Our mental health may be more fragile than we realize, sometimes even completely sidelining us to the point that one might say “I don’t want to get out of bed”. We each have a certain capacity to withstand distressing events or situations, accessing our personal coping skills and emotional reserves as needed. But when events begin to spiral and multiply, those reserves may become depleted and any coping skills we have can become totally ineffective. This is when a depressive disorder can set in.
Depression is a very common mental health disorder, impacting more than 17 million Americans every year, according to the National Institute of Mental Health. Depression takes a toll on families and employers, as the individual suffering from depression becomes increasingly disconnected from their daily responsibilities. Depression is also hard on relationships, causing frustration and confusion, and destabilizing marriages and friendships as a result.
When depression becomes so severe that you say, “I don’t want to get out of bed anymore,” it is time to get some help from a mental health provider. There are effective treatment methods available to help manage depression symptoms and improve overall quality of life.
The Signs of Severe Depression
It is difficult to describe severe depression to someone who has never experienced it. Family members and loved ones may wonder why you can’t just snap out of it and get back to functioning normally. It helps for these individuals to have a better understanding of just what depression, especially severe depression, looks like. Symptoms include a cluster of the following:
- Hopelessness. Negative emotions and dark thoughts begin to gather critical mass in major depressive disorder, such as feelings of hopelessness, despair, guilt, worthlessness, helplessness, and shame. The individual sees him or herself in a negative light, and may blame themselves for perceived faults and flaws. As these thoughts become more pervasive and self-esteem plummets, the threat of self-harm increases.
- Changes in Eating Habits. When someone is suffering from major depressive disorder there may be a sudden change in their weight. Some may experience an increased appetite and eat more as a coping mechanism, resulting in weight gain. Others may become so depressed that they have no desire to feed themselves or take care of their nutritional needs, leading to weight loss.
- Loss of Interest. One of the predominant signs of severe depression is the individual’s sudden loss of interest in activities or hobbies they once enjoyed. While in the darkness of depression, these individuals have no desire to attend social events or to socialize at all. This can eventually include going to work where feel forced to interact with coworkers.
- Sleep Disturbances. Severe depression can cause changes in sleep habits and rhythms. In some cases the individual wants to sleep excessively (hypersomnia). Major depression can also cause an inability to fall asleep or stay asleep (insomnia), featuring fragmented sleep patterns.
- Anger or Irritability. Anger symptoms are more prevalent in depressed men, although depressed women can also exhibit mood swings and irritability. The source of the anger may be due to feeling frustrated, or possibly the result of feeling out of control and unable to shake the depression. Depression can cause the individual to be easily annoyed and even prone to violent outbursts.
- Excessive Fatigue. A pronounced loss of energy is one of the common signs of severe depression, leading to comments such as “I don’t want to get out of bed anymore.” The individual feels so exhausted they can barely function. Even daily personal hygiene or fixing meals requires too much effort, so the individual may spend the majority of time in bed due to feeling drained.
- Increased Substance Use. Individuals with depression may begin to self-medicate through the use of alcohol or drugs. Substance abuse is a reaction to feelings of despair and hopelessness and wanting to numb the emotional pain. There is a real danger that addiction can form, leading to a dual diagnosis of major depressive disorder and a coexisting substance use disorder.
- Suicidal Ideation. Pay attention if your loved one who is struggling with deepening depression begins to obsess about death, or say their loved ones would be better off without them. According to the National Alliance on Mental Illness, 90% of the individuals who have committed suicide had an underlying mental health disorder, usually depression or bipolar disorder.
When depression has reached the point when you think, “I don’t want to get out of bed anymore,” it is very serious. This is the point at which depression has become debilitating, severely impairing one’s ability to function normally and increasing the risk of suicide.
Different Types of Depression
Major Depressive Disorder (MDD)
Major depressive disorder is diagnosed in individuals who experience five or more of the diagnostic criteria most of the time for more than two weeks. To summarize:
- Persistent feelings of hopelessness or sadness
- Change in eating habits, weight gain or loss
- Difficulty concentrating or making decisions
- Irrational feelings of guilt or shame
- Slowed movements or thinking
- Sleep disturbances
- Loss of interest in activities usually enjoyed
- Suicidal thoughts
Dysthymia (Persistent Depression Disorder)
This is a type of MDD that persists for more than two years. Someone with dysthymia may experience periods of severe depression alternating with periods of milder depression, but experiences no relief of the depressive symptoms for two years or more.
This involves MDD with psychotic features. The individual may experience delusional thoughts or hallucinations in addition to the symptoms of depression. There may be a theme for the illness, such as revolving around a serious illness or fear of poverty.
Some women experience serious symptoms of MDD during and/or after giving birth. The symptoms may be so severe that the mother is unable to care for her child or themselves, and often experience severe fatigue, anxiety, exhaustion, and profound sadness.
Seasonal Affective Disorder (SAD)
In certain climates individuals may experience symptoms of MDD that are caused by a lack of sun exposure and vitamin D intake during the winter months. The individual may experience weight gain, hypersomnia, and isolation behaviors in addition to the symptoms of depression.
This disorder features alternating dramatic and unpredictable shifts between depressive and manic moods. The depressive episodes may last anywhere from a day or two to several weeks.
Suicide Warning Signs
Recent statistics show that more people in the United States now die by suicide than in automobile accidents, with about 44,000 Americans choosing to end their lives annually. In many instances, especially in individuals who say, “I don’t want to get out of bed anymore,” there may be signs that an individual is despondent enough to possibly attempt suicide. These warning signs and symptoms might include:
- Symptoms of depression
- Loss of interest in activities once enjoyed
- Humiliation or shame
- Increased use of alcohol or drugs
- Isolating from family and friends
- Extreme fatigue
- Excessive sleeping
- Saying they are a burden to other
- Expressing hopelessness
- Saying they have no reason to live
- Sharing that they are in unbearable pain
- Gives away prized possessions
- Talks of killing self
In the event where a loved one is exhibiting a mental health crisis or several of the warning signs, immediately call the National Suicide Prevention Lifeline at (800) 273-8255.
Comprehensive Residential Depression Treatment
When someone is in the grip of depression they may not even be aware of how serious their condition has become. More often than not it is a loved one who becomes alarmed at the increasing severity of the individual’s depression symptoms that reaches out to get the person professional help. Depression treatment consists of a combination of antidepressant drug therapy and psychotherapy. Other complementary therapies, such as yoga, meditation, and mindfulness training can augment the effects of the traditional therapies. Changes in diet and getting regular exercise can also positively impact mood.
Medication is considered the first-line treatment element for individuals with a depressive disorder. Antidepressant therapy involves medications available as SSRIs, SNRIs, MAOIs, or tricyclic antidepressants that help adjust brain chemistry and hopefully alleviate the symptoms of depression.
Evidence-based psychotherapies are an effective addition to antidepressant drug therapy in treating depression. Individual talk therapy sessions allow the therapist to guide the individual toward resolving unaddressed emotional issues that may be contributing to the depression. These may involve past trauma, childhood abuse, grief and loss, divorce, and other painful life events. Thought and behavior patters are also examined and adjusted through cognitive behavioral therapy.
Small groups discuss topics introduced by the therapist and engage in sharing their personal feelings and experiences. This provides a sense of connection and camaraderie with others who are also struggling with depression.
There is a growing trend in psychiatry to include holistic therapies among the treatment elements for depression. These activities can help reduce stress and induce feelings of inner peace.
In the event that an individual is suffering from a mental health crisis, such as a suicide attempt, a higher level of care is appropriate. A residential treatment program offers acute stabilization provisions, as well as extended care for severe depression. The residential setting provides a more intensive, customized treatment protocol for the individual with severe and persistent depression.
Elevation Behavioral Health Provides Comprehensive Depression Treatment
Elevation Behavioral Health is a full-spectrum mental health center providing residential mental health treatment, transitional housing, and outpatient services. Elevation Behavioral Health believes in an integrated approach to treating depression, offering evidence-based therapies, medication management, and holistic activities for a well-rounded program. For more details about our depression treatment program, please reach out to Elevation Behavioral Health today at (888) 561-0868.