Talking about certain thoughts, feelings, and memories in therapy may cause you to feel worse after a therapy session instead of better. This is sometimes known as a therapy hangover.
A therapy hangover is common in the beginning as you get used to discussing difficult topics and learning coping strategies, and it doesn’t mean that therapy won’t help you in the long run.
In some cases, feeling worse after therapy could be a sign that you and your therapist are not a good fit, and you may benefit from seeking a new mental health professional.
If you’ve been struggling with stress, anxiety, or depression for a while, you may feel eager to see a therapist and start feeling better. This is a great first step to finding relief, but your first appointment is unlikely to “cure” you. You might even experience a therapy hangover — when you actually feel worse after a session.
If you feel worse after a therapy session, it may be tempting to think that you’re just not cut out for it. But this is not the case. Therapy hangovers are relatively common, and they tend to get better with time.
Talking about your stressors, difficult symptoms, relationship challenges, or traumatic memories can be difficult. This is especially true if:
Therapy is new for you.
You’re not used to talking about your feelings.
You’re discussing topics that you’ve been avoiding or suppressing.
You’re talking about a triggering memory, such as childhood trauma.
The very act of learning to open up may be exhausting. “Releasing things can take as much or more energy as holding them in, and allowing yourself to be vulnerable with a person you have just met is a form of emotional heavy lifting,” says Cole Rennix, a licensed marriage and family therapist in California and Oregon.
At the beginning of your therapy journey, you may also not have coping skills yet for dealing with those feelings. Coping skills are something you learn over time that can help you sit with emotions without turning to unproductive habits, like substance use. Examples of coping skills include mindful breathing, exercise, or journaling.
In general, it may take at least 6 to 12 therapy sessions before you start seeing progress in your mental health. This doesn’t mean that all your problems will be gone after six sessions. But you may start feeling better.
Everybody’s experience of therapy is different. The amount of time you are in therapy can depend on why you are seeking help. Some people see a therapist for just a few months as they navigate a difficult life event, but others may benefit from therapy for years. Whether you’re receiving online therapy or meeting in person, psychotherapy is not usually a one-and-done treatment.
In the early sessions, your therapist will generally ask a lot of questions to get to know you, your history, and your needs. These early conversations can help your therapist identify certain themes or patterns in your life that may be affecting your mental health.
Topics that may come up include your:
What work or school is like for you
One goal of psychotherapy could be to identify and change how you think about certain issues, which may improve your quality of life. Another might be to learn coping skills or interpersonal skills.
You can expect to sometimes face difficult issues or emotions in therapy. This can be uncomfortable or distressing at first. As sessions progress, you should see growth in the way that you think, feel, and respond to stressors. This will likely help improve your symptoms and daily functioning.
“Ideally, therapy will help you to expand your range of feelings and emotions,” says Rennix. This is especially true if you tend to have unhelpful thinking patterns, such as black-and-white thinking, jumping to conclusions, or catastrophic thinking. Therapy may help you deconstruct those thinking patterns and approach the world with more flexibility.
Expanding your ways of thinking and coping doesn’t mean getting rid of emotions that can sometimes feel uncomfortable. For example, during COVID-19, many people experienced an uptick in stress and anxiety. People feared contracting the infection, losing loved ones, or losing their income.
These were valid and reasonable feelings and thoughts for many people, especially early in the pandemic. So your therapist may instead help you find ways to manage that stress and cope with those feelings, such as through acceptance and commitment therapy (ACT) or cognitive behavioral therapy (CBT).
It’s also important to know that therapy isn’t just for talking about struggles and traumatic memories. Therapy can also be a time to discuss your strengths, progress, and successes.
“While seeking relief from emotional pain is likely the reason you started therapy, it is also important to affirm positive experiences,” says Rennix. “Even the tiniest moments of joy can help to defend against hopelessness.”
Talking about your therapy hangovers could actually be a great discussion topic for therapy. It may be useful for your therapist to hear how you feel after a session. Are you ashamed of what you discussed? Do you feel judged — or are you worried about being judged? Is there anything you need from your therapist to make you feel safer or more validated during the session?
“The best time to address this is at the beginning of your next session,” says Rennix. “Your therapist can suggest additional tools or resources to help you manage distress, [and] the two of you can assess whether to adjust the pacing of the work.”
Rennix also recommends asking the best way to reach your therapist between sessions. That way, if you’re experiencing serious distress (from a therapy session or otherwise), you can reach out for help. “Do not wait,” says Rennix. “Let your therapist know and/or contact a helpline or emergency services if needed.”
You don’t have to worry about hurting your therapist’s feelings when you bring up what isn’t working for you. It’s part of their job to address your concerns. Ways to start the conversation include:
“I’ve been having a hard time after our sessions coping with the emotions that come up.”
“Some of our conversations have been triggering for me. What can I do about that?”
“Is it normal that I sometimes feel like I’m in a bad place after our sessions?”
Your therapist might not be a good fit for you if:
You feel like you need to explain or teach them too much about your specific issues.
You don’t feel safe opening up to them.
You feel pressure to tell your therapist what they want to hear, even if it’s not the truth.
You feel judged, shamed, or invalidated by your therapist.
You don’t think you’re meeting your treatment goals.
Each mental health professional has their own style, personality, and methodology. There may be differences in how much they talk, how they express compassion, or how they guide the conversation. All of these differences may affect your comfort level.
In some cases, you may feel worse after therapy because you and your therapist are not a good fit. You might find their approach intimidating or their personality offputting. If your communication styles are not a good match, you might feel belittled or invalidated — even if that’s not what your therapist intended.
“After a tough therapy session, it is important to be especially gentle with yourself and pay attention to what your body needs,” says Rennix. “Your psyche needs time to integrate what you explored in therapy, so it will help if you practice mentally ‘filing’ the matter until your next session.”
During a therapy hangover, you may feel tempted to self-soothe with substances or emotional eating. These types of behaviors may help you feel better at first. But they could also make you feel worse in the long run. Plus, they may cause you to avoid the feelings that come up in therapy, which can be counterproductive to the therapy process.
It may be a good idea to talk with your therapist about how to manage emotional triggers, such as the topics you might discuss in therapy. Examples of productive coping strategies include:
Getting enough sleep
Listening to music
Meeting up with a friend
Eating a nourishing meal
Cuddling with a pet
Practicing mindfulness strategies, such as deep breathing or body scans
Watching a funny video or movie
Therapy takes time and effort, and you may feel worse before you feel better. This doesn’t necessarily mean that therapy isn’t for you or that your therapist isn’t a good fit. Give yourself time to grow, learn, and self-reflect. And be patient. If you’re really struggling in therapy, it’s worth having a discussion with your therapist about what’s going on and finding ways to cope during a therapy hangover.
If you’re concerned about yourself or a loved one, you can also get help now. If you or someone you know has suicidal thoughts, you can call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text "HOME" to 741741 to reach someone at the Crisis Text Line.
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Rennix, C. (2022). Transpersonal Magic. [interview].
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