Depression is a common mental health issue, but in some cases it can be especially debilitating. It can prevent people from completing daily tasks such as working, eating, and sleeping.

People who have experienced severe depression sometimes say it feels “crippling.” However, this word has also been used as a hurtful or insulting way to refer to people with physical disabilities.

For this reason, it’s better to use the clinical term for severe depression, which is major depressive disorder (MDD), or to use words like “debilitating,” “overwhelming,” and “devastating” to describe it.

Language matters

Many people with physical disabilities find the word “crippling” offensive because they feel it diminishes the impact of having a disability and contributes to ableism. According to the Center for Disability Rights, ableism is a set of beliefs or practices that devalue and discriminate against people with physical, intellectual, or psychiatric disabilities.

For some people, MDD may lead to a significant decline in functioning.

Read on to find out how MDD is treated and what you can do if your depression feels debilitating or overwhelming.

Depression is usually diagnosed based on your symptoms and behavior patterns. Your doctor may ask you to complete a questionnaire to help them determine if you have depression and how severe it might be.

Debilitating depression, while not an official category of MDD, is more frequently recognized by doctors and mental health experts than before.

The symptoms of major depression include:

  • persistent and intense feelings of sadness, anger, or frustration
  • thoughts of suicide
  • sleep disturbances, sleeping too much or too little
  • apathy, lack of interest in activities or people
  • difficulty working
  • poor personal hygiene
  • severe mood swings or shifts in temperament
  • weight changes, gain or loss
  • difficulty concentrating
  • frequent pain such as headaches or backaches
Is It Depression?

While a self-test for depression will not diagnose you, it can help you decide if you should talk to a mental health expert or your doctor. If you answer “yes” to four or more of these questions, you should make an appointment to speak with a professional to decide the next step.

  1. Do you have difficulty falling asleep or staying asleep at night?
  2. Do you sleep more than 10 to 12 hours per day or sleep for most of the day?
  3. Have you lost interest in the things that used to bring you joy or excite you, including hobbies?
  4. Have you missed work more than once in the last month because you felt too fatigued or too pained to work?
  5. Do you notice that you’re more irritable and easily upset in recent days or weeks?
  6. Have you had thoughts of self-harm or suicide?
  7. Has your appetite increased or decreased unexpectedly?
  8. Do you have days when you feel as if you don’t have the energy to do the things you need to do?

Treatment for major depression involves some of the same methods as treatment for other types of depression, but the process may be more intense at times to help you overcome the most potent effects of this condition.

Treatment options include:

Psychotherapy

Psychotherapy, or talk therapy, is a common treatment for depression. For people with debilitating depression, seeing a therapist regularly can be a catalyst for improvement. Your therapist can help you learn to adjust to stressors and to respond or react in ways that produce healthier emotions.

Medication

Antidepressants are often prescribed for MDD and other forms of depression. These drugs help regulate the hormones and chemicals that contribute to many aspects of mental and emotional health, including the balance of neurotransmitters.

Electroconvulsive therapy (ECT)

This treatment is generally used only in cases where other treatment options have not succeeded. In this treatment, a doctor will electrically stimulate portions of your brain while you’re under anesthesia. The goal of ECT is to alter chemicals in your brain to stop symptoms of depression.

Hospitalization

People who experience debilitating depression may consider suicide or even attempt it. They may also be unable to care for themselves. In those cases, short-term inpatient treatment is often necessary. This intensive treatment combines therapy, medication, and group counseling. The goal is to help you reach a place where you can safely leave and continue your treatment outside the hospital setting.

Find Help now

If you are considering suicide or have thoughts of harming yourself, you can call the Substance Abuse and Mental Health Services Administration at 1-800-662-HELP (4357).

The 24/7 hotline will connect you with mental health resources in your area. Trained specialists can also help you find your state’s resources for treatment if you do not have health insurance.

It’s not clear what causes any form of depression. Certain factors can increase your risk for developing it. But why some people develop debilitating depression while others don’t is unknown.

Risk factors for debilitating depression include:

  • long-term depression
  • family history of MDD
  • persistent, high levels of stress
  • chemical and hormonal changes
  • other illnesses
  • personal life changes, such as divorce or job loss

Major depression can be treated in many cases. You and your doctor or therapist can work together to find a combination of treatments that is likely to be most effective. You can also continue to adjust your treatment based on how you feel and whether your symptoms are improving.

Many employers, health professionals, and advocacy organizations recognize that depression can be a disability. Indeed, a recent literature review found that depression is a risk factor for retirement due to disability.

Prevention and treatment can reduce symptoms of depression as well as reduce the likelihood the depression will become debilitating.

Treating depression takes time. Commitment to your treatment, accountability from friends or family, and regular evaluation with a mental health expert can help you even if your depression feels debilitating.