Navigating anxiety, depression and antidepressants for young people

More young people are experiencing mental health problems than ever before. 

Results from the 2021 HILDA survey estimated that 45% of Australians aged 15–24 years received a serious mental illness diagnosis during their life – up from 15% in 2009. Similarly, the 2020-22 National Study of Mental Health and Wellbeing survey reported that almost 2 in 5 people aged 16-24 experienced a mental health disorder in the previous 12 months, with anxiety (26%) and depression (17%) being the most common mental health and behavioural chronic conditions.

The consequences of untreated or undertreated mental health disorders can have far-reaching impacts on all parts of a young person’s life; including education, work, relationships and physical health. They can also lead to an increased risk of suicide, which accounted for 1 in 3 deaths among young Australians in 2023. This age group also has the highest rates of hospitalisation for intentional self-harm in Australia. The evidence also tells us that for most adults living with a mental health disorder, symptoms started before the age of 24 years. This emphasises the importance of early diagnosis and optimal management¹.

Caring under pressure

Non-pharmacological interventions should be the first-line approach for managing depression and anxiety in teens and young adults. Yet, barriers such as limited availability to care providers, cost of access, long waiting times for psychological services and regional inequities often push both patients and clinicians towards pharmacological options. 

This misalignment between best practice and real-world care may help explain why PBS data shows antidepressant use among Australians under 18 years doubled between 2012 and 2023. This trend is concerning, given the limited evidence base for medicine efficacy in this age group, the associated potential for harms and lack of long-term safety data.

Rethinking our approach

Current Australian guidelines recommend a stepped-care approach for the management of anxiety and depression in young people, with education, lifestyle strategies and psychological therapies forming the foundation of this care.

Use of medicines such as SSRIs may be appropriate for some individuals. If introduced, they should form part of a broader, holistic treatment plan. 

This approach provides care that is beyond symptom control, helping to build resilience and coping skills while strengthening the social and emotional support in a young person's environment.  For general practice, this means integrating clinical judgment, context, and patient-centred discussion, to ensure the young person’s mental wellbeing remains the key focus.

Nationally supporting quality use of medicines

In recognition of these challenges, the latest program from the Quality Use of Medicines Alliance (available here on QHUB) will be providing an expert interpretation of the latest evidence and guidelines to support health professionals in this complex and recurrent area of practice, through a range of opportunities such as educational visits, webinars, online learning and more. 

Pivotal to these clinical conversations are point-of-care tools, including a 2-page clinical guide designed to improve clarity around medicine use and raise awareness regarding the role of non-pharmacological options for this cohort.

This latest Australian Government-funded program from the Quality Use of Medicines Alliance has been developed in conjunction with consumers and carers, as well as experts from across the mental health sector, including the Black Dog Institute. This collaborative approach helps ensure that these resources and learning opportunities will assist health professionals to make safe, informed clinical decisions with greater confidence. 

The Quality Use of Medicines Alliance has worked in collaboration with Black Dog Institute to develop patient fact sheets – now available to share with your patients.

References

1. Kessler R, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 2005;62:593-602.

2. Australian Bureau of Statistics. National Study of Mental Health and Wellbeing, 2020-2022 | Australian Bureau of Statistics [Internet]. 2024 [cited 2025 June 19]. Available from: https://www.abs.gov.au/statistics/health/mental-health/national-study-mental-health-and-wellbeing/latest-release

3. Australian Institute of Health and Welfare. Health of young people [Internet]. Australian Institute of Health and Welfare. 2024 [cited 2025 May 7]. Available from: https://www.aihw.gov.au/reports/children-youth/health-of-young-people

4. Australian Institute of Health and Welfare. Suicide and self-harm among young people - Suicide & self-harm monitoring [Internet]. Australian Institute of Health and Welfare. 2025 [cited 2025 June 23]. Available from: https://www.aihw.gov.au/suicide-self-harm-monitoring/population-groups/young-people/suicide-self-harm-young-people

5. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005 June;62(6):593–602. 

6. Therapeutic Guidelines. Depressive disorders [Internet]. 2021 [cited 2024 June 6]. Available from: https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Psychotropic&topicfile=overview-depressive-disorders 

7. Therapeutic Guidelines. Generalised anxiety disorder [Internet]. 2021 [cited 2024 June 6]. Available from: https://tgldcdp.tg.org.au/viewTopic?etgAccess=true&guidelinePage=Psychotropic&topicfile=generalised-anxiety-disorder 

8. Australian Institute of Health and Welfare. Mental health prescriptions - Mental health [Internet]. Australian Institute of Health and Welfare. 2024 [cited 2025 May 7]. Available from: https://www.aihw.gov.au/mental-health/topic-areas/mental-health-prescriptions 

9. Thorne L. Antidepressants, antipsychotics and stimulants up: Why are children taking more mental health medications? ABC News [Internet]. 2024 Sept 24 [cited 2025 Nov 25]; Available from: https://www.abc.net.au/news/2024-09-25/adhd-autism-drugs-and-antidepressants-ssris-in-children-teens/104310158  

Resources:

Youth Mental Health: Life changing tools beyond the script
Join this practical, case-based webinar to build confidence and competence in managing mental health consultations with young people aged 13–24.

Clinical Guide: Depression and Anxiety in Teens and Young Adults
A summary resource designed to guide health professionals through evidence-based management of depression and anxiety, including non-pharmacological interventions and best-practice approaches to SSRI prescribing in young people.

Decision Aid: Minding your mental wellbeing
Supporting clinician-patient discussions and encouraging shared decision-making and action-planning for the management of depression or anxiety. Support informed decisions on ways to manage anxiety or depression, that take your needs, values and preferences into account.