How Often Should I See a Psychiatrist If I’m Severely Depressed?

Summary: When you receive a diagnosis for major depressive disorder and a referral to a psychiatrist for care, you and your treatment team will assess a variety of factors to determine how often you should see a psychiatrist if you’re severely depressed.

Key Points:

There is no single answer to this question: frequency of psychiatry sessions varies from person to person.
It’s reasonable to expect to see your psychiatrist more often at the start of treatment, with frequency of sessions decreasing as you make progress.
Treatment for severe depression may begin with one session per week minimum, more often two sessions per week.

How Do Psychiatrists Help People With Depression?

First, it’s important to understand that among mental health professionals, psychiatrists are the most highly trained providers available. They go to medical school and receive specialized training in diagnosing and treating mental health disorders. Psychiatrists spend six to eight years – sometimes longer – after medical school receiving additional training and getting practical experience in a wide variety of mental health settings.

Therefore, they’re the most qualified to provide an accurate diagnosis and offer referrals for appropriate care. When you ask how often you should see a psychiatrist if you’re severely depressed, the answer depends on the following:

Levels Of Disruption Caused by Depression

You may be severely depressed, but severe depression impacts each person in different ways. Your severe depression may exist on a continuum. The symptoms you experience may:

Stop you from socializing, interacting with anyone, or stop you from wanting to socialize or interact with anyone, including friends and family.
Significantly impair work or school performance
Completely nullify your interest in hobbies or previously loved activities
Prevent you from getting out of the house to go to work or school
Prevent you from getting out of bed in the morning, eating, and attending to the basics of personal hygiene

Your symptoms of severe depression may range from preventing you from doing or enjoying anything extra – i.e. outside of work or school – to preventing you from doing anything at all. The more serious the disruption the more often you can expect to see your psychiatrist.

However, there are evidence-based guidelines you can use to set and manage your treatment expectations. To achieve treatment success and feel recovered, evidence from the American Psychological Association (APA) shows:

Roughly half of patients need 15-20 sessions
Some only need 12-16 sessions
Patients and providers place the sweet spot at about 20-30 sessions.

Keep in mind we’re talking about middle-of-the-road, moderate depression, moderate symptom severity, and a moderate level of disruption. Patients in that category generally see a psychiatrist or therapist once a week. For severe depression, the overall duration of treatment may increase, as well as the frequency of treatment sessions.

How About for Severe Depression? How Often Will I See My Psychiatrist?

If you see your psychiatrist for medication management only, you may only need to see your psychiatrist once a month. However, if your psychiatrist also provides psychotherapy you may need to see them more often, especially if you’re severely depressed. Psychotherapy may include:

Cognitive Behavioral Therapy (CBT)
Dialectical Behavior Therapy (DBT)
Acceptance and Commitment Therapy (ACT)
Motivational interviewing
Solution focused therapy

Research shows that in the early phases of treatment for severe depression you may need to see your psychiatrist twice a week. Researchers who conducted a study called “Frequency And Change Mechanisms of Psychotherapy Among Depressed Patients: Study Protocol For a Multicenter Randomized Trial Comparing Twice-Weekly Versus Once-Weekly Sessions” concluded:

“While keeping total number of sessions equal, twice-weekly sessions lead to better outcomes than once-weekly sessions for depression in a head-to-head comparison.”

That’s compelling evidence for initiating treatment with two sessions per week and adjusting based on progress assessed through collaborative decision-making between patient and provider. We’ll summarize the information in this article now.

How Often Should I See a Psychiatrist If I’m Severely Depressed?

Note: these bullet points are not medical advice: they’re a helpful summary of available, evidence-based resources designed to give you an idea what to expect as you initiate treatment.

For medication management only:
- Once a week in initial phase
- Once every two weeks after stabilization
- Monthly for ongoing management and maintenance
For psychotherapy and medication management:
- Twice a week for the first month
  - More severe cases may require increased frequency
  - More severe cases may require longer duration
- Once a week after stabilization or progress is achieved
- Once every two weeks as frequency and severity of symptoms decrease
- As needed for ongoing maintenance, with progress assessed through collaborative decision-making between patient and provider.

We’ll discuss this information below.

For Severe Depression, More Frequent Treatment Over a Longer Period Yields Best Results

The APA source we cite above – How Long Will it Take For Treatment to Work – indicates that for complex disorders, such as depression with psychosis, or for treatment-resistant depression (TRD), a treatment duration of 12-18 months may be necessary. Treatment of that duration would likely begin with two therapy sessions per week, with frequency decreasing based on progress related to predetermined treatment goals.

Finally, it’s essential to understand that if you have severe depression, you may need to engage in ongoing therapy with no predetermined end-date. You may go through periods where you see your psychiatrist once a month or less. However, life circumstances may trigger symptom recurrence, and you may need to return to once weekly or biweekly therapy until you meet your treatment goals.

In the end, the frequency and length of treatment for severe depression is impossible to accurately predict ahead of time, and depends on the outcomes of a shared decision-making process between you, your psychiatrist, and the rest of your treatment team

Angus Whyte

Angus Whyte has an extensive background in neuroscience, behavioral health, adolescent development, and mindfulness, including lab work in behavioral neurobiology and a decade of writing articles on mental health and mental health treatment. In addition, Angus brings twenty years of experience as a yoga teacher and experiential educator to his work for Crownview. He’s an expert at synthesizing complex concepts into accessible content that helps patients, providers, and families understand the nuances of mental health treatment, with the ultimate goal of improving outcomes and quality of life for all stakeholders.