What Are The Stages of Depression?
Depression can develop so gradually that you might not even become aware of it until it consumes your life. While experiencing occasional bouts of sadness is normal, feeling sad and hopeless all the time is not. If you're unsure what constitutes depression, knowing the warning signs and understanding the stages can help you take proactive measures and cope with the illness.
Before you can fully understand the stages of depression, you first need to understand the illness and how the stages are defined. Once you have a better understanding of how depression feels or after discovering vividly the symptoms of depression, you'll be able to recognize them when they appear.
While all people experience depressive symptoms at some point in their lives, not all people experience depression that requires professional intervention. However, in this article, we’ll talk about depression diagnosis, and general notes on treating depression through talk therapies as well as depression medications.
Depression Basics - What Constitutes Depression?
Depression is a mental illness which you experience a low mood for an extended period of time. While everyone experiences low moods from time to time, they’re generally in response to some sort of life challenge and usually go away after a relatively short period. That isn’t depression in the clinical sense, but rather is what’s called situational depression.
Depression as a medical condition is altogether different. Rather than depression in the colloquial sense, this is a mental illness known as Major Depressive Disorder (MDD), or, clinical depression.
There are actually several types of clinical depression:
- Persistent depressive disorder — Also known as dysthymia, thisis a less severe but more persistent kind of depression. Even though it's typically not incapacitating, persistent depressive disorder can make it difficult for you to go about your daily life.
- Seasonal affective disorder — Seasonal affective disorder is triggered by the changing of the seasons; typically the onsets of fall and winter, bringing with them a persistently low mood on the part of the sufferer. Typically, these symptoms go away in the spring and summer.
- Postpartum depression — Postpartum depression affects women who have recently given birth.
- Psychotic depression — Psychotic depression is a kind of major depression that develops in conjunction with psychosis such as delusions or hallucinations.
There’s also bipolar disorder, which is similar to depression, but technically considered a different a different illness. According to the Diagnostic and Statistical Manual on Mental Disorders used by the American Psychiatric Association, bipolar disorder comes with the same low mood as depression, but is also defined by symptoms of mania. This makes it different from depression, which is unipolar (only one kind of mood).
Common life events can bring on bouts of depression, such as loss, death, or the end of a relationship. In most cases, the afflicted grieves over a period of time and then returns to finding joy in life. However, when someone is depressed, the sadness persists and deepens, eventually affecting every aspect of life.
This form of depression, also called clinical depression or major depression, may materialize with no distinguishable trigger or event. You may not be able to pinpoint one specific reason to explain your depression, and despite your best efforts to 'get over it,' the depression will continue on for weeks and months, becoming a chronic illness.
In fact, that’s one of the major ways to tell major depression from regular experiences like grief or other kinds of adjustment. Major depression occurs because of an imbalance of chemicals in the brain. These can be caused by many factors, including difficult life circumstances and substance abuse, but that may seem to come on out of nowhere.
For some people, depression lasts as long as it takes for them to adjust to their “new normal” - possibly through the help of counseling or talk therapy. A therapist may prescribe antidepressants to help control the more severe symptoms. Most people see the best results in the shortest amount of time by combining these two approaches.
Symptoms of Depression
Depression isn’t a universal condition that is experienced in the exact same way by everyone. However, some common symptoms of depression, sometimes, can be identified. Less severe symptoms may include feelings of pessimism, helplessness, worthlessness, guilt, anxiety, irritability, self-blame, and restlessness.
Some people with major depression may also experience some other symptoms of depression including less interest in previously enjoyable activities; aches and pains; sleeping disorders; weight changes & appetite problems; deterioration of energy leading to fatigue, and difficulty remembering, concentrating, or making decisions.
When these feelings or some other basic symptoms of depression consistently occur for at least two weeks or more at several intervals within a year, it's diagnosed as a major depressive disorder. In its worst form, depression leads to severe symptoms. These can include suicidal thoughts and psychosis. In these situations with psychosis and severe depression, hallucinations can occur. Nonetheless, even without psychotic symptoms, depression can become a very debilitating condition which can interfere with one’s daily life, and thus should be taken seriously.
Since depression is highly treatable, it's important to recognize the warning signs so that you can seek professional help. However, in some situations, some people with major depression tend to be unaware of their challenges or fail to seek help when they discover that they have a depressive disorder.
For the reasons discussed in the previous section, developing depression takes some people months or years, making it difficult for them to realize that it has taken over. The symptoms can also be different for different kinds of people.
For example, women with depression are more likely to their thoughts of despair or suicide with others while men with depression are more likely to turn to certain substances. In fact, “self-medicating” for depression – whether diagnosed or otherwise – with illicit drugs or alcohol is extremely common in both men and women with the condition. This often makes a diagnosing and treating depression more difficult.
Are There Stages of Depression?
Depression does not manifest the same with everyone. The length of time it takes to develop, the symptoms, and the severity of the illness will vary.
There are, however, some key elements most people will experience, and these form the basis for the five stages of depression. Before looking at the stages of depression, it may be helpful to understand the five stages of grief. Studies on depression, medically reviewed by experts, show that people diagnosed with depression often go through a variation of the five stages of grief, from initial denial to acceptance.
We often think of grief as recovering from the loss of a friend or family . However, the loss of just about anything – a friend or family , a job, a way of life, an opportunity – can result in similar feelings of sadness, anxiety, and confusion. Research shows that online therapy can be a powerful tool in reducing depression symptoms.
Stages of Depression Modeled on 5 Stages of Grief
The five stages of grief were developed by Dr. Elisabeth Kübler-Ross to explain the experiences of people diagnosed with a terminal illness, but it's since been used to describe the experiences of people struggling with loss as well.
It's important to keep in mind that not everyone goes through these stages in the same order or for the same set period of time. Some people skip stages entirely or go back and forth between stages.
- Denial and Isolation. Denial is usually short-lived when it comes to depression. The feelings of intense sadness experienced during a depressive episode can be difficult to ignore. However, it's not uncommon to refuse to admit there's an issue. You may also feel you can overcome the feelings of sadness or eventually get over it.
- As denial begins to wear off, you may start to feel angry that you're having to go through this, angry because you see no way of overcoming the feelings of depression, and even angry toward the world as you wonder why this had to happen to you.
3. As the illness progresses, the depression takes on a life of its own. It tells you horrible things about yourself. You begin to engage in negotiations, trying to stave off the thoughts brought on by the depression in favor of something more positive. Unfortunately, this tactic is rarely successful, and the negative thoughts invariably win out, making way for the next stage.
4. When you're in the depths of depression, you may feel you're lost in the wilderness with no way out. You may feel you'll never be happy again. During this stage of your depression, you'll have obsessive, debilitating thoughts, further perpetuating the depression, making you feel increasingly desperate and alone. You may even consider taking your own life. It is critical that you watch out for the symptoms of depression so as to take urgent steps to get them treated when identified before depression becomes a critical mental health condition.
5. When you've reached this final stage, it means you've come to accept the reality of your illness. At this point you'll likely realize you need help, so you see a therapist, take your medications, and follow your treatment plan. Eventually, you start to feel better! The fear of a relapse is there, but eventually you come to recognize you need to keep focusing on the positives.
Symptoms of the Five Stages of Depression
Now that we have a clearer understanding of how the stages of grief relate to depression, let's look at the five different stages of depression. These stages are based on the symptoms of the depressive disorder itself, however, the actual experiences may vary considerably from person to person.
Some people will experience all five stages, while others will skip steps entirely. The following five stages of depression provide a loose outline of what most people will go through.
- Negative Thought Patterns. Depression often starts with a pattern of negative thoughts that are disruptive, intrusive, and difficult to dismiss. These negative thoughts may be about your appearance, your work, or your social standing. Your negative thoughts may also be focused on the world around you. You may find yourself preoccupied with poverty in developing countries, the war in the Middle East, or climate change, and feel that situations are so hopeless, they'll never get better, and there's no point in going on with life. You may feel anxiety, wondering, "What's the use of living if everyone is doomed?" Incessant reflection on this negativity may launch you into a depressed mood.
- Changes in Appetite. Many people who go through depression experience changes in appetite. Some lose their appetite entirely, while others may begin to eat more as a coping mechanism, risking the development of an eating disorder or food addiction. Some people have no changes in appetite at all. It depends on the individual and their typical eating habits. These changes are common symptoms of depression that may eventually result in weight changes which can either be weight gain or weight loss.
- Changes in Sleep Patterns.Almost everyone with depression experiences changes in sleep patterns because the brain is looking for an escape from the stress and pain of the illness. This causes a shift in the hormone levels, wreaking havoc with your sleep patterns. But like appetite changes, this too varies from person to person. Some people experience some depression symptoms such as insomnia because the negative thoughts consume them at night, making sleep impossible. As a result, they're left feeling tired, fatigued, and sluggish during the day. Conversely, some people feel so drained from the barrage of negative thoughts, they have difficulty getting out of bed and tend to sleep more.
- Self-Blame.You might find you're blaming yourself for things beyond your control. You may even blame yourself for being depressed. You may feel ashamed and guilty for being unable to keep up with your usual activities and responsibilities. It turns into a vicious cycle of feeling unworthy, helpless, and feeling like a failure. You feel as though you have nobody to blame but yourself. As the symptoms worsen, you sink even lower, and your depression becomes more severe, until you begin to feel that life may not be worth living. This can easily lead to increased risk for self-harm.
- Suicidal Thoughts and Behaviors.As the severity of the illness increases, so do the chances of suicidal behavior or self-harm. Not everyone gets to this stage, because they chose to get help before their disorder worsens. And for some, this stage is more about wanting the feelings of depression to go away as opposed to wishing for death. But regardless, when you've reached this stage or the point where you're having any thoughts regarding suicide, such as making a plan or giving away personal belongings, you need to seek professional mental health treatment immediately.
Getting Help Early
As with other mental health disorders, getting treatment during the early stages of depression can make an enormous difference in how quickly you get back on your feet. Fortunately, there are different signs of depression that can conspicuously be identified. So, when the signs of any type of depression appear, it is important to seek professional help.
Often the idea of making a trip to a therapist's office can feel daunting, but that doesn't mean you can't get the treatment you need.
You may want to consider the convenience of online resources such as BetterHelp, which provides thousands of licensed therapists to help treat your depression and get you back to feeling like yourself again. Research shows that online therapy can be a powerful tool in reducing depression symptoms.
Read below for some reviews of BetterHelp counselors, from people experiencing similar issues.
"I love having Kristin as my counselor! I came to her extremely depressed, anxious and self loathing with a lot of problems with my adult sons and wanting to give up! It has been several months and I feel like a new person. I am mostly happy, more centered, with new boundaries and self care in place. I have a ways to go, but I am now confident for the very 1st time in my 64 years on this earth! She is excellent at listening, supporting, and encouraging me. It's never too late to change and heal. I have been to many counselors in my life, but didn't realize much progress. With Kristin, I have made excellent progress! I am extremely grateful!"
"I've worked with Courtney for 3 months. From our first session, she gave me strategies and a formula to immediately start working with to pull myself out of my depression. She is warm hearted, kind, supportive, and encouraging. I found her really easy to talk to about anything, she listened and always had a way to solve the issue. Outside of our weekly video appointment, she took the time during the week to check in, and it was a lovely reminder to myself to keep focusing on the formula and that she cares about her clients. I absolutely recommend Courtney, if you're looking for an effective and friendly therapist."
Depression is treatable - it doesn't have to be something you struggle with forever. It's never too late to get help. If you recognize any of the stages of depression, or feel you may be going through something similar having seen related signs of depression, it's important to seek help. Therapy from a trained mental health professional can often treat depression.
Treatment options for depression include various kinds of talk therapy (such as cognitive-behavioral therapy), usually combined with some sort of antidepressant medication (most commonly SSRIs, but there are non-SSRI antidepressants as well). Regularly attending a support group is also helpful and can supplement treatment.
You don't have to battle depression alone. Get professional treatment, accept the support from your friends and loved ones, and start living a fulfilling life. Take the first step today.
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