What are the stages of depression?

Many experts believe that depression can be categorized into four distinct stages. Each stage is based on the extent of a person’s symptoms. One of these experts presented a staged model outline that consists of the following:

Wellness — The first stage is the wellness stage. When someone is in the wellness stage, they typically experience limited emotional distress. During this stage, low-intensity intervention methods may improve mental health and well-being. Interventions during this stage are considered more “preventive” treatments. These measures limit the risk of developing progressive mental health conditions. They also prevent the need for greater levels of treatment or support.

Distress — The second stage of this model of depression is called the distress stage. This stage is typically characterized by a mild or moderate level of emotional disturbance. Someone in this stage has progressed past the stage of wellness, where preventive measures can be taken. The periods of distress associated with this stage don’t typically last long. To address the symptoms experienced during the distress stage, most professionals recommend leaning into a strong social support network and making extra efforts to perform self-care.

Depressive disorder — The third consecutive stage of depression is when a person develops depressive disorder. A person is believed to develop depressive disorder as a result of genetics and emotional disturbances that span more than a few weeks. Depressive disorder causes a person to experience difficulty performing routine tasks and activities. Treatment for people in this stage usually involves antidepressants and talk therapy. During treatment for depressive disorder, most medical providers aim to help their patients reach recovery.

Recurrent or refractory (treatment-resistant) depressive disorder — The fourth and final level of the proposed model is the recurrent stage. This stage is also known as the refractory depressive disorder stage. During this stage, the depression symptoms have become resistant to treatment. Treatment resistance is generally defined as unresponsiveness to at least two trials of antidepressants. Treatment-resistant depressive disorder is more likely to result in the recurrence of symptoms. The aim of treatment for people at this stage is to improve their quality of life and stabilize their symptoms.

What may help those in the treatment-resistant depressive disorder stage?

If you’ve entered the treatment-resistant stage of depressive disorder, you should know that you may still be able to experience positive changes. Some treatments that may help people experiencing recurrent or refractory depressive disorder include:

Transcranial magnetic stimulation (TMS) — TMS therapy is a form of treatment designed to alleviate many of the symptoms of treatment-resistant depression. It’s a non-medication, noninvasive option. TMS therapy involves pulses of magnetic energy being sent to specific areas of the brain involved in mood regulation. For those with depression, these pulses are delivered to the dorsolateral prefrontal cortex.

Spravato/esketamine — Esketamine (Spravato) is another option for people experiencing treatment-resistant depressive disorder. It’s an FDA-approved nasal spray augmentation treatment. Spravato is self-administered but must be taken under the supervision of a clinician. It is also taken in conjunction with oral antidepressants. Spravato works by targeting NMDA receptors to improve depression symptoms rather than increasing neurotransmitters like most oral antidepressants.

Need help for your treatment-resistant depression? Active Path Mental Health can provide it

We understand how much of an impact treatment-resistant depression can have on your life. It may cause you to feel as if you have little control over your own life. It can also lead you to feel overwhelmed by your symptoms. This is especially true when they don’t respond to multiple trials of treatment. This condition can affect your daily functioning, interpersonal relationships and quality of life. We’ll help you manage your symptoms and experience stability. Let us help you.

Active Path Mental Health has multiple locations in both Oregon and Washington. The team members at each one of our locations are committed to helping patients. We aim to help each patient experience positive results with treatment for their mental health condition, like treatment-resistant depression. But don’t just take it from us, take it from our patient reviews.

Contact our team today for more information or to schedule an initial appointment.