The following is Dr. Rosi’s final blog on Adolescent Depression.

As we’ve discussed in the previous blogs, Adolescent Depression is a challenging, and often debilitating, disease that needs to be diagnosed and treated as soon as possible to achieve the best results. First and foremost is identification. If your adolescent is undergoing stress and/or emotional changes, which is not uncommon in this day and age, talk to them about it and observe their methods of coping. Ask your child and yourself these important questions: 

• How are they coping with the stress? What coping skills do they have? 
• Is their daily routine (sleep, appetite, energy, motivation) being affected in any way?
• Are there changes in grades, peer interactions, engagement in family activities?
If the answers to these questions are concerning, then your radar for depression should be high.

The next step is seeking professional assistance in order to clarify the diagnosis. Typically, this is from a psychologist or psychiatrist. It is essential you locate a provider that has training and experience in treating children and adolescents. This can be a major barrier, so ask for assistance from various sources, such as your child’s pediatrician, school psychologist or from you own primary care doctor. Of course, if you have insurance, contact your carrier for referrals as well. It is preferable to utilize a Child and Adolescent Psychiatrist, but due to the nationwide shortage of such doctors, you may have some investigative work to do.

Assuming you have found a Child and Adolescent Psychiatrist, this doctor can assess the symptoms, and provide a diagnosis and treatment plan. If Adolescent Depression is diagnosed, a thorough review of the medication and non-medication treatment options is essential. Remember the importance of a strong support system for the adolescent, making treatment more of a “team approach”. The sooner you get treatment, the more likely your adolescent will achieve remission in this episode, which decreases risk for future episodes as well. Medication and therapy are the most common forms of treatment, both having potential benefits and limitations. In general, there are only a few FDA approved medications for Adolescent Depression and response rates are slightly smaller when compared to those in adults treated for depression. Also, children and adolescents appear more likely to have medication side effects than adults. Despite these trends, the future of treatment is bright.

Not only are new medications in development that have novel mechanisms of action, but a new branch of treatment, called Neuromodulation, is emerging. Transcranial Magnetic Stimulation (TMS) appears to be the forerunner of this movement since it is non-invasive and involves a more targeted approach to modifying the brain circuits involved in depression. Approved by the FDA for treatment-resistant depression in adults in 2008, TMS is now covered by most insurance and is leading to improved response and remission rates. A TMS trial for Adolescent Depression is now underway and results should be published this year. It is a very exciting time for Psychiatry and the treatment of depression.

Being a child can have enough challenges, adding Adolescent Depression to those challenges can be overwhelming. The most important thing that you can do as a parent of an adolescent with Adolescent Depression is to be an integral part of their treatment by being a positive support.

Since graduating from a Child & Adolescent Psychiatry Fellowship at Stanford University in 2007, Dr. Kevin Rosi has focused primarily on treating mood and anxiety disorders in children, adolescents and young adults. He is Board Certified in Adult Psychiatry by the American Board of Neurology and Psychiatry, and completed a visiting fellowship in Transcranial Magnetic Stimulation at Duke University in 2015.

Dr. Rosi’s areas of expertise include early onset Bipolar Disorder, ADHD, and eating and developmental disorders. He also has extensive experience in dealing with behavioral disorders, such as Oppositional Defiant Disorder, as well as impulse control and psychotic disorders.

Dr. Rosi believes in building a trusting working relationship with his patients thorough open communication, and in educating them about all available modalities so treatment decisions can be made collaboratively.

Using a holistic approach that emphasizes pharmacologic and non-pharmacologic treatments, such as psychotherapy, neuromodulation and developing healthy living habits, Dr. Rosi works together with his patients toward the goals of symptom elimination and restoring health.

Dr. Rosi joined TMS Health Solutions in 2015 after serving over eight years in a community mental health outpatient clinic and maintaining a private practice in Davis, California.