Only about 50 percent of adolescents with depression get diagnosed before reaching adulthood and experts say as many as 2 in 3 depressed teens don't get the care that could help them.
Twenty-five-year-old Stephanie Cardamone knows how crippling anxiety and depression can be.
"Looking back on my entire life, it's just like situations that I'm thinking of where I'm like that wasn't normal," she said.
Cardamone was diagnosed with depression in her early 20's but she recalls symptoms much earlier.
"It was there, in my teenage years, I just didn't know what it was; I didn't know how to deal with it," she said.
Now, the American Academy of Pediatrics is issuing updated guidelines on adolescent depression.
Research shows by age 20, about 20 percent of teens says they've experienced some depression, which can affect them long term.
"It can lead to social problems, family problems, school problems, substance abuse," Dr. Rachel Zuckerbrot, an associate professor of clinical psychiatry at Columbia University's Irving Medical Center.
The goal is to help pediatricians identify depression early.
The new guidelines recommend doctors talk about mental health with adolescents and their parents and implement universal depression screening for children 12 and older.
Doctors also say it's important to also keep a close eye on at-risk children.
"Those include children who have a family history of depression and other mental health issues…children who have already had an episode of depression," Dr. Zuckerbrot explained.
Cardamone who works with the Anxiety and Depression Association of America to Raise Awareness says sharing her story is therapeutic.
"I just think it's really important, no matter what someone's going through, to make sure they don't feel isolated," she said.
The new recommendations also call for families with a depressed teen to develop a safety plan to restrict access to lethal weapons.
Suicide is a leading cause of death for teens. Experts say adolescent suicide risk is strongly associated with firearm availability.