lead to withdrawal symptoms or a rapid return of depression. For teens who are pregnant or breastfeeding, consultation with a doctor is crucial to determine safe options.

Psychotherapy is a core part of treatment. This includes talk-based approaches such as cognitive behavioral therapy or interpersonal therapy. These sessions help teens understand the causes of depression, identify harmful thought patterns and learn healthy coping strategies. Therapy can be done individually, with family or in group settings. It helps teens set realistic goals, explore relationships and experiences, regain optimism and manage emotions more effectively.

In some cases, hospitalization or day treatment programs may be needed. Hospitalization provides a safe environment for teens who may harm themselves or others. Day treatment programs offer intensive support and therapy while allowing teens to continue living at home. These structured settings help stabilize symptoms and build coping strategies that support long-term recovery.