Depression Mental Health Mood Disorders Therapy Treatment

Is Depression Medication for Teens Better Than Therapy?

Teen depression is one of the most common adolescent mental health issues in the world, second only to teen anxiety disorders. Depression is a serious and often debilitating mental health issue among teens and remains the most common cause of disability in the US. And for parents looking for different treatment options for their child, it’s not uncommon to wonder if depression medication for teens would be a better alternative than therapy or if it would be best to seek both.

Let’s talk about it.

When It’s More Than Sadness

More than just sadness, depression is overwhelming fatigue, unexplained aches, total loss of joy, increased pain sensitivity, lack of ability to generate or feel motivation, and unknown flare-ups in symptoms.

Many teens who struggle with depression struggle academically, have a hard time developing to their full potential and go through a much tougher road in life. Thankfully, depression is treatable. Unfortunately, there is no one-size-fits-all treatment plan that works.

How Is Depression Treated?

The first line treatment for any teen or adult with major depressive disorder, the most common mood disorder and most common form of depression is a combination of psychotherapy and selective serotonin-reuptake inhibitors (SSRIs).

SSRIs are some of the most recent antidepressants in a long line of different drug families, and they are some of the most well-researched psychiatric drugs in the world. But they are not a miracle cure for depression, and they often don’t work too well just on their own.

Psychotherapy is one-on-one talk therapy between a trained mental health professional and a patient. In the case of depression, the most commonly used therapeutic method is cognitive-behavioral therapy (CBT), a type of talk therapy developed in the 1970s and 1980s by combining the individual successes of cognitive therapy (focused on patient thoughts and thinking patterns) and behavioral therapy (focused on habits, actions, and controlling one’s responses in life).

When combined, modern SSRIs and talk therapy represent the most successful treatment plan for depressed patients. But the success rate is never 100 percent. Furthermore, it can take time for both therapy and the medication to work.

What Are Antidepressants?

There are half a dozen different subtypes of SSRI and well over a dozen branded and generic SSRI drugs. Each of these compounds reacts in different patients differently, with varied potential side effects and side effect severity. Some people react the least to citalopram, while others are better off on sertraline.

When a patient takes a recommended SSRI, it can take multiple weeks for the drug to begin taking effect. If side effects show up and they inhibit a patient’s life, it can take several more weeks for the drug to be completely flushed out before a different compound is used.

SSRIs are not addictive nor particularly dangerous. The side effects can be frustrating – such as weight gain, loss of sex drive, and drowsiness – but SSRIs are very, very rarely associated with serious risks, such as rare cases of increased suicidality or heart arrhythmia. Nevertheless, it can take a few different tries until a patient finds a drug that works best for them.

If no SSRIs work well, a patient may consider different, older classes of antidepressants, such as SNRIstricyclic antidepressantsMAOIs, and atypical antidepressants. While these may work, they are usually associated with a higher risk of side effects.

Therapy for Depression

Talk therapy is not a drug and does not have conventional side effects. But as far as treatment methods go, there is no guarantee that a patient will respond well to individual therapy either. Some teens are very receptive, while others have a much harder time responding or opening up in therapy. Some teens do better in a group setting, while others prefer solely one-on-one therapy sessions. While CBT is the premier therapeutic treatment method, there are other valid forms of talk therapy for depression, including dialectic behavioral therapy, behavioral activation therapy, and interpersonal psychotherapy.

Even among first-line treatments – like antidepressants and therapy – it’s hard to say which is better. Furthermore, it’s hard to say which is best for your teen. SSRIs and CBT are the most studied treatment methods, but that does not mean you or your teen won’t respond better to older drugs and a completely different therapy plan.

Are Antidepressants Better Than Placebo?

The research on antidepressants can be confusing. There are studies supporting the continued use of antidepressants in the treatment of depression. There are also conflicting review papers that find that antidepressants match placebo at best and that serotonin availability may not be a factor in depressive symptoms.

One particularly polarizing review involved a thorough analysis of the evidence behind the serotonin theory of depression, one of the cornerstones of antidepressant use. It found that there is no consistent evidence nor support for the hypothesis that depression is caused by lowered serotonin activity based on current research.

Furthermore, the criteria for inclusion in a phase III trial for an antidepressant do not necessarily reflect the reality of the majority of people who are prescribed antidepressants. Many people who take antidepressants would not actually be included in a clinical trial for the drug they are taking.

The rabbit hole of research on the efficacy of depression treatments goes deep. Here are some interesting things research can tell us:

  • Mindset matters a lot. A patient’s receptiveness to both therapy and antidepressant drugs can be highly indicative of their success.
  • Antidepressants need more research. The link between depression and serotonin availability is not clear, and what we do know tells us that medication on its own is not often a useful therapeutic tool.
  • Patients differ wildly. Depression is a condition with many comorbid conditions, all of which can modify and exacerbate depressive symptoms. Teens with depression often also struggle with anxiety, with chronic health issues like asthma and irritable bowel syndrome, or may have a history of drug use. Treatment plans must be highly individualized to help patients.

Depression Medication for Teens or Therapy: Which is Best?

Based on what we currently know, the best available answer is both, although therapy may be more important than medication.

While the serotonin theory of depression may not hold up in the long term, antidepressants seem to work – even if their mechanism of action is not completely understood. What we can agree on is that medication use must occur alongside therapy for the best effect.

Furthermore, not all teens will respond effectively to medication and therapy. Some teens need a different treatment approach or need a treatment plan that takes other factors into consideration, including comorbid mental and physical health conditions.

What About Treatment-Resistant Depression Options?

There are other treatments for depression than just antidepressants and therapy. However, the jury is often still out on these treatments. They include ketamine (a controversial dissociative anesthetic drug), electroconvulsive therapy, and transcranial magnetic stimulation.

Despite being one of the most common mental health conditions on the planet, depression is not completely understood. In any given case, careful consideration of all factors is needed, and treatment must be individualized. More importantly, therapy nearly always plays an important role in depression treatment.

Get Depression Treatment for Teens

Are you or your teen struggling with depression? Reach out to Visions Treatment Center to explore depression treatment for teens today.

Depression Mental Health Mood Disorders

Overcoming Seasonal Affective Disorder in Teens this Season

Holiday stress is a common phenomenon, even among teens. But there’s a stark difference between feeling melancholy over the winter break and developing a cycle of depression around the time snow starts falling. This feeling may be more than just being a little down and could be the result of seasonal affective disorder in teens.

While we don’t fully understand how and why some people are susceptible to mood disorder symptoms during the winter months (and, in some cases, over the summer holidays), we do know that seasonal affective disorder in teens is a very real and underdiagnosed mental health problem.

Here is what you should know.

What is Seasonal Affective Disorder (SAD)?

Seasonal affective disorder, or SAD, is a mood disorder characterized by symptoms tied to a change in season, usually either the peak of summer or the peak of winter.

Most people recognize SAD as the “winter blues,” but it is a little more serious than that – while holiday stress is common, only an estimated 10 million Americans are diagnosed with seasonal affective disorder each year, and there are multiple strict prerequisites for a professional diagnosis.

In other words, even if you tend to feel a little more stressed over the holidays, it might not necessarily be SAD – especially if there are other conflating factors or comorbid conditions that might explain your symptoms.

Treatments for SAD differ from case to case but are unique when compared to other mood disorders. For example, teens who develop SAD may be prescribed light therapy, a special type of therapy involving simulated sunlight. While seasonal affective disorder is its own condition, it shares many similarities with other mood disorders, such as major depressive disorder, cyclothymia, and bipolar disorder.

Furthermore, teens with a history of comorbid conditions are much more likely to struggle with seasonal affective disorder, especially conditions like:

Because seasonal affective disorder usually happens at the peak of winter, many researchers believe that sunlight – or the lack thereof – plays a primary role in the development of this mental health condition. However, that doesn’t mean your teen’s symptoms will improve with light therapy alone.

What Does Seasonal Affective Disorder in Teens Look Like?

The symptoms of seasonal affective disorder in teens will usually be like those of major depressive disorder. Major depressive disorder is one of the most common mental health problems in the world and the most well-known mood disorder. Signs and symptoms can include:

  • Feelings of hopelessness
  • Feelings of guilt
  • Mental and physical fatigue
  • Unexplained aches and pains (especially stomach pain) and occasional nausea
  • Lack of joy (anhedonia)
  • Loss of interest in old hobbies
  • Social withdrawal and isolation
  • Low mood/sadness as the new “baseline” for normal emotions
  • Lowered pain threshold, more likely to experience chronic pains
  • Emotional outbursts and increased irritability/agitation
  • Rapid weight gain or rapid weight loss
  • Loss of focus and lowered concentration
  • Signs of self-harm or suicidal ideation
  • Frequently discussing/fantasizing about death or disappearing
  • And more

A diagnosis of seasonal affective disorder in teens requires a thorough psychological assessment. Any teen with depressive symptoms over the course of a seasonal shift may be a candidate for seasonal affective disorder, but to be more specific, a diagnosis is usually only met when:

  • A teen meets most of the criteria for major depressive disorder.
  • A teen’s depressive symptoms occur almost exclusively during specific seasons, such as only feeling depressed or showing signs of major depression in the summer or the winter.
  • A teen’s seasonal shift in mood has been occurring for at least two years in a row. Symptoms of SAD can occur sporadically, meaning they become worse in some years or don’t flare up at all in some years. Therefore, the validity of this specific point might depend on a teen’s mental health history and individual circumstances.
  • A teen’s depressive episodes must be more severe or frequent during the shift in seasons in order to be distinguished as seasonal affective disorder. This is important if a teen has already experienced other mood disorders or has had a history of mental health problems.

Therapy and Other Treatment Options

Seasonal affective disorder is thought to be at least somewhat related to the body’s ability to regulate mood through the release of certain neurotransmitters or brain chemicals like serotonin. The release of serotonin may be linked to the body’s circadian rhythm and may be dependent on a healthy supply of sunlight.

Long-term sunlight deprivation, especially in teens with rigid school schedules (where they might wake up and be in school before the sun has risen and be back on their way home after sunset), can affect a teen’s hormone and neurotransmitter production and may affect their mood and mentality as a result.

Outside of any potential neurochemical origins, seasonal affective disorder in teens might also be linked to an increase in holiday-related stressors, both over the winter and summer months. The weather alone can be a factor – it being consistently too warm or too cold – as are elements such as family stress related to the holidays, financial stressors, or even an increase in rates of domestic violence towards the end of the year.

Addressing seasonal affective disorder in teens means figuring out what any individual teen’s circumstances are. There are no quick fixes or effective cookie-cutter cures – a treatment plan must take a teen’s living situation, concurrent physical and mental health issues, as well as family history into consideration. Here are a few different modalities and common treatments.

  • Light Therapy – For teens with winter-based seasonal affective disorder, a doctor may prescribe a special light box for frequent light therapy. 
  • Medication – Depending on the severity of the condition and comorbid conditions, a teen with seasonal affective disorder may be prescribed antidepressants or other psychiatric medication.
  • Talk Therapy – Cognitive-behavioral therapy is the golden standard for depressive psychotherapy and can also help reduce symptoms of seasonal affective disorder.
  • Sleep Hygiene – Sleep habits can break down over the peak winter or summer months, which can affect mood and mental health. Better sleep hygiene can improve both mental and emotional functioning.

Can Seasonal Affective Disorder Be Prevented?

If a teen’s symptoms tend to ramp up towards the winter months (or the summer months), then a professional mental health treatment plan can be developed to plan ahead accordingly and start addressing the issue before it flares back up.

In some cases, this can mean starting treatment even before the depression usually starts to come back. This can help some teens avoid an episode of seasonal affective disorder altogether.

For more information about depression or seasonal affective disorder, contact Visions Treatment Centers.

Mental Health Mood Disorders

What Are Teen Disruptive, Impulse Control, and Conduct Disorders?

Disruptive, impulse control and conduct disorders are a group of conditions diagnosed in children and teens, characterized by long-lasting and consistent destructive behavior across multiple situations and a disregard for others and the law. These conditions are understood to be like anxiety and depression.

Still, instead of directing these negative thoughts and destructive forces inward, those diagnosed with a disruptive behavior disorder or impulse control disorder direct them outward. Common conditions that fall under the umbrella of impulse control disorder and disruptive behavior disorders include:

While kleptomania and pyromania are among the rarer ones, affecting under one percent of children, the other disorders are more common. About 6 percent of children are estimated to have an oppositional defiant disorder or conduct disorder, and nearly 3 percent have an intermittent explosive disorder.

More than just another name for unruly behavior, these disorders are only diagnosed in children who display symptoms of severe aggression, destruction of property, constant rule-breaking despite certain consequences, and highly impulsive behavior, among other characteristics.

Teen Intermittent Explosive Disorder (IED)

Teen intermittent explosive disorder is characterized by repeated and sudden physical and verbal violence and extreme anger. While children and even teens are not particularly known for being in control of their emotions, there is a point at which the constant lack of control can cause concern.

IED can be identified by these severe and recurring temper explosions more than just a simple anger management problem. If your teen is likely to throw temper tantrums and lose their temper at the slightest push, repeatedly flying off the handle with little to no warning regardless of the setting or circumstances, then they might be struggling with IED.

They may be separated by weeks of nonaggression, but if they have been an issue for a year or longer and often happen with no discernable reason, they may be a sign that your teen needs treatment. These episodes can manifest in different ways and usually consist of either:

    • Fights
    • Tirades
    • Temper tantrums
    • Property damage
    • Extreme threats against people and/or animals

Teens with the intermittent explosive disorder usually feel relaxed or relieved after an episode has ended. They may regularly express regret or remorse yet fail to control their temper.

Teen Oppositional Defiant Disorder (ODD)

Oppositional behavior is yet another trademark of the average teen. Children and teens may intentionally defy orders and go against the wishes of those around them. The trope of the rebelling teenager is universally understood because, for many of us, a big part of becoming independent is figuring out what we do not like and want.

But normal oppositional behavior has its limits, and teens either know where to draw the line or learn it quickly. When a child or teen repeatedly shows anger, disdain, and even abject hatred towards any authority figure (including their family), they may have oppositional defiant disorder.

ODD is characterized by oppositional behavior that is consistently impairing a teen’s social life and relationships at home and school, rarely developing late into puberty, and the first signs are usually seen in preschool. Its latest onset is during the early teen years. Some common signs of ODD include (but is not limited to):

    • Consistently irritable mood.
    • Argues often with authority figures.
    • Blames others for their mistakes and failures.
    • Refuses to follow or deliberately ignores requests and rules.

The causes behind oppositional defiant disorder can differ from teen to teen, though both temperament and parenting play significant roles. When the bridge between a teen and their parents has been burnt, professional help might be the best next answer.

Teen Conduct Disorder (CD)

Where violent episodes characterize the IED, and ODD is usually directed solely at authority figures, a CD is characterized by behavior that is generally callous and inconsiderate, to the point of completely ignoring others’ needs and rights and causing direct and indirect harm to other people. Conduct disorders can include theft and property destruction, hurting or abusing animals, and cruelty. Other common behaviors include (but is not limited to):

    • Relentless bullying.
    • Physical abuse towards a friend or partner.
    • Lying to no real benefit (for the fun of lying).
    • Stealing items of no value (for the fun of stealing).
    • Deliberately causing harm or annoyance for self-gratification.
    • Coercing people with threats of violence or even death, including wielding a weapon.

Another important characteristic is that conduct disorders are not learned behavior, i.e., they are not something a teen picked up from others and decided was normal. Teens who grew up in abusive households may be more likely to develop a conduct disorder. Still, an important distinction to make is that a teen with a conduct disorder understands that they are hurting others or doing harm but takes pleasure in it. Children and teens with conduct disorders may develop and be diagnosed with antisocial personality disorder.

Kleptomania and Pyromania

Kleptomania (stealing things) and pyromania (arson) are two classic examples of an impulse control disorder and are sometimes associated with obsessive-compulsive disorder (OCD). These conditions are like behavioral addictions, characterized by consistent dangerous behaviors that a teen cannot fully control or refrain from. While some teens steal and other teens fuel fires, the inability to stop oneself from dangerous impulses to cope with anxieties and struggles may hint at an impulse control disorder.

Co-Occurring Conditions

These conditions are often related to or can co-occur alongside other teen mental health issues, including:

When to Seek Professional Help

The main difference between disordered behavior and unwanted or unsavory behavior is the inability to change without intervention, the severity of the behavior, and how it affects others. It is entirely normal for teens to misbehave and push boundaries. Sometimes, they go too far and make mistakes they learn from. Some teens take longer to learn certain lessons than others.

But when a teen repeatedly and remorselessly hurts others, or shows remorse yet fails to control themselves, or otherwise becomes a danger to themselves or those around them, it is time to seek professional advice. Disruptive, impulse control and conduct disorders can be severe and damaging to teens and their loved ones. If you suspect that your teen might not be able to improve their behavior on their own, it may be time to get help.

Mental Health Mood Disorders Personality Disorder Recovery Self-Care

Mental Health is Mental Wealth

When someone suffers from mental illness, there is a deprivation of the joy and emotional wealth that’s present when there is ideal mental health. Mental illness can drain our joie de vivre, and make for a muddy emotional existence. Relationships with loved ones tend to be difficult, and there tends to be a propensity for loneliness and isolation. Worse yet, when mental illness is left untreated, the toll it can take on the one suffering and their loved ones can be taxing and sometimes devastating.


Some types of mental illness are more straightforward in their treatment: anxiety and depression, for example, are often treated with various modalities of psychotherapy and balanced with medication. Personality disorders are complex and there are some instances where the patient doesn’t recognize their illness despite their deep suffering. The work involved in treating all mental illness requires a nexus of therapeutic support and a desire for positive change from the patient themselves. The question many have is, Why are personality disorders so challenging?


Personality disorders are grouped into three clusters:

  • Cluster A personality disorders are “characterized by odd, eccentric thinking or behavior.” The disorders that fall into this category are:  paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder
  • Cluster B personality disorders are “characterized by dramatic, overly emotional or unpredictable thinking or behavior.” The disorders that fall into this category are: antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.
  • Cluster C personality disorders are “characterized by anxious, fearful thinking or behavior.” The disorders that fall into this category are: avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.


Psychotherapy is the most common treatment for all types of mental illness; the most efficacious modality is determined by the needs of the client. Findings show that DBT (Dialectical Behavioral Therapy) in particular is the most effective therapeutic treatment for personality disorders and bipolar disorders. Other effective tools used in treatment may include:

  • Individual psychotherapy
  • MBSR (Mindfulness Based Stress Reduction)
  • Yoga
  • Meditation
  • Somatic Experiencing
  • Neurofeedback


To date, the FDA hasn’t approved of any medications to treat personality disorders. However, medications are often used to treat symptoms that are detrimental to the individual’s recovery. Medications like:


  • Antidepressents: for depressed mood, anger, irritability, mood swings, impulsivity and hopelessness.
  • Mood stabilizers: to even out mood swings, and to reduce impulsivity, irritability and aggression.
  • Antipsychotic medications (also known as neuroleptics): if symptoms include losing touch with reality (psychosis), and sometimes anxiety and difficulty with anger
  • Anti-anxiety medications: For anxiety, agitation or insomnia. Note, in some cases, they may increase impulsive behavior and are avoided with some personality disorders.


Treating mental illness requires the cultivation of balance. Participation from the client, a cohesive treatment team, and the correct combination of medication can create the desired environment of mental health.  It takes work, dedication, and a willingness to unveil one’s difficulties in order to create a healthy shift toward mental health. I have experienced the shadow side of untreated mental illness with family members who are unwilling to get help. It does, in fact, take a toll on everyone involved. I have learned that one of the key pieces for my own recovery is developing clear communication skills, creating firm, compassionate boundaries, and building consistent program of self-care. Families struggling with mental illness need to ensure that their own wells are filled, that they are getting their own needs met, and that they have a community of support around them.

Dialectical Behavioral Therapy (DBT) Mental Health Mood Disorders Recovery Therapy Treatment

DBT With Dr. Georgina Smith, Ph.D

We are pleased to welcome Dr. Georgina Smith, Ph.D to the Visions clinical team. She has been working with adults, families, and children since 2001, making her vast knowledge of neurofeedback and Dialectical Behavorial Therapy (DBT) accessible to a wide range of clientele. Dr. Smith specializes in treating survivors of trauma, abuse, and those suffering from eating disorders, and addiction. She also treats individuals suffering from chronic depression, self-injury, mood, personality, and anxiety disorders. Her knowledge and use of neurofeedback and DBT allows her to help her clients in a way that empowers them be engaged in their own recovery. Dr. Smith’s approach is holistic, and caring, and she ardently believes in ensuring that her clients feel seen. Her work with adolescents has built an authentic treatment style where she is able to form a genuine connection with her clients, so they feel seen, heard, validated and challenged. Dr. Smith encourages them to be ok in the skin they’re in. That particular tenant of treatment spreads healing throughout one’s mind, body, and spirit.

With the addition of Dr. Georgina Smith, clients have access to DBT in all phases of their treatment. DBT, in particular, is one of the most efficacious treatments for mood disorders, namely Borderline Personality Disorder. DBT uses mindfulness, self-awareness, and skill building in the areas of trauma, emotional regulation, interpersonal effectiveness and crisis management.  One of the most remarkable pieces of DBT is its effectiveness in teaching clients to regulate their emotions and recognize when they are becoming deregulated. Self-awareness in someone trying to manage extreme emotions is undeniably helpful.

Currently, Dr. Smith is seeing Visions’ clients for DBT as well as running a DBT group on a weekly basis. We are looking forward to working with Dr. Smith and are excited to have her as part of our clinical staff.  She is down to earth, and brings a sense of realness to her groups and throughout her clinical practice. She says it best, “So many of the kids I’ve worked with are struggling to make sense of things they’ve been through, struggling with their sense of self and others, and a confusing, chaotic world. The space I create with them is about being ok wherever they are, whoever they are, so we can open the doors to choice and change. It is about ownership, realness & empowerment.” Welcome to the VTeam, Georgina!

Exit mobile version