Depression feels like a heavy, invisible weight that’s always there, making it hard to move forward. For some people, depression can be so severe that it becomes nearly impossible to function day-to-day, causing physical problems and a deep sense of hopelessness. However, even when this is the case, there’s still hope. A combination of therapy and medication can help people with depression start to feel better.

What To Know About Depression

Depression can manifest in various forms, from fatigue to feelings of hopelessness. For some, these symptoms resolve with supportive strategies or minor lifestyle adjustments. However, for others, depression becomes a persistent condition requiring professional intervention, and severe depression can cause symptoms that interfere with nearly every aspect of life, from maintaining relationships to succeeding at work or school.

According to the National Institute of Mental Health (NIMH), an estimated 21 million adults in the United States have experienced at least one major depressive episode, representing 8.3% of all U.S. adults.¹

What Are the Signs of Severe Depression?

Severe depression often looks different than mild forms of the condition. At its worst, depression can lead to an inability to function, total withdrawal, and suicidal thoughts. If any of these symptoms resonate with you, it’s important to seek proper treatment. These symptoms may indicate a need for specialized support through a comprehensive, personalized treatment plan.

Some signs of severe depression to look out for include:

• Feeling completely drained: Constant exhaustion that doesn’t go away, no matter how much rest you get, making it hard to get through the day.
• Struggling with hopelessness: Feeling like things will never improve or that positive change is out of reach, or persistent worry about bad things happening.
• Feeling overly irritable: Grouchiness and negativity due to consistent low mood, often leading to difficulties in relationships.
• Flat affect: Fewer facial expressions, more monotone voice, or just less emotional response in general.
• Social withdrawal: Losing interest in spending time with family and friends, even if they were once sources of joy. Spending most of your time alone, almost in hibernation.
• Changes in sleep or appetite: Drastic shifts in sleeping too much or struggling with insomnia, overeating or losing interest in food entirely.
• Concentration problems: Difficulty focusing or making decisions, impacting work and personal responsibilities.
• Inability to care for yourself: Spending most of your time in bed, to the point where you’re not showering, eating properly, or moving your body.
• Unexplained physical aches and pains: Joint pain, back pain, or gastrointestinal problems that can’t be explained by another physical issue.
• Psychotic symptoms: In very severe cases, depression can lead to delusions of guilt, inadequacy, or disease, or even some hallucinations.
• Thoughts of death or suicide: Persistent thoughts of dying or harming oneself.

Northeast Health Services is dedicated to supporting your mental health. If you are experiencing suicidal thoughts, we encourage you to reach out for immediate support through your local crisis services by dialing 988, contacting your local emergency services, or visiting your local emergency room.

Is Severe Depression the Same as Treatment-Resistant Depression?

Severe depression can be incredibly challenging, but it doesn’t always mean someone has treatment-resistant depression (TRD). TRD happens when someone hasn’t found relief after trying at least two different antidepressant medications. This lack of progress often leads to heightened frustration and despair. However, many people with severe depression symptoms can still find relief with medication and therapy.

Getting Help for Severe Depression Symptoms

Even severe depression can respond well to treatment. While it may take a bit longer to feel better if you’re starting from a really low place, consistent therapy and medication can make a big difference in how you’re feeling.

Treatment options for depression can include:

• Medication: A psychiatric provider can prescribe an antidepressant, such as SSRIs, SNRIs, or other medication to help alleviate symptoms. These work by helping the brain produce and process important neurotransmitters responsible for mood regulation.
• Therapy: A therapist can help you understand more about the roots of your depression and learn important coping skills for moving forward. Cognitive behavioral therapy (CBT) is typically the first-line modality for depression, as it helps people learn about the connections between their thoughts, feelings, and behaviors, and how to make small changes to improve mood and functioning.
• Spravato® (esketamine): Spravato® is the first nasal spray approved by the FDA for treatment-resistant depression. Unlike traditional medications, Spravato® works quickly, with many finding relief in just a few hours. It is typically part of a comprehensive treatment plan that also includes therapy and potentially other antidepressant medications.
• Transcranial magnetic stimulation (TMS): TMS involves the use of magnets placed on the outside of the head to stimulate areas of the brain that may be underactive due to depression. TMS is also typically reserved for treatment-resistant depression when other medications haven’t done enough to relieve symptoms.

Other Ways to Cope with Severe Depression

If you’re dealing with severe depression, seeking help as soon as possible and sticking to your treatment plan are key to long-term healing. Prioritizing your physical health and boosting social connections can help you cope and remember you’re more than your depression.

• Establish a routine: A therapist can help you figure out what you need to prioritize every day and come up with a schedule to stick to even when you’re feeling low or unmotivated. Sticking with a similar pattern everyday can remove some decision-making energy and streamline as much as possible so you can focus on getting better.
• Prioritize your physical health: Make sure to get enough sleep, eat nourishing foods, and move your body regularly. Even small ways you can care for your body can make a positive difference.
• Stay connected to loved ones: Depression can be isolating and make you feel like you’re on your own. Make sure you have a roster of social supports you can reach out to who can remind you that you’re loved, and who can help with practical things like meals and housework when you don’t have the energy.

Find Support for Severe Depression at Northeast Health Services

Severe depression doesn’t have to define your life. With a comprehensive treatment plan and an empathetic care team, it’s possible to get back to a full and meaningful life. Whether talk therapy or treatments like Spravato® are what you need, the team at Northeast Health Services is ready to offer you the support you deserve.

If you’re ready to take the next step in your mental health journey, call our team at 508-794-8711 or fill out a brief online form to reach out to our team of empathetic mental health care experts. For existing clients, find your office location to contact your office directly.

 

Footnote:

1. National Institute of Mental Health. “Major Depression.”