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Children, Adolescents, and Adults

Depression Treatment in Manchester, NH

Depression rarely announces itself the way people expect.

A child who stops wanting to play. A teenager who seems fine at school but withdraws from everyone at home. An adult who is technically getting through the day but has not felt like themselves in months. 

In my years treating patients across every age group, I have learned that depression is often quieter, and more easily missed, than most people realize. 

That is exactly why an accurate evaluation matters, and why our team at Serene Behavioral Healthcare is built to catch it at every stage of life.

Your Care Team

I am Dr. Lionel Pereira, a Board Certified Child and Adolescent Psychiatrist and the founder of Serene Behavioral Healthcare. Our practice treats depression across every stage of life, from young children through adulthood, through a team that includes board-certified nurse practitioners seeing patients in person and via telehealth. 

Meet our full team for complete provider bios and credentials.

Conditions We Treat Under the Depression Umbrella

How We Approach Depression Treatment

Depression does not look the same in every patient, so treatment starts with a thorough evaluation, not a one-size-fits-all plan.

Our approach typically includes:

Comprehensive Evaluation

We take the time to understand each patient's history, symptoms, and daily life. For younger patients, this includes input from parents and caregivers.

Individualized Treatment Planning

Depending on the severity and type of depression, treatment may include therapy, medication management, or both.

Medication Management When Appropriate

When medication is part of the plan, we monitor it closely and adjust as needed, in partnership with the patient and, for minors, the family.

Safety planning when needed

If a patient is experiencing thoughts of self-harm, we prioritize safety first and build a plan collaboratively with the patient and family.

Coordination With Your Care Team

We regularly collaborate with therapists, primary care providers, and, for younger patients, schools, to make sure care is consistent across every part of life.

Ongoing Follow-Up

Depression treatment is not a single appointment. We track progress over time and adjust the plan as needed.

Signs and Symptoms of Depression

Depression does not always look like sadness on the surface. In my practice, I see it show up differently depending on age, which is part of why an accurate evaluation matters so much.

Symptoms in Children

In young children, I often see:

  • Irritability or frequent tantrums rather than visible sadness
  • Loss of interest in play or favorite activities
  • Changes in appetite or sleep
  • Frequent complaints of physical symptoms like stomachaches, with no medical cause
Symptoms in Teenagers

In adolescents, common signs include:

  • Withdrawal from friends and family
  • Irritability, anger, or sensitivity to criticism
  • Declining grades or loss of interest in school
  • Changes in sleep or appetite
  • Low energy, low motivation, or a persistent sense of hopelessness
  • In some cases, thoughts of self-harm or suicide, which should always be taken seriously
Symptoms for Adults

In adults, depression often presents as:

  • Persistent low mood or loss of interest in things once enjoyed
  • Fatigue or low energy most of the day
  • Difficulty concentrating or making decisions
  • Changes in sleep or appetite
  • Feelings of worthlessness or excessive guilt
  • Thoughts of self-harm or suicide, which should always be taken seriously

If these patterns sound familiar, whether in yourself or your child, that is a good reason to schedule an evaluation rather than wait to see if it resolves on its own. Early treatment can change the entire trajectory.

Dr Lionel Pereira

Why Patients Choose Serene Behavioral Healthcare

Patients and families come to us because they want providers who take depression seriously and treat it with both clinical rigor and genuine warmth.

Here is what sets our care apart:

Frequently Asked Questions

Take it seriously and reach out right away, even if you are not sure how serious they mean it. Statements like this warrant an immediate evaluation, not a wait-and-see approach. If there is any immediate danger, call or text 988 or go to your nearest emergency room. Otherwise, contact our office and we will prioritize getting your child seen quickly.

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We're Here to Help

Have questions about care for you or your child? Reach out — our team is happy to talk through your options and next steps.