The 5 Stages of Depression in Psychiatry: Symptoms, Diagnosis, Treatment, Prevention

Updated 2 years ago on April 08, 2023

As far back as 1969, Dr. Elizabeth Kübler-Ross described the 5 known stages of grief acceptance, which includes depression. But there are also specific stages of depression, which fully describe what a person with this disorder has to face. Notably, depression can last for years, and psychosomatic disorders develop slowly, negatively affecting a person's quality of life.

Psychiatry states that a person experiences serious negative events in the following sequence: denial, anger, bargaining, depression and acceptance. But the duration of these transitions can vary greatly. For example, a single depression can take 2, 3 years, or 5 years, depending on perceptual patterns and the availability of quality medical care.

5 stages of acceptance by E. Kübler-Ross

According to the doctor, the stages described are protective mechanisms of the human psyche. By experiencing all these moments, a person tries to accept grief without serious disturbances in mental activity.

  1. Denial. The person refuses to believe in the change that has occurred. In fact, denial of a problem or grief means that the psyche tries to isolate itself from it, as if to pretend that change does not really exist.
  2. Anger. At this stage comes anger and a search for guilt. A person may blame himself or herself, others, or higher forces for the troubles that are occurring. The event is seen as an injustice, someone else's mistake.
  3. Bargaining. A person tries to bargain to avoid consequences. For example, he may begin to work through wear and tear if it is a matter of work trouble. Or make a bargain with God if, for example, the death of a loved one or some fatal illness is involved. This stage indicates an active attempt to find a way out.
  4. Depression. It comes when the bargaining stage has not yielded results. The person falls into a depressed state, he gets apathy, laziness, sadness, pessimism. Nothing can make him happy, he is completely seized by the event that happened.
  5. Acceptance. This stage already indicates a real assessment of the situation, the possible search for prospects in the new situation. The person in acceptance understands that there is no choice, all paths have been tried, and simply prepares morally for the consequences.

In her work the author also argued that people can feel hesitation in each of the stages. For example, acceptance was about to happen, but then the person learned some other circumstances, which brought him back to the bargaining stage.

Stages of depression

In addition to the stages of acceptance of change, there are also degrees of depression. Below we will look at them in detail.

  1. Pessimism. A person forms negative thoughts and feelings, which are obsessive in nature. If he remembers something, it is only in negative colors, if he learns the news, he sees negative consequences in the events. He is upset by his social position, his own appearance, his future prospects, his job position, the people around him. At this stage, the person ceases to see the bright side and hope.
  2. Appetite disorders. Most patients suffering from depressive disorders change their eating behavior. They may lose their appetite or, conversely, begin to eat in increased amounts.
  3. Sleep disorders. At the third stage, there are disorders of night sleep. Insomnia occurs more often: it is explained by the brain's attempts to cope with chronic stress. The person spins, digests negative thoughts over and over again, which does not promote falling asleep. After waking up, he feels sluggish, frazzled, and unrested. Sometimes people fall asleep normally, but wake up in the middle of the night for no apparent reason.
  4. Feeling of guilt. A person takes responsibility for certain events, things. Often he feels guilty for things that are in principle beyond his control. Thus a feeling of insecurity, helplessness and despair is born. Later the person sees his guilt in everything that happened in his life and around him.
  5. Suicidal tendency. This is the final stage, which becomes a natural consequence of destructive feelings of guilt. This stage may also manifest itself in the infliction of various injuries on oneself: cuts, blows, and so on.

People can live depressed for years, and those around them may sincerely consider depressive behavior the norm, some personality trait. Outwardly, such people may be withdrawn, depressed, melancholic, and sad.

How is depression treated?

Only a psychiatrist or psychotherapist can diagnose a depressive disorder. The patient undergoes consultations with a specialist, psychological testing, and blood tests, including tests for hormone levels. The diagnostic methods described above allow for a correct diagnosis. For treatment purposes, a comprehensive approach is used: these are medication regimens, psychotherapy. Antidepressants are prescribed, which begin to work already in 2-3 weeks after starting to take them; cognitive-behavioral therapy and other techniques.

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