text: Insomnia and sleep disturbance are common symptoms of depression in adults, but this is not always the case in adolescents. In fact, a group of researchers at the University of Pittsburgh who studied insomnia in depressed teens found that, compared to adults, insomnia in adolescents is different—very different. A 2005 study examined sleep differenc
  
  Considering pregnancy, taking ADs If moderate to severe depressive symptoms, delay conceiving, continue and optimize meds until stable
  If in early remission (started AD less than 6 months ago), delay conceiving, continue meds until stable
  If in full remission, but history of both recurrence and non-response to psychotherapy, continue meds
  
  Historically, research into the effectiveness of antidepressants for depressed youths has been unimpressive. In the 1980s, Joaquim Puig-Antich studied the then-popular tricyclic antidepressants and found no evidence to support their effectiveness (Puig-Antich J, Arch Gen Psych 1987;44(1):81–89). To make matters worse for tricyclics, in the 1990s sever
  
  We know that for many conditions, both medications and psychotherapy work about equally well. Common sense would dictate that there is some final common pathway of neuropsychiatric change underlying the symptomatic improvements we see. But identifying what is happening in a living human brain is extremely tricky. Recently, a number of articles have revi
  
  The extent to which antidepressants are effective for pediatric depression continues to stir controversy, as discussed in this issue of CCPR. Parents, the media, and even our young patients themselves sometimes tell us that our medications don’t work and may well be dangerous. And yet, as clinicians, we know of many children who have apparently benefi
  
  What To Ask?
  Some key questions to help you ascertain depression in your adolescent patients Have you been feeling irritable or angry?
  Have you been getting in more fights than usual with your parents or siblings?
  Do you have such a hard time waking up in the morning that you’re often late for school?
  How are you doing with you schoolw
  
  No clinician wants to be a “pill-pusher,” and most of our patients do not want that kind of treatment. So what can we offer our depressed patients beyond medications? In this article, we’ll review the literature on nonpharmacological strategies, including dietary supplements, food recommendations, light therapy, yoga and mindfulness meditation, an
  
  Are all psychotherapies equally effective for the treament of depression? Or do cognitive behavioral techniques clearly rise above the pack, as implied by the amount of media coverage they receive? In this article, we'll take a hard-nosed look at the evidence. Cognitive therapy (CT). Teaching patients to examine the evidence for their underlying nega
  
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  Dr. Aiken is the director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice.