Treating Teen Mental Health Issues without Medication

Exercise, yoga, and talk therapy may be alternative options for treating teen mental health issues. Here’s what parents should know.

American teens, the story goes, may as well be zombies, with an epidemic of doctors overprescribing antidepressants and other psychiatric drugs.

So you might be surprised to know that only about 10 percent of U.S. teen girls take antidepressants and a bit more than 5 percent of boys. Yet, according to the Centers for Disease Control and Prevention, in 2018, 15 percent of 12- to 17-year-olds had a major spell of depression and almost 9 percent attempted suicide. Nearly 37 percent said they had persistent feelings of sadness or hopelessness.

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If these numbers are correct, large numbers of troubled teens aren’t taking a medication.

Many teens may simply lack access to doctors. Less than 15 percent of teens living in poverty who have mental health issues get treatment, some studies suggest. But others may be avoiding medication and seeking other ways to feel better.

Carl Tishler is a psychologist and adjunct associate professor of psychiatry and psychology at The Ohio State University who has worked with children and teens for more than 30 years. Tishler says many good options exist aside from medications to help teens suffering from anxiety, depression, or other mental health problems.

Prescription medications involve side effects, he notes, which include being unable to drive, “drowsiness, weight gain, and being thirsty all the time.” If teens are reluctant to experience those side effects, non-medication therapies may be a better fit.

Tishler cautions that medication is sometimes essential to proper care and treatment. “Certainly, we have a group of kids in our practice who come in and need to talk about their problems, and they seem to find that as helpful, if not more helpful, than the medications. But … there are also a group of kids who really severely need their medications.”

Whether you’re seeking help for yourself or a teenager you know, Tishler suggests the following non-medication options for mild-to-moderate depression and anxiety, as well as attention deficit hyperactivity disorder in teens.

Exercise

Zumba, karate, swimming, and tap dancing are all strenuous forms of exercise that provide significant health and mental health benefits. “Sweat-provoking is really the key. Aerobic exercise needs to be really running around for a good solid 40 to 50 to 60 minutes,” Tishler says. “I really like to see it four or five times a week.”

Exercise in a class is “particularly helpful,” he says. If a teen is not athletically inclined, he suggests classes that offer less competitive environments — for example, at a local YMCA, Boys or Girls Club, or community center. “A lot of times something like a class at the Y is a much better and more accepting place for them to go rather than to the local high schools, where there's a lot of competition.”

Just don’t exercise too close to bedtime, which can exacerbate sleep problems — a major marker of depression and other mental health issues, Tishler says. Instead, a good time to exercise is right after school.

Mindfulness, yoga, and biofeedback

Mindfulness, a practice of meditation that involves focusing on the present moment, is "another thing that has become quite popular these days that seems to be helpful for kids," Tishler says.

Yoga can also help get “kids through periods of debilitating, sometimes, anxiety and depression,” he notes, while biofeedback — in which physiological indicators like heartbeat and breathing rate are measured — is “just one more way of helping a person be more aware of their body so they're not feeling as bad as they were.”

Journaling

It may seem “old-fashioned” to some teens, Tishler says, but the practice of writing down thoughts and feelings is “good for kids that wouldn't want to be in a class or do exercise or yoga or group mindfulness.”

Talk therapies

Studies have shown cognitive behavioral therapy and more traditional therapies are “extremely helpful for kids,” Tishler says. Family therapy is another option but may not always be realistic. “If a family is fairly accepting and they can listen to what their teenagers have to say, that can be an extremely helpful way for a kid to deal with anxious feelings or depressive feelings. It just depends on a particular family whether they can tolerate family therapy. If a family's going through their third divorce, to bring all the players together I'm not so sure is always a great idea.”

Adopting a pet

Pets are helpful for troubled teens, Tishler has found. “Adolescents can talk to them and not receive judgment from the pet, such as why’d you go out and get drunk,” he says. A pet “has total unconditional positive regard as long as they're walked and fed.”

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