Long term therapy

“Do you think you’ll always need psychological input?” we were asked during one of the hospital group sessions. The discussion was based around  the Better Access scheme limiting us to ten sessions with a psychologist per year. We paused. “You’d hope not,” another patient finally answered.

Are there actually people who completely rid themselves of psychological and/or psychiatric services and manage to stay well though? Not needing to see a psychologist, take medication, see a psychiatrist or be hospitalised again? I’m not asking this rhetorically, I actually want to know. Is it just that I don’t know enough people? Or are those who get and stay well a rarity?

Sometimes it seems as though my answer to the original question posed is “Yes”. I was told by my GP this week I’d probably need ‘long term therapy’. Which in itself, isn’t a statement that fazes me much anymore. I’ve been told the same by at least two psychiatrists.  Except that I’ve been in therapy for the past three years. How much more ‘long term therapy’ could I possibly need before I’m considered recovered? Surely three years is plenty long enough?

13 thoughts on “Long term therapy

  1. Totally understand where you’re coming from.

    I’m scared that I also feel the need to answer yes to the question of always needing psychological input. I used to think that wasn’t true, and that things would get better; you read about “people” getting better – it’s just that “people” does not seem to include me! And that comes towards the end of 18 months of psychological input – in fact if anything, the last 6 months have highlighted how much more shit I’ve got going on in my head. I try to think of it as I’ve had 34 years of fucked-up-ness, so I shouldn’t expect a quick fix solution in a matter of months.

    I guess maybe view it as good that you at least recognise that there is a need to explore yourself, and that hopefully that’ll make you a better-functioning human being, as opposed to “better”.

    Keep going.

  2. Three years yes, but granted, you haven’t found a meaningful relationship with any of those people and it hasn’t been a regular every-week support system right? I think there is a big difference. Perhaps things will be different for you if you could access such services/find that healing relationship.

  3. I’ve been in therapy for 8 years, although it takes me at least a year or two to talk about anything worthwhile since trust issues and i have switched through different people. But I’ve also been on meds since I was a kid and had some therapy as a child until my parents pulled me out. Everyone is different and takes different times to “get well.” For me being well will mean that I don’t need CONTINOUS services but only when crisis or life events happen that I’m not able to deal with. But I’ll always need the meds. It’s just me though.

  4. I spent nearly 12 years (from age 12 – nearly 24) with depression, often severe. Had several hospitalisations, went on lots of different types of meds, and saw a couple of therapists as a teen. I’m no longer depressed or have any mental health input.

    What worked for me was a combination of the right medication, supportive doctors who I could trust (GP and psychiatrist), a good support system at home, and enforced rest caused by getting ME/CFS :p I’m not sure I’d advise getting a chronic physical illness as a recovery method as that brings its own problems (especially since I’m now bedbound and completely dependant on my husband for everything) but the rest of it is helpful, even if it doesn’t result in complete recovery.

    I came off the last of my psychiatric medications a few months ago, with no relapse. I still have anxiety issues, but they’re mostly related to my autism, and I’m currently not doing anything about them as my physical health problems are a bigger issue.

    I think the biggest thing that helped me recover though was accepting who I was and being kind to myself. This is very difficult if you’re depressed or similar, but you can start with little things like having your favourite foods and not feeling guilty about it.

    I know that therapy can be helpful if you get the right therapist, and it’s something I’ll be looking into in the future when my health is more stable (I still have some issues that crop up rarely related to childhood stuff). I had problems finding the right person while depressed which is why I didn’t have much, but it probably would have been good if I had.

    I am hoping that things go well for you. You may need long term therapy, but the most important thing is you have a therapist you get on with. And you might recover- I don’t want to say you will as I can’t see the future, but it’s definitely a possibility. I used to think I’d always be depressed, and I’ve now been depression-free for over 18 months. Good luck.

  5. I would have hoped that I wouldn’t need long term support either but I have been in therapy for 18 years so far. I don’t say that to scare you but to just say that sometimes it ireally is a long term thing and for me, I have to and I do accept that. Is it really a bad thing if that turns out the case for you? I also agree that you haven’t gelled with any of your treating team at all. You really do need to find someone to trust, who you can let your guard down with. Thinking of you!

  6. How much treatment you need depends on so many factors. To simplify it, you can divide the congenitally imbalanced (those born with a disorder) from the situationally ill (those who acquired a disorder through, say, a traumatic childhood). What for short? Mutants & mutates, to use comic book language from my youth? Natives & tourists? Kind of dismissive. How ’bout Group A and Group B?

    Group A (includes most bipolar, schizophrenic, etc.) is much less likely to approach a real cure for their disorder. It’s more or less hardwired in. They can learn, however, to manage their disorders. A very small minority may be able to manage the disorders with no medication and no regular therapy at all.

    Group B, ideally, use meds temporarily while acquiring the insight or the cognitive-behavioral patterns or whatever is most useful for healing necessary to either cure or manage the disorder.

    I tend not to hang around with Group B types, because I don’t necessarily get them. What? You mean this is something you can put on and take off? Mine is part of me. My alcoholism will be lifelong, and my bipolar has flared up so dangerously when I’ve fucked with the meds that I’m convinced that’s also permanent. I don’t know about borderline. There is evidence of genetic and chemical factors there, which may point to lifelong management as opposed to cure. Then again, trauma has such a profound effect on brain chemistry that there is not necessarily a difference between the Groups.

    For me, I’m resigned to living with my disorders for the rest of my life, but, in my better moments, I’m committed to do whatever I can to effectively manage them and have a more peaceful, content, (happy–how I hate that word) existence today … one day at a time … because I don’t know what will happen tomorrow.

    That’s what I want to say when I see you in pain like this: focus on right now, let go of past and future, what are you going to do (and not do) today?

  7. I think it’s different for everyone. I have been in and out of therapy for severe depression since I was 14 – I’m now 29. Like sanity said, some of those clinicians really sucked and their treatment wasn’t really appropriate treatment, so does it count? I don’t know. Currently seeing a wonderful psychiatrist for therapy and meds who expects I’ll be in therapy with her for a couple of years, but fully expects that after that, I likely won’t be. She does, however, think that I’ll be on medication for the rest of my life, and perhaps choose to go back to therapy at stressful periods. I think that makes sense – I have a biological depression and medication treats that. That is not likely to disappear, any more then my allergies or migraines will. Once it is under control, once things have been stable for a *truly* long period of time, then no real reason to stay in therapy unless I’m finding benefit from it. I’m lucky to have a professional who can see that perspective and encourages it. I see it as rational.

  8. I agree with the above, I think it’s different for everyone. I’ve been in therapy for seven years with 25+ hospitalizations over that time, but have now been out of hospital for the last year (other than emergency). I’ll be on medication for the rest of my life, and I still see a psychologist, and that’s enough to keep me (relatively) well for now. I know people that have ended all psychiatric treatment and stayed well though, and people who have continued treatment but stayed well out of hospital. I don’t think it matters so much whether or not people need ongoing medication, therapy & monitoring – staying well and functional is the main thing. I hope that eventually I’ll be able to end therapy, after processing traumas & doing more day to day practical therapy around learning to be functional and lead a ‘normal’ life. For me it’s about management of a chronic illness. But again, I think it’s different for everyone.

  9. yes. people do get better and not need these things. my best friend in school went to a psychiatric ward after a suicide attempt a few years ago. she ended up staying there over a year, being allowed to go to school and then back to hospital each day. then had therapy for several years. she moved back to bris and now doesn’t see anyone and is all better. basically, have hope 🙂

  10. I have been in, and am still in long term therapy. It has been 4 years so far, and I am recovering. It is a very slow process, but recovery and management of a mental illness can happen. Stay strong, you are working so hard right now. Be kind to yourself, you deserve it. xx

  11. I was put into therapy A LOT. Every one of the many schools i went to immediatly decided i needed to be referred to a psyhologist, an anger management course, a counseller and usually a behavioural expert. not to mention being practically stalked by the school nurse sometimes.

    I never got any better. CBT, DBT, Psychotherapy, Art Therapy etc. All it did was rip me open, and leave me totally open and raw, and then they never seemed to know how to help me heal it again.

    Its funny, i only started to recover once i was in no therapy.When i was old enough to make the decision to say ‘no more’. I had a support worker, but no actual pyshc input. At one point i started seeing a psych on top and i derailed faster than i ever have before.

    I guess its diff for everyone BTF, but for me, therapy just wasnt what i needed, and i actually needed out of it to recover. I think you can defo recover without. Just depends what you need. xx

  12. Yes, I know a few people and of a few more who were in services for years, had dozens of hospitalisations (often under section) and seem to have tried every medication available who have now, by their own definitions’ “recovered” – for some that means no meds, others still take some, but all are much happier and content and don’t really take a lot of professional input.

    And without fail, everyone that I’ve spoken to said, that what they were going through it, they couldn’t have imagined getting to where they are now.

    But like others have said, what worked for them is so individual, some needed therapy, others say it just made things worse, some say they had to learn to accept their problems, others say they had to reject the entire concept of mental illness and redefine themselves, some needed meds, others say they got better once off them.

    All of them do seem to agree that having understanding others they could talk to/with/about things (in whatever context that might be), in some way helped, but then I tend to hang around peer-support groups, so even that might be because of the people that I’ve actually met and talked to…

    But what will work for you, I guess only time and experience will really tell. I hope you find it soon though.

    Take care.

  13. Bit late to the party here, but totally know where you’re coming from. I don’t know the answer to the question though. I’ve been in therapy for 7 years and I got told by my first GP that I would have to stay on medication for the rest of my life, but I disagree. I don’t think it’s always forever. Sometimes it must be, of course, but not always.

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