How often do you see your therapist?

I'm curious about how frequently most people with major depression (moderate, not in remission) see their therapists. Is once every 4-6 weeks typical? Can a person make much progress with this amount of time between visits?

Also, can weekly group therapy be a substitute for not getting regular individual therapy?

I have severe depression, so I may not be the right person to answer, but I think once every 4-6 weeks is a long stretch of time, I would say 1-2 weeks is ideal, so with such a long stretch, it may not give the therapist a good idea of whether there is social or psychological factors that exacerbate the depression. I know a lot of people find group therapy more helpful than individual therapy, being in a group with other people like yourself can be so comforting and rewarding in and of itself, which individual therapy will not be able to normalise depression in the same way. Both have their place, they both have advantages and disadvantages, it just depends which one is most likely to suit your personality and current situation.

Best wishes.

I see mine twice a week. He says that's how often I need to recover. My depression is pretty severe though. I think if you ask your therapist how often he or she thinks you need to see him or her to make progress, you'll get the best answer. Most mental health professionals know how often they need to see each client to make progress.

No, once every 4-6 weeks is not typical. On the other hand, if group therapy is now your "main" form of therapy - maybe that's what's going on. Obviously if you are unclear or concerned you should bring it up with your therapist - you both should be on the same page about what you're doing and why.

I see my therapist every two weeks. When I'm not doing well or if I'm very focused on a specific issue it's every week. Just before I ended up in the hospital it was twice a week. At times I've seen her every 3 weeks (when I've been very stable, not much going on, and also not really working on any issues - or not ready to).

As for group therapy - I've done it in the past and for me it was more helpful than individual - at the time at least. And that was to my surprise. But it's like anything else with therapy - it depends on the person, their needs, the type of group therapy, the skills of the leader, the other people in the group, etc. So it's definitely a YMMV kind of thing.

Thanks for the responses. I'm glad to know that I'm not being unreasonable in thinking that I'm going too long between individual therapy appointments.

The group therapy is really more of a class on depression/anxiety, and the patients don't talk except for a minute or two during "check in", or occasionally when they are asked a question. The leader said 4-6 weeks between individual visits is typical for them because of the case load, and the groups are a way to keep tabs on patients during that time frame. He said if I started feeling bad, I needed to go to the emergency room. My previous clinic instructed me to do this the last time I had a major depressive episode and couldn't get in to see anybody for weeks, and it did not end well for me.

Unfortunately, I'm forced to stay with this clinic due to my insurance. It was the same story with the last place I was at -- my doctors were all residents rotating through an outpatient clinic at a major university hospital, and I saw three of them in less than two years before I moved out of state. I thought that this time, things would be different and I could start to actually get better, as opposed to taking meds and keeping everything "contained". I guess I was mistaken.

Hyalella wrote:Thanks for the responses. I'm glad to know that I'm not being unreasonable in thinking that I'm going too long between individual therapy appointments.

The group therapy is really more of a class on depression/anxiety, and the patients don't talk except for a minute or two during "check in", or occasionally when they are asked a question. The leader said 4-6 weeks between individual visits is typical for them because of the case load, and the groups are a way to keep tabs on patients during that time frame.

In my experience over the last twenty-six years, this is in no form or fashion treatment nor is it a class, because even college self improvement "courses" are once or twice EVERY week. This is more of a thing made by the community to feel better about itself in how it is NOT providing people like you and myself. But! That said, I have had to do huge amounts of personal research to learn what I have over those same years, so if this "course" can teach you things and it is all insurance will pay for, use it for all it is worth!

He said if I started feeling bad, I needed to go to the emergency room. My previous clinic instructed me to do this the last time I had a major depressive episode and couldn't get in to see anybody for weeks, and it did not end well for me.

Yeah, I see you have found out just how well the US system works for those of us with severe depression. You went to the ER, they either had no capacity to deal with you and had the police cuff you and TAKE YOU to the county/state psychiatric hospital OR that ER was marginally qualified and well... drugs, screaming in the distance, lots of sedatives later... one way or the other you were released 3-7 days later with a state evaluation and told to go get help with your professional, correct? If you went into a real psychiatric hospital, they may have told you the only thing they do is evaluate you, sedate you so you are not a threat to others or yourself, and by law they only have to hold you for 72hrs, after that... your problem, don't let the door hit you on the way out.

Unfortunately, I'm forced to stay with this clinic due to my insurance. It was the same story with the last place I was at -- my doctors were all residents rotating through an outpatient clinic at a major university hospital, and I saw three of them in less than two years before I moved out of state. I thought that this time, things would be different and I could start to actually get better, as opposed to taking meds and keeping everything "contained". I guess I was mistaken.

Yeah, the money issue is THE issue in US psychiatric treatment. The psychiatric hospitals around here (we have many of them, but i'm in a major city) cost $1000-$3000/day and if you can't afford it, well they won't even talk seriously with you. They only have to evaluate you for 72hrs, nothing more. And trust me, they hit you with thorazine, you have NO WANT to hurt anything, so after 72hrs oh yeah, you are a lot better and not dangerous, until the drugs were off.

So, what does someone with depression, anxiety, PTSD, history of being child abused, and autism do? The internet is your friend, Hyalella. Friends out here saved my life three years ago next month. That was when twenty plus years of all that above finally overwhelmed me and the US health care system told me there was nothing wrong, I just needed to get over myself.

Friends out here that have lived it, have endured it, they are your new age help. I struggle on disability to get any help. I have medical, dental, and psychiatric issues, and I can only afford to treat ONE, and by treat I mean less than $100/mon. So I know all too well what you mean by situation locks you in.

http://www.psychforums.com/coping-methods-techniques/ Read everything in those forums. I mean all of it. Ask questions, talk to others, and read, read, read. Learn everything you can about your problem, make it personal. Because Hyalella, in the end, know what a good therapist is going to tell you, truthfully? You are your best source of help. He/she can't do it for you. They can give you the tools, they can help you with the bad days (strong maybe here, because none of them ever have helped me), but mostly, they will only show you the door, it is up to you to walk through it.

I found out recently there depressed people typically also suffer a deficiency in folic acid and the big neural transmitters (dopamine, serotonin, oxysomething). Now, my psychiatrist as a part of telling me this gave me a medical supplement for folic acid to try to help me, because my autism means I suffer wicked side effects on anti depressants (most anti anxiety meds ARE anti depressants so same problem there) and no benefits. It helps, some. The reason I'm bringing this up, is vitamins are your friends. Yeah, if you got the money eat better, but that isn't an option for me, I ate what i'm given and that is all i can do.

Additionally, i'm older and do to other factors can no longer do this, but twenty years ago during the only time of my life where my depression was under control, I jogged three miles every day. The pain finally got more than I could endure, but... exercise pumps your brain FULL of endorphins, the pleasure neural transmitters. If all you deal with is depression, count yourself blessed, and slowly work yourself up to more and more exercise. Aerobic exercise, not weight lifting stuff. Go for an hour walk every day. Yoga. Jogging if your body can handle it. But it has to make you sweat, be longer than 20 min, AND has to hurt a little. It is that pain that is key! That pain causes your body to dump dopamine into your blood stream to cope with the pain and THAT makes the rest of the endorphins fire.

Basically... any SSRI you ever took? You were paying to trick your brain into doing what jogging two miles does. Just has to hurt a little, just enough...

This might get deleted later, but... I was doing research for a BDSM story i was writing and someone pointed me to this article on BDSM, pain, pleasure and brain chemistry, and it taught me a LOT. Follow up its claims and confirm i'm not just pumping smoke up your arse and to make you feel better about the info: http://www.rosecoloredasses.com/sirreal/bdsmscience.htm