Although biological processes have been directly targeted to substantial advantage in effective treatments for major depression, the evidence base for addressing potential “existential” contributions to depressive syndromes has lagged behind that related to other tractable mediators of the condition, such as cognitive bias, nonadaptive learned behavior, and variation in monoamine neurotransmission. Whether the experience of existential conflict is a cause or an effect of these phenomena is incompletely understood. Here, we provide a clinical update on knowledge surrounding a psychotherapeutic tradition that addresses existential issues but has not consistently been invoked in contemporary approaches to adolescent depression, and we consider whether the evolution of this approach, in concert with parallel advances in positive psychology, is nearing readiness for more systematic implementation in the treatment of adolescent depression. The goal of this article is to briefly summarize the state of the literature on logotherapy and to consider ways in which its implementation might be incorporated to advantage in the approach to treating adolescent depression.