Summary: This article illustrates that adolescent depression, a problem of major public health and clinical importance, need not present only with depressed mood, decreased energy, altered sleep or appetite, but can present with irritability, defiance, and impaired school functioning, The authors present a conversation that introduces the patient to therapy and shared decision-making with a depressed adolescent at their first session.

Authors: Gordon Harper, MD, Stuart Copans, MD, and the Committee on Adolescence of the Group for the Advancement of Psychiatry, Contemporary Pediatrics, April 2010