Stages of Depression: Symptoms, Treatment and Recovery

Depression affects people differently. Some people suggest that depression has stages similar to stages of grief, but there is no research to support this. Studies suggest that the stages of depression are on a continuum of increasing symptom severity.

Depression is a common but serious mental illness that affects millions of people around the world. Approximately 1 of 6 adults will have the condition at some point in their lives.

Different types of depression exist and cause a variety of symptoms. Despite the lack of evidence, some people propose that depression occurs at stages similar to the stages of grief.

This article explores whether depression has different stages. It also explains what depression is, along with the signs and symptoms, diagnosis, and treatment.

Depression is a serious mood disorder characterized by persistent feelings of emptiness or sadness and loss of interest. It affects the way a person thinks, acts and feels.

The effects of depression can interfere with a person’s ability to manage relationships, work, and daily activities such as eating and sleeping. Medical professionals also refer to the condition as major depressive disorder (MDD) and clinical depression.

The National Institute of Mental Health (NIMH) lists the following types of depression:

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) added other types list of depressive disorders:

Bipolar disorder is another mood disorder that causes episodes of depression. However, people with bipolar disorder also experience episodes of mania.

Depression affects each individual differently. People may come across claims on the internet suggesting that most people with depression experience stages or characteristics similar to the five stages of grief.

Although research does not support these claims, some studies suggest that depression occurs on a continuum of increasing symptom severity. We examine these theories in more detail below.

Five Stages of Grieving

The five stages of grief provide a well-known model or framework for the experience of death and bereavement. Dr Elisabeth Kübler-Ross introduced the theory in his 1969 book On death and dying.

The five stages of death, often abbreviated as “DABDA”, are:

  • denial
  • anger
  • negotiation
  • the Depression
  • acceptance

Kübler-Ross initially applied this model to the experience of people dying from terminal illnesses, but she and others later used it in additional contexts such as bereavement and major life changes.

Some experts have also used this model to describe the experiences of people with chronic conditions such as diabetes or who have received HIV diagnostics.

Learn more about the link between depression and chronic disease.

A person coming to terms with the loss or impending loss of a loved one may also experience these stages.

Some health-related blogs and websites claim that the DABDA model applies to people with depression, but there is no research to support the theory that depression occurs in stages similar to the five stages of death or bereavement.

Stages of depression

Research suggests that some people think that depressive disorders fall on a continuum of increasing symptom severity.

In 2017, a mental health professional proposed a staged model for classifying the continuum of depressive symptoms. The proposed steps are:

  • The well-being
  • distress
  • depression
  • recurrent or refractory depressive disorder (resistant to treatment)

The authors of a 2022 review provided a similar staged model, starting with a prodromal stage (early depressive symptoms) and ending with resistance to pharmacological treatment.

Learn more about the signs of a depression relapse.

Many studies also refer to the degrees of severity of depression – mild, moderate and severe – as stages of the disease. Some research from 2018 suggests that a person’s “stage” of depression predicts their willingness to seek help for the illness.

A 2017 study suggests that gender, life events and coping styles may have varying effects on depression, depending on the severity of the condition.

The DSM-5-TR states that responses to a significant loss such as bereavement or disability can cause symptoms similar to a depressive episode. It also indicates that a person may experience a major depressive episode in addition to their response to a major loss.

Most specialists will diagnose depression through patient interviews and clinical assessment according to the DSM-5-TR Criteria.

To be eligible for a diagnosis of MDD, a person must have at least five of the nine symptoms indicated above for at least 2 weeks. One of the symptoms must be depressed mood or loss of interest or pleasure (anhedonia).

A doctor may also do physical exams and run lab tests to rule out other medical conditions that may be causing similar symptomslike hyperthyroidism.

Many people with depression do not receive a diagnosis or seek treatment. A person experiencing the following symptoms should see a doctor:

  • sleep disturbances or excessive sleep
  • changes in appetite or weight
  • loss of interest in activities they enjoyed
  • fatigue or decreased energy levels
  • difficulty concentrating
  • feelings of hopelessness or worthlessness
  • irritability or restlessness
  • thoughts of suicide or death

If someone is experiencing emotional distress or has suicidal thoughts, they or a loved one should seek help from a mental health professional as soon as possible.

People can also call the 998 Suicide & Crisis Lifeline to get the help and support they need right away.

Many websites claim that depression occurs at stages similar to the five stages of grief, but there is no research to back this up.

Many experts view depression as a continuum of increasing severity of symptoms and believe that a person’s stage of depression predicts their willingness to seek help for their condition.

Regardless of the stage or severity of symptoms, a person should seek help from a mental health professional if they notice mood changes that affect their overall functioning. People should seek immediate help if they are in emotional distress or have suicidal thoughts.

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