Some people suggest that depression has stages similar to the stages of grief, but no research supports this. Instead, studies suggest the “stages” of depression are a continuum of symptom severity.

Depression is a common, serious mental health condition affecting millions of people worldwideTrusted Source.

Different types of depression 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 the states of depression. It also discusses what depression is as well as its signs and symptoms, diagnosis, and treatment.

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Depression is a serious mood disorder that involves persistent low mood, loss of interest in activities, and other symptoms. 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.

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

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, text revision (DSM-5-TR) includes other typesTrusted Source of depressive disorders to the list:

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

No, there are not different stages of depression. Rather, experts view depression as a continuum: Its symptoms change in severity over time.

Kübler-Ross stages of grief

Some blogs and health-related websites claim that the five stages of grief (denial, anger, bargaining, depression, and acceptance) apply to people with depression.

Dr. Elisabeth Kübler-Ross introducedTrusted Source the theory of grief stages in her 1969 book, “On Death and Dying.” She originally applied this framework to the experience of people dying from terminal illnesses. She and others later used it in additional contexts, such as grief and major life changes.

Today, the Kübler-Ross stages of grief are not considered accurate, and no research supports the theory that depression occurs in stages like these, either.

Severity of depression

Instead of depression occurring in stages, experts view depression as a continuum — a condition with symptoms that change in severity over time.

In 2017, one mental health professional suggested a staged model for classifying this continuum. The proposed stages are:

  • wellness
  • distress
  • 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 medication treatment resistance.

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 Chinese study suggests that gender, life events, and coping styles may have varying effects on depression, depending on its severity.

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.

Learn more about the signs of a depression relapse.

Depression symptoms can include:

  • low mood
  • reduction in or loss of pleasure in activities
  • significant changes in weight or appetite
  • hypersomnia (excessive sleep) or insomnia (lack of sleep)
  • changes in movement (either less activity or agitation)
  • fatigue
  • guilt or feelings of worthlessness
  • indecisiveness or problems with concentration
  • suicidal thoughts, plans, or attempts

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Learn more about the common symptoms of depression.

Experts recommend people seek medical advice if they experience the following symptoms:

  • trouble sleeping or excessive sleeping
  • depressed or low mood
  • 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

Many people who have depression do not seek support, but it is a treatable condition. If someone is experiencing emotional distress or having suicidal thoughts, they or a loved one are encouraged to seek help from a mental health professional as soon as possible.

People can also call the 998 Lifeline 24 hours a day, 7 days a week to receive the assistance and support they need immediately.

Most specialists diagnose depression through interviews with the person and a clinical evaluation according to the DSM-5-TR criteria.

To qualify for a diagnosis of depression, a person must have at least five of nine symptomsTrusted Source for at least 2 weeks. One of the symptoms must be a depressed mood or anhedonia, which is a loss of interest or pleasure.

A doctor may also do physical exams and order some lab tests to rule out other medical conditions that may cause similar symptomsTrusted Source, such as hypothyroidism (underactive thyroid).

There is not yet a cure for depression, but several treatment options can help relieve symptoms. Receiving treatment earlier is more effectiveTrusted Source.

Treatment for depression typically involves medication, psychotherapy, or both. Combining medication and therapy can decrease the risk of symptoms returning.

Psychotherapy for depression may include cognitive behavioral therapy (CBT) 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 find support is to schedule 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 NIMHTrusted Source also offers help and resources for people with depression.

Here are some frequently asked questions about depression.

What are the three levels of depression?

Clinicians may classify depression into three levels of severity: mild, moderate, and severe.

What are the 3 R’s of depression?

The three R’s of depressionTrusted Source are the states a person may experience with depression. They are relapse, recurrence, and remission and recovery.

Many websites claim that depression occurs in “stages” similar to the Kübler-Ross stages of grief, but no research supports this.

Instead, experts view depression as a continuum — its symptoms change in severity over time. They believe symptom severity predicts a person’s readiness to seek treatment.

Regardless of a person’s severity of depression symptoms, help is available. A person can reach out to a healthcare professional for help if they notice changes in their mood that affect their daily life and well-being. People are encouraged to seek immediate support if they are in emotional distress or are having suicidal thoughts.