Depression affects people differently. Some people suggest that depression has stages similar to the stages of grief, but no research supports this. Studies suggest the stages of depression are a continuum of increasing symptom severity.
Depression is a common yet serious mental health condition affecting millions of people worldwide. Approximately
Different types of depression exist and cause a variety of symptoms. Despite a lack of evidence, some people propose that depression occurs in stages similar to the stages of grief.
This article explores whether depression has different stages. It also discusses what depression is, as well as 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 how 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. Healthcare professionals also refer to the condition as major depressive disorder (MDD) and clinical depression.
- major depressive disorder
- persistent depressive disorder (dysthymia)
- perinatal depression
- seasonal affective disorder
- depression with symptoms of psychosis
The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) added
- disruptive mood dysregulation disorder
- premenstrual dysphoric disorder
- depressive disorder due to another medical condition
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 encounter claims on the internet suggesting that most people with depression experience stages or features similar to the five stages of grief.
While research does not support these claims, some studies do suggest that depression occurs on a continuum of increasing symptom severity. We take a look at these theories in more detail below.
Five stages of grief
The five stages of grief is a well-known model or framework for the experience of death and grief. Dr. Elisabeth Kübler-Ross
The five stages of dying, frequently abbreviated as “DABDA,” are:
Kübler-Ross originally applied this model to the experience of people dying from terminal illnesses, but she and others later used it in additional contexts such as grief and major life changes.
Some experts have also used this model to describe the experiences of people who have chronic illnesses such as diabetes or have received
Learn more about the link between depression and chronic illnesses.
A person who is coming to terms with the loss or impending loss of a loved one may also experience these stages.
Some blogs and health-related websites claim that the DABDA model applies to people with depression, but no research supports the theory that depression occurs in stages similar to the five stages of dying or grief.
Stages of depression
Research suggests that some people believe depressive disorders fall along a continuum of increasing symptom severity.
In 2017, one mental health professional suggested a staged model for classifying the continuum of depressive symptoms. The proposed stages are:
- depressive disorder
- recurrent or refractory (treatment-resistant) depressive disorder
The authors of a 2022 review provided a similar staged model, beginning with a prodromal stage (early depression symptoms) and ending with pharmacologic treatment resistance.
Learn more about the signs of a depression relapse.
Many studies also refer to degrees of depression severity — mild, moderate, and severe — as stages of the condition. Some research from 2018 suggests that a person’s depression “stage” predicts their readiness to seek help for the condition.
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 may cause symptoms similar to a depressive episode. It also says that a person may experience a major depressive episode in addition to their response to a significant loss.
A person with depression may present with the
- low mood
- reduction in or loss of pleasure in activities
- significant changes in weight or appetite
- excessive sleep (hypersomnia) or lack of sleep (insomnia)
- changes in movement (either less activity or agitation)
- fatigue, or loss of energy
- guilt or feelings of worthlessness
- indecisiveness or problems with concentration
- suicidal thoughts, plans, or attempts
Most specialists will diagnose depression through interviews with the patient and clinical evaluation according to the DSM-5-TR criteria.
To qualify for a diagnosis of MDD, a person must have at least five of the
A doctor may also do physical exams and run some lab tests to rule out other medical conditions that may cause
There is not yet a cure for depression, but several treatment options can help relieve depressive symptoms. Receiving treatment earlier is
The usual treatment for depression involves medication, psychotherapy, or a combination of these two. Combination therapy has an association with
Learn more about the different medications for depression.
Psychotherapy for depression may include cognitive behavioral therapy and interpersonal therapy.
If these methods do not help, a doctor may recommend exploring electroconvulsive therapy and other brain stimulation therapies.
A person’s first step to finding support is to set up an appointment with a healthcare professional, who can evaluate them or refer them to a mental health specialist.
Many support groups are available for people with depression. Some people find support groups to be a helpful addition to professional treatment.
The Anxiety & Depression Association of America has a list of support groups that meet in person or virtually. The
Many people who have depression do not receive a diagnosis or seek treatment. A person who experiences the following symptoms should consult a doctor:
- trouble sleeping or excessive sleeping
- changes in appetite or weight
- loss of interest in activities they used to enjoy
- 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 having 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 receive the assistance and support they need immediately.
Many websites claim that depression occurs in stages similar to the five stages of grief, but no research supports this.
Many experts view depression as a continuum of increasing symptom severity and believe that a person’s depression stage predicts their readiness to seek help for their condition.
Regardless of the stage or the severity of symptoms, a person should seek help from a mental health professional if they notice changes in their mood that affect their general functioning. People should seek immediate support if they are in emotional distress or are having suicidal thoughts.