Adolescent Depression Management and Medication

According to the American Academy of Pediatrics, studies show that up to 9% of teenagers meet criteria for depression, with as many as 1 in 5 teenagers having a history of depression at some point during adolescence. In primary care settings, point prevalence rates are likely higher, with rates up to 28%.

Because adolescents face barriers in receiving specialty mental health services, only a small percentage of adolescents with depression are treated by mental health professionals. As a result, primary care settings have become the de facto mental health clinics for this population. However, most primary care clinicians feel inadequately trained, supported or reimbursed for the management of depression.

Listen to mental health professionals discuss teen depression

In today’s episode we sit down with Jenna Glover, PhD, and clinical pharmacist Danielle Stutzman, PhD, to talk through practical approaches to screening, anticipatory guidance and medication management of depression in adolescents.

Dr. Glover is the former Director of Clinical Psychology Training at Children’s Hospital Colorado and former Assistant Professor of Child Psychiatry at the University of Colorado School of Medicine. Dr. Stutzman is a clinical pharmacist at Children’s Colorado with a special interest in psychiatry medication.

In this episode, our experts discuss:

• The rates of mental health issues among adolescents
• Best practices primary care providers should follow to screen for depression
• Reimbursement and compensation policies for screeners
• Next steps after a positive screen for depression
• When medication is recommended for depression management
• How to differentiate isolated depression versus depression with anxiety
• Importance of using behavior activation for depression management
• Recommendation for getting patients connected to the psychoeducational material
• Screener’s ability to differentiate between low mood teenage angst and actual depression
• Approach for recommendation to start antidepressants
• A good approach for starting medication in an outpatient setting
• The subtle differences in selective serotonin reuptake inhibitors (SSRIs) and when they are most useful
• Contraindications to consider when prescribing SSRIs
• Common comorbidities and how it affects medication management
• Effectiveness of antidepressants in teenagers compared to adults
• Approach for dealing with substance abuse in depression management
• Community-based resources that primary care providers should share with families
• Importance of discussing sleep hygiene as an early intervention for depression

Resources mentioned in this episode:

• Severity Measure for Depression, child age 11-17
• PROMIS Measure

Treatment of depression at Children’s Colorado

Our pediatric mental health experts at the Pediatric Mental Health Institute (PMHI) provide the highest quality mental health services to children, adolescents and their families. We strive to deliver evidence-based, family-focused and youth-centered services that make a difference. We are also dedicated to training the next generation of mental health professionals and conducting research to advance the field of child and adolescent mental health.