What’s the Best Prescription for Depression?
Couples Therapy
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by
David C. Mathis, Ed.D.
We usually think that the prescription for the treatment of depression would be an antidepressant medication such as Prozac or Zoloft, or whatever is the newest and is being promoted by the drug companies. It would probably surprise you that the best prescription for depression was couples therapy. A recent study was published in the British Journal of Psychiatry (177:95 - 100) which found that couples therapy was more effective for treating depression than medication.
We have known for many years that psychotherapy is effective for treating depression. Conventional wisdom and research as also supported the approach of combining psychotherapy and medication. This study narrowed the focus to an area which is known to contribute to relapse of depression. We have learned that if an individual’s partner is seen as having a critical attitude that individual is more likely to relapse into another depressive episode at some time in the future. This study addressed that concern of a relapse by identifying individuals who were seeking treatment for depression who also saw their spouse as critical. Individuals were assigned to one of two groups: treatment with medication alone or treatment with his or her spouse through couple counseling sessions. Couples therapy concentrated on helping the patient and partner to develop new ways of seeing the problems. Rather than focus on the individual with his or her problems, the couples were helped to find new ways of understanding how they each contributed to the patterns and how they could both contribute to solutions. They were assisted in finding new was of relating to each other as they addressed the problems.
Individuals were assessed through using various measures, such as paper and pencil questionnaires, of the symptoms of depression. Both types of treatment proved to be helpful to the individuals with depression. However, those individuals who were in couples therapy show significantly more improvement. This finding was not only found at the conclusion of the treatment but also one year after the treatment had ended.
Another important finding was that couples therapy was more cost effective when an overall view of health care was considered. A simple comparison of the direct costs, that is, cost of medication versus costs of couples therapy, reveals that couples therapy costs slightly more. However, what was discovered was that the individuals who were not in couples therapy made greater use of other health services through hospital and community services. It has also been found to be true in other research that individuals who participate in counseling services in addition to their medical care have lower overall health care costs.
If you feel a need to talk to your physician about feeling depressed and it is suggested that you need a prescription, you might first need to consider which prescription: medication or couples therapy.
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