Depression and Its Impact on Adolescents

The adolescent period is a crucial time for brain development. Emotional skills mature, knowledge deepens, and coping skills develop. However, the development of depression during this period of life can have severe and potentially permanent effects on a person's life. The prevalence of adolescents with mental disorders, especially depression, has been steadily increasing. The diagnosis of depression is often accompanied by co-occurring, comorbid disorders (eg, psychosis, anxiety, conduct issues, and oppositional defiant behavior), addictive behaviors, and a preexisting or ongoing history of traumatic exposure. Untreated depression affects the ability to pursue education, to be consistently employed, and to have adequate physical health. Treatment options for depression in adolescents include pharmacological management and psychotherapy. Only two antidepressant agents (fluoxetine and escitalopram) are approved for treatment of depression in adolescents, with no approved augmentation agents. Psychotherapeutic interventions that include the family network show advantage over individual-centered therapy alone. Among individual-centered therapies, cognitive-behavioral interventions have the most support. A modular treatment approach with multifocus areas is the most effective, with shorter treatment duration and faster, more sustained symptomatic improvement. In cases of comorbid depression and substance use, treatment of substance use is usually not enough, so treatment of depressive symptoms is also necessary. Lastly, the contribution and impact of trauma in the genesis and perpetuation of depression cannot be emphasized enough, and successful treatment needs to address trauma antecedents and prioritize safety. [ Psychiatr Ann. 2019;49(6):256–262.]