Medication should not be readily dished out to children and young people with depression, say experts.
Some anti-depressants have been linked to suicide risk
The National Institute for Health and Clinical Excellence (NICE) has ruled drugs should be considered only in moderate or severe cases.
The NHS drug watchdog said young people should first be offered a course of psychological therapy lasting for at least three months.
Campaigners say this is not happening as therapists are in short supply.
There is concern that too many young people are being medication without any access to psychiatric therapy.
DEPRESSION IN THE YOUNG
Around 1% of children and 3% of adolescents suffer from depression in any one year
A national survey found 10% of five to 15-year-olds had a mental disorder, and 4% had an emotional disorder, such as depression
More than 40,000 children and adolescents use anti-depressants in the UK
Around 10% of young people with depression recover spontaneously within three months
However, up to 30% remain clinically depressed after two years
CPS:LINK HREF="" ID="4286318" STYLE="rightarrow">'I had to battle for help'
The NICE guidance stressed drugs should only be offered in tandem with, and not instead of, therapy.
Most of a class of anti-depressants called SSRIs have already been barred from use in young people in the UK over concerns of a heightened risk of suicide.
NICE also warned many young people with depression are not being diagnosed - putting them at increased risk of self-harm and suicide.
It said healthcare professionals in primary care, schools and other relevant community settings should be trained to detect symptoms of depression, and to assess children and young people who may be at risk.
And the guidance emphasised that in some cases parents' psychiatric problems need to be treated in parallel if a young person's mental health is to improve.
See your doctor
Andrew Dillon, NICE chief executive, said: "Psychological treatments are the most effective way to treat depression in children and young people.
"It is important that children and young people taking anti-depressants do not stop taking them abruptly, but we would advise people to talk to their GP at their next regular review about whether a psychological treatment may be a more effective treatment option."
Dr Tim Kendall, of the National Collaborating Centre for Mental Health, said the evidence supporting the effectiveness of psychological therapies was "robust".
He said: "It is vital that the NHS provides psychological therapies to ensure everyone who needs these treatments can access them rapidly."
However, Dinah Morley of the charity YoungMinds said there was a significant shortage of practitioners able to offer psychological therapies.
There was also a general lack of awareness of the prevalence of depression in the young.
"Too many children's lives are blighted by depression, a condition for which there are effective treatments," she said.
"We look to increasing investment in services which support the mental health of children and young people and to improvements in the training of all practitioners working with children, to help them in identifying symptoms of depression and in seeking effective help."
The Department of Health described the NICE recommendations as "thorough and comprehensive".
Professor Louis Appleby, National Director for Mental Health, said more than £300m was being invested in child and adolescent mental health services.
"We know that not everyone who needs treatment is able to access it easily or quickly and expertise and services are not equally distributed around the country.
"These resources are going towards providing more staff, better services and faster and easier access to those services around the country."
Have you been affected by issues covered in this story? Send us your comments and experiences using the form below.
I myself have suffered with depression for a number of years, and found the medication I was given made me feel worse. Upon moving to another doctor's surgery I was offered counselling which I have found to be a great deal of help, Definintly a better option than anti-depressants.
Hayley Cooper, Buxton, High Peak
My 19-year-old son has battled with depression throughout his teens and trying to get anyone to take it seriously was a nightmare. All he was offered were inappropriate drugs and it wasn't until a serious suicide was attempted, that he finally received psychiatric care. Sadly now he is an adult however the quality of that care has been very patchy due to a severe lack of CPN's and doctors experienced in working with young people.
Eve, Stoke on Trent, Staffordshire
From 15 to 18 I was prescribed anti-depressants, depressants, tranquilizers and sleeping pills all at the same time. Subsequently, I developed ulcers from the meds and had to take medicine for those as well. I eventually went into short-term treatment and it got me on the right track. Instead of just shoving pills down my throat to turn me into a zombie, people were actually listening to what I had to say. I'm sure the pills (some of them, anyway) were a help, but being 'understood' made an incredible difference. I doubt that I'd be around right now if I hadn't found that kind of support.
My husband was prescribed tranquilisers at 14. It took him until he was nearly 30 to come off them, and he is still wrestling with the issues that should have been addressed when he was 14. I definitely feel that counselling and therapy are the treatment of choice for all with depression/anxiety, but especially young people.
Heather, London, UK
I have suffered from depression for 7 years since the age of 16. I went and saw my doctor and was prescribed the anti-depressant Fluoxetine. That was 7 years ago, and when I go see my GP about it today I am just prescribed more drugs, when what I really need is someone to listen. If I had been given the proper counselling when I was younger I would be fine now, not relying on pills.
Kelly, Anglesey, Wales
Anti-depressants are useless without support and help from counsellors. They open the door to the healing process but can have devastating effects if the person taking them doesn't want to get better, or just isn't getting the support to give them that extra will power. There is a serious problem with teenage depression and it is grossly underestimated. I personally have suffered depression and know many people still suffering, one particularly serious case where my friend is NOT getting the help she needs or deserves from her school and councillor.
Mark, Farnham, Surrey, England
I'm 29, and I suffered from depression and anxiety disorder as a child, although I only realised this as an adult, and I am still being treated for these conditions. As a child, one doctor diagnosed me with gastroenteritis, another said I was just miserable and I needed to play outside more. I'm pleased that, despite the difficulties highlighted in this piece, at least the condition is recognised and taken seriously, and children nowadays do not have to go through the years of misery and despair that I did.
Michael, Newcastle, England