Why do I feel worse after therapy?

Therapy is supposed to help you feel better, right? So why do some people walk out of sessions feeling more emotional, more exhausted, more weighed down than when they arrived?

This is actually incredibly common. In my practice, I see it happen for a few very human reasons: Therapy exposes raw, hurting parts of yourself that you’ve been covering up—often without realizing it. When you finally start examining those wounds, it hurts. And even though that pain is part of healing, it can leave you feeling drained. Your emotional walls come down, and suddenly things that normally wouldn’t bother you feel overwhelming.

It seems backwards, but this discomfort is often a sign therapy is working. Here’s why it happens and what you can do about it.

Why therapy can leave you feeling drained

There are a few reasons therapy might make you feel worse temporarily. Understanding what’s happening can help it feel less alarming:

1. Your body physically processes emotions.

The most common reason people feel worse after therapy is physical. When you talk through difficult emotions, your body responds. You might leave the session with fatigue, heaviness, tension headaches, or that “hit by a truck” feeling.

This happens because emotions aren’t just psychological—they’re stored in your nervous system. Research shows that emotional experiences activate the autonomic nervous system, which controls involuntary body functions like heart rate and breathing. When therapy helps you reorder painful thoughts and feelings in a healthier way, your body has to process that shift. It’s vulnerable, intense work. The exhaustion you feel afterward isn’t a sign something’s wrong. It’s your system doing exactly what it needs to do.

2. You’ve stopped compartmentalizing.

Many of us survive by neatly folding away difficult emotions—shutting them in drawers so we can stay functional. Therapy opens those drawers. Even when it’s helpful, that exposure is exhausting.

Here’s what makes it harder: Your nervous system doesn’t reset in 50 minutes. After you leave a session, your brain is still processing what you talked about. You might feel the full weight of something you discussed days later, seemingly out of nowhere. That delayed reaction just means your mind is still working through something real.

3. Your usual coping strategies aren’t working anymore.

Therapy often lowers your defense mechanisms. Coping strategies that were used to quiet emotions—distraction, overthinking, staying busy—stop working as well. Without those old tools, emotions can feel louder and harder to manage.

When this happens, it usually means you’ve touched something unresolved. Maybe you challenged an avoidance pattern you didn’t realize you had. Maybe you recognized a thought your brain had been clinging to for years that wasn’t actually true. For example, some clients might realize mid-session that they’ve spent decades believing they’re “too much” for people—a belief that shaped every relationship they’ve had. That recognition is progress, but it’s also disorienting. The short-term discomfort shows you’re getting closer to the root of the problem, which is how change actually happens.

What’s happening in your brain when therapy feels hard

When you process difficult emotions in therapy, your brain reactivates memory networks—especially ones tied to emotions and physical sensations. Studies on memory reconsolidation show that recalling emotional memories makes them temporarily unstable as the brain updates them with new information.

Think of it like hiking. The trails you use regularly are worn down—cleared of grass and debris, easy to navigate. But when you encounter a jagged rock or fallen tree blocking your usual path, you have to work harder to get around it. Your brain does the same thing with difficult memories or emotions. When therapy brings them up, your mind has to navigate around obstacles it usually avoids. It takes more effort. It feels unfamiliar.

This is where the body’s threat response kicks in. Even though you’re logically safe in a therapy room, your nervous system can register emotional vulnerability as danger. Your autonomic nervous system—the part that controls automatic functions like heart rate and breathing—activates your amygdala, your brain’s fear center. Stress hormones like cortisol spike. That’s what creates the uncomfortable, sometimes overwhelming feeling during and after therapy. Your body is treating healing like a threat, even though it’s not.

How to take care of yourself between sessions

Here are some strategies I use with clients to help them manage the discomfort between sessions:

1. Try intentional closing rituals (5 to 10 minutes).

If you’re dealing with difficult emotions in session, many therapists will use the last few minutes to help you contain what came up—not to shove it down, but to put it somewhere you can access later so you can function when you leave.

Examples include:

• Grounding breath exercises: Box breathing (inhale for 4, hold for 4, exhale for 4, hold for 4) or 4-7-8 breathing (inhale for 4, hold for 7, exhale for 8) can quiet intense emotions. Research shows that controlled breathing exercises reduce cortisol levels and activate the parasympathetic nervous system. I pair these with progressive muscle relaxation (tensing and releasing different muscle groups) to reconnect breath with the physical tension that shows up when emotions feel out of control.
• Sensory resets: Cold water, strong scents (like peppermint or citrus), or a short walk activate your vagus nerve, which lowers heart rate and slows rapid breathing. I have clients hold a cold glass of water or ice cube on their wrists until they feel a sharp intake of breath.

These signal to your nervous system: “We’re safe now. Processing can pause.”

2. Move your body to move through emotions.

Movement-based regulation is one of the simplest ways to manage the heaviness between sessions. Walking, light stretching, shaking out your arms and legs, even dancing if you’re up for it.

This works because emotions are physiological. They create stress hormones like cortisol that get stored in your body. Physical activity helps metabolize stress hormones and prevents emotions from staying stuck. You’re not distracting yourself from feelings, but you’re helping your body process them.

3. Give yourself permission to not figure it all out yet.

When you feel “worse” after therapy, those emotions can feel all-encompassing. Thoughts race. Everything feels urgent. In those moments, sometimes the best thing you can do is tell yourself: “This can unfold later.”

That simple permission often helps people re-regulate. Trying to solve everything immediately keeps your nervous system activated. Journaling, analyzing, writing out questions—all of that puts your brain in fix-it mode, which makes the lack of immediate answers even more stressful. Integration and problem-solving happen better when your system is calm, not when you’re interrogating yourself. Let it rest.

RELATED: What 20 therapists do when they’re feeling overwhelmed

The bottom line

Therapy isn’t easy. An hour once a week isn’t going to “fix” anything instantly. Processing emotions takes time, so immediate relief is unlikely, but that also takes the pressure off you to feel OK right away.

That said, if distress consistently escalates without any relief, or if you don’t have grounding skills that help you stabilize between sessions, talk to your therapist. Your treatment plan may need adjustment.

Think of therapy like physical therapy for your emotional muscles. You’re going to be sore afterward, but you’ll be stronger later. Feeling worse doesn’t mean you’re broken or doing therapy wrong. It means you’ve stopped numbing something that needed attention. If it feels like too much, that sensation is just information about what’s working—and what might need to change.