Depression can zap your motivation and joy, make you feel worthless and exhausted, and even bring on a stream of negative or suicidal thoughts. Here are some reasons why it might happen.
If you have depression or have watched someone go through it, you may know how debilitating it can be.
When depression is severe and debilitating, some people use the term “crippling depression” to express how it’s so completely overwhelming in mind and body. But this word has been used in hurtful ways to refer to people with disabilities, so it’s best to use other ways to describe depression — like “severe” or “overwhelming.”
If depression feels debilitating, there are actually a few potential conditions it could be, such as major depressive disorder, postpartum depression, or a bipolar disorder depressive episode.
You’re not alone. And even if it’s hard to believe, depression is very treatable.
As explained in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), major depressive disorder refers to the presence of “sad, empty, or hopeless” moods that cause cognitive and behavioral changes, and affect your ability to function.
In fact, depression is the number one cause of disability in the world. According to the World Health Organization’s 2017 report, 4.4% of the global population experiences depression — that’s around 300 million people.
We aren’t completely sure what causes depression, but experts believe it’s a mix of biological, social, and psychological factors.
Depression can last anywhere from weeks to years. It doesn’t necessarily have to be long term to be debilitating, as shorter periods of depression can actually be more severe.
Here’s a quick breakdown of the most common types of depression, which may be behind your severe depression:
Major depressive disorder (MDD) — sometimes called clinical depression — is the most frequently diagnosed type of depression.
An estimated 7% of U.S. adults (17.3 million) had at least one major depressive episode in 2017, and 68% who did had “severe impairment.”
Per the DSM-5, MDD is characterized by symptoms of depression lasting at least 2 weeks (often longer) that significantly affect your ability to function. This includes at least five key symptoms:
- feeling sad or hopeless everyday
- sudden weight changes
- insomnia or hypersomnia
- psychomotor agitation (body tics, fidgeting, restlessness)
- fatigue or energy loss
- feeling worthless or guilty
- trouble concentrating
- recurring thoughts of death or suicide
Postpartum depression (aka perinatal depression) can begin during pregnancy or anytime within the first year after childbirth.
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While it’s most commonly associated with those who give birth, other people (like partners) can also have this form of depression.
While having a new baby is naturally stressful and challenging, postpartum depression amplifies these feelings to an extreme degree. Symptoms can include:
- difficulty bonding with your baby
- crying more than usual
- feeling sad or hopeless
- being more irritable or angry than usual
- changes in appetite
Persistent depressive disorder (formerly dysthymic disorder)
Persistent depressive disorder (PDD) is a type of chronic depression that usually lasts at least 2 years in adults and 1 year for children and teens.
While PDD is similar to major depressive disorder, it typically has less severe symptoms but is longer lasting — so it can be just as debilitating.
Feeling sad and hopeless for such a long period of time can wear you down, making it harder to function at work, school, or home. You might find it challenging to enjoy hobbies or time with friends, and feel pessimistic about the future.
PDD is characterized by its chronic, long-term nature, which can involve:
- consistent low energy and fatigue
- trouble sleeping (insomnia)
- sleeping too much (hypersomnia)
Bipolar disorder depression
Bipolar disorder is a mental health condition characterized by extreme shifts in mood. There are several types, each with different diagnostic criteria.
Around 4.4% of U.S. adults will have bipolar disorder during their lifetimes.
Many people with bipolar disorder have depressive episodes. People with bipolar I have manic episodes, and sometimes experience depressive episodes. People with bipolar II have both hypomanic episodes (a less severe form of mania) and depressive episodes.
Manic episodes are periods of heightened energy, confidence, and productivity, and might include being irritable, having trouble sleeping, and making reckless decisions.
Depressive episodes in bipolar disorder have the same criteria as a major depressive episode. Some differences based on types include:
- When people with bipolar I have depressive episodes, they typically last at least 2 weeks.
- People with bipolar II may have mood changes that are less severe than bipolar I.
- Cyclothymia, a type of chronic bipolar disorder, can be just as debilitating as the other types but doesn’t involve severe depression. Someone usually has symptoms of hypomania and depression, but not full mood episodes.
Those with bipolar disorder have a particularly high rate of suicide compared to the general population.
Debilitating depression may seem like it will last forever, but help is available.
With the right support, depression is very treatable. Often, multiple treatment options will work hand-in-hand to get you the best possible outcome.
If you have depression, common treatments include:
- antidepressants combined with talk therapy (aka psychotherapy) — this is considered the gold standard in depression treatment
- lifestyle changes like eating more nutritious foods, exercising, or joining a support group
- self-help methods or self-care strategies
Some people may also try herbal supplements, though none of these are FDA-approved. If you do want to add any supplements, consider reaching out to your doctor or a pharmacist first. It’s especially important if you’re already taking medications, as they may interact.
If you haven’t responded to medications or several treatments, your depression may be considered treatment resistant. Don’t despair! There are still many options to explore, including:
If you believe you’re going through depression — especially overwhelming, severe, and debilitating depression — the most important thing you can do is to talk to someone.
Having a strong emotional support network is key.
No matter how lost you feel, there are plenty of experts, advocates, and loved ones who want to be part of your journey to healing.
Depression hotlines are also widely available to help, if you prefer to stay anonymous or aren’t ready to share with your family and friends.
For more information, you can check out some of these resources on depression: