Depression in children and teenagers

What is depression in children and teenagers?

If a young person is in immediate danger or talking about ending their life, do not wait. Call 999 or go to A&E. You can also call Samaritans free any time on 116 123, call Papyrus HOPELINE247 on 0800 068 4141 (for people under 35), or text SHOUT to 85258. For urgent mental health support, call 111 and choose the mental health option in England, Scotland or Wales; in Northern Ireland, call Lifeline free on 0808 808 8000, or contact your GP out-of-hours service.

Depression in children and teenagers is more than ordinary sadness or a bad week. It is a lasting low mood, loss of enjoyment, or irritability that goes on most days for weeks and starts to affect school, friendships, sleep, appetite and how a young person feels about themselves.

It is common, it is not a sign of weakness or bad parenting, and it can be helped. The first-line treatment for children and young people is talking therapy, not medication. For some young people with moderate to severe depression, medication may be added, but only under specialist care and with careful monitoring.

Treatment aims to lift mood, restore daily life and reduce the risk that comes with depression. It works best alongside support at home and school, good sleep and routine, and treating anything else that is going on, such as anxiety, bullying or difficulties at home.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your treatment

• If there is any immediate risk to safety, treat that first with 999 or A&E; therapy is not for emergencies.
• Start with the GP, who can assess, support and refer to CAMHS or therapy where needed.
• Make a few notes on how long the low mood has lasted, sleep, appetite, school and any thoughts of self-harm.
• List any medicines, supplements, alcohol or drug use, and other professionals involved.
• Bring the young person's views; therapy works best when they are involved in choosing it.
• Think about practical support at school and home that could help during treatment.
• If medication is being considered, prepare questions about benefits, side effects and monitoring.

What happens

Treatment starts with an assessment of how severe the depression is, how long it has lasted, and what else is going on, including any thoughts of self-harm or suicide and any safeguarding concerns. For milder, recent low mood, a short period of watchful waiting with support and reassessment may come first.

If depression continues or is more significant, talking therapy is offered. National guidance (NICE) recommends psychological therapy as the first-line treatment for children and young people, with the type chosen to suit the young person. For moderate to severe depression in 12 to 18 year olds, this is often individual CBT for at least a few months, with alternatives such as IPT-A or family therapy.

Medication is not the first step. If moderate to severe depression does not improve enough with therapy, a child and adolescent psychiatrist may, after a multidisciplinary review, add fluoxetine, the antidepressant with the best evidence in young people, alongside continued therapy. There should be close monitoring, especially in the first weeks, because a small number of young people can feel more agitated or have more thoughts of self-harm early on. Families are told what to watch for and how to get help quickly.

Progress is reviewed regularly, and the plan is adjusted. Recovery is usually gradual rather than sudden, and support at home and school is part of it.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

The most important safety point is that, for a small number of young people, antidepressants can increase agitation or suicidal thoughts in the early weeks. That is why medication is specialist-led, started carefully, and monitored closely, and why families are told exactly what to watch for. Untreated depression also carries risk, so doing nothing is not a safe option either.

Published figures to discuss

Quoting precise success or harm percentages for an individual young person would be misleading, because outcomes vary with the type and severity of depression, what else is going on, and how well therapy and any medication fit. The key safety point that guidance is clear about is that antidepressants can, in a small number of young people, increase agitation or suicidal thoughts in the early weeks, which is why monitoring is close and warning signs are explained. Untreated depression also carries real risk.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no physical recovery. 'Afterwards' means how mood improves over time with therapy and support, the early weeks of any medication, and the reviews that keep treatment on track.

• Slow, uneven progress with better and harder days
• Feeling tired or emotional after therapy sessions
• Some mild, settling side effects in the first weeks of medication
• Needing ongoing routine, sleep and support at home and school

Aftercare

• Keep therapy appointments and practise any skills or homework between sessions.
• If medication is prescribed, take it as directed and never stop suddenly; ask the specialist before changing anything.
• Watch for and report any increase in agitation, irritability or thoughts of self-harm, especially in the first weeks.
• Support good sleep, routine, activity and time outdoors, which all help mood.
• Keep crisis numbers handy: 999 or A&E for emergencies, Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141, and text SHOUT to 85258. For urgent mental health support, call 111 and choose the mental health option in England, Scotland or Wales, or call Lifeline on 0808 808 8000 in Northern Ireland.
• Work with school on practical support and reasonable adjustments.
• Look after the whole family; supporting a young person with depression is demanding.

• Therapy appointments in the diary
• Medication routine clear, with no sudden stopping
• Agreed list of warning signs to watch for
• Crisis numbers saved in phones
• Review or monitoring appointments booked
• School aware of agreed support
• Support in place for parents and carers

⚠ Get urgent help if…

• Any talk of suicide, feeling hopeless, or that others would be better off without them: call 999 or go to A&E now
• A new or increasing urge to self-harm, especially after starting or changing medication
• Becoming much more agitated, restless or unable to sleep soon after starting an antidepressant
• A sudden, severe drop in mood or withdrawal from everyone and everything
• Stopping eating or drinking, or a rapid decline in self-care
• Heavy alcohol or drug use to cope
• For urgent but non-emergency support: Samaritans 116 123, Papyrus HOPELINE247 0800 068 4141, or text SHOUT to 85258. For urgent mental health support, call 111 and choose the mental health option in England, Scotland or Wales, or call Lifeline on 0808 808 8000 in Northern Ireland

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your psychiatrist gives you.

Results & realistic expectations

With treatment, many children and teenagers recover from depression, though it can take weeks to months and sometimes more than one approach. A good outcome is improving mood, getting back to daily life, and learning skills that lower the chance of it returning.

No treatment can guarantee a young person will never feel low again, and depression can come back, especially at stressful times. That is why recovery includes a plan to spot early warning signs and seek help promptly. Talking therapy aims to give lasting tools, not just short-term relief.

Depression can be a one-off or can recur. After recovery, support and any medication are usually continued for a period to reduce relapse, then reviewed. Knowing personal warning signs and having a plan to seek help early makes future episodes easier to manage. As a young person grows, their treatment and support are reviewed and may move into adult services.

Related tests, treatments or support

Depression often travels with other difficulties. Treatment is frequently combined with help for anxiety, self-harm, sleep problems, or stresses at home and school. Where both therapy and medication are used, they work together, and lifestyle support such as sleep, routine and activity is part of the picture.

Follow-up & long-term care

Young people are reviewed regularly to check progress, safety and any side effects. If medication is started, there is weekly contact early on and ongoing specialist review. After recovery, there is a period of continued support before discharge back to the GP, with clear advice on when and how to seek help again.

• Continue therapy skills and routines after recovery
• Continue and then review medication as advised, never stopping abruptly
• Keep an agreed plan for spotting early warning signs
• Maintain sleep, activity and supportive routines
• Stay alert for relapse at stressful times and seek help early

Repeat, follow-on and what comes next

• If the first therapy or medication does not help enough, the plan is reviewed and changed.
• Doses, therapy type and intensity may be adjusted over time.
• Depression can recur, so a relapse plan and the option to re-engage with help are part of care.
• Care is reviewed as a young person grows and may transfer to adult services.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Regular review of mood, safety and side effects, with weekly contact early in any medication
• A named contact and clear crisis numbers for out of hours
• A written relapse plan with personal early warning signs
• School liaison and practical adjustments where helpful
• Continued support after recovery before stepping down, and support for the family

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Type and number of therapy sessions and the therapist's training
• Whether care is therapy-only or also involves a psychiatrist for medication
• The depth of initial assessment and any reports
• Frequency of monitoring and review appointments, especially if medication is used
• Whether family sessions or school liaison are included
• Treatment of any coexisting difficulties, such as anxiety or self-harm

• The therapist's qualifications and experience with young people
• Which therapy is recommended, how many sessions, and at what frequency
• Whether a psychiatrist is involved if medication may be needed
• What monitoring and review are included, particularly early in any medication
• What is included if more sessions or a change of plan are needed
• How urgent concerns are handled out of hours
• Cancellation policy and arrangements if the young person is too unwell to attend

On the NHS? Assessment and treatment for depression in young people are available on the NHS through GPs and CAMHS; private therapy or psychiatry may be used for choice or speed, with the same therapy-first approach.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the psychiatrist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good psychiatrist will welcome every one of these.

• Which talking therapy do you recommend for my child, and why?
• How will we know if therapy is working, and when would you change the plan?
• If medication is considered, what are the benefits, side effects and monitoring?
• What specific warning signs should we watch for in the first weeks of treatment?
• What support can school provide while my child recovers?
• What is the plan if my child's mood gets worse, especially out of hours?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this treatment not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified psychiatrist for depression in children and teenagers

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE NG134 — Depression in children and young people: identification and management NHS — Depression in children and young people YoungMinds — Depression and low mood Papyrus — HOPELINE247 (0800 068 4141) Samaritans — call 116 123 free, any time NHS England — 111 offering crisis mental health support NHS inform Scotland — urgent mental health help NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency and Lifeline (Northern Ireland) nidirect — urgent and emergency care services (Northern Ireland) nidirect — GP out-of-hours service (Northern Ireland)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.