⚡ Key Takeaways
- Ages 13 and up — specialized care for teens navigating adolescence
- Judgment-free environment — where teens feel safe to actually talk
- Board-certified psychiatrist — medical training to prescribe medication when appropriate
- Therapy expertise — psychodynamic and evidence-based approaches, not just medication
- Confidential care — you stay informed if there is a safety issue
- Most insurance accepted — Premera, Regence, Aetna, Cigna, First Choice, Medicare
The Teen Mental Health Crisis Is Real
If it feels like more teenagers are struggling than ever before, that’s because they are. The numbers are staggering, and behind every statistic is a young person trying to figure out how to get through each day.
I’m Dr. Cara Erkut, and in my Mercer Island practice I see the real faces behind these statistics. Thoughtful kids who’ve lost interest in things they used to love. Bright students whose grades have tanked. Teenagers who’ve shut out their parents and friends because they don’t have the words to explain what’s happening inside.
Half of all mental health conditions show their first signs before age 14. That means the teenage years aren’t just a time of emotional turbulence. They’re often when lifelong patterns are established, for better or worse.
“My depression is causing me physical pain… I don’t know how to stop it.”
“I’m afraid if I ask for help… I’ll get called dramatic.”
“Would any of you have any idea of what to do? Because I definitely don’t.”
— Real posts from teens on Reddit, analyzed by University of Alberta researchersThese aren’t isolated feelings. They reflect what millions of adolescents experience: wanting help but not knowing how to ask for it, fearing judgment, or having been dismissed before.
⚠️ The Treatment Gap Is Devastating
According to the CDC, 40% of high school students report persistent feelings of sadness or hopelessness. Yet more than half of depressed teens receive no mental health treatment at all. The average delay between first symptoms and getting help is 8 to 10 years. That’s nearly their entire adolescence spent struggling without proper support.
What Makes Adolescent Care Different Here
Treating teenagers isn’t the same as treating adults or younger children. Adolescents exist in a unique developmental space where they need independence but aren’t fully equipped to handle everything alone. They need to be heard, not lectured. Respected, not controlled.
💡 The Core Difference
Teens have finely tuned BS detectors. They know immediately if someone is being genuine or just going through the motions. I create an environment where your teenager can speak openly about what’s actually going on, without fear of being dismissed, lectured, or reported to you for every little thing. In the state of Washington, teens ages 13 and up are legally allowed to seek mental health treatment confidentially without their parents’ consent. I honor that autonomy while ensuring safety remains the top priority.
Respecting autonomy matters. Adolescents are developing their sense of self. Treatment that ignores this fails. I work with your teen as an active participant in their own care, not a passive recipient of adult decisions. This means explaining what we’re doing and why, involving them in treatment planning, and respecting their growing capacity to make informed decisions about their mental health.
Safety always comes first. If there are safety concerns—thoughts of self-harm, suicidal ideation, or danger to others—parents are immediately informed. This is explained clearly to teens from the beginning, so there are no surprises. Beyond safety issues, treatment remains confidential unless your teen chooses to involve you.
Medical expertise when needed. As a board-certified psychiatrist with medical training, I can prescribe medication if it’s appropriate. But medication is never the automatic first answer. For many teens, therapy alone is highly effective. For others, the right medication can provide the stability needed to engage in therapy and daily life.
Signs Your Teen May Need Professional Help
Normal teenage moodiness exists. But there’s a difference between typical adolescent ups and downs and something more serious. Trust your instincts. If something feels wrong, it probably warrants attention.
🔎 You Don’t Need to Wait for a Crisis
Early intervention leads to better outcomes. If you’re noticing changes and wondering if it’s serious enough to warrant professional help, that question itself is often the answer. Many parents tell me they wish they’d reached out sooner. Trust your instincts about your child.
Conditions I Treat in Adolescents
Depression
Major depressive disorder, persistent depressive disorder, and other mood conditions that steal motivation, energy, and joy
Anxiety Disorders
Generalized anxiety, social anxiety, panic disorder, and excessive worry making everyday activities overwhelming
Bipolar Disorder
Mood cycling between depression and elevated states, requiring specialized medication management and monitoring
ADHD
Attention-deficit/hyperactivity disorder affecting focus, organization, impulse control, and academic performance
Eating Disorders
Anorexia, bulimia, binge eating disorder, and ARFID. I spent a year treating eating disorders at Thira Health, a partial hospital program for women and girls
Substance Use
Assessment and treatment of substance use concerns, including co-occurring mental health conditions
Psychosis
Early identification and treatment of psychotic symptoms, including first-episode psychosis and schizophrenia spectrum disorders
Adjustment Difficulties
Processing major life changes like divorce, moves, loss, or transitions that have knocked your teen off balance
Treatment Approaches
Psychotherapy
Talk therapy is often the foundation of adolescent treatment. I use psychodynamic approaches to help teens understand the underlying patterns driving their symptoms, combined with practical skills they can use in daily life. Therapy gives teens a space to make sense of their experiences and develop healthier ways of coping with stress, relationships, and the demands of adolescence.
Medication Management
When medication is appropriate, I prescribe thoughtfully and conservatively. SSRIs are typically first-line for adolescent depression and anxiety, and I explain all options, benefits, and potential side effects thoroughly. Teens provide informed consent for their own treatment. Medication is never forced or given without understanding.
💡 The Black Box Warning Question
Parents often ask about the FDA warning on antidepressants for teens. This relates to a small increased risk of suicidal thinking (not completed suicide) when starting certain medications. In practice, close monitoring during the first weeks mitigates this risk. Research shows that untreated depression carries far greater risks than appropriately monitored medication treatment. We’ll discuss this thoroughly before any prescribing decisions.
Many teens do well with therapy alone. Others benefit from medication support while they develop coping skills. The approach is always individualized to what your teen actually needs.
Insurance & Payment
Most patients use their insurance benefits for adolescent psychiatric care. I’m in-network with several major carriers:
Your Teen’s Provider
Cara J. Erkut, M.D.
Board-certified psychiatrist and psychoanalyst with training from Mayo Medical School and residency at the University of Washington, where I served as Chief Resident. I founded the Advanced Psychotherapy Studies track during residency and completed full psychoanalytic training at the Seattle Psychoanalytic Society & Institute. I spent a year treating eating disorders at Thira Health, a partial hospital program for women and girls. My approach with adolescents emphasizes genuine connection, respect for developing autonomy, and evidence-based treatment tailored to each teen’s unique needs.
Frequently Asked Questions
Most teens are more willing to open up than parents expect, especially when they feel genuinely heard and not judged. The first session focuses heavily on building rapport and trust. Many teenagers actually want to talk about what they’re experiencing. They just need a safe space to do it.
This is common. Sometimes starting with a parent consultation can help. We can discuss what’s happening and strategize how to engage your teen. Often, framing it as “someone to talk to” rather than “going to a psychiatrist” reduces resistance. If your teen is in crisis, we may need more direct approaches.
No. Medication is never automatic. For mild to moderate symptoms, therapy alone is often tried first. If medication is recommended, I’ll explain the reasoning, the specific medication, potential benefits, and possible side effects thoroughly. Your teen will have all the information needed to make an informed decision about their own care.
It varies based on severity and individual response. Some teens see significant improvement in a few months. Others benefit from longer-term support, especially when working through deeper patterns. We reassess regularly and adjust the treatment plan as your teen progresses.
A psychiatrist is a medical doctor who can both provide therapy and prescribe medication. A therapist (psychologist, counselor, social worker) provides therapy but cannot prescribe. For many teens, having one provider who can do both simplifies care. For others, seeing separate providers works well. We can discuss what makes sense for your teen’s situation.
I see adolescents ages 13 and up. For younger children, I can provide referrals to colleagues who specialize in child psychiatry. Many of my adolescent patients continue with me into young adulthood as their needs evolve.
Serving Washington State
My practice is located on Mercer Island, easily accessible from Seattle, Bellevue, and surrounding communities.
Mercer Island
Practice locationSeattle
Capitol Hill, Madison Park, Central DistrictBellevue
Downtown, Factoria, NewportEastside Communities
Kirkland, Redmond, IssaquahThe teenage years are hard enough without anxiety or depression making everything harder. If you’re worried about your teen, trust that instinct.
BOOK A CONSULTATIONSources
- Mental Health America. State of Mental Health in America 2024 Report.
- CDC Youth Risk Behavior Survey, 2023.
- American Academy of Child and Adolescent Psychiatry. Workforce Maps, April 2024.
- AACAP. Workforce Issues: 8-10 year delay between symptom onset and treatment.
- National Survey of Children’s Health. Adolescent Mental and Behavioral Health, 2023.
- Hartling L, et al. University of Alberta. Reddit analysis of youth mental health experiences, 2023.
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