What is Crippling Depression?
Crippling depression is also clinical depression (major depressive disorder) but to the point of being so severe that you may find that you are lying in bed all day, unable to carry on with normal daily functioning, including the performance of daily living activities and going to work. This can last for a few weeks or months, but in some it can haunt throughout one’s life, necessitating lifelong treatment.
Thus, it literally is crippling. Typically, the word crippling has been associated with physical disabilities, but to use it in the mental context is also justifiable because it incapacitates you almost as if you had some physical disability that was limiting your activities. So, although crippling depression is not a clinical diagnosis and label, it is still OK to let people continue to use the term “crippling” if they feel that it is a more accurate description of their experience and the other clinical categories of depression do not do justice to the disability they are experiencing. As if in agreement, nowadays many mental health professionals, employers, and organizations, including the WHO, have acknowledged depression as a disability. Of course, instead of “crippling”, some may prefer to use words like “debilitating,” “overwhelming,” and “devastating” to describe their depression.
Signs and Symptoms of Crippling Depression
You will be unable to do your job properly at the workplace, which will make you end up losing your job. Once you start staying at home, you will find yourself lying in bed all day, without eating or drinking, just wallowing in self-pity. You will be unable to sleep or you may end up sleeping too much. You will feel that living itself is overwhelming as you find even the simplest of tasks or responsibilities most difficult to carry out. You will neglect basic hygiene and the paying of bills. So, there is a drastic decline in functioning in all areas of life. You could frequently get suicidal thoughts. In addition, other classical symptoms of depression will be present, such as:
- persistent and intense feelings of sadness, anger, or frustration
- feelings of worthlessness, and excessive guilt
- low self-esteem
- inability to enjoy things you once found pleasurable, such as watching TV, having sex, etc.
- apathy, lack of interest in activities or people
- weight gain or loss
- difficulty concentrating
- frequent unexplained pain such as headaches or backaches
Self-test for Depression
While a self-test for depression is no substitute for a professional diagnosis, it can enable you to decide if you should see a mental health professional such as a psychiatrist. Also, this self-test can help you catch the onset of depression in its early stages so that you can get treated on time and avoid having to end up with crippling depression. Answering “yes” to four or more of these questions means you need professional help to diagnose and treat you for depression:
- Are you finding it difficult to fall asleep or do you stay awake most of the night?
- Are you sleeping more than the normal 7-9 hours per day, like say, 10-12 hours?
- Has your appetite increased or decreased recently?
- Have you become disinterested in things you once found pleasurable, such as hobbies?
- Have you skipped work more than once in the last month on account of fatigue, tiredness or pains?
- These days are you more easily upset and irritable than was the case previously?
- Do you get thoughts of self-harm or suicide?
- Some days do you feel a lack of energy to do things?
Treatment of Crippling Depression
Your doctor has several options to choose from when it comes to treating crippling depression. Usually, the mainstays of treatment are medications and/or psychotherapy. Rarely, the doctor may prescribe brain stimulation therapies if he finds that you are not responding adequately to the treatment. Occasionally, you may need to undergo short-term hospitalization, particularly when you are having active suicidal thoughts so that you can be closely monitored and you may not harm yourself.
Antidepressants are the drugs of choice. There are several classes of antidepressants to choose from, such as SSRIs, SNRIs, tricyclic antidepressants, MAOIs, and atypical antidepressants. Through trial and error, your doctor can find the antidepressant that works best for you. However, you need to give 4-6 weeks for the beneficial effects of the antidepressant to set in. You should not stop the antidepressant on your own even if you start to feel better or normal; otherwise, there is a good likelihood that your symptoms will relapse. Typically, the antidepressant needs to be taken for 6 months to 1 year, and those having more than one relapse within 2 years, may need to be on lifelong medication.
There are three varieties in this form of therapy, which often gets referred to as “talk therapy”: (1) Cognitive-behavioral therapy, (2) Psychodynamic therapy, and (3) Interpersonal psychotherapy. They are premised on the principle that thoughts drive emotions. They involve the correction of your erroneous patterns of beliefs and habits of thinking.
Brain Stimulation Therapies
In case your depression is resistant to the above modalities of treatment, then there are other alternatives, such as (1) Electroconvulsive therapy, (2) Reverse transcranial magnetic stimulation, (3) Deep brain stimulation, and (4) Vagus nerve stimulation.