Is there long term therapy available from the NHS?

I have suffered with anxiety and depression on and off for probably 10 years.

I am just completing 8 sessions of CBT following a period of decline Sept 2014 but the therapist has been unable to do much CBT focused work due to my low mood and extreme emotion. I feel I need more intense therapy which she agrees and my GP has referred me back to mental health team.

My occupational health adviser suggested a referral to a psychologist for longer term support and medication review but my GP thinks this is unlikely and to be honest I’m so confused about what is available and what to do next. I am desperate to reduce my medication and try and get my life back but am finding a massive lack of support to do this. I seem to have yearly breakdowns in mood and ability to function and would so love to prevent this, rather than wait for it to happen and keep having medications increased.

Would be very grateful for your advice. I currently take 375mg Venlefaxine and 15 mg Mirtazapine daily.

Thank you so much.


Thank you for your question and for sharing your story to date.

It’s pleasing to read that you are determined to interrupt what has become predictable for you. Finding that ‘key’ to unlocking your negative thoughts and emotions is, as you are aware now, paramount.

There is generally (sadly) no long-term therapy available via the NHS other than any ongoing support from your GP and others who see you in primary care. It’s both pleasing and heartbreaking that you recognise what is required if you are to have an opportunity to reduce your symptoms.

Unless you can find the finances required to see a private therapist the options are to  continue to search for your own solutions where available. This is how I finally came to find my ‘peace’.

When you buy care from psychological services privately, you do have an opportunity for your strategies to be created in collaboration with the therapist, so it becomes a bespoke program that is unique for you, and driven by you. There is also greater accountability for both!  

Without understanding more about what you have tried and experienced over the ten years or so I couldn’t suggest anything more specific at this time. For me however, it was Mindfulness and learning the practise this way of ‘being’ that has brought the greatest change.

I wish you every peace and thank you again for sharing. Do get in touch if I can help any further.