What Is Crippling Depression?

Although not a formal clinical term, when clinical depression or major depressive disorder presents as so severe that a person is no longer able to complete basic life tasks such as getting up and going to work every day, or even just taking a shower, it is sometimes referred to as crippling depression.

According to the National Institute of Mental Health (NIMH), approximately 7.1% of adults in the United States will experience at least one major depressive episode in their lives. Crippling depression is not an uncommon state of being. Unfortunately, knowing you aren’t alone doesn’t necessarily make dealing with the debilitating impacts of this condition any easier. 

Crippling Depression Symptoms

Everyone experiences the occasional down day or period of sadness, but depression is much more than that. Its symptoms can impact both your mood and your physical health. Untreated clinical depression can lead to thoughts of self-harm and suicide.

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Symptoms That Impact Mood and Thought Processes

A person struggling with what they might describe as "crippling depression" may experience many of the following:

• Persistent feelings of sadness and/or anxiousness
• Feeling empty and alone
• Struggling with hopelessness and seeing every situation pessimistically
• Trouble enjoying activities that used to bring pleasure
• Irritability and less patience with others
• Constantly feeling worthless and like a burden to those around you
• A decrease in concentration
• An inability to make decisions
• Fatigue
• Agitation or slowing
• Feelings of worthlessness, hopelessness, or guilt
• Thoughts of death or suicide

Symptoms That Impact Overall Health and Wellness

Depression isn’t just a disorder of the mind. Symptoms can manifest physically as well: 

• Low energy
• Sleeping all the time or struggling to sleep
• Restlessness
• Loss of appetite or overeating
• Weight fluctuations
• Headaches
• Body pains
• Digestive issues

These symptoms vary among individuals, but general appetite and sleep changes are very common among those dealing with severe, or what they may refer to as "crippling," depression.

How Is Depression Diagnosed?

The "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5-TR) defines a major depressive episode as any period of two weeks or more where a person experiences the following nearly every day for most of the day:

• Depressed mood
• Loss of interest in activities that previously brought pleasure
• Sleep disturbances
• Appetite changes
• Decrease in concentration and memory

It is important to note that a doctor or psychiatrist will not diagnose you with "crippling depression." Instead, you may be diagnosed with major depressive disorder (MDD) or another type of mood disorder.

Your depression may also be classified as mild, moderate, or severe depending on the number, type, or severity of your symptoms and the degree of impairment you are experiencing.

What Causes Depression?

The exact causes of depression are not entirely understood, but it is believed that a number of factors play a role. Research has found a high level of heritability for depression, particularly severe cases of depression.

Still, genetics are not the only potential risk factor for developing severe depression. In fact, NIMH identifies four main categories that can increase a person’s risk of depression:

1. Genetic
2. Biological
3. Environmental
4. Psychological

Depression does not discriminate by age, gender, race or ethnicity. It can occur in adults who have never previously dealt with depression or in teenagers who have extensive family histories of depression.

It can be a common comorbidity of serious medical disorders (e.g, cancer or chronic conditions like diabetes) as well as a response to traumatic life events.

Types of Depression

There are several forms of depressive disorders which can lead to an episode of crippling depression:

• Persistent depressive disorder: Otherwise referred to as dysthymia, this form of depression is marked by symptoms of depression lasting two or more years.
• Postpartum depression or major depressive disorder with peripartum onset: Depression that develops during pregnancy or after giving birth that can result in extreme anxiety or exhaustion and may make it difficult for a new parent to bond with or care for their babies, let alone themselves.
• Psychotic depression or major depressive disorder with psychotic features: Depression combined with symptoms of psychosis, to include delusions and hallucinations.
• Seasonal affective disorder (SAD) or major depressive disorder with seasonal pattern: Depression that usually develops during the winter months in response to less daylight.
• Bipolar disorder: A person who experiences extreme highs and lows in moods, with those lows resulting in major depressive episodes.
• Disruptive mood dysregulation disorder (DMDD): A type of mood disorder diagnosed in childhood, presenting as extreme periods of irritability and anger.
• Premenstrual dysphoric disorder (PMDD): More serious than premenstrual syndrome (PMS), but similarly triggered by changes in the menstrual cycle, PMDD can result in severe symptoms of irritability, depression, and anxiety in the week before the menstrual cycle starting.

Effective Treatments for Depression

Depending on the type of depression you might be experiencing, there are a variety of treatment options to help you overcome a period of what you might describe as crippling depression.

If your depression is severe or debilitating, it is important to stay in close contact with your therapist or doctor. They can monitor your symptoms and determine if your treatment is providing adequate relief.

Psychotherapy

You might have heard of psychotherapy being referred to as "talk therapy" in the past. This type of therapy involves you working with a licensed mental health professional to talk through what you are experiencing and to formulate solutions that can help.

There are several different psychotherapy approaches, including:

• Cognitive behavioral therapy (CBT): A type of therapy that focuses on helping people learning to identify and change negative thought patterns that contribute to problems with mood and behavior
• Interpersonal therapy (IPT): A type of therapy that focuses on helping people improve their relationships in order to combat symptoms of depression
• Problem-solving therapy: A type of therapy that works to give people tools to help them solve problems that they will face in their life

While some approaches are generally recognized as being more effective than others, psychotherapy as a whole is the most commonly prescribed form of treatment for depression—even when other treatment options (such as medication) are also used.

Medication

Antidepressants can help to alter your brain chemistry so that you are better able to regulate your mood and stress response. There are five major classes of antidepressants available, though you are likely most familiar with these two classes:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)

Not all antidepressants will work for every patient struggling with depression, and some can come with side effects such as nausea, weight gain, and trouble achieving orgasm.

You may need to work with your doctor to find the right antidepressant for you. But for patients who are able to find a medication that helps, the results can be life-changing.

Electroconvulsive Therapy

Today’s electroconvulsive therapy (ECT) is nothing like what you may have seen portrayed in television and movies from previous time periods. ECT now is painless (patients are anesthetized before treatment) and can be an extremely effective treatment option for patients who have not been able to achieve results with medication or psychotherapy.

Ketamine-Infusion Therapy

Ketamine infusion therapy is a promising treatment that may be helpful for people with severe or treatment-resistant depression. If you have not responded to at least two other medications to treat your depression, your doctor might suggest Spravato (esketamine) or another ketamine treatment. 

Coping With Severe Depression

There are a lot of self-care practices that can help you to deal with a period of crippling depression, and may include:

• Daily exercise
• Meditation
• Spending time with friends and loved ones
• Volunteering
• Starting a gratitude journal
• Joining a support group

If you are currently dealing with a bout of crippling depression, partaking in any of these activities probably sounds impossible. But if you can force yourself to try, and if you can avoid isolating, you may find you experience a gradual improvement in mood over time.

There is nothing easy about dealing with crippling depression. And if you have a job or kids to take care of, it can feel even more debilitating as you struggle to keep up with your daily responsibilities.

Coping with life while you try to overcome this depressive episode may seem impossible, but committing to treatment and doing what you can each day can help. Reaching out to people you love and letting them know what you are dealing with and what you may need from them can also mean getting the necessary support.

You deserve to live a happy and healthy life. You are not alone. And you won’t always feel this way.