Therapy
Suicide in Teenagers
When antidepressants are started in teens, there is a small increase in suicidal thoughts or behaviors—roughly 2 additional teens out of 100—but studies did not find any increase in completed suicides. The risk is highest during the first few weeks, making close follow-up and therapy especially important. Antidepressants are not inherently unsafe; they simply need to be started thoughtfully and monitored carefully.
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The Black Box warning on Antidepressants
Antidepressants in teens carry a small increased risk of suicidal thoughts or behaviors when treatment first begins—about 2 extra teens out of 100—but studies found no increase in actual suicides. The greatest risk is in the first few weeks, so close monitoring and therapy are important. The goal isn’t to avoid treatment, but to use it carefully and safely.
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How to Prepare for Your Initial Visit with a Psychotherapist
Your first therapy session can feel intimidating, but you do not need to have the right words or know exactly where to begin. Therapy is not a test or a performance—it is simply a space to show up honestly, even if all you can say is, “I’m not sure where to start.” The first session is less about fixing everything and more about finding a safe, supportive connection with someone who can help you make sense of what you are carrying and begin moving toward change.
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Antidepressants in Bipolar Disorder
The STEP-BD Trial found that adding antidepressants to a mood stabilizer in bipolar depression did not improve recovery rates and offered no clear benefit over placebo. In fact, patients on mood stabilizers alone did slightly better, reinforcing that antidepressants aren’t reliably helpful—and may complicate treatment—in bipolar disorder.
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