# data[].attributes.attachment_link.readable_text
Mindfulness has emerged as powerful tool to help children (and parents!) with a wide range of concerns, from ADHD to anxiety, autism spectrum disorders to depression and stress. To give parents a better picture of how mindfulness can help kids, we've put together information on how it works, how it can be used at home and in school, and the role mindfulness can play in treating a variety of mental health issues.

More Topics

All

Latest

Anxiety

Anxiety Disorders

Attention

Autism Spectrum Disorder

Behavior Problems

Confidence and Self-Esteem

Depression

Holidays and Vacations

Learning

Learning and Development Disorders

Managing Disruptive Behavior

Media and Tech

Parenting Challenges

Parenting Styles

Responding to Traumatic Events

School

Sleep

Special Needs

Stress and Resilience

Teenagers

Young Adults

# data[].attributes.attachment_link.title
How Mindfulness Can Help You and Your Kids | Child Mind Institute

# data[].attributes.attachment_link.description
Mindfulness has emerged as powerful tool to help children (and parents!) with a wide range of concerns, from ADHD to anxiety, autism spectrum disorders to depression and stress. To give parents a better picture of how mindfulness can help kids, we've put together information on how it works, how it can be used at home and in school, and the role mindfulness can play in treating a variety of mental health issues.

# data[].attributes.attachment_link.readable_text
Getting treatment for depression can feel daunting. Often the depression itself gets in the way. A child who is depressed might be feeling overwhelmed, tired and hopeless. They might also be unfairly blaming themselves or their circumstances for the way they feel. These are some of the characteristic symptoms and thoughts that accompany depression, and they can make it hard for someone who's depressed to speak up and ask for help, or believe concerned parents when they say treatment for depression can help them.

But treatment can really help children and adolescents struggling with depression, including several different kinds of therapy and medication that have all been proven to be effective. Research shows that the most effective treatment is a combination of therapy and medication.

Wendy Nash, MD, a child and adolescent psychiatrist, says she considers therapy "nearly a requirement" when she is prescribing medication for depression, explaining that the skills taught in therapy are essential. Part of the advantage with therapy is that the skills children learn will always stay with them.

What to expect from a clinician

Having a good relationship with your child's clinician is essential, because the more engaged and committed your child is in treatment, the more likely it is to be successful. A good clinician should make sure you understand the goals of treatment and make you feel like your questions are being taken seriously. You should also feel that you can be honest about how your child is doing.

Jill Emanuele, PhD, senior director of the Mood Disorders Center at the Child Mind Institute, says one of the first things she does with a new patient is try to establish a good rapport. "You get to know the person, you make them comfortable. You establish a safe space where you show them that you're listening and you care. Often enough we're the first person that's actually listening to them in a way they haven't experienced before, or have not experienced often."

If a person is resistant to treatment, Dr. Emanuele says she tries to address that. "Maybe they've had a difficult experience with therapy before, or they don't really trust adults, or perhaps they are shamed by their behavior or what they're feeling, and they don't want to show it to another person."

If your child hasn't received a formal diagnosis yet, his clinician should begin with an evaluation. This is to confirm that your child actually does have depression, and also to determine if they have another mental health or learning disorder as well. It isn't that uncommon for kids with undiagnosed anxiety, ADHD, learning disorders and other issues to develop depression. If your child has multiple disorders, then their treatment plan should include getting help for all of them.

Therapy for depression

There are different kinds of therapy that are considered "evidence-based" for treating depression, which means that they have been studied and clinically proven to be effective. Here is a breakdown of some of them:

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy is the gold standard therapy for treating children and adolescents with depression. CBT works by giving people skills to cope with symptoms like depressed mood and unhelpful thoughts (like "no one likes me" or "things will always be like this"). In CBT the child and their therapist collaborate to meet set goals, like catching those unhelpful thought patterns and improving problem-solving ability.

Central to the treatment is teaching kids that their thoughts, feelings and behaviors are all interconnected, so changing one of these points can change all three. For example, one technique called "behavioral activation" encourages them to participate in activities and then observe the effect it has on their mood. In Dr. Emanuele's words, "We set up a hierarchy of activities they can start to engage in. The idea is to get moving and active, so you not only get that physical momentum, but you also start to experience more positive thoughts from having success and interacting more with others."

Behavioral activation helps counter the isolation that teenagers with depression often experience, which can reinforce their depressed mood.

Dialectical behavior therapy (DBT)

For teenagers with more severe depression, dialectical behavior therapy can be helpful. DBT is a form of CBT that was adapted for people who have trouble managing very painful emotions, and may engage in risky behavior, self-harm like cutting, and suicidal thoughts or attempts.

To manage intense emotions, people participating in DBT learn to practice mindfulness (being fully present in the moment and focusing on one thing at a time, without judgment) and develop problem solving skills like tolerating distress, handling difficult situations in a healthy way and interacting more effectively with friends and family. DBT is a highly structured treatment that includes individual therapy and skills groups. DBT for adolescents includes sessions with parents and their child learning skills together.

Interpersonal psychotherapy (IPT)

Social relationships can sometimes influence and even maintain depression. When a person is depressed their relationships can also suffer. Interpersonal therapy works by addressing a child's relationships to make them more healthy and supportive. In this therapy children learn skills for better communicating their feelings and expectations, they build problem-solving skills for handling conflicts, and they learn to observe when their relationships might be impacting their mood.

IPT has been adapted for adolescents with depression to address common teen relationship concerns including romantic relationships and problems communicating with parents or peers. Called IPT-A, this specialized form of interpersonal therapy is typically a 12- to 16-week treatment. Parents will be asked to participate in some of the sessions.

Mindfulness-based cognitive therapy (MBCT)

While its efficacy is still being measured in adolescents, mindfulness-based cognitive therapy is another treatment that has been shown to work for young adults and adults with depression.

MBCT works by combining cognitive behavioral therapy (CBT) methods with mindfulness. Mindfulness teaches people to be fully present in the moment and observe their thoughts and feelings without judgment. This can help them interrupt undesirable thought patterns that can maintain or lead to a depressive episode, like being self-critical or fixating on negative things in ways that are not constructive.

MBCT was originally developed to help people with recurring episodes of depression, but it can also be used for treating a first episode of depression.

Medication treatment

Children and adolescents with depression can also benefit from medication, and clinicians often prescribe medication for more severe depression or when therapy alone isn't providing effective treatment.

Medications most often prescribed to treat depression are selective serotonin reuptake inhibitors (SSRIs) like Zoloft, Prozac and Lexapro, and serotonin-norepinephrine reuptake inhibitors (SNRIs) like Strattera and Cymbalta. These medications are also known as antidepressants. Your child's clinician may also prescribe an atypical antidepressant like Wellbutrin.

Dr. Nash says that sometimes young people (and their families) are worried about taking medication for depression. People often worry that medication will change their personality, or they will feel "drugged." They also worry that they might become addicted to the medication.

She takes these concerns seriously, and talks to patients and their families about what to expect. The right medication at the right dose won't make a child feel drugged and it won't change who he is, but it should help his symptoms of depression. She also explains that antidepressants are not addictive. "You don't have an urge to take them, or seek them out to the detriment of your relationships," she says. When it is time to stop taking antidepressants, it is uncommon for people to have ongoing symptoms of withdrawal if they taper off the medication carefully, and under the supervision of their doctor.

Dosage and side effects

It is rare for a person to stay on the same dose she is initially prescribed. Instead, doctors adjust dosage once every week or every two weeks in the beginning, as the medication builds up in the brain to reach an effective level. During this time your child's clinician will ask questions about how she is tolerating the medication, including side effects she might be experiencing.

"Most uncomfortable side effects will present early," says Dr. Nash. "I tell patients you might experience side effects before the desired effects." Clinicians should stay in touch with families during these first several weeks, monitoring how children are feeling and providing guidance because, as Dr. Nash says, "It can be a hard time for patients, who might feel headaches or insomnia, but not feel better yet." She says the side effects can go away after one to two weeks.

It can take a while for a patient to start feeling the full effect of an antidepressant medication. "The medication might start to work at two to four weeks, but you can still be feeling more benefit at six weeks further out," says Dr. Nash.

Monitoring for suicidal thinking

The Food and Drug Administration has issued a warning that children and adolescents taking some antidepressant medications may experience an increased risk of suicidal thoughts. Many studies have shown that the benefits of antidepressant medications outweigh the risks of going without treatment, so they are still prescribed to young people. To keep patients safe, a protocol has been developed for prescribing clinicians to help them closely monitor patients for any worsening in depression or emergence of suicidal thinking as they are adjusting to a new medication.

Going off medication

To avoid a recurrence of depression, Dr. Nash says it is a good idea to stay on medication for at least a year after a child has stopped feeling any symptoms of depression. She also warns that it is important to think about the "optimal" time to stop taking medication. For example, it isn't a good idea to stop taking his medication right before the SATs or when he's going off to college.

To avoid unpleasant side effects, your child shouldn't stop taking medication cold turkey. Tapering off antidepressants gradually, with the guidance of a clinician who is monitoring him to make sure he is healthy, is important.

Family involvement

Both Dr. Nash and Dr. Emanuele emphasize that families should always be involved in the treatment of a child's depression. "Part of treatment, especially in the beginning, is to teach parents about depression and how therapy works, says Dr. Emanuele. "It's really important that parents understand the concepts behind the treatments so that they can coach their child, day-to-day, to use the skills that they're learning." Dr. Emanuele adds that parents often find that they benefit from learning the skills as well.

Clinicians can also be helpful in giving parents tips on interacting with a child with depression, which can sometimes be difficult. Children with depression might try to isolate themselves from family, or interpret even well-meaning parental concern as critical rather than loving. Knowing how to be supportive is important. Dr. Emanuele says that she helps parents develop a situation-specific plan to help them know when to lean in and when to back off. Clinicians can also give advice about fostering more positive interactions.

For parents who are struggling because of their child's illness, getting this support can be a big relief. And, of course, as soon as a child starts feeling better, her parents will start feeling better, too.

Frequently Asked Questions

What is the most effective way to treat adolescent depression?

What are the best medications to treat adolescent depression?

Is it important for parents to be involved in treating their adolescent's depression?

# data[].attributes.attachment_link.title
Treatment for Depression - Child Mind Institute

# data[].attributes.attachment_link.description
What parents need to know about treatment for depression, from different kinds of therapy and medication to finding a good clinician.

# data[].attributes.attachment_link.readable_text
Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children? Do these mood changes affect how your child acts at school or at home?

Some children and teens with these symptoms may have bipolar disorder, a brain disorder that causes unusual shifts in mood, energy, activity levels, and day-to-day functioning. With treatment, children and teens with bipolar disorder can get better over time.

What is bipolar disorder?

Bipolar disorder is a mental disorder that causes people to experience noticeable, sometimes extreme, changes in mood and behavior. Sometimes children with bipolar disorder feel very happy or "up" and are much more energetic and active than usual. This is called a manic episode. Sometimes children with bipolar disorder feel very sad or "down" and are much less active than usual. This is called a depressive episode.

Bipolar disorder, which used to be called manic-depressive illness or manic depression, is not the same as the normal ups and downs every child goes through. The mood changes in bipolar disorder are more extreme, often unprovoked, and accompanied by changes in sleep, energy level, and the ability to think clearly. Bipolar symptoms can make it hard for young people to perform well in school or to get along with friends and family members. Some children and teens with bipolar disorder may try to hurt themselves or attempt suicide.

Most people are diagnosed with bipolar disorder in adolescence or adulthood, but the symptoms can appear earlier in childhood. Bipolar disorder is often episodic, but it usually lasts a lifetime.

Signs and symptoms of bipolar disorder may overlap with symptoms of other disorders that are common in young people, such as attention-deficit/hyperactivity disorder (ADHD), conduct problems, major depression, and anxiety disorders. Diagnosing bipolar disorder can be complicated and requires a careful and thorough evaluation by a trained, experienced mental health professional.

With treatment, children and teens with bipolar disorder can manage their symptoms and lead successful lives.

What causes bipolar disorder?

The exact causes of bipolar disorder are unknown, but several factors may contribute to the illness.

For example, researchers are beginning to uncover genetic mechanisms that are linked to bipolar disorder and other mental disorders. Research shows that people's chance of having bipolar disorder is higher if they have a close family member with the illness, which may be because they have the same genetic variations. However, just because one family member has bipolar disorder, it does not mean that other members of the family will have it. Many genes are involved in the disorder, and no single gene causes it.

Research also suggests that adversity, trauma, and stressful life events may increase the chances of developing bipolar disorder in people with a genetic risk of having the illness.

Some research studies have found differences in brain structure and function between people who have bipolar disorder and those who do not. Researchers are studying the disorder to learn more about its causes and effective treatments.

What are the symptoms of bipolar disorder?

Mood episodes in bipolar disorder include intense emotions along with significant changes in sleep habits, activity levels, thoughts, or behaviors. A person with bipolar disorder may have manic episodes, depressive episodes, or "mixed" episodes. A mixed episode has both manic and depressive symptoms. These mood episodes cause symptoms that often last for several days or weeks. During an episode, the symptoms last every day for most of the day.

These mood and activity changes are very different from the child's usual behavior and from the behavior of healthy children and teens.

Children and teens having a manic episode may:

Show intense happiness or silliness for long periods of time.

Have a very short temper or seem extremely irritable.

Talk fast about a lot of different things.

Have trouble sleeping but not feel tired.

Have trouble staying focused, and experience racing thoughts.

Seem overly interested or involved in pleasurable but risky activities.

Do risky or reckless things that show poor judgment.

Children and teens having a depressive episode may:

Feel frequent and unprovoked sadness.

Show increased irritability, anger, or hostility.

Complain a lot about pain, such as stomachaches and headaches.

Have a noticeable increase in amount of sleep.

Have difficulty concentrating.

Feel hopeless and worthless.

Have difficulty communicating or maintaining relationships.

Eat too much or too little.

Have little energy and no interest in activities they usually enjoy.

Think about death, or have thoughts of suicide.

Can children and teens with bipolar disorder have other problems?

Young people with bipolar disorder can have several problems at the same time. These include:

Misuse of alcohol and drugs. Young people with bipolar disorder are at risk of misusing alcohol or drugs.

Attention-deficit/hyperactivity disorder (ADHD). Children and teens who have both bipolar disorder and ADHD may have trouble staying focused.

Anxiety disorders. Children and teens with bipolar disorder also may have an anxiety disorder.

Sometimes extreme behaviors go along with mood episodes. During manic episodes, young people with bipolar disorder may take extreme risks that they wouldn't usually take or that could cause them harm or injury. During depressive episodes, some young people with bipolar disorder may think about running away from home or have thoughts of suicide.

If your child shows signs of suicidal thinking, take these signs seriously and call your child's health care provider.
If you think your child is in crisis and needs immediate help, call 911. You also can call the National Suicide Prevention Lifeline (Lifeline) at 1‑800‑273‑TALK (8255), or text the Crisis Text Line (text HELLO to 741741). The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889. These services are confidential, free, and available 24/7.

How is bipolar disorder diagnosed?

A health care provider will ask questions about your child's mood, sleeping patterns, energy levels, and behavior. There are no blood tests or brain scans that can diagnose bipolar disorder. However, the health care provider may use tests to see if something other than bipolar disorder is causing your child's symptoms. Sometimes health care providers need to know about medical conditions in the family, such as depression or substance use.

Other disorders have symptoms like those of bipolar disorder, including ADHD, disruptive mood regulation disorder, oppositional defiant disorder, conduct disorder, and anxiety disorders. It also can be challenging to distinguish bipolar disorder from depression that occurs without mania, which is referred to as "major depression." A health care provider who specializes in working with children and teens can make a careful and complete evaluation of your child's symptoms to provide the right diagnosis.

How is bipolar disorder treated?

Children and teens can work with their health care provider to develop a treatment plan that will help them manage their symptoms and improve their quality of life. It is important to follow the treatment plan, even when your child is not currently experiencing a mood episode. Steady, dependable treatment works better than treatment that starts and stops.

Treatment options include:

Medication. Several types of medication can help treat symptoms of bipolar disorder. Children respond to medications in different ways, so the right type of medication depends on the child. This means children may need to try different types of medication to see which one works best for them. Some children may need more than one type of medication because their symptoms are complex. Children should take the fewest number of medications and the smallest doses possible to help their symptoms. A good way to remember this is "start low, go slow." Medications can cause side effects. Always tell your child's health care provider about any problems with side effects. Do not stop giving your child medication without speaking to a health care provider. Stopping medication suddenly can be dangerous and can make bipolar symptoms worse.

Psychosocial Therapy. Different kinds of psychosocial therapy can help children and their families manage the symptoms of bipolar disorder. Therapies that are based on scientific research-including cognitive behavioral approaches and family-focused therapy-can provide support, education, and guidance to youth and their families. These therapies teach skills that can help people manage bipolar disorder, including skills for maintaining routines, enhancing emotion regulation, and improving social interactions.

What can children and teens expect from treatment?

With treatment, children and teens with bipolar disorder can get better over time. Treatment is more effective when health care providers, parents, and young people work together.

Sometimes a child's symptoms may change, or disappear and then come back. When this happens, your child's health care provider may recommend changes to the treatment plan. Treatment can take time, but sticking with the treatment plan can help young people manage their symptoms and reduce the likelihood of future episodes.

Your child's health care provider may recommend keeping a daily life chart or mood chart to track your child's moods, behaviors, and sleep patterns. This may make it easier to track the illness and see whether treatment is working.

How can I help my child or teen?

Help begins with the right diagnosis and treatment. Talk to your family health care provider about any symptoms you notice.

If your child has bipolar disorder, here are some basic things you can do:

Be patient.

Encourage your child to talk, and listen to your child carefully.

Pay attention to your child's moods, and be alert to any major changes.

Understand triggers, and learn strategies for managing intense emotions and irritability.

Help your child have fun.

Remember that treatment takes time: sticking with the treatment plan can help your child get better and stay better.

Help your child understand that treatment can make life better.

How does bipolar disorder affect caregivers and families?

Caring for a child or teenager with bipolar disorder can be stressful for parents and families. Coping with a child's mood episodes and other problems-such as short tempers and risky behaviors-can challenge any caregiver.

It is important that caregivers take care of themselves, too. Find someone you can talk to or consult your health care provider about support groups. Finding support and strategies for managing stress can help you and your child.

Where do I go for help?

If you're not sure where to get help, your doctor, pediatrician, or other family health care provider is a good place to start. A health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating bipolar disorder and can evaluate your child's symptoms.

You can learn more about getting help and finding a health care provider on the National Institute of Mental Health website. Hospital health care providers can help in an emergency. The Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to help you find mental health services in your area.

I know someone who is in crisis. What do I do?

If you know someone who might be thinking about hurting themselves or someone else, get help quickly.

Do not leave the person alone.

Call 911 or go to the nearest hospital emergency room.

Call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or the toll-free TTY number at 1-800-799-4TTY (4889). You also can text the Crisis Text Line (text HELLO to 741741) or go to the National Suicide Prevention Lifeline website.

What should I know about clinical trials?

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future.

Researchers at NIMH and around the country conduct clinical trials with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit the NIMH Clinical Trials webpage.

Reprints

This publication is in the public domain and may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH Information Resource Center at 1-866‑615‑6464, email nimhinfo@nih.gov, or refer to our reprint guidelines.

For More Information

MedlinePlus (National Library of Medicine) ( En español)

ClinicalTrials.gov ( En español)

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
National Institutes of Health
NIH Publication No. 20-MH-8081
Revised 2020

# data[].attributes.attachment_link.description
Does your child go through extreme changes in mood and behavior? Does your child get much more excited or much more irritable than other kids? Do you notice that your child goes through cycles of extreme highs and lows more often than other children?

# data[].attributes.attachment_link.provider_name
National Association of Anorexia Nervosa and Associated Disorders

# data[].attributes.attachment_link.readable_text
If you're interested in learning more about eating disorders and body image, ANAD has the resources you need to get informed. ANAD is the leading nonprofit in the U.S. providing free, peer support to anyone struggling with an eating disorder. From our eating disorder statistics to our blog and webinars, there are so many ways to get informed at ANAD!

# data[].attributes.attachment_link.title
Get Informed at ANAD | National Association of Anorexia Nervosa and Associated Disorders

# data[].attributes.attachment_link.description
If you're interested in learning more about eating disorders and body image, ANAD has the resources you need to get informed. ANAD is the leading nonprofit in the U.S. providing free, peer support to anyone struggling with an eating disorder. From our eating disorder statistics to our blog and webinars, there are so many ways to get informed at ANAD!

# data[].attributes.attachment_link.title
Child Mind Institute | Transforming Children’s Lives.

# data[].attributes.attachment_link.description
The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children struggling with mental health and learning disorders.

# data[].attributes.attachment_link.provider_name
Substance Abuse and Mental Health Services Administration

# data[].attributes.attachment_link.description
Frequently Asked Questions - What is SAMHSA’s National Helpline?

# data[].attributes.body
ADD/ADHD

# data[].attributes.attachment_link.readable_text
You indicate the behaviors that are making you concerned about your child by answering a series of questions. The Symptom Checker analyzes your answers to give you a list of psychiatric or learning disorders that are associated with those symptoms.

Since individual symptoms can reflect more than one disorder, this tool will give you a range of possibilities and guide you toward next steps. This tool cannot diagnose your child, but it can help you inform yourself about possible diagnoses and will offer information and articles to help you learn about them, to facilitate a conversation with a professional.

# data[].attributes.attachment_link.title
The Child Mind Institute Symptom Checker

# data[].attributes.attachment_link.description
You indicate the behaviors that are making you concerned about your child by answering a series of questions. The Symptom Checker analyzes your answers to give you a list of psychiatric or learning disorders that are associated with those symptoms. Since individual symptoms can reflect more than one disorder, this tool will give you a range of possibilities and guide you toward next steps.

# data[].attributes.attachment_link.readable_text
What Symptoms Should Parents Look for?

There are four basic types of behavior that characterize conduct disorder:

Physical aggression (such as cruelty toward animals, assault or rape).

Violating others' rights (such as theft or vandalism).

Lying or manipulation.

Delinquent behaviors (such as truancy or running away from home).

Conduct disorder is characterized by aggression toward others and a callous disregard for their rights and needs. Adolescents and teens with conduct disorder can find acts of aggression, deceit and coercion to be gratifying. Your child may meet the criteria for conduct disorder if you find them engaging in several of the below behaviors:

Many young people with conduct disorder will have trouble:

Feeling and expressing empathy or remorse.

Showing emotion toward others.

Performing well in the school or community and blaming others for poor performance.

They often misinterpret the actions of others as being hostile or aggressive. They respond by escalating the situation into verbal or physical conflict.

In adolescents and teens, conduct disorder may be associated with other difficulties, including:

In younger children, it can be more of a challenge to distinguish signs of conduct disorder from more typical "acting out." Your younger child may be exhibiting signs of conduct disorder if you find them engaging in just one of the behaviors listed above.

At times, these same symptoms can be seen in children without the disorder. The difference is frequency, intensity, and duration, as well as to what extent it impacts their functioning. In children with conduct disorder, these behaviors happen much more frequently.

# data[].attributes.attachment_link.description
There are four basic types of behavior that characterize conduct disorder: Physical aggression (such as cruelty toward animals, assault or rape). Violating others' rights (such as theft or vandalism). Lying or manipulation. Delinquent behaviors (such as truancy or running away from home).

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
Children with attention-deficit/hyperactivity disorder (ADHD) experience more obstacles in their path to success than the average student. The symptoms of ADHD, such as inability to pay attention, difficulty sitting still, and difficulty controlling impulses, can make it hard for children with this diagnosis to do well in school.

To meet the needs of children with ADHD, schools may offer

ADHD treatments, such as behavioral classroom management or organizational training;

Special education services; or

Accommodations to lessen the effect of ADHD on their learning.

Classroom Treatment Strategies for ADHD Students

There are some school-based management strategies shown to be effective for ADHD students: behavioral classroom management and organizational training.

The behavioral classroom management approach encourages a student's positive behaviors in the classroom, through a reward systems or a daily report card, and discourages their negative behaviors. This teacher-led approach has been shown to influence student behavior in a constructive manner, increasing academic engagement. Although tested mostly in elementary schools, behavioral classroom management has been shown to work students of all ages.

Organizational training teaches children time management, planning skills, and ways to keep school materials organized in order to optimize student learning and reduce distractions. This management strategy has been tested with children and adolescents.

These two management strategies require trained staff-including teachers, counselors, or school psychologists-follow a specific plan to teach and support positive behavior.

The American Academy of Pediatrics (AAP) recommends that the school environment, program, or placement is a part of any ADHD treatment plan. AAP also recommends teacher-administered behavior therapy as a treatment for school-aged children with ADHD. You can talk to your child's healthcare provider and teachers about working together to support your child.

Special Education Services and Accommodations

Most children with ADHD receive some school services, such as special education services and accommodations. There are two laws that govern special services and accommodations for children with disabilities:

The Individuals with Disabilities Education Act (IDEA)

Section 504 of the Rehabilitation Act of 1973

The support a child with ADHD receives at school will depend on if they meet the eligibility requirements for one of two federal plans funded by IDEA and Section 504: an individualized education program (IEP) or a 504 Plan.

What are the main differences between the two Plans?

IEPs provide individualized special education services to meet the unique needs of the child.

A 504 Plan provides services and changes to the learning environment to meet the needs of the child as adequately as other students.
Learn more about IEP and 504 Plans [PDF - 2.75 MB]
Accommodations

IEP and 504 Plans can offer accommodations for students to help them manage their ADHD, including:

Extra time on tests;

Instruction and assignments tailored to the child;

Positive reinforcement and feedback;

Using technology to assist with tasks;

Allowing breaks or time to move around;

Changes to the environment to limit distraction; and

Extra help with staying organized.

There is limited information about which types of accommodations are effective for children with ADHD. However, there is evidence that setting clear expectations, providing immediate positive feedback, and communicating daily with parents through a daily report card can help.

What Teachers Can Do To Help

For teachers, helping children manage their ADHD symptoms can present a challenge. Most children with ADHD are not enrolled in special education classes, but do need extra assistance on a daily basis. The National Resource Center on ADHD provides information for teachers from experts on how to help students with ADHD.

Here are some tips for classroom success.

Communication

Give frequent feedback and attention to positive behavior;

Be sensitive to the influence of ADHD on emotions, such as self-esteem issues or difficulty regulating feelings;

Provide extra warnings before transitions and changes in routines; and

Understand that children with ADHD may become deeply absorbed in activities that interest them (hyper-focus) and may need extra assistance shifting their attention.

Assignments and Tasks

Make assignments clear-check with the student to see if they understand what they need to do;

Provide choices to show mastery (for example, let the student choose among written essay, oral report, online quiz, or hands-on project;

Make sure assignments are not long and repetitive. Shorter assignments that provide a little challenge without being too hard may work well;

Allow breaks-for children with ADHD, paying attention takes extra effort and can be very tiring;

Allow time to move and exercise;

Minimize distractions in the classroom; and

Use organizational tools, such as a homework folder, to limit the number of things the child has to track.

Develop a Plan That Fits the Child

Observe and talk with the student about what helps or distracts them (for example, fidget tools, limiting eye contact when listening, background music, or moving while learning can be beneficial or distracting depending on the child);

Communicate with parents on a regular basis; and

Involve the school counselor or psychologist.

Close collaboration between the school, parents, and healthcare providers will help ensure the child gets the right support.

Parent Education and Support

CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their child. Learn more about their services.

How to best advocate for your child

Understand your child's diagnosis, how it impacts their education, and what can be done at home to help.

Understand your child's IEP. If you have questions, don't be afraid to ask.

Speak with your child's teacher.

When possible, obtain written documentation from teachers, administrators, or other professionals working with your child.

Know your rights.

Play an active role in preparing your child's IEP or 504 Plan.

Keep careful records, including written documentation, communication between home and school, progress reports, and evaluations.

Try to maintain a good working relationship with the school while being a strong advocate for your child.

Communicate any concerns you may have about your child's progress or IEP or 504 Plan.

Encourage your child every day, and work with your child to create a system to help with homework and other school projects.

What every parent should know

More Information

Reference

1. Evans S, Owens J, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology 2014;43(4):527-551 [Read overview]

2. DuPaul GJ, Chronis-Tuscano A, Danielson ML, Visser SN. Predictors of receipt of school services in a national sample of youth with ADHD. Journal of Attention Disorders Published online December 10, 2018. [Read summary]

3. Harrison JR, Bunford N, Evans SW, Owens JS. Educational accommodations for students with behavioral challenges: A systematic review of the literature. Review of Educational Research 2013;83(4):551-97.

4. Moore DA, Russell AE, Matthews J, Ford TJ, Rogers M, Ukoumunne OC, et al. School-based interventions for attention-deficit/hyperactivity disorder: A systematic review with multiple synthesis methods. Review of Education. Published online October 18, 2018.

5. https://chadd.org/for-parents/individuals-with-disabilities-education-act/

# data[].attributes.attachment_link.description
To meet the needs of children with ADHD, schools may offer ADHD treatments, special education services, or accommodations to lessen the effect of ADHD on their learning.

# data[].attributes.attachment_link.provider_name
Centers for Disease Control and Prevention

# data[].attributes.attachment_link.readable_text
Children sometimes argue, are aggressive, or act angry or defiant around adults. A behavior disorder may be diagnosed when these disruptive behaviors are uncommon for the child's age at the time, persist over time, or are severe. Because disruptive behavior disorders involve acting out and showing unwanted behavior towards others they are sometimes called externalizing disorders.

Oppositional Defiant Disorder

When children act out persistently so that it causes serious problems at home, in school, or with peers, they may be diagnosed with Oppositional Defiant Disorder (ODD). ODD usually starts before 8 years of age, but no later than by about 12 years of age. Children with ODD are more likely to act oppositional or defiant around people they know well, such as family members, a regular care provider, or a teacher. Children with ODD show these behaviors more often than other children their age.

Examples of ODD behaviors include

Often being angry or losing one's temper

Often arguing with adults or refusing to comply with adults' rules or requests

Often resentful or spiteful

Deliberately annoying others or becoming annoyed with others

Often blaming other people for one's own mistakes or misbehavior

Learn more about ODD
Conduct Disorder

Conduct Disorder (CD) is diagnosed when children show an ongoing pattern of aggression toward others, and serious violations of rules and social norms at home, in school, and with peers. These rule violations may involve breaking the law and result in arrest. Children with CD are more likely to get injured and may have difficulties getting along with peers.

Examples of CD behaviors include

Breaking serious rules, such as running away, staying out at night when told not to, or skipping school

Being aggressive in a way that causes harm, such as bullying, fighting, or being cruel to animals

Lying, stealing, or damaging other people's property on purpose

Learn more about CD
Treatment for disruptive behavior disorders

Starting treatment early is important. Treatment is most effective if it fits the needs of the specific child and family. The first step to treatment is to talk with a healthcare provider. A comprehensive evaluation by a mental health professional may be needed to get the right diagnosis. Some of the signs of behavior problems, such as not following rules in school, could be related to learning problems which may need additional intervention. For younger children, the treatment with the strongest evidence is behavior therapy training for parents, where a therapist helps the parent learn effective ways to strengthen the parent-child relationship and respond to the child's behavior. For school-age children and teens, an often-used effective treatment is a combination of training and therapy that includes the child, the family, and the school.

Get help finding treatment

Here are tools to find a healthcare provider familiar with treatment options:

Managing Symptoms: Staying Healthy

Being healthy is important for all children and can be especially important for children with behavior or conduct problems. In addition to behavioral therapy and medication, practicing certain healthy lifestyle behaviors may reduce challenging and disruptive behaviors your child might experience. Here are some healthy behaviors that may help:

Engaging in regular physical activity, including aerobic and vigorous exercise

Eating a healthful diet centered on fruits, vegetables, whole grains, legumes (for example, beans, peas, and lentils), lean protein sources, and nuts and seeds

Getting the recommended amount of sleep each night based on age

Strengthening relationships with family members

Prevention of disruptive behavior disorders

It is not known exactly why some children develop disruptive behavior disorders. Many factors may play a role, including biological and social factors. It is known that children are at greater risk when they are exposed to other types of violence and criminal behavior, when they experience maltreatment or harsh or inconsistent parenting, or when their parents have mental health conditions like substance use disorders, depression, or attention-deficit/hyperactivity disorder (ADHD). The quality of early childhood care also can impact whether a child develops behavior problems.

Although these factors appear to increase the risk for disruptive behavior disorders, there are ways to decrease the chance that children experience them. Learn about public health approaches to prevent these risks:

# data[].attributes.attachment_link.title
Behavior or Conduct Problems in Children | CDC

# data[].attributes.attachment_link.description
Children sometimes argue, are aggressive, or act angry or defiant around adults. A behavior disorder may be diagnosed when these disruptive behaviors are uncommon for the child's age at the time, persist over time, or are severe. Learn about behavior or conduct problems in children.

# data[].attributes.attachment_link.title
Anxiety Disorders | NAMI: National Alliance on Mental Illness

# data[].attributes.attachment_link.description
Discover the symptoms, causes, diagnosis advice, treatment options and related conditions of anxiety disorders.

# data[].attributes.attachment_link.readable_text
Obsessive compulsive disorder (OCD) is characterised by recurring unwanted and intrusive thoughts, impulses and images (obsessions), as well as repetitive behavioural and mental rituals (compulsions).

It can be difficult, demanding and exhausting to live with a person who has OCD. Family members and friends may become deeply involved in the person's rituals and may have to assume responsibility and care for many daily activities that the person with OCD is unable to undertake. This can cause distress and disruption to all members of the family.

People with OCD are usually aware that their obsessions and compulsions are irrational and excessive, yet feel unable to control or resist them. OCD can take up many hours of a person's day and may severely affect work, study, and family and social relationships.

Understanding OCD can help

People with OCD often feel frustrated and distressed about their need to act compulsively. When family members and friends are more informed about OCD, it is easier to be supportive and understanding.

Many people with OCD experience intense fears of something terrible happening to themselves or others, have constant doubts about their behaviour, and frequently seek reassurance from others.

Common misconceptions include that OCD is caused by laziness, lack of willpower, bad parenting or trauma. Assumptions like these lead to blame and guilt. Many OCD behaviours that are irritating and demanding are actually symptoms of the condition.

There are many available that can help resolve misunderstandings and concerns about this disorder. These include , , and websites with information about specific aspects of OCD (such as , obsessional thinking and hyper-responsibility) and community resources such as telephone helplines and .

Offer support and understanding to people you know with OCD

It is important to communicate clearly that you understand the difference between the behavioural symptoms of OCD and the person: 'I know this is not you, this is your OCD.' This will help to diminish the person's feelings of guilt and low self-worth and reduce their levels of stress and anxiety. Other suggestions include:

Encourage the person to talk about the disorder so that you can learn how it affects them and how you can be more supportive, but don't engage in discussions about the logic of OCD as most people with OCD know their obsessions and compulsions are excessive and irrational.

Encourage the person to seek professional help. OCD is generally not a condition that will go away without treatment. You can assist in locating an experienced therapist and offer to be involved in their treatment program. If the OCD has involved you or other family or friends extensively in rituals and avoidance behaviours, you will need to know the best ways to modify your involvement so that the treatment can be as effective as possible.

Encourage discussion about OCD as a common and treatable anxiety condition that is nothing to be embarrassed or ashamed of. Support the person with OCD to share their experiences with family and friends - this will help to break the secrecy about OCD.

Acknowledge improvements, however small, and encourage the person to reward themselves for their progress.

Try to be patient and maintain a non-judgemental attitude - this will support the person to focus their efforts on recovery rather than dealing with anger and resentment.

If their motivation wanes and they consider stopping treatment, remind them of the gains they have made.

Don't reinforce obsessive compulsive behaviours

Families and friends often get involved in OCD behaviours. It may seem like the only way to reduce the distress that the person with OCD is experiencing. You may feel that it is easier to keep things functioning if you can quickly comply with their request, rather than dealing with the protracted anxiety, tears, or arguments that may arise if you don't do what is asked.

Helping a person with OCD with their rituals, responding to requests for reassurance or undertaking tasks that they want to avoid, are all behaviour patterns that maintain OCD and may create an obstacle to the person's recovery.

It can be very difficult to reduce this type of involvement in a person's OCD, especially if it has been going on for a long time. It is important to 'normalise' family or household routines and refuse to participate in reinforcing OCD behaviours. This should be done in a gradual way and preferably as part of a cognitive behavioural treatment program.

Suddenly stopping all involvement in a person's OCD could trigger overwhelming distress for the person with OCD and lead to increased symptoms, high agitation, anxiety and depression.

Some suggestions include:

Talk openly about behaviours that impact on household routines and time. Plan ways in which family and friends can gradually reduce their participation in the person's rituals and explain the reasons for doing this. Encourage the person with OCD to be a part of decision making about how this is achieved. Set realistic goals together and talk about ways to ensure that everyone will abide by the plan.

If the person with OCD is in treatment, offer to attend a session with them so that you can seek advice about how you can best support their treatment program.

Try to maintain normal household routines whenever possible.

Focus on strengthening family and social connections, and reinforce a sense of stability by maintaining positive traditions and occasions - celebrate birthdays and anniversaries, or have regular family dinners. Reinforce positive communication and behaviours (such as sharing, hugs and helping each other) and keep up family activities such as going to the footy, or taking the dog to the park.

Reach out for support and help for yourself

If you live with someone with OCD, it is likely you will need some support and help for yourself. Over time, OCD in the family or household can lead to everyone feeling isolated and alone. It is important to maintain your connections and supports among your extended family and friends.

If these support networks are limited or unable to meet your needs, consider seeking out supports in the community. Suggestions include:

Contact a telephone helpline for families and carers of people with OCD and anxiety conditions, such as the Tel, 1300 269 438.

Attend a support group for families and friends in similar situations.

Attend education and skills groups for carers of people with OCD.

Seek out information or workshops on stress management, relaxation and mindfulness meditation, and healthy living.

If your physical or emotional health is suffering, seek professional help for yourself - short-term counselling and support can be found through your GP, local community health centre, or a private psychologist.

Take time out for yourself whenever possible and try to maintain hobbies and outside interests.

When the person who has OCD refuses treatment

A person who has OCD may be reluctant to seek professional help. They may have fears such as:

the stigma associated with mental illness

the possibility of being found to be really 'mad' or 'crazy'

having to give up their compulsions - they may feel that the behaviours are necessary to their survival and that it would be impossible to stop them

becoming addicted to medications

'failing' at the therapy

appearing weak because they can't deal with their problem on their own.

Suggestions for supporting the person with OCD include:

Offer reassurance that OCD is a recognised and treatable illness.

Assist them to be fully informed about effective treatments, including medication and psychological therapy. Information about available options can help alleviate many of the fears that people with OCD have about treatment, such as: how the treatments work, what is expected of the person, how long it should take, what self-management strategies can improve recovery, and how these treatments have helped others with OCD.

Encourage them to seek treatment from a professional who is experienced in treating OCD. Fears and worries about treatment may be exacerbated if the person with OCD is exposed to an incompetent or inappropriate treatment service.

Don't try to bully or ridicule a person with OCD into getting treatment - strong-arm tactics won't work and will only increase their feelings of powerlessness and failure.

Emphasise that knowing when to seek help is actually a sign of strength, not weakness.

Seek advice from professionals and support groups on your own, if necessary.

Sometimes, despite your best efforts, you have to accept there's nothing more you can do to encourage the person to seek help - in this case, you need to find avenues of support and strength for yourself.

If you think the person is in danger of harming themselves or someone else, call your doctor, local mental health service crisis assessment team or the police (dial 000).

Where to get help

# data[].attributes.attachment_link.title
Obsessive compulsive disorder - family and friends | betterhealth.vic.gov.au

# data[].attributes.attachment_link.description
Obsessive compulsive disorder (OCD) is characterised by recurring unwanted and intrusive thoughts, impulses and images (obsessions), as well as repetitive behavioural and mental rituals (compulsions). It can be difficult, demanding and exhausting to live with a person who has OCD.

# data[].attributes.headline
Learning Disabilities Association of Texas

# data[].attributes.subject
Learning Disabilities Association of Texas

# data[].attributes.attachment_link.readable_text
The development of an inclusive school culture means taking into account the needs of all members of the learning community.

This module is the crossroads where the best practices from the other modules come together. To create an inclusive spirit, a leader will draw on student and faculty voices, key constituents and data to make sure underrepresented students are empowered with a sense of self and self-sufficiency to rise to their fullest potential within the school.

Equity Through Intervention
See how interdisciplinary discussions and activities can create a supportive learning structure in which equal advantages and a sense of fairness for all take their place at the forefront of reform. View Transcript

Teaching Acceptance
Students are key to fostering an inclusive school culture. See the activities and institutions-both small and sweeping-that can make the difference. View Transcript

A Parent's View
Success is derived from support. See how to get parents and community members to take charge - helping to lead learning initiatives and acting as liaisons. View Transcript

Collaborative Activities

Activity 4 - Equity

# data[].attributes.attachment_link.title
Module 4: Building an Inclusive School Culture

# data[].attributes.attachment_link.description
The development of an inclusive school culture means taking into account the needs of all members of the learning community. This module is the crossroads where the best practices from the other modules come together.

# data[].attributes.body
Mayo Clinic

# data[].attributes.attachment_link.readable_text
Diagnosis

When teen depression is suspected, the doctor will typically do these exams and tests.

Physical exam. The doctor may do a physical exam and ask in-depth questions about your teenager's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem.

Lab tests. For example, your teen's doctor may do a blood test called a complete blood count or test your teen's thyroid to make sure it's functioning properly.

Psychological evaluation. A doctor or mental health professional can talk with your teen about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications.

Types of depression

Symptoms caused by major depression can vary from person to person. To clarify the type of depression your teen has, the doctor may use one or more specifiers, which means depression with specific features. Here are a few examples:

Anxious distress - depression with unusual restlessness or worry about possible events or loss of control

Melancholic features - severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness

Atypical features - depression that includes the ability to be temporarily cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in arms or legs

Other disorders that cause depression symptoms

Several other disorders include depression as a symptom. An accurate diagnosis is the key to getting appropriate treatment. The doctor or mental health professional's evaluation will help determine if the symptoms of depression are caused by one of these conditions:

Bipolar 1 and 2 disorders. These mood disorders include mood swings that range from major highs to major lows. It's sometimes difficult to distinguish between bipolar disorder and depression.

Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.

Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.

Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent functioning normally in daily routines and from living life to its fullest.

Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of a menstrual period. The symptoms are minimal or gone after the period ends.

Other causes of depression. This includes depression that's caused by the use of recreational or illegal drugs, certain prescribed medications, or a medical condition.

Treatment

Treatment depends on the type and severity of your teenager's depression symptoms. A combination of talk therapy (psychotherapy) and medication can be very effective for most teens with depression.

If your teen has severe depression or is in danger of self-harm, he or she may need a hospital stay or may need to participate in an outpatient treatment program until symptoms improve.

Here's a closer look at depression treatment options.

Medications

The Food and Drug Administration (FDA) has approved two medications for teen depression - fluoxetine (Prozac) and escitalopram (Lexapro). Talk with your teen's doctor about medication options and possible side effects, weighing the benefits and risks.

FDA alert

Most antidepressants are generally safe, but the FDA requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. Though it's uncommon, some children, teens and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when first beginning a new medication or with a change in dosage. If your teen has suicidal thoughts while taking an antidepressant, immediately contact your doctor or get emergency help.

For most teens who need an antidepressant, the benefits of taking an antidepressant outweigh any risks. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Finding the right medication

Everyone's different, so finding the right medication or dose for your teen may take some trial and error. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as the body adjusts. Encourage your teen not to give up.

Managing medications

Carefully monitor your teen's use of medications. To work properly, antidepressants need to be taken consistently at the prescribed dose. Because overdose can be a risk for teens with depression, the doctor may prescribe only small supplies of pills at a time, or recommend that you dole out medication so that your teen does not have a large amount of pills available at once. Locking up all pills in the home is one measure families can take to reduce the risk of suicide.

If your teen has bothersome side effects, he or she shouldn't stop taking an antidepressant without talking to the doctor first. Some antidepressants can cause withdrawal symptoms unless the dose is slowly tapered off - quitting suddenly may cause a sudden worsening of depression.

Antidepressants and pregnancy

If your teen is pregnant or breastfeeding, some antidepressants may pose an increased health risk to the unborn or nursing child. If your teen becomes pregnant or plans to become pregnant, make certain your teen talks to the doctor about antidepressant medications and managing depression during pregnancy.

Psychotherapy

Psychotherapy, also called psychological counseling or talk therapy, is a general term for treating depression by talking about depression and related issues with a mental health professional. Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy.

Psychotherapy may be done one-on-one, with family members or in a group. Through regular sessions, your teen can:

Learn about the causes of depression

Learn how to identify and make changes in unhealthy behaviors or thoughts

Explore relationships and experiences

Find better ways to cope and solve problems

Set realistic goals

Regain a sense of happiness and control

Help ease depression symptoms such as hopelessness and anger

Adjust to a crisis or other current difficulty

Hospitalization and other treatment programs

In some teens, depression is so severe that a hospital stay is needed, especially if your teen is in danger of self-harm or hurting someone else. Getting psychiatric treatment at a hospital can help keep your teen calm and safe until coping skills are learned and a safety plan is developed.

Day treatment programs also may help. These programs provide the support and counseling needed while your teen gets depression symptoms under control.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Alternative medicine

Make sure that you and your teenager understand the risks as well as possible benefits if your teen pursues alternative or complementary therapy. Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a good substitute for medical care.

Examples of techniques that may help in dealing with depression include:

Acupuncture

Relaxation techniques, such as deep breathing

Yoga or tai chi

Meditation

Guided imagery

Massage therapy

Music or art therapy

Spirituality

Relying solely on these methods is generally not enough to treat depression. But they may be helpful when used in addition to medication and psychotherapy.

Lifestyle and home remedies

You are your teenager's best advocate to help him or her succeed. In addition to professional treatment, here are some steps you and your teen can take that may help:

Stick to the treatment plan. Make sure your teen attends appointments, even if he or she doesn't feel like going. Even if your teen is feeling well, make sure he or she continues to take medications as prescribed. If your teen stops taking medications, depression symptoms may come back. And quitting suddenly may cause withdrawal-like symptoms.

Learn about depression. Education can empower your teen and motivate him or her to stick to a treatment plan. It can also benefit you and other loved ones to learn about depression and understand that it's a treatable condition.

Encourage communication with your teen. Talk to your teen about the changes you're observing and emphasize your unconditional support. Create an environment where your teen can share concerns while you listen.

Pay attention to warning signs. Work with your teen's doctor or therapist to learn what might trigger depression symptoms. Make a plan so that you and your teen know what to do if symptoms get worse. Ask family members or friends to help watch for warning signs.

Help your teen adopt healthy habits. Keep healthy foods in your home, keep unhealthy foods out, and set regular mealtimes. Encourage routine exercise, noting that even light physical activity can help reduce depression symptoms. Set a time for lights out at bedtime with no use of electronic devices in bed, which can help promote quality and quantity of sleep. If your teen is having problems with sleep, ask the doctor for advice.

Help your teen avoid alcohol and other drugs. Your teen may feel as if alcohol, marijuana or other drugs lessen depression symptoms, but in the long run they worsen symptoms and make depression harder to treat. Talk with the doctor or therapist if your teen needs help to deal with alcohol or drug use.

Eliminate or limit access to items your teen could use for self-harm. This can include removing or securing guns, and removing sharp items, alcohol or risky medications in your home if you live with a teen who has depression.

Coping and support

Showing interest and the desire to understand your teenager's feelings lets him or her know you care. You may not understand why your teen feels hopeless or has a sense of loss or failure. But listen without judging and try to put yourself in your teen's position. Help build your teen's self-esteem by recognizing small successes and offering praise about competence.

Encourage your teen to:

Make and keep healthy friendships. Positive relationships can help boost your teen's confidence and help him or her stay connected with others. Encourage your teen to avoid relationships with people whose attitudes or behaviors could make depression worse.

Stay active. Participation in sports, school activities or a job can help keep your teen focused on positive things, rather than negative feelings or behaviors.

Ask for help. Teens may be reluctant to seek support when life seems overwhelming. Encourage your teen to talk to a family member or other trusted adult whenever needed.

Have realistic expectations. Many teens judge themselves when they aren't able to live up to unrealistic standards - academically, in athletics or in appearance, for example. Let your teen know that it's OK not to be perfect.

Simplify life. Encourage your teen to carefully choose obligations and commitments, and set reasonable goals. Let your teen know that it's OK to do less when he or she feels down.

Structure time. Help your teen plan activities by making lists or using a planner to stay organized. Sticking to a regular routine may help improve mood.

Keep a private journal. Journaling may help improve your teen's mood by allowing your teen to express and work through pain, anger, fear or other emotions.

Connect with other teens who struggle with depression. Ask the doctor or therapist if there are local support groups for teen depression. Depression support groups are offered online, but check them out to make sure they're trustworthy sites - such as the National Alliance on Mental Illness or the Depression and Bipolar Support Alliance.

Preparing for your appointment

It's a good idea to be well prepared for your appointment. Here's some information to help you and your teenager get ready, and what to expect from the doctor.

What you can do

To the extent possible, involve your teenager in preparing for the appointment. Then make a list of:

Any symptoms your teen has had, including any that may seem unrelated to the reason for the appointment

Key personal information, including any major stresses or recent life changes your teen has experienced

All medications, vitamins, herbal remedies or other supplements that your teen is taking

Questions that you and your teen want to ask the doctor

Basic questions to ask the doctor may include:

Is depression the most likely cause of my teen's symptoms?

What are other possible causes for the symptoms?

What kinds of tests will my teen need?

What treatment is likely to work best?

Are there any possible side effects with the medications you're recommending?

Is there a generic alternative to the medicine you're prescribing?

How will we monitor progress and effectiveness of treatment?

What are the alternatives to the primary approach that you're suggesting?

My teen has these other health conditions. Could they be linked to depression?

Are there any restrictions that my teen needs to follow?

Should my teen see a psychiatrist or other mental health professional?

Will making changes in diet, exercise or other areas help ease depression?

Are there any printed materials that we can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your teen's doctor

Your teen's doctor or mental health professional will likely ask your teen a number of questions, including:

When did family members or friends first notice your symptoms of depression?

How long have you felt depressed? Do you generally always feel down, or does your mood change?

Does your mood ever swing from feeling down to feeling extremely happy and full of energy?

Do you ever have suicidal thoughts when you're feeling down?

How severe are your symptoms? Do they interfere with school, relationships or other day-to-day activities?

Do you have any blood relatives - such as a parent or grandparent - with depression or another mood disorder?

What other mental or physical health conditions do you have?

Are you using any mood-altering substances, such as alcohol, marijuana or recreational drugs? Do you use nicotine?

How much do you sleep at night? Does the amount change over time?

What, if anything, seems to improve your symptoms? What appears to worsen them?

What is your diet like? Do you have a history of significant weight gain or loss?

The doctor or mental health professional will ask additional questions based on your teen's responses, symptoms and needs. Preparing and anticipating questions will help make the most of your appointment time.

# data[].attributes.attachment_link.description
This serious mental health problem affects how your teenager thinks, feels and behaves, and can cause emotional, functional and physical problems.