Only in the past two decades has depression in children been taken very seriously. The depressed child or teen may pretend to be sick, refuse to go to school, cling to a parent, or worry that the parent may die. Older children may be irritable, sulk, get into trouble at school, be negative, grouchy, and feel misunderstood.

Because normal behaviors vary from one childhood stage to another, it can be difficult to tell whether a teen is just going through a temporary phase or is suffering from depression. Sometimes the parents become worried about how the teen's behavior has changed, or a teacher mentions that your child doesn't seem to be himself. In such cases, if a visit to the child's pediatrician rules out physical symptoms, the doctor will probably suggest that the child be evaluated, preferably by a psychotherapist who specializes in the treatment of teenagers.

The good news is that psychotherapy has been found to be the preferred treatment over medications. Research has shown that, as in adults, depression in children and adolescents is treatable. Certain antidepressant medications, called selective serotonin reuptake inhibitors (SSRIs), can be beneficial to children and adolescents with major depressive disorder, the severest form of depression. However, there has been some recent concern that the use of antidepressant medications themselves may induce suicidal behavior in youths. Following a thorough and comprehensive review of all the available published and unpublished controlled clinical trials of antidepressants in children and adolescents, the U.S. Food and Drug Administration (FDA) issued a public warning in October 2004 about an increased risk of suicidal thoughts or behavior (suicidality) in children and adolescents treated with SSRI antidepressant medications. In 2006, an advisory committee to the FDA recommended that the agency extend the warning to include young adults up to age 25.

There's no doubt that since the introduction of SSRI antidepressants in the 1980s suicide rates have dropped significantly. However, three recent studies -- in 2002, 2008, and 2010 -- have shown that these types of antidepressants work only in the severest forms of depression some of the time, and that for mild, moderate, and even severe depression, they work no better than sugar pills. According to the latest study, published in the Journal of the American Medical Association on January 6, 2010, "True drug effects...were nonexistent to negligible among depressed patients with mild, moderate, and even severe baseline symptoms..." (Click here to read more about this research)

Fortunately, there are alternatives, such as psychotherapy, lifestyle changes, and other complementary and alternatives therapies. These are my specialty areas. To learn more about depression, visit my website at DrRandiFredricks.com or call .