Couple therapy effectively treats depression

Family Therapy Magazine, which is usually quite good, is simply outstanding this month. Highlighted by Michael Yapko’s “Skills or Pills? What MFTs Can Do Better than Antidepressant Medication,” the magazine examines some hard truths about depression, medication, and family therapy:

  • Antidepressants are no better than placebos. An extensive study of the six most popular antidepressants found that when unpublished trial data were combined with published trial data, “the benefit (of medication) falls below accepted criteria for clinical significance.”
  • Couple therapy is a promising treatment approach for depression. While more research needs to be done, Emotionally Focused Therapy and Behavioral Marital Therapy both appear to alleviate depression at least as much as individual therapy, while simultaneously improving the couple relationship.
  • Treatment for depression is very different in other parts of the world. Even other western, industrialized nations have found success in treating depression when it is de-medicalized. In other words, the whole person should be treated, not merely a set of depressive symptoms.

Perhaps most interesting — and depressing — in all of this is some discussion that therapy is winning the battle but losing the war. In other words, mounting evidence suggests that psychotherapy (and particularly systemic therapy) is a preferable treatment to antidepressants in the successful treatment of depression. Yet, the promise of relief in pill form, without substantial work, keeps Americans going back to the MD instead of the MFT. Antidepressants are now so widely prescribed that they show up in our drinking water.

If science alone will not turn the tide, what will? What do you think needs to happen to convince people that therapy is a better long-term fix for depression than pills?