The U.S. Food and Drug Administration's recent decision to update its black-box warning on anti-depressants for young adults may leave depression sufferers and their families perplexed about their treatment options, say mental-health experts.

The agency acted on data showing suicidal thoughts among four out of every 1,000 young adults, 18 to 24, who take the drugs. Nineteen million Americans suffer from depression, and untreated depression is one of the leading causes of suicide in the United States.

But before consumers become alarmed, it's crucial to distinguish suicidal thoughts -- which many people will occasionally have -- from suicidal behavior, which is less common, said psychiatrist Dr. Nada Stotland, a board member of the non-profit Mental Health America. The FDA board relied on data about suicidal thoughts.

Stotland offered these tips for depression patients and their families to wade through the tangle of messages on treating depression:

-- No medication is absolutely safe. Medications aren't cure-alls, but they still are often the best course of action.

-- Don't settle for less. Get a real, thorough evaluation that's not based on just one visit to your doctor's office.

-- Read the package insert. Talk to your doctor, and most importantly, realize there may be side effects before the therapeutic effects of medication kick in. In most cases, the symptoms will subside in three days.

-- Don't give up. You need a full dose of six to eight weeks of medication before you can figure out if an anti-depressant will work for you.

-- You're in charge. You're not on a moving sidewalk, so think critically about how long you want to stay on medication. An episode of depression lasts an average of nine months. If you decide after that time you feel better, taper off the medication under a doctor's care.

Mental Health America also put out these tips in response to the FDA warning:

-- Seek help. If you feel depressed, don't wait.

-- Weigh the risks and benefits. If your provider prescribes an anti-depressant, make sure to request continual follow-ups and careful monitoring -- particularly in the first several weeks.

-- Know the warning signs. If you detect red flags of suicide in another -- feelings of hopelessness, uncontrolled rage, talking or writing about death and withdrawal from family members -- act quickly.

-- Separate fact from fiction. Use credible sources based on sound medical science rather than rumor or opinion.

-- Treatment trumps none at all. The worst possible situation for anyone with depression is to go without it.

Another key to successful treatment is monitoring your own progress, said Julie Totten, president of Families for Depression Awareness. Totten and colleagues have developed a three-step wellness model to guide patients and their families in treating depression.

The first step involves defining a benchmark for what wellness is -- what does it feel like when you're well and unwell? Figuring out a personal level of wellness doesn't mean going it alone: Family members, friends and even co-workers can be crucial in noticing any behavior changes in someone with depression, especially if the person himself can't see a shift.

Secondly, Totten advises patients to keep a diary and record their treatments for that day; how many hours they slept; whether they went to work and pleasurable activities, such as going to the movies.

The last step is journaling, an alternative or enhancement to talk therapy. People can track how they feel -- especially noting whether they lose interest or pleasure in their daily activities. Journaling feelings gives perspective and may give a patient a comfortable outlet for expressing emotions.

Overall, said Totten, the risks and benefits of anti-depressants should be weighed individually, and people should realize "there isn't a straight path to wellness." There is no laboratory test for depression, and most people need tailored medications for their illnesses, which can mean experimenting with different types of drugs.

The majority of depression sufferers do benefit from medication, said Totten: "The last thing you want is for people to think there's no hope for them. This is a treatable illness."