If your child or teen is diagnosed with depression, they may be prescribed medications and may be advised to undertake psychotherapy or make lifestyle changes. The type of treatment your child receives depends on the severity of their depression.
How psychotherapy can help treat depression
Psychotherapy, also known as "talk therapy", involves a trained therapist working one-to-one with a patient or a group of people on common objectives. Depending on the type of psychotherapy, the therapist can offer support, teach coping skills or help the patient(s) explore their relationships.
How to access psychotherapy
Based on your child's diagnosis and the severity of their symptoms, your doctor may suggest a therapist or centre that is right for your child. You can also access psychotherapy through:
- a mental health agency
- a recommendation from a trusted friend or family member
- an employee or family assistance program
Fees for psychotherapy vary. Some costs might be covered through public health agencies or plans or through private insurance.
The therapy that has been shown to be most effective for depression is cognitive behavioural therapy.
Cognitive behavioural therapy
Cognitive behavioural therapy, or CBT, is a structured form of therapy involving one session a week usually for 10 to 16 weeks. CBT can be effective for a range of mental health issues.
How CBT works
CBT is based on cognitive theory, the idea that our thoughts influence our feelings and our behaviours. When it is focused on treating depression, it helps children:
- recognize their signs of depression
- develop "cognitive strategies" (different ways of thinking) for the things that make them sad
- practise "exposure" or "behavioural strategies" to help them gradually re-engage in activities that they might have avoided because of the depression
CBT helps a person with depression look at some of the thoughts behind their avoidant or other poor coping behaviours. It also teaches them how to have more balanced thoughts and how to cope with depression with relaxation techniques.
Over time, CBT can include exposure therapy. This typically involves experiments that gradually expose a patient to activities that they have avoided because of their depression. The patient would usually start with the easiest activity and work up to the most difficult.
CBT can be done one on one with a therapist or with a group of patients and a therapist. It can be conducted with a child on their own or with their parent(s) or caregiver(s) present. Some parent participation is usually encouraged.
Teens and parents can also work through self-help CBT resources on their own.
Interpersonal psychotherapy for adolescents (IPT-A)
Interpersonal psychotherapy is a form of therapy for depression that has been adapted for teens. It is more helpful for people that have depression without anxiety. Typically, it involves attending weekly sessions over 16 to 20 weeks.
The therapy is based on a standard set of written guidelines. It usually explores important relationships in a teen's life within one of the four following areas:
- role transitions (for example, transitioning to high school or university or entering puberty)
- grief (a significant loss, typically a death)
- interpersonal disputes (typically poor relations with a parent or caregiver)
- interpersonal sensitivities (difficulties establishing relationships).
The therapist will use different techniques, including analyzing communication in detail and role playing other ways the teen can communicate with others.
Other forms of psychotherapy
Sometimes patients and families choose other psychotherapies based on:
- availability
- the presence of other difficulties or disorders
- their own preferences, for example a shared language or culture
Other therapies include:
- family therapy, if there is a lot of family tension or conflict
- trauma-specific therapy, if there is a history of trauma
- behavioural approaches, for example if a child or teen has depression with attention deficit hyperactivity disorder (ADHD) or oppositional defiant disorder
- mindfulness and acceptance based therapies, which involve learning to live in the moment and experience life without judgment
Importance of patient/therapist relationship
Psychotherapy is more helpful when there is a good relationship between the therapist and the child. If there is a poor fit, you may need to talk to the therapist or else switch to another therapist.
Lifestyle changes and general support
Children and teens with mild symptoms of depression may see their symptoms improve by following some general healthy routines.
These include:
- getting at least eight to 10 hours of sleep a night
- eating a balanced diet, following Canada's Food Guide
- getting regular exercise in line with the physical activity guidelines for children and youth
- obtaining peer support, where they can talk to others their age about how they are feeling (your child's doctor may be able to recommend a group)
- spending time doing healthy activities they enjoy
- taking time to see if they can reduce or remove any unnecessary stressors
If your child's depressive symptoms prevent them from following these suggestions, your pediatrician or family doctor can offer advice.
Further information
For more information on depression, please see the following pages: