Long time Firefox user here. I use a metric shit-ton of addons, and customize everything drastically. "Refreshing" is a massive pain in the ass, as re-configuring everything while also maintaining the "clean settings" is just a difficult combination.
Despite this, I've completely wiped out both my settings and firefox install on several occasions in an attempt to keep things stable.
It doesn't help.
I'm aware that my addons are likely a big contributor to the memory-hogging and eventual crashes, but if I didn't want to use these addons, I'd just use fucking chrome. The ENTIRE point of Firefox is for the customizability. Dropping addons to improve stability just isn't an option for me.