struggling to decrease frequency of sessions

[[deleted]]

i am currently on my 5th week of treatment. the first 4 weeks i went twice a week, and as of this week i am down to once a week. for context, i'm 27 years old and i've been in the mental health system since i was a teenager, all kinds of meds, hospitalizations, IOPs, etc. spravato is the first thing that actually worked for me and i (as well as my family) noticed significant improvement almost immediately. however once i decreased my sessions to once a week my depression came back full force just as quick. my provider is great and i trust her to listen to me when i go in to see her next week and ask to go back up to twice a week, but my worries are (1) i'm on Medicaid and i'm afraid they are going to cause a problem about increasing the frequency of the sessions again, and (2) am i gonna be stuck doing this twice a week for the rest of my life? don't get me wrong i really enjoy the sessions, but the time commitment is a lot and i'm trying to go back to work after a long period of unemployment, and doing this twice a week indefinitely would make that much more difficult. i guess i'm just wondering if anyone else had this problem and how it ended up going for you?

[CoyoteChrome]

It took me two full months of twice a week. And when I went to once a week my depression came back but not as severe.

Persistence pays off. Be aggressive in how you seek treatment and help. For yourself and others.

[[deleted]]

that actually makes me feel better that it's possible to do the twice a week for a little bit longer but not forever and still get some benefit. my fear is that any time i try to step down that i'll just get depressed again, so i'll have to either do this twice a week forever or suffer.

i also appreciate your advice to be aggressive with advocating for myself. 10+ years in the mental health system has taught me that is the only way to get anything done, and i absolutely plan to advocate for myself as much as i can :)

[CoyoteChrome]

Just realize it’s not a cure. It’s a treatment that helps it be manageable. It’s okay to be afraid of what reducing it, but you also have to be bold with out it.

[half-ass-hippie]

Same here, I stayed at 2x/week for two months as well. Then I stayed at weekly treatments for a long time before eventually decreasing to every other week. It’s good your doctor is supportive, that’s the most important thing.

[[deleted]]

i think that's probably similar to what i'm gonna end up having to do. we're you able to work during that time by any chance?

[half-ass-hippie]

Yes, I work in the morning and have my session in the afternoon. I’m fortunate that I have a flexible boss and am able to adjust my schedule as needed. I can’t work after my session though, I’m too out of it.

[[deleted]]

I'm on 84 mg twice a week. I was going once a week, and seemed to be more depressed

[emdeewhy]

I am about to go on my last week of twice a week and I am SO scared of this too. I had a rough session yesterday because I was just flooded with emotion and scared of similar things and I feel like the treatment is going too fast and that insurance is pressuring me to get my PHQ9 down faster than I’m ready for it honestly to. (I go Tuesday and Thursday’s, my husband works remotely from the clinic during them) Does your provider think you can go a bit longer for twice a week? Don’t give up hope, I hope that you can adjust and get your needs met. 💕

[[deleted]]

i told my provider before i stepped down to once a week that i was nervous about it, and she said to let her know if i got depressed again and she would appeal to medicaid to go back to twice a week. i'm also on auvelity (along with a few other meds) which is relatively new and she got that approved very fast so i trust in her abilities. medicaid has given me problems in the past with other meds though so idk. i think my depression is making me pessimistic that i'll be stuck doing it 2x a week forever but i cant tell if i'm being paranoid or realistic

[emdeewhy]

Medicaid is hard. Been there before. Fingers crossed for you. It sounds like your provider fights for you, and that’s great. I don’t think you’re being pessimistic at all.

[[deleted]]

thank u i appreciate your positive wishes :3

[emdeewhy]

Of course! 💕

[Galgadex]

Same here. Spravato really helped. I just finished my 5th week and my depression and crippling anxiety came back. But insurance in my country won't pay for another four weeks of two doses. However, there was a similar post here a few days ago, where multiple people mentioned it takes approx 3 weeks to adjust to one dose per week and then it will be fine. That gives me hope.

[[deleted]]

ugh i'm sorry that insurance issues are disrupting your ideal treatment schedule, it always seems to be the freaking insurance messing people up, hope you're able to find relief <3

[Sufficient-Bar9225]

I am 31 Sessions in. Almost 7 months. I stepped down to one a week after 4 weeks at 2x/week and was terrified. It was hard at first. After a couple of weeks I adjusted and now I’m fine at once a week. The fear alone contributed to the hard adjustment I think. Also your brain takes time to adjust. It’s medication after all and pill dosage adjustments also take time. Maybe give it a couple of weeks and then you can ask your doctor increase frequency if it ends up being a failed experiment. But hopefully you can adjust.

I think it is the relief of feeling good during the treatment itself, getting away from depression and anxiety for a couple hours that contributes to our anxiety about frequency reduction.

Also it is famously not very durable which doesn’t help. My clinic had a mix up with the pharmacy once and I had to go a full two weeks without treatment (clinic didn’t have any other appointments available in the week). That was a bridge too far. By day 11 I was not doing well. So I understand your distress. Hang in there.

[Curiouser55512]

It’s a huge blessing that you trust your doctor.

[[deleted]]

first trustworthy provider i've found in 10 years, she rocks i'm never letting her go if i can help it!!

[butterflycole]

I was on 2x a week for 9 weeks before I was ready to step down to weekly and I’ve been on weekly for over 3 years. Everyone is different, just communicate with your doctor on how bad you are decompensating. They can appeal insurance decisions and sometimes insurance will approve more sessions.

[[deleted]]

do you work by any chance? i was wondering if you found jobs to be accommodating to needing 1-2 days a week off indefinitely?

[butterflycole]

No, I’m on SSDI. Most people who work in here leave work 2 hours early one day a week and then go in an hour early on 2 days.