Youth: A Different Way of Healing; When treating depressed kids, do drugs work better than therapy?(Cover Story)

Byline: Tara Pepper

When 18-year-old Gemma Tovey went to her doctor complaining she felt low, had trouble getting out of bed in the morning and dreaded the thought of leaving her house, he prescribed Prozac. Gemma, who lives in Birmingham in the north of Britain, found the drug's side effects--dizziness, nausea and memory loss--unbearable. With the help of a nutritional therapist, she was able to cut her dose, but she was far from cured. She began to see a psychotherapist, who suggested that her depression had something to do with bullies at school and her grandfather's recent death, but she's not sure: because of waiting lists in the national health service, three years after her initial diagnosis she's had only a few sessions. "I do find it useful," she says, "but I think it will take a long time."

Stories like Gemma's suggest that when it comes to depression, adolescents are not easy to treat. It's not always apparent where normal adolescence ends and mental illness begins--even healthy teenagers tend to be impatient, insecure and overly emotional. Symptoms of teen depression--oversleeping, overeating, irritability, oversensitivity--can often be mistaken for typical adolescent moodiness. With little data available, doctors have been left to their instincts. What few studies have been done have tended to stoke, rather than resolve, the debate over drugs versus talk therapy.

A new study, though, has tipped the scale toward drugs as the most effective therapy. Last week the U.S. National Institute of Mental Health released preliminary results of a decadelong survey of nearly 400 children from across the country. Researchers divided the children into four groups--those treated with Prozac, cognitive behavioral therapy (CBT), a combination of the two and a placebo--and compared the results. The best treatment turned out to be a combination of drugs and therapy, followed by Prozac alone. CBT by itself--the most effective treatment for adults--rated hardly better than the placebo. "Surprisingly for all of us, the results are very different from the results we've seen in adults," says Dr. Harold S. ...