Stages Of Depression – All Things You Need To Know 2024

Depression is a mental illness affecting an estimated 5% of the global adult population.^[1] The mental condition can affect anyone at any age and stage in life and manifests in different ways at varying levels of severity.

For many people, depression comes in phases, fluctuating over time. Though some stages of depression may sound familiar or similar to those experienced by others, no two people with the illness experience the same thing. This article looks at the stages of depression and their characteristics to enable you to seek professional help to cope with the debilitating mental illness.

What Is Depression?

Depression^[2] is a mood disorder that affects thinking, feeling, and acting. It is more than just feeling sad or low; it is a persistent and pervasive feeling of sadness and hopelessness that affects the quality of daily life.

According to the American Psychiatric Association,^[3] symptoms must last more than two weeks for a diagnosis of depression.

People with depression often feel trapped in a cycle of negative thoughts and emotions and may struggle to see a way out of their situation. At its core, the illness is characterized by a persistent feeling of extreme sadness, emptiness, or hopelessness. People with the condition experience a sense of numbness or disconnection from the world around them and find themselves avoiding social interactions.

Diagnosing depression involves a comprehensive evaluation by a mental health professional. The Diagnostic and Statistical Manual of Mental Disorders, i.e., DSM-5,^[4] provides diagnostic criteria for depression alongside rating scales like the Beck Depression Inventory that the mental health professional will use for diagnosis.

Lab tests may be conducted to check your family history and rule out any underlying medical condition, chronic illness, or genetic predisposition causing your depressive symptoms.

The Different Stages Of Depression

Here’s a breakdown of the 5 stages of depression based on typical symptoms and experiences associated with the condition:

Negative Thought Patterns

People in the early stages of depression often begin by exhibiting persistent negative thinking patterns, i.e., rumination.^[5] It involves a negative outlook on oneself, others, and the future characterized by:

• Self-criticism.
• Feelings of worthlessness.
• Pessimism.
• Hopelessness.
• Excessive guilt.

There is a noticeable shift in mood and cognitive processes. People have difficulty concentrating, experience a lack of motivation, struggle with decision-making, and lose pleasure in activities that were once enjoyed.

Changes In Appetite

As depression progresses, your appetite becomes affected, instigating changes in eating habits. Changes in appetite impact overall physical well-being. You could experience a decrease in appetite, resulting in weight loss and a lack of interest in food. 

Conversely, you may turn to food as a coping mechanism due to an increased appetite, leading to weight gain.

Sleep Disturbances

Irregular sleep patterns characterize the middle stage of depression. Studies show that patients with repetitive negative thinking are highly susceptible^[6] to circadian rhythm disruptions.

Self-Blame

In the next stage of depression, individuals start blaming themselves excessively for their perceived failures, shortcomings, or negative situations. They may have low self-esteem and believe they are responsible for their struggles, even for things beyond their control.

Feelings of guilt, shame, and worthlessness often accompany the stage. Self-blame^[7] contributes to a negative self-image and further leads to more depressive symptoms.

Suicidal Ideation

At its most severe, depression triggers suicidal thoughts, where the patient develops recurrent thoughts of death, suicide, or self-harm. This mental illness is the most significant cause of suicide worldwide.

Patients have persistent thoughts of ending their lives, ranging from fleeting ideas to detailed plans. Suicidal ideation^[8] should always be taken seriously and requires immediate professional intervention and support.

Note: These stages of depression are not universally agreed upon. But they offer a general framework for understanding the progression of depression based on different ways of describing emotional and psychological changes. Some specialists classify depression traditionally — from a binary viewpoint — distinguishing cases from noncases. Another group proposes a dimensional approach^[9] that considers the varied degrees of depressive symptoms and their impact on individuals.

Whichever method is used should acknowledge people’s diverse experiences with depression while providing a framework^[10] for assessing and addressing depression symptoms.

Symptoms Of Depression

Depression is a difficult experience, so learning about the symptoms is essential to understand what you’re going through. Here are some common symptoms:

• Feelings of sadness, emptiness, guilt, or worthlessness.
• Low self-esteem.
• Loss of interest in activities that you typically enjoy.
• Changes in appetite lead to weight gain or loss.
• Lack of energy and difficulty focusing on tasks.
• Disrupted sleep patterns. You either have hypersomnia, i.e., excessive sleeping, or experience insomnia, i.e., trouble sleeping.
• Suicidal thoughts or actions.

If you’re experiencing any of these symptoms, it’s best to talk to a mental health specialist to advise you on managing your depression.

What Are The Common Types Of Depression?

The National Institute of Mental Health^[11] lists the common types of depressive mental health conditions as follows:

Major Depressive Disorder

Also known as unipolar depression, major depressive disorder,^[12] i.e., MDD, is the most commonly diagnosed form of depression. If untreated, MDD develops into more serious depressive disorders.

Persistent Depressive Disorder

Persistent depressive disorder is a chronic depressive disorder lasting at least two years. Also known as dysthymia,^[13] the chronic condition is characterized by low mood, sadness, hopelessness, and a lack of interest in daily activities.

Bipolar Disorder

Bipolar disorder, previously known as manic-depressive illness, is a mood disorder that involves extreme shifts in moods, ranging from manic highs to depressive lows, with episodes lasting for days or weeks or rapidly shifting throughout the day.

During these bipolar episodes,^[14] individuals experience high levels of energy and talkativeness, bouts of excitement, elation, and hyperactivity, followed by major depressive episodes characterized by low moods, difficulty concentrating, and indecisiveness.

Psychotic Depression

This is a severe form of clinical depression involving typical symptoms of MDD but with psychotic symptoms such as hallucinations and delusions.

People with this condition are at high risk of suicide attempts and require prompt medical attention, even after treating unipolar depression. Brain stimulation therapies, antipsychotic medications, and antidepressants help treat psychotic depression.^[15]

Postpartum And Prenatal Depression

Some women are diagnosed with postpartum depression after childbirth. It is characterized by difficulty bonding with the baby and sadness, anxiety, and irritability. Prenatal or antenatal depression,^[16] on the other hand, arises during pregnancy.

Antenatal depression is estimated to affect around 12% of pregnant women^[17] and can significantly impact both the mother and the developing baby.

Situational Depression

Situational depression, also known as adjustment disorder with low mood, is a type of depression triggered by major life changes,^[18] such as the death of a loved one, job loss, or serious illness.

Seasonal Affective Disorder

Seasonal affective disorder,^[19] i.e., SAD, occurs during specific periods of the year, especially during the winter months. SAD is thought to be caused by a lack of exposure to sunlight, which disrupts the body’s circadian rhythm and is associated with the production of serotonin and melatonin, neurochemicals involved in mood and sleep.

Treatment for SAD involves bright light therapy,^[20] medication, psychotherapy, or lifestyle changes.

Tips To Manage Depression

The Anxiety and Depression Association of America^[21] provides these tips for managing depression:

• Seek professional help: To get a proper diagnosis, create a personalized treatment plan, and provide support and guidance throughout the different stages of depression. If this plan includes medication compliance, then that should be adhered to.
• Regular exercise: Exercise can be an effective tool for managing depression. Exercise boosts mood^[22] and reduces depressive symptoms.
• Maintain a healthy diet: Eating a healthy, balanced diet boosts energy levels and overall health, positively impacting mood.
• Get enough sleep: Poor sleep can worsen depression symptoms. Establish a regular sleep schedule,  create a calming bedtime routine, and try to get 7-8 hours of sleep each night to improve sleep quality.
• Focus on self-care: Taking time for self-care activities^[23] such as reading, listening to music, or practicing mindfulness. Meditation, deep breathing, or yoga help reduce stress and anxiety, which exacerbate symptoms of depression.
• Identify and challenge negative thoughts: Depression often involves negative thoughts and self-talk. Identifying and challenging these thoughts can help change the patterns of thinking that contribute to depression and other mental illnesses.
• Avoid alcohol and drugs: Substance abuse worsens symptoms of depression and makes it harder to help someone with depression manage the condition.
• Build a support system: A support system of friends, family, and mental health professionals provides a sense of connection. This help manage feelings of isolation that often accompany depression.

The Takeaway

Depression is a complex, multi-faceted disorder that affects people in multiple ways. However, understanding depression basics can help you better understand the stages of the mental disorder.

When managing depression,^[24] it’s best to consult a medical professional or therapist. With the right support and resources, you can start to make a positive and lasting change.

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