According to the National Institute of Mental Health (NIMH) the use of antidepressant medications may induce suicidal behavior in youths.

In fact, the Food and Drug Administration (FDA) has required anti-depressant medications formulated for children and teens to carry a black box warning which states that these pharmaceutical products were found to increase the risk of suicidal thinking and behavior in children and adolescents with major depressive disorders.

The reports have sent many physicians and parents to turn to alternative traditions to help kids cope with mental and emotional distress. A number of medical doctors are mixing alternative techniques into their approaches in order to help these children.

Some practitioners have not ruled out the use of psychiatric medication in some cases, but reserve them only as a last resort. Those who do use medications in combination with other alternative strategies say dosages can be kept low and get patients off the drugs more quickly.

Institute for Health and Healing, California Pacific Medical Center">Michael Cantwell, a pediatrician at the Institute for Health and Healing at the California Pacific Medical Center says understanding what's going on in both the patients' bodies and their lives - what they eat, relationships and events in their families - is the key to working effectively with depressed or anxious children.

"When you see a kid who’s depressed, you have to ask,'What’s the cause?'" he says. "Holistic medicine tries to look at causes a little more closely, not to just take depression and say, 'We have a pill for that.'"

According to Cantwell the underlying problem may be biological or caused by environmental factors such as stress or unhappiness in their lives. But environmental and biochemical factors are not isolated from each other but are interactive. Grief from the death of a loved one can decrease the levels of the neurotransmitter serotonin and a poor attachment between a mother and infant can have a lasting negative impact on the structure of a child’s brain.

"The question is not whether depression or anxiety is biological," says James Gordon, a psychiatrist and director of the Center for Mind-Body Medicine in Washington, D.C. "The question is how you approach biology. For example, if you can use exercise to lower levels of cortisol or increase neurotransmitter levels, why use drugs?"

Some kids show rapid improvement by eliminating high-sugar products from their diets. Some just need more sleep. Others require a combination of different approaches relaxation techniques, yoga, biofeedback, exercise, and some form of counseling or therapy. The Mayo Clinic lists possible warning signs for depression in children and adolescents. When evaluating a child, therapists consider the symptoms along with their duration, frequency and severity:

In Preschoolers:

• Listlessness
• Decreased interest in playing
• Cries easily and more often than usual

• Listlessness and moodiness
• More irritable than usual
• Looks sad
• Easily discouraged
• Complains of boredom
• More distant with friends and family
• Difficulty with schoolwork
• Talks about death

• Always tired
• Drops out of favorite activities
• Has more arguments with parents and teachers
• Refuses to do chores or homework
• Engages in harmful behavior, such as cutting himself or herself
• Has suicidal thoughts