Depression after EMDR Session: What You Need To Know

Written By

Helen Kaminski, MSc


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EMDR (Eye Movement Desensitization and Reprocessing) therapy has become an increasingly popular and evidence-based treatment for post-traumatic stress disorder (PTSD).

However, some clients report increased depression in the days or weeks following EMDR sessions. It’s crucial we understand this phenomenon and properly support clients through it.

Why Does Depression Occur Post-EMDR?

There are a few hypothesized reasons why depression may emerge after an EMDR session:

  • EMDR allows suppressed emotions to surface. As clients process traumatic memories, they may start feeling emotions that were previously blocked for coping. This can be overwhelming at first.
  • Unresolved memories may initially worsen symptoms. While EMDR helps create long-term relief, in the short-term, working through traumatic memories can exacerbate negative thought patterns.
  • Neurological changes from EMDR may contribute. EMDR is believed to forge new neurological pathways and alter limbic system functioning. These brain changes may temporarily worsen mood.

The important thing is to anticipate and properly address this depression.

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Risk Factors: Who’s More Vulnerable?

Certain clients seem more prone to post-EMDR drops in mood. Risk factors include:

Pre-existing mood disorders

  • Clients with diagnoses like major depressive disorder, bipolar disorder, or persistent depressive disorder tend to be more susceptible. EMDR may trigger downward spirals in their condition.

Lack of social support

  • Isolated clients without close friends or family to talk to after EMDR seem impacted more heavily. Having emotional support through the process is key.

Childhood trauma

  • Those who endured chronic childhood abuse and neglect tend to struggle more with post-EMDR mood crashes. Their neural pathways are strongly engrained.

Table 1. Main Risk Factors for Post-EMDR Depression

Risk FactorDescription
Pre-existing mood disordersDepression or bipolar diagnoses
Lack of social supportNo friends/family to talk to
Childhood traumaChronic early-life abuse/neglect

Strategies Clinicians Can Use

As therapists, what steps can we take to help clients avoid steep drops in mood after EMDR?

Thorough assessment

  • Carefully screen clients beforehand for risk factors like mood disorders. Adjust the EMDR approach accordingly.

Prepare clients mentally

  • Forewarn clients that increased depression is possible so they aren’t blindsided by it. Set expectations.

Check-in frequently

  • Closely monitor clients in the days/weeks after. Ask about mood changes at each session.

Have coping plans ready

  • Equip clients with healthy coping strategies they can use if depression emerges post-EMDR.

Adjust EMDR intensity

  • With very high-risk clients, use a gentle EMDR approach. Target less intense memories first.

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When to Seek Extra Support

If clients experience severe, unremitting depression after EMDR that impairs functioning, extra help may be needed. Options include:

  • Medications. A psychiatric evaluation for antidepressant medications may provide relief.
  • Intensive therapy. Extra therapy sessions to work through the depression can stabilize mood.
  • Inpatient care. If depression is profoundly impairing or clients have suicidal thoughts, inpatient hospitalization lets clients heal in a protected environment.

With proper precautions by clinicians, post-EMDR depression can usually be well-managed. But in more severe cases, extra treatment is key.

Bottom line

While EMDR therapy often reduces traumatic stress over the long-term, temporary depression is a common side effect in the days or weeks afterwards for many clients.

By understanding risk factors, using preventative strategies, and seeking additional care when necessary, we can help clients successfully move through this phase to achieve EMDR’s full benefits.

Consistent support as clinicians is critical.

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About the author

Helen Kaminski, MSc

Helen Kaminski, MSc

Mindful living for a happier, healthier you. I’m a writer and mental health advocate in Warsaw, Poland, with five years working as a therapist. I hold a psychology degree from the University of Warsaw. I specialize in writing about mental health, using my experiences and academic background to educate and inspire others. In my free time, I volunteer at a Disability Learning Center and go for nature walks. My writing aims to break down mental health stigma and help others feel understood. Social

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