Sequenced Treatment Alternatives to Relieve Adolescent Depression (STAR-AD)

This study is testing a sequenced treatment approach for teenagers aged 13–18 with moderate-to-severe major depressive disorder (MDD) — trying different therapies in a structured order to find what works best if the first treatment doesn't fully help. **You may be eligible if...** - You are 13–18 years old - You have been diagnosed with major depressive disorder (non-psychotic) according to DSM-5 criteria - Your depression scores are significantly elevated on the standard assessment scale (CDRS-R score of 40 or above) - You and at least one of your parents have given written consent - If you have suicidal thoughts, your doctor believes outpatient treatment is safe for you **You may NOT be eligible if...** - You have a history of bipolar disorder, schizophrenia, autism, or an eating disorder - Your depression involves psychotic features - You are not in the 13–18 age range Talk to your doctor to see if this trial is right for you.