What Are The Stages of Depression?
By: Nadia Khan
Updated November 03, 2020
Medically Reviewed By: Audrey Kelly, LMFT
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.
What Constitutes Depression?
Depression refers to a medical health challenge that negatively influences that way you feel, think, and act for an extended period of time. Depression isn't mood fluctuations and tentative emotional responses to daily happenings or encountering difficult life experiences. Major depression is outrightly different; however, depression can occur for different reasons, nonetheless.
Common life events can bring on bouts of depression, such as loss, a 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.
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 a number of issues, 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. For others, depression lasts until their brain chemistry is restored through antidepressant medication. 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. These may include feelings of pessimism, helplessness, worthlessness, guilt, irritability, restlessness.
Some people with major depression may also experience some other symptoms of depression including loss of interest in what you once found pleasurable; 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 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 suicidal thoughts, and some people even go on to develop psychosis. In these situations with psychosis and severe depression, hallucinations can occur. Nonetheless, even without psychotic symptoms, depression can become a very debilitating condition and 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 share 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 depression diagnosis and treatment 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 who suffer from 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 member. However, the loss of just about anything – a friend or family member, a job, a way of life, an opportunity – can result in similar feelings of sadness and confusion. Research shows that online therapy can be a powerful tool in reducing depression symptoms.
You may read the full study here: Effectiveness of a Multimodal Digital Psychotherapy Platform for Adult Depression: A Naturalistic Feasibility Study.
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.
- 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.
- 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. It is expedient 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.
- 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 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 wonder, "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.
- 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 related to suicide, such as making a plan or giving away personal belongings, you need to seek professional help immediately.
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Getting Help Early
Getting help 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 help 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.
You don't have to battle depression alone. Get professional help, accept the support from your friends and loved ones, and start living a fulfilling life. Take the first step today.
Frequently Asked Questions (FAQs)
What are the Levels of Depression?
Depression isn’t experienced in exactly the same way by everyone, but there are various types of depression that vary from mild bouts of sadness to overwhelming emotions that are disturbing and negative. These may result in different signs of depression without leaving out suicidal thoughts and unhealthy habits or actions.
Depression symptoms may be indicators that your feelings, actions, and thoughts are wrongly influenced. Consequently, it may affect your daily life. You may be diagnosed with an episode of major depression if the symptoms of depression last for two weeks or longer. If you are battling with a major depressive episode, you may be troubled with unpleasant feelings of malaise, sadness, and depressed mood which may affect the way they perceive yourself and your environment.
Which Type of Depression is the Most Common Type of Mood Disorder?
There are different identified types of depression including major depression, persistent depressive disorder (dysthymia), perinatal depression, seasonal affective disorder (seasonal depression), psychotic depression, situational depression, and atypical depression. Out of these listed types of depression, two of them are considered to be the most common types of mood disorders. These two common types of depression include:
Major Depression: Major depressive disorder basically refers to a type of depression characterized by depression symptoms that may last for most of the day. Major depression is one of the depression types that may occur every day for at least two weeks. The episode of major depression can be experienced once in a lifetime. However, several episodes of depression may occur more often. Major depression affects your ability to sleep, work, eat, study, and derive pleasure from life.
Persistent Depression: Persistent depressive disorder can also be called to dysthymia or chronic depression. Persistent depression is a depression that lasts for two or more years. Several people with a longer time persistent depression may feel, over time, that the condition is part of their normal living.
You may experience episodes of major depression with a period of less severe symptoms if you are diagnosed with persistent depression. The feeling of persistent depression may not be as intense as major depression. Some people may experience double depression by having episodes of major depression while going through persistent depression.
Other types of depression include:
Perinatal Depression: Perinatal depression can also be referred to as postpartum depression. Several women battling with perinatal depression may go through, during pregnancy and after delivery, full-blown major depression. Perinatal depression may appear with the feelings of exhaustion, anxiety, and sadness.
New mothers who experience perinatal depression may have difficulty with proper life management with respect to their own lives or that of their babies. Several women who have a history of depression or who have no support may be at risk to develop perinatal depression.
Seasonal Affective Disorder: Seasonal Affective Disorder is a type of depression that can also be referred to as a seasonal depression. It is called seasonal depression because it is associated with the seasons.
Naturally, the seasonal affective disorder starts in the months of winter and goes away during summer and spring. Seasonal depression has symptoms such as dissociation, increased sleep, and weight gain.
Bipolar Disorder: Bipolar disorder showing the relationship between mania and depression. It can also be called manic depression. Manic depression or bipolar disorder is characterized by depressive episodes of low moods (one of the symptoms of major depression). Manic depression as one of the types of depression may affect your mental health through symptoms such as moderate or high-irritable or euphoric moods.
Psychotic Depression: This is a type of depression that manifests in several people as mental health imbalance. Psychotic depression is characterized by severe depression and some other forms of psychosis such as delusion or hallucinations.
Situational Depression: Situational depression is referred, clinically, to as adjustment disorder with depressed mood. Major depression and situational depression look similar in many ways. It is one of the types of depression triggered by some specific situations such as the death of someone loved, dangerous events, serious ailments, relationship problems, physical or emotional abuse, serious difficulties pertaining to unemployment or finance, or having legal issues. These situations may result in situational depression that may affect your daily life.
Atypical Depression: Atypical depression is one of the types of depression that tentatively disappears when you encounter positive events or situations. It may also be clinically referred to as a major depressive disorder that has atypical characteristics. That it is referred to as atypical does not indicate that atypical depression is rare. Several people who experience atypical depression may not consistently look depressed to others or to themselves. You may experience double depression by going through atypical depression and persistent depression at the same time. The symptoms of atypical depression may include increased appetite, insomnia, eating disorder, negative self-awareness, weight gain, aches and pain, feeling of rejection, and heaviness in legs or arms that may last for hours.
How Many People in the World have Depression?
According to the World Health Organization (WHO), an estimation of more than 264 million people of all ages was confirmed to be suffering from depression worldwide. Also, the Anxiety and Depression Association of America showed that there are 322 million people in the world living with depression.
Depressive disorder has no age or gender restrictions. Many younger children, teens, younger adults, older adults, men, and women are claimed and proved to be suffering from different types of depressive disorder worldwide. It’s also important to remember that many people experiencing depression never seek out professional help, meaning that actual numbers are likely higher than estimates.
Is Depression and Anxiety a Disability?
According to the WHO, depression is seen to be the core cause of disability in the entire world and "a major contributor to the overall global burden of disease."
Depression and anxiety may be considered as disabilities based on the fact that they can negatively influence your ability to stay responsible or devoted to surrounding tasks.
Also, the Social Security Disability Insurance listed depression and anxiety as disabilities.
What is MDD?
MDD or major depressive disorder can also be referred to as major depression, classic depression, or unipolar depression. A major depressive disorder (MDD) is a type of depression that is characterized by intense and persistent feelings of sadness for a long period of time.
The triggers of a major depressive disorder may include serious challenges such as relationship problems or serious illness. As a depressive disorder, it may affect your behavior, mood, and other problems such as eating disorders or changes in appetite.
In addition, a major depressive disorder may also affect your interest in daily activities and sometimes may make you feel that your life is worthless. It is a condition that is highly treatable and the most common forms of treatment used for dealing with depression are medication and psychotherapy.
What is meant by Clinical Depression?
Clinical depression is otherwise called major depression. It is a depressed mood with episodes of depressive disorder that last for most of the day. It can affect your interest in normal daily activities and relationships.
Clinical depression is characterized by symptoms of depression that lasts for at least 14 days. The Symptoms of Clinical depression may include sadness, irritability, restlessness, difficulty making decisions and concentrating, lethargy, eating disorder, pessimism, loss of interest in people, sex, and activities, negative self-awareness, sleeping problems, suicidal thoughts, feeling empty and diffused anxiety.
What Causes Long Term Depression?
The long term depression is referred to as chronic depression, dysthymia, or persistent depressive disorder. It is a depressive disorder that lasts for a long period of time (two years or more).
Although the causes of depression or dysthymia are a bone of contention in mental health, the cause can still be associated with some factors such as genetic, environmental, physiological, and so on. This implies that depression may stay long if such a mental state runs in the history of the family.
The malfunctioning of the nerve cells or brain circuits pathways responsible for mood regulation may be responsible for dysthymia. Other causes of long term depression may include chronic illness, medications, major life stressors, challenges in relationships, or work.
Is Depression Hereditary?
There are many factors that can lead to the emergence of depression. If depression runs in the family, you have a high risk of developing it. This implies that depression through genetic factors (a combination of genes and not a single gene) may be hereditary.
However, many of the social factors that may cause depression also run in families for non-genetic reasons. For example, modern generations of a family may all experience the same environmental or economic causes of depression.
Further, depression is more likely in people that don’t have healthy support networks. In other words, parents without the understanding of depression required to prevent it can “pass on” depression to their children – not by genetic means but by failing to provide them with the emotional support that they need.
How do You Overcome Mood Disorders?
Mood disorders are treatable mental health challenges and even the most severe form of depression can be managed effectively. The primary ways through which you can overcome mood disorders are therapy and medications. You may be required to see a therapist for any of the different kinds of therapy. The common one is psychotherapy (talking therapy or counseling).
There are also different medications that are potent enough to palliate or treat the symptoms of depression. You are expected to notify your doctor before the use of antidepressants and anti-anxiety medications.
Can Depression Change your Personality?
Your mood has lots to do with your behavior and your behavior has a serious connection with your personality and your life in general. Your personality can be changed by depression due to time to time fluctuations in mood.
If you are depressed, you may uncharacteristically feel aggressive, moody, irritable, or euphoric in a manner contrary to the normal way of behaving.
Why can't I Control my Emotions?
Sometimes you may find it difficult to control some emotions such as anger, anxiety, or sadness, especially when you are constantly exposed to things or events that trigger them. Your inability to control your emotions can be tentative. In this situation, it may be because of some conditions such as exhaustion or a drop in blood sugar.
Furthermore, another reason why some people are unable to control their emotions may be because of a chronic condition such as heart disease, kidney problems, or lung problems.
How do I Know if my Mental Health is Deteriorating?
Your mental health is part of the health features which determine the state of your living. There are some specific conditions you must watch out for to determine if your mental health is degenerating.
These may include sleep problems, feeling worried, concerned and anxious, appetite and weight changes, emotional outbursts, drug and substance abuse, dissociation, suicidal thoughts, behavior and feeling swings, and feeling guilty and worthless.
How can I be Mentally Stable?
There are possible ways you can maintain positive mental health. You can do yourself the favor of seeking professional assistance, thinking positively, associating with others, getting enough sleep, rendering a helping hand to others, getting physically active, and improving on tour coping skills.
What are the two types of depression?
While there are many more types of depression, one way to look at it is that the two forms of depression are unipolar depression and bipolar depression.
In unipolar depression, you experience feelings of hopelessness, feelings of sadness, feelings of worthlessness, low energy, fatigue, and other symptoms of depression only. But when depression is a phase of bipolar, those feelings alternate with feelings of elation, energy, and euphoria. In either case, untreated depression can be devastating to your health and your life.
So, health treatment is essential to improve your mental health.
Is depression classed as an illness?
Yes, depression is an illness. It is classed as a mental illness. Health treatment is critical so you can function well, have a good quality of life, and pursue your most cherished goals.
How do depressions start?
Depressions can start in many ways. Sometimes, it can start with feelings of sadness after the death of a loved one. Sometimes health conditions can be the first problem that leads to depression. Other times, the stress of day to day living can also put someone at an increased risk of depression.
If you're feeling aches and pains after an injury, depression can follow, either due to the discomfort itself or because of pain medications you take to relieve it. As soon as you realize that the depression is taking hold, it's important to seek health treatment right away.
Is anxiety and depression a disability?
Depression, anxiety, and other mental concerns can be considered a disability. They decrease your ability to function at work, at home, at school, or in social groups.
If you are seeking disability compensation for health conditions, everything that impacts your day to day functioning should be considered, So, it's important to include any health treatment you are undergoing, including mental health services for anxiety and depression.
What are 5 symptoms of anxiety?
Anxiety can affect people in several ways. The following are five of the symptoms of anxiety. If these symptoms don't go away, get worse, or interfere with daily life, it's important to find a doctor and get the health treatment you need to get better.
- Feeling nervous or tense
- Having a sense of impending doom
- Increased heart rate or rapid breathing
- Weakness or tiredness
- Trouble concentrating
What types of health treatment are available for depression and anxiety?
A wide variety of health services are available for the health treatment of depression and anxiety. Explore your treatment options online or by contacting your local health department for information on health treatment in your community.
If you're dealing with ongoing feelings of worthlessness, feelings of sadness, aches and pains, difficulty sleeping, binge eating, thoughts of death, or other symptoms related to depression, seek health treatment as soon as you can.
One form of anxiety and depression treatment is medications. A doctor or psychiatrist can help you with this type of health treatment. If you have other medical issues, you might need to get health treatment for those, too, because it's hard to be mentally healthy when medical problems are out of control.
Therapists can also treat depression and anxiety with talk therapy, which encompasses treatment options ranging from cognitive behavioral therapy to exposure therapy. In therapy, your counselor can help you assess your thoughts and change them as needed.
In therapeutic health treatment, they can also teach you coping strategies to deal with your illness more effectively. Finally, having support from your friends and family is crucial, and you can also get help in a support group for depression and anxiety.
What can I do for myself to relieve my depression?
In addition to any health treatment you receive from a doctor or therapist, there are things you can do to help yourself.
For example, if you have difficulty sleeping, you can practice good sleep hygiene, such as going to bed and getting up at the same time every day, not using electronics for at least an hour before bedtime, and having a bedtime routine. Or, if you experience a lot of aches and pains, you can use relaxation techniques to minimize your discomfort.
Because depression can affect people differently, it's important to do what helps you as an individual. That's why health treatment often includes instruction and planning for how to help yourself.
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