Debunking the myths about teen antidepressant use

February 26, 2020

Swedish Behavioral Health Team

teen girl sitting on her bed hugging a pillow and looking out the window

[3 MIN READ]

Studies show medication can be an effective component of treatment for clinical depression in teens.
Antidepressants are well tolerated by most adolescents, who tend to experience few physical side effects with their use.
While antidepressants should not be abruptly discontinued, they are not addictive.
Talk to your Swedish physician if your child needs professional support.

Today’s teens face challenges and situations past generations never even considered. Reports of school violence regularly make the headlines, increasing the stress levels of high school students everywhere. Social media invades every corner of their lives. Many face enormous pressure to succeed — academically, competitively and socially. Most are unsure of who they are or where they’re headed.

It’s no wonder so many adolescents are depressed.

“Depression can affect up to 15-20% of teens at some point in their life by the time they turn 18,” said Alicia Jorgenson, M.D., a board-certified child and adolescent psychiatrist with Swedish. She attributes the condition’s prevalence to a complex interplay between genetics and environment. Clinical depression is relatively rare in younger children becomes much more common post-puberty.

“My observation is that teens are fairly open to treatment recommendations as I think this generation has less stigma about mental health. Often there is more hesitation on the part of parents,” said Dr. Jorgenson.

Treatment typically consists of therapy and may also include medication if the symptoms warrant additional intervention. “My observation is that teens are fairly open to treatment recommendations as I think this generation has less stigma about mental health. Often there is more hesitation on the part of parents,” said Dr. Jorgenson.

The reasons for the hesitation may vary, according to Dr. Jorgenson. “Maybe they worry about the impact of antidepressants on the developing brain more than the impact of untreated depression on the developing brain. Or they know someone who had a bad reaction to an antidepressant.”

Maybe they think that their teen needs to “get over it” rather than accepting that their teen has a mental health condition and needs help. Whatever their origin, when myths and half-truths are accepted as fact, the teens that need mental health help may not get access to the care they desperately need.

We talked to Dr. Jorgenson about five common myths surrounding teens and antidepressants and why it’s important to act right away if you or someone you know is connected with a teen that may need help.

MYTH #1:

There’s no proof that antidepressants work for teens

That’s simply not true. The FDA has approved two antidepressants — fluoxetine and escitalopram — for use by adolescents. There are several randomized controlled studies of teens with clinical depression or major depressive disorder. This type of evidence-based research allows us to thoughtfully choose which treatment is best.

One of the top studies, the Treatment of Adolescents with Depression Study looked at hundreds of teens with severe to moderate depression and how they responded to different types of treatment. After three months, 70% of the teens got better with a combination of medication and therapy, 60% got better with antidepressants alone, and about 50% got better with therapy alone.

MYTH #2:

Antidepressant meds are dangerous

Antidepressants are actually very well tolerated by the majority of teens. In fact, many experience few — if any — side effects. Common side effects include headaches, stomach aches, nausea, and sleep problems.

Overall, studies show treating depression with medication and therapy lowers suicide risk.

In rare cases, medication may increase suicidal thoughts in people up to age 25. This may be hard to recognize since suicidal thoughts are often a sign of major depression in adolescents. None of the studies show an increase in death by suicide rates for teens taking medication. Overall, studies show treating depression with medication and therapy lowers suicide risk.

MYTH #3:

I will be addicted to my medications

The classic definition of addiction involves using a substance to get high or feel really good and then continuing to use that substance in spite of harmful consequences that stem from the effects of the drugs – like job loss, relationship problems or DUIs. While it’s true that antidepressant medications will accumulate in your body and should not be discontinued abruptly, they won’t cause behavior that meets the criteria for addiction.

“Antidepressants are unlikely to make you feel high. And if they do, you should alert your provider. They tend to just gradually turn the volume down on depression or anxiety,” said Dr. Jorgenson.

“Antidepressants are unlikely to make you feel high. And if they do, you should alert your provider. They tend to just gradually turn the volume down on depression or anxiety,” said Dr. Jorgenson. “The goal is that they help you make healthier choices in life — which is the opposite of compulsive behaviors that we see in addiction.”

MYTH #4:

I will feel better right away

Antidepressant medications take time to build up in your system. Typically, you start with a lower dose and then increase it gradually to hit a therapeutic dose. Medication usually takes four weeks to take full effect, but some teens may see results as early as two weeks after beginning treatment.

The rule of thumb is to be patient and look for small changes. Looking for an immediate sweeping change can be discouraging. Keep taking your medicine as prescribed and report any changes, however minor, to your doctor. Over time, you should see a gradual improvement in your mood and better functioning in everyday life.

MYTH #5:

I can stop the medications when I am feeling better

Even after you start to feel better, we recommend continuing treatment for teens recovering from major depression for six to 12 months or as recommended specifically by your doctor. There is a high risk for relapse to depression if antidepressant medications are discontinued prematurely. Since major depression is a serious medical condition with relapsing and remitting pattern, longer-term use of medications may be needed, and your doctor can help determine what treatment is best for you.

There is a high risk for relapse to depression if antidepressant medications are discontinued prematurely.

“Here is the bottom line: When thinking about antidepressant medications, you have to weigh the risks of untreated or partially treated depression, which can cause significant disability, versus the risk of possible side effects,” said Dr. Jorgenson.

Find a doctor

If you have questions about your teen’s mental health, contact the behavioral health and wellbeing department at Swedish. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.