How Intensive Outpatient Programs Help with Depression

Depression does three things that make it incredibly difficult to battle on your own:

1. It isolates you
2. Breaks down your daily routine
3. Drains the very energy and motivation you need to push against it

Intensive outpatient programs (also known as IOPs) tackle depression by addressing all three of these issues at once.

It rebuilds the structure of your daily routine, re-connects you with people, and helps you build the coping mechanisms needed to keep depression at bay.

In this article, we’ll walk you through what IOP does for depression, and how to decide if it’s the right fit.

What Is an Intensive Outpatient Program for Depression?

IOP is a structured form of mental health treatment. You attend a program for around 3 hours each day, 3-5 days per week.

You live at home, and it allows you to keep up with the other parts of your life.

For depression, most IOP programs include a mix of group therapy, 1-on-1 sessions with your own therapist, time with a psychiatrist to discuss medication, and family sessions (when relevant).

If once-a-week therapy sessions are on one end of the spectrum, and around-the-clock hospital or residential care are at the other. An IOP is somewhere in the middle.

Why Isn’t Weekly Therapy Enough for Depression?

Weekly therapy gives you one good hour each week. And it’s so easy for depression to expand to fill the other 167 hours of the week.

With only one session a week, a lot of sessions end up being spent recapping low points from the week instead of addressing them. The lessons you learn from your therapist barely have time to take root before the next hard day undoes them.

If this situation sounds familiar, it typically means that you’ve outgrown what a single weekly therapy session is able to support. And it’s a good indication that you’re ready for a higher level of care.

Here are the signs we typically see that indicate weekly therapy sessions might not be enough:

• Hopelessness that won’t go away, even on your better days
• Losing interest in things you used to look forward to
• Running on an empty tank, no matter how much sleep you get
• Trouble concentrating at work or at home
• Sleeping or eating much more (or much less) than usual
• Pulling away from the people who care about you

If a handful of these sound familiar, it could be worth asking your therapist whether more support might make sense.

Depression has a cruel logic to it. Getting better takes energy. And energy is the first thing depression takes. That’s what makes the time between weekly sessions so hard. You’re left to hold it all together on the days you have the least to give. IOP programs provide additional support throughout the week, which can help give you the energy to make progress.

What Does an IOP Do for Depression?

Like we mentioned earlier, IOP helps tackle depression by working on it from three directions at once, by:

• Pulling you back towards other people
• Rebuilding your routine
• Helping you build skills you can use when your own head turns against you

Here’s how each of those work to address depression at it’s root.

1. Structure: Replacing the Routine That Depression Takes Away

The first thing that depression erases is the normal routine that you used to have in your day. And basic tasks like getting up, eating, or leaving the house start to feel like overwhelming decisions you don’t want to make.

An IOP gives you that structure back. You have somewhere to be – at a set time – several days a week, with people expecting you to be there.

And that consistent structure is actually an important part of the treatment itself.

When your days are predictable, your nervous system has less to brace against. For someone whose inner world feels like chaos, a predictable, consistent schedule can do a lot of heavy lifting.

On the hard days… when even getting out of bed feels like a battle… having a concrete place to be is its own kind of progress.

2. Connection: Breaking the Isolation Depression Feeds On

Isolation is one of depression’s most effective tricks. It tells you to cancel plans and stay under the covers where you don’t have to see anyone. The problem is that isolation is also what makes depression worse.

IOP breaks this loop using group therapy.

It’s normal to dread this part. A lot of people show up picturing the TV version of therapy – laying on a couch, talking to a therapist. And the group sessions throw them at first. But that feeling almost always eases once you realize you’re in a safe space.

Group therapy is the core of the IOP model. And it does something for depression that individual therapy can’t. When you’re sitting in a room with people who are struggling with a similar version of the same thing you’re struggling with… When someone else puts your exact situation into words… The shame around it starts to loosen its hold. And you start to realize that you’re not alone.

Our groups are led by licensed clinicians who are able to help the room stay steady, even when emotions run high. The topics that come up are from the real-life situations folks in the group are dealing with:

• Building a healthy relationship and spotting one that isn’t
• Handling a toxic workplace
• Making peace with the family you didn’t choose
• Sitting with what falls outside your control

Most people carry these kinds of things alone. Group therapy is where you learn you don’t have to.

3. Developing Skills & Tools to Interrupt the Depression Spiral

Talking helps, but depression also needs tools. A lot of what happens in IOP is learning practical skills that you can use during real situations in your daily life – most of it drawn from cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT).

The purpose of these tools is to give you something you can use when the spiral starts. For example, that might mean

• Catching a thought as it starts to slide toward the worst case scenario – and learning to question it before it runs away with your whole day.
• Learning about behavioral activation – a clinical term for doing a small thing before you feel like doing it. With depression the motivation usually follows the action instead of coming first.
• Other times it’s coming up with practical ways to calm yourself down when a feeling start to get overwhelming.

Your individual therapy sessions are where you go deeper on the things that are harder to say out loud in a group. A psychiatrist keeps an eye on your medication alongside the therapy, so the two are rowing in the same direction.

The Benefits of an IOP for Depression

Beyond how an IOP treats depression, the way the program is structured is a huge benefit in itself. You get intensive treatment. But you don’t have to put your normal life on hold (the way checking into a hospital or residential treatment would).

• You get to keep your life outside the program. Since you live at home during an IOP program and attend only for a few hours each day, you can keep going to work, school, or caring for your family while you get treatment.
• It asks less of you than a hospital stay. IOP gives you a high level of care. But you still get to go home at night and sleep in your own bed. That makes intensive treatment feel much more do-able for a lot of people.
• You get more than “once a week” support. Programs are typically 3-5 days a week, so if you hit a rough patch at any time, you’re able to get support typically within a day or two. This allows you to make consistent progress without feeling like you’re starting over each week.

Does an IOP Actually Work for Depression?

Yes. For most people with depression, IOP programs make a real, measurable difference. And there’s good research behind it.

One study of an adult outpatient program built around CBT and DBT found that people came out noticeably less depressed than when they started – with similar improvements in anxiety. And because so much of the work in IOP is learning skills that you can use when you leave the program, people are often able to keep those results over time.

Of course, no program is perfect, and results can vary from person to person. But the overall picture is hopeful. Most people come out of an IOP with real relief from their depression.

Is an IOP the Right Fit for Your Depression?

If weekly therapy sessions aren’t enough for you, but you’re safe at home and don’t need round-the-clock care – then IOP could be a good fit.

It may be exactly the right amount of support if:

• Your symptoms make daily life hard to manage
• Weekly sessions feel like they’re not progressing as much as you’d like
• You’re safe at home and not in crisis
• You’re still able to keep up with some amoutn of work, school, or family

IOP isn’t always right for everyone

If you’re having active thoughts of suicide, can’t keep yourself safe, or need supervision around the clock – IOP is not enough support for what you need. If you’re in that place right now, please reach out to the 988 Suicide and Crisis Lifeline by calling or texting 988.

From there, your next step would be inpatient care where you can get a greater level of support to help you stabilize. And then an IOP program is often the next step after inpatient care.

It can go the other way too. If your symptoms are mild – and a weekly session with your therapist is enough to support you right now – then IOP is likely too much support for what you need.

The right amount of support is whatever matches the place you’re in right now.

You Don’t Have to Wait Until It’s Unbearable

You don’t have to be at rock bottom to reach out for support. If weekly therapy doesn’t feel like it’s doing enough for your depression right now, that alone is reason enough to look into an IOP.

Reaching out is a small, low-stakes first step.

If you’re in the Los Angeles area, our admissions team would love to help. We can help you figure out if IOP is a good fit for your situation, and also check to see if your insurance covers IOP.

There are no surprise costs, and absolutely no pressure to commit. Call us at 888-293-3205, or fill out the form on our website.