Treatment for Depression and Suicidal Behavior

Psychotherapy or medications might be helpful for helping a suicidal child or adolescent solve problems that are causing them to feel suicidal. A trained professional can assess the situation and make treatment recommendations.

According to Division 53 of the American Psychological Association several specific forms of short-term psychotherapy have been shown to be beneficial in the treatment of depression in children and teens. Cognitive behavioral therapy (CBT) is likely to help both children and teenagers by identifying maladaptive behaviors and replacing them with more adaptive ones, as well as identifying problematic thought problems or perspectives and helping them adopt more adaptive perspectives and problem-solving approaches. For depressed teenagers, interpersonal therapy (IPT) is a well-established treatment. IPT helps teens understand and address problems in their relationships with family members and friends that contribute to depression. Group therapy has also been shown to be an effective intervention in teens either alone or in conjunction with individual therapy.

Behavior Therapy and Behavioral Interventions for Children and Adolescents

Guidelines for Choosing a Behavior Therapist

Drug Therapy

Some medications (specifically, selective serotonin reuptake inhibitors or SSRIs) may help relieve youth depressive symptoms, especially for teens. However, little is known about their long-term effects or effectiveness for younger children.

According to the Academy of Child and Adolescent Psychiatry, the use of antidepressants seems indicated with children and adolescents who have such severe symptoms that psychotherapy is not effective, who have tried psychotherapy and it has not worked, or who have long-lasting or a recurrent (keeps coming back) form of depression. If your provider determines that medications are necessary to treat your child’s or adolescent’s depression, SSRIs are the initial antidepressants of choice.¹ The American Academy of Child and Adolescent Psychiatry recommends that psychiatric medications should not be used alone, and should only be one part of a comprehensive treatment plan.

It is important to consider potential side-effects compared to the benefits of medications. Not all medications work the same for everyone; therefore it is important that you consult with your pediatrician or a child psychiatrist to determine which medication (if any) is best for a child.

Questions to ask your child’s provider about psychiatric medications.

The United States Federal Drug Administration (FDA) directed manufacturers of antidepressants to revise their labeling to include a "black box" warning to alert health-care providers to an increased risk of suicide in children and teens. More

The American Psychiatric Association and American Academy of Child and Adolescent Psychiatry have produced The Use of Medication in Treating Childhood and Adolescent Depression: Information for Patients and Families. This guide provides a different perspective on the FDA’s "black box" warning, useful information about depression and suicide, and guidelines to help patients and families make informed decisions about obtaining the most appropriate care for a child with depression.

TRICARE Pharmacy Information

Treatment of Children With Mental Disorders
A booklet with answers to frequently asked questions about the treatment of mental disorders in children -- includes a medication chart.

Because even symptoms of depression that do not meet criteria for a diagnosis of a depression related disorder can impact a child, there are things parents can do to assist health care provider(s) in determining the right course of treatment for a teen or child.

Keep a folder system to organize all of your child's academic, assessment and treatment records. You do not have to wait for advice to collect information. Collect anything that you may think relevant to communicate to your provider. This can include documentation that tracks mood, specific behavior, or change in behavior, weight or diet concerns, and changes in activity level. The goal is to gather and organize as much detail as possible by being descriptive and including information such as time, date and duration.

Identify potential factors in a child’s environment that may be impacting the child. This can include things like divorce, substance use, moves, or any significant change or loss. These things do not have to directly impact your child, but may be something experienced by a primary caregiver or close sibling. A family member’s mental health issues may also be impacting a child. Other environmental conditions that are related to childhood depression are physical or sexual abuse, changes in primary caregiver, ongoing problems with learning or peer interaction, and disruption of family housing or employment. Seek counseling for yourself and your child when these environmental issues are present in your family life.

Help children develop a strong social network. The goal is to provide a child with a social group that has the potential to increase a child’s daily or regular interaction and activity level, which can lead to a better overall mood (e.g. Boy/Girl Scouts, YMCA, etc.). Another benefit to a strong social network is the addition of people to reach out to or who are concerned and supportive of a child, especially if the child’s mood begins to worsen.

¹American Academy of Child and Adolescent Psychiatry (1998). Practice parameters for the assessment and treatment of children and adolescents with depressive disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 37(10suppl).