Feeling sick after therapy sessions? What might be going on

You may be considering therapy to alleviate symptoms of mental health conditions such as anxiety or depression. Alternatively, you may hope to find support in addressing a life challenge, like conflict in your marriage or career turbulence. One thing is possible: you may not be seeking therapy because you’re worried it will make you feel worse. But in many situations, that can happen—you leave a therapy session feeling worse than before the session began. In some cases, that feeling may manifest in physical symptoms within your body. You may be wondering why going to therapy has left you feeling sick.

The truth is, feeling sick after your therapy session may indicate that the therapy is working. You might be in a situation where you feel worse before you feel better, but that better feeling may be coming soon—you might just have to hold on and keep trying for a little bit longer. 

Therapy’s potential impacts on the body

The most immediate results of therapy are often an increased level of self-awareness. This shift may ultimately be a good thing, but it can also leave you exhausted. Understanding how your brain works can give you increased control over your thoughts and feelings, which can manifest itself within your body. 

The initial therapy process has been compared to the daunting task of cleaning out your closet. At first, you just have to get everything out there—all your clothes and boxes out on the floor, your feelings and experiences out of the deep corners of your brain. And just like dumping everything out of your closet makes a huge mess inside your bedroom, looking at what you may have hidden away in your brain can make a huge mess in your mind. You may even discover that you have experienced past trauma.

What is trauma?

Many people have experienced traumatic events as part of their childhood or, more recently, as adults. Traumatic events have several characteristics in common. They are distressing situations inflicted on a person involuntarily (meaning that experiencing trauma is never a person’s fault). Trauma may make a person feel out of control, threatened, afraid, exhausted, and emotionally and physically vulnerable. These feelings may continue long past the conclusion of the traumatic experience. They may surface unexpectedly in a person’s life even after feeling safe and removed from the event, potentially negatively impacting their relationships and functioning.

Traumatic experiences may include:

• Physical, emotional, or sexual abuse
• Adverse childhood experiences (losing an immediate person in the family, not having one’s basic needs met, etc.)
• Living through a natural disaster such as a hurricane, earthquake, flood, or fire
• Sexual or physical assault
• Experiencing war, either as a combatant or refugee
• Surviving a violent encounter or losing a loved one to an act of violence

It is important to note that the list above is not exhaustive and that intense and distressing events can be experienced by people in different ways. Sometimes, a reaction to a traumatic event can depend on a person's support system, meaning that one person might survive an earthquake with no lasting effects. At the same time, another person may develop post-traumatic stress disorder (PTSD). 

If you have experienced a traumatic experience, you may seek therapy to help process that experience. But sometimes, in attending therapy for another reason, past trauma can also rise to the surface. 

Recovering what’s been suppressed

Even if you have not experienced a traumatic event, therapy may still take a physical toll on you, resulting in what some people may call an “emotional hangover” or even a “therapy hangover.” Many people have stressors, painful memories, and negative feelings built up inside of them—not just inside their brains but in their bodies. 

It is entirely normal to avoid unpleasant thoughts and feelings. However, avoidance is typically not a sustainable long-term strategy for addressing your emotions. Without proper processing, intense emotions may surface in unhealthy ways, such as through mental health symptoms or unproductive behaviors that may damage relationships. Unprocessed emotions from past traumas may sometimes lead a person to maladaptive coping mechanisms, such as substance use or emotional eating.

Possible physical symptoms of therapy

Discussing past traumas and uncovering unconscious emotions can be mentally and physically taxing. You may experience some of the following physical symptoms after attending a therapy session:

• Sweating
• Elevated heart rate
• Fatigue
• Digestive issues (stomachache, gastrointestinal discomfort, etc.)
• Malaise
• Headaches or migraines
• Body and muscle aches
• Flu-like symptoms
• Disrupted sleep (prevalent after participating in trauma therapy)

Therapeutic support and self-compassion

Feeling sick after your therapy session does not necessarily indicate that you need a new therapist (although if you continue to feel worse after therapy with no improvement as you progress further into treatment, it may be time to reevaluate). Therapy can be a complex process, but ultimately, unearthing what may have been causing stress without your realizing it can be a transformative experience. 

The therapeutic relationship can be especially important in these instances, where you may uncover aspects of your thoughts, feelings, and memories that you have not addressed for a long time. A licensed therapist may help you build self-compassion and practice self-care as you progress through intense phases of therapy. You can also tell your therapist that you have symptoms of feeling unwell following sessions and they can help process this with you and try to find solutions.

Scientific research indicates that there may not be a difference in effectiveness between online therapy and traditional in-person therapy. One study found that completing a course of online cognitive behavioral therapy was beneficial in reducing symptoms associated with a range of mental health conditions, including post-traumatic stress disorder, depression, and anxiety. If you start to have physical symptoms after a session, you may prefer to take sessions from the comfort of your home, where you can relax on the couch immediately after a session.