What Are The Stages Of Depression?

Medically reviewed by Melissa Guarnaccia, LCSW
Updated May 14, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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While many people experience moments of sadness, depression goes beyond occasional sadness, involving persistent feelings of sadness or hopelessness that can significantly interfere with functioning. However, if you experience symptoms of depression, you're not alone. According to the Anxiety and Depression Association of America, over 260 million people worldwide live with this mental illness.  

Depression is often included in the "five stages of grief" framework as the fourth stage. For this reason, some may wonder if depression also has stages that can be tracked and understood. However, it may be valuable to note that depression can affect different people differently, and it may look different from one person to the next. Depression is not widely defined in stages and is often experienced through symptoms, so understanding those symptoms may help you understand the condition.

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What is depression?

Depression is a mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition involving a low mood for an extended period, a loss of interest in previously enjoyed activities, and a loss of motivation. The word is an umbrella term to describe any of the several depressive disorders listed in the DSM-5, most used to refer to major depressive disorder (MDD). Other depressive disorders include the following: 

  • Persistent depressive disorder (PDD): PDD is a less severe but more persistent type of depression than MDD. It involves classic depressive symptoms lasting most days for two years or more. 
  • Seasonal affective disorder (SAD): Seasonal affective disorder is brought on by the changing seasons, with low mood often beginning in late fall or winter. It can also occur in areas with a lack of sun. 
  • Post-partum depression: Post-partum depression occurs when a person experiences depression after giving birth or adopting a child. It can impact gestational and non-gestational parents.  
  • Major depressive disorder with psychotic features: This form of depression involves symptoms of major depressive disorder with the addition of psychosis. 
Although commonly grouped with depression, bipolar disorder is a mood disorder, not a depressive disorder. However, this condition can involve depressive episodes. The American Psychiatric Association explains that bipolar disorder involves cycling between two or more mood states, including mania, hypomania, and depression.

The exact causes of depression are unknown, but various factors may have an impact, including brain chemistry, hormones, inherited traits, and biological differences. In addition, various environmental risk factors may increase the likelihood of depression, including traumatic life events, a history of other mental illnesses, and serious chronic illness.  

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

The five stages of grief vs. depression  

Dr. Elisabeth Kübler-Ross developed the five stages of grief based on her work with people diagnosed with a terminal illness. Though initially developed to describe the experiences of people facing their death, the theory has been adapted to offer a model for the various stages of grief that a person might experience when coping with any loss. 

Note that this is a theory, not a psychological fact. For this reason, the stages of grief model might not make sense for everyone who has experienced loss. In addition, people might go through the stages differently or skip one or two. If the model makes sense to you, you can use it. If not, there are other theories on grief you might explore. 

The five stages of grief include the following: 

  1. Denial: When faced with loss, resisting the loss and pretending it is not happening can be common. 
  2. Anger: Anger can also be a common reaction to loss; there might be anger or frustration about the unfair situation, and anger might feel easier to express than other emotions. 
  3. Bargaining: In the face of loss, some people may try to make a deal to change the situation or find relief. It might involve "what if" statements or trying to appeal to a higher power. 
  4. Depression: Experiencing profound sadness and other symptoms of depression might be a reaction to loss. These symptoms might meet the criteria for a depressive disorder or dissolve after processing the grief. 
  5. Acceptance: Many people can accept the loss and readjust after a certain period. Acceptance might come in waves and may not be an "end state" to grief.   

Although depression is a stage of grief in this model, depression and the five stages of grief are not necessarily directly related.

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Does depression have stages? 

Depression does not manifest the same for everyone. The amount of time it can take to develop, the symptoms, and the severity can all vary. As there are multiple depressive disorders and multiple ways to experience depression, it can be challenging to put it into neat "stages." Instead, you might find it helpful to consider common symptoms that individuals with depression often experience.

These symptoms include but are not limited to the following:

  • Pessimism
  • Feelings of hopelessness or worthlessness 
  • Feelings of guilt 
  • Anxiety 
  • Irritability or anger 
  • Self-blame 
  • Restlessness
  • Loss of interest in previously enjoyed activities 
  • Body aches 
  • Sleep disorders like insomnia 
  • Appetite changes
  • Reduced energy and fatigue 
  • Difficulty remembering, concentrating, or making decisions 
  • Suicidal thoughts or actions

If you are experiencing suicidal thoughts or urges, call the 988 Suicide & Crisis Lifeline at 988 or text 988 to talk to a crisis provider over SMS. They are available 24/7 to offer support. 988 also offers an online chat for those with an internet connection.

Five possible symptoms of depression

If you prefer looking at symptoms in a linear fashion, it can be helpful to consider a few of the most common symptoms of depression. While experiences can vary considerably from person to person, the following list provides a summary of five symptoms those with depression may experience. 

Maladaptive thought patterns 

Depression often includes a pattern of maladaptive thoughts that are disruptive, intrusive, and difficult to dismiss. These negative thoughts may be about your appearance, work, relationships, or life in general. In addition, thoughts may be focused on the world around you or your beliefs about who you are. You may feel that situations are hopeless or that change isn't possible. 

Appetite changes 

Many people living with depression experience changes in appetite. Some may lose their appetite entirely, while others may begin to eat more as a coping mechanism. Some people have no changes in appetite at all. These changes are common symptoms of depression that may eventually result in weight changes. 

Changes in sleep patterns 

Many people with depression experience changes in sleep patterns. Some people may experience symptoms like insomnia due to racing thoughts at night or co-occurring anxiety. Others might feel so drained from symptoms that they have difficulty waking up or feel fatigued during the day, leading to extra sleep. 

Self-blame 

Another common symptom of depression is guilt or self-blame, including blaming yourself for your situation or past mistakes or failures. You might blame yourself for what you cannot control, including having a depressive disorder. Feeling you can't keep up with your usual activities and responsibilities could also prompt these feelings, which might turn into a cycle of feeling unworthy, helpless, and hopeless. 

Difficulty caring for your needs

Some people with depression may struggle to bathe, brush their teeth, get out of bed, clean their homes, pay bills, work, or complete other essential tasks. When this occurs, they might experience more guilt or feelings of hopelessness. In severe cases, neglecting oneself might lead to health problems, loss of income, hoarding behaviors, or hygiene challenges. If you're struggling to care for yourself and don't have support, consider contacting a therapist or case manager for guidance.

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Help is available for treating depression symptoms

Treatment options for depression 

Depression is a treatable condition, and many clients find they can manage their symptoms effectively with therapy. Standard treatment options for depression include cognitive-behavioral therapy, other therapeutic modalities, and medications. For some people, a combination of therapy and medication is most effective. Consult a medical professional before starting, changing, or stopping any medication. 

For others living with depression, leaving the house and going to a therapist's office can feel exhausting. In these cases, you might try online therapy through a platform like BetterHelp, which offers connections to over 30,000 licensed therapists with experience in depression and other mental illnesses. With an online platform, you can choose between phone, video, and chat sessions with your therapist and reach this support from home or anywhere you have an internet connection. 

Research shows that online therapy can be an effective tool in reducing depression symptoms. One study examined the effectiveness of an online cognitive-behavioral therapy program in improving symptoms of depression and anxiety. The researchers observed that the program significantly reduced depression and anxiety symptoms, allowing researchers to conclude that "digital interventions can support sustained and clinically meaningful improvements in depression and anxiety."

Read below for some reviews of BetterHelp counselors, from people experiencing similar concerns.

Counselor reviews

"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, and more centered, with new boundaries and self-care. 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."

Takeaway

Depression may look different from one person to the next, so while there are various possible symptoms of depression, it is not experienced in the same way by every person. Instead of considering depression in stages, looking at how each symptom might present can be useful. If you are experiencing depression, support is available. Consider contacting a therapist to discuss how depression manifests for you and potential treatment options.
Depression is treatable, and you're not alone
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