Many illnesses progress over time and can be described as a series of stages. That’s not true of depression.
There are different kinds of depression; major depression isn’t the same as bipolar disorder, which requires different medication. Seasonal affective disorder only strikes when you’re not getting enough sunlight.
If something tough happens, you might be sad about it but that doesn’t mean you’re depressed. Sadness is a normal emotion that fades with time. Most of us, most of the time, move past losses and disappointments. Depression is different. It can strike without any triggers. Your life could look wonderful from the outside but feel empty to you.
One key is that depression tends to color more than one part of your life. Everything is less fun, important and interesting. You’re more impatient and easily overwhelmed, quicker to anger, and quicker to give up.
Although psychologists have not defined stages of depression as part of a diagnosis, symptoms often accumulate gradually. Long before physical changes show up, you are likely to be plagued by sad or angry thoughts. You might scold yourself or assume other people think badly of you. You might feel angry or despairing about your own problems and the problems you see around you. Eventually, you might lose your appetite or overeat or binge. Your sleep patterns are likely to change as well. Some people stay up fuming or worrying. Others sleep late and can spend entire days in bed.
Depressed people very often blame themselves for things they don’t control. You might blame yourself for being depressed. You might begin to have thoughts of suicide—many more people think about it than make attempts.
To be diagnosed with depression, you need to show at least five of these eight possible symptoms for at least two weeks.
- Are you down or irritable most of the time?
- Are you uninterested in activities you used to enjoy?
- Have you lost or gained weight or had changes in appetite?
- Are you slowed down or restless?
- Are you tired or sluggish?
- Do you feel worthless or guilty?
- Do you have trouble concentrating or find it hard to make decisions?
- Do you think about suicide or being dead?
There are also stages people go through before they take action and recover. You might be depressed for some time before you even define your problem. That’s called the pre-contemplation stage. When you start thinking about change, you begin to define your illness.
In the preparation stage, you might talk to someone informally about whether you could be depressed. You might read articles like this one or browse self-help books.
In the action stage, you’d go to a psychotherapist, psychiatrist, or regular doctor and ask for a diagnosis. You might take medication or start therapy. You would start an exercise program or take steps to get more sleep or cut back on stressful obligations.