Depression Treatment: What Are Outpatient Programs Like?

After months of displaying severe depression symptoms, but refusing to address it, I was forced to face my mental health struggles head-on.

I could no longer get out of bed, I felt hopeless for reasons I couldn’t pinpoint and my husband and I were out of options. I’d let this go on too long so in July of 2011, I entered a behavioral health outpatient program at McLean Hospital outside of Boston. Here’s what my experience was like.

First Steps

My family, husband and I were all unaware a program like this existed, otherwise I may have signed up sooner. It became clear that the antidepressants I was taking and the weekly counseling I was receiving weren’t enough. After speaking with a doctor, I was told about two outpatient programs at different hospitals in and around Boston.

I just had to call them and ask about availability.

It was a Thursday. I called both facilities. McLean called me back first. I’d start on Monday and attend each day from 8:30am to 3pm for 10 business days.

I went to work Friday morning and spoke with my HR department. Then I left the office. An email went out to my coworkers explaining I’d be on medical leave for at least two weeks. I don’t know if anyone figured out where I went. The girls who would often hear me crying in a bathroom stall probably did.

I spent the weekend with my family and my husband. My emotions were a mix of fear and relief. Maybe I’d finally get some answers, but what would it be like?

The First Day

On Monday morning, my husband drove me to the hospital. After filling out paperwork and meeting some staff, it was official. I was a patient in McLean’s behavioral health program.

The first day reminded me of attending orientation in college. Everyone is a stranger to you, you’re all there for the same reason and there are usually one or two gregarious people who alternate between making things awkward and fun.

I was given a weekly schedule of sessions I would be expected to attend; there were usually three or four to choose from each hour. They focused on different skills such as self-care, cognitive behavioral therapy or coping with loss. Some groups were also designed for specific issues such as bipolar disorder or anxiety.

The session rooms were bland, as you might expect. Chairs lined the perimeter and a whiteboard was often situated at the front or side of the room. I sensed the room was designed to facilitate group conversion which felt intimidating. I wasn’t prepared to share anything with a group of strangers, however, each discussion leader was compassionate and understanding. You were never required to divulge personal details or provide a backstory about why you were there. This didn’t mean you were allowed to fly under the radar, though. Staff members encouraged you to participate in the conversation, even if that meant squeaking out a one-word answer in an hour-long session.

By the end of the first day, I felt conflicted. Could 10 days in group therapy really get me over this hurdle? Would I start to feel hopeful again?

The First Week

My second day started with a meeting with a psychiatrist. We discussed my depression symptoms and medication levels. I hadn’t been sleeping well for at least six months. I learned that this was likely contributing to my depression but it’s a vicious cycle, really. You can’t sleep because you’re depressed, but you’re depressed because you’re not sleeping.

The doctor prescribed Seroquel, which is an antipsychotic used for bipolar disorder and schizophrenia. It’s also commonly used to treat insomnia. He wanted to regulate my sleep so he could then determine the severity of my depression. (I stayed on the medication for a few weeks after leaving McLean. After experiencing side effects, my regular doctor replaced Seroquel with Trazodone.)

Throughout my first and second week, I met individually with other staff members, including a social worker and a counselor. The social worker checked on my overall progress and met with my husband to answer questions and provide guidance (with my permission).

The private counseling sessions were used to build on the skills I was looking in group therapy. It was also a place where I could talk more specifically, and privately, about why I was in the program and what help I needed.

Because it’s a rolling admission into the program, you would often find out it was someone’s last day during a conversation, or sometimes you just never saw them again. Several of us ended treatment on the same day. As we walked to the parking lot, we exchanged email addresses, perhaps to alleviate any awkward goodbyes. But we never stayed in touch.

Can I Use My Cell Phone During Treatment?

Outpatient treatment is intended to give you structure and skills. It’s not a punishment. While every program is different, McLean permitted patients to use cell phones between sessions. We were also allowed to leave campus during lunch.

You were required to sign in when you arrived in the morning. Staff checked attendance for safety reasons. If you didn’t show up, they would call you or your family to be sure everything was alright.

Although your days were tightly scheduled, it didn’t feel oppressive. Keeping us occupied was a way to create structure for a group of people who were experiencing chaos in their mind and lives.

Did Outpatient Treatment Work?

Two weeks in outpatient treatment didn’t cure me, but it helped me make sense of my life again.

I was beginning to learn how to take care of myself in a more effective way and I now had a greater understanding of what led me to this dark place.

Structure was reintroduced to my life and for the first time in months, I felt like I was in control. On my last day, I walked out armed with new skills to help me stop depression in its tracks.

The best part? I always knew I could return if I lost my way.