How Long Might Psychiatric Treatment Last?

You’ve started treatment, and you’re beginning to feel better. A natural question starts to form in your mind: How long do I have to do this? Will I be on medication forever? Will I need to be in therapy for the rest of my life? These are important and common questions. The answer is that it depends on your specific condition, your personal history, and your goals.

At Televero Health, we believe in having open conversations about the expected duration of treatment. While there is no one-size-fits-all timeline, understanding the general phases of treatment and the factors that influence its length can help you set realistic expectations for your journey.

The Phases of Treatment

Psychiatric treatment, particularly with medication, is often thought of in three phases:

1. The Acute Phase: This is the initial phase of treatment. The goal here is to get your current, acute symptoms under control and to achieve remission (meaning your symptoms are minimal or gone). This phase typically lasts for a few months. For example, after starting an antidepressant, it may take 2 to 3 months of dose adjustments to find what works best and get you to a place of stability.
2. The Continuation Phase: Once you have achieved remission, the work is not done. The continuation phase is the period immediately following the acute phase. The goal here is to prevent a relapse of the same episode. Your brain needs time to heal and solidify the changes that have occurred. It is strongly recommended that you continue your medication at the same effective dose for at least 6 to 12 months after you have gotten better. Stopping the medication too soon during this phase carries a very high risk of your symptoms returning.
3. The Maintenance Phase: After you have successfully completed the continuation phase, you and your doctor will have a conversation about long-term treatment. This is the maintenance phase. The goal here is to prevent any future episodes from occurring. The decision about whether to continue treatment long-term is a personal one, based on several factors.

Factors That Influence the Duration of Treatment

So, will you need to be on medication forever? For some people, the answer is yes, and for others, it’s no. The decision to continue treatment long-term is based on your risk of having another episode in the future.

Your doctor will likely recommend long-term or even lifelong maintenance treatment if:

• You have had multiple past episodes. The single biggest predictor of a future depressive episode is having had one in the past. The risk of recurrence goes up with each new episode. If you have had three or more major depressive episodes, lifelong maintenance treatment is almost always recommended.
• Your episodes are severe. If your past episodes have been particularly severe, have included thoughts of suicide, or have required hospitalization, the risk of a future severe episode is high, and the benefits of staying on medication usually outweigh the risks.
• You have a chronic condition. Some conditions, like bipolar disorder or schizophrenia, are considered lifelong illnesses that require continuous treatment to manage, much like diabetes or high blood pressure.
• You have a strong family history of mental illness.

If you have only had one, mild-to-moderate episode that was clearly triggered by a specific life stressor, you and your doctor might decide to try tapering off your medication after the continuation phase is complete. This is a decision that must be made carefully and in partnership with your provider. You should never stop a psychiatric medication on your own.

What About Therapy?

The duration of therapy can also vary. Some forms of therapy, like Cognitive Behavioral Therapy (CBT), are designed to be short-term and skill-based, often lasting for 12 to 20 sessions. The goal is to teach you the skills you need to become your own therapist. Other forms of therapy, particularly those that delve into deeper personality patterns or past trauma, may be more long-term. Many people also choose to continue with less frequent “booster” sessions after a course of therapy is complete to help them maintain their progress.

The length of your treatment is not a measure of your success or failure. It is a clinical decision based on your specific needs and your risk factors. The goal is to create a plan that gives you the best possible chance of achieving and maintaining long-term mental wellness.

Key Takeaways

• The duration of psychiatric treatment varies greatly depending on the individual and the condition.
• Treatment is often thought of in three phases: acute (getting symptoms under control), continuation (preventing relapse of the current episode), and maintenance (preventing future episodes).
• The decision to continue medication long-term is based on your risk of recurrence, particularly if you have had multiple or severe past episodes.
• Never stop taking a psychiatric medication without consulting your doctor. The decision about the length of your treatment should be a collaborative one.

Ready to take the first step? We can help. Get started with Televero Health today.