Major depressive disorder (MDD), often simply called depression, is a serious mental health condition that affects how you feel, think, and function in daily life.
The symptoms go far beyond ordinary sadness or a low mood – they can include fatigue, changes in sleep or appetite, loss of interest in activities, difficulty concentrating, and feelings of hopelessness or guilt. These symptoms are acute and intense, and can be deeply disruptive and exhausting.
MDD is diagnosed when symptoms last for at least two weeks. But how long major depressive disorder lasts beyond that, depends on the individual. Without treatment, episodes can last for months, or even years. But with the right care, most people experience meaningful relief much sooner.
In this article, we’ll break down how long major depressive disorder typically lasts with and without treatment, the factors that influence recovery, and the treatment options – from talk therapy to antidepressants to esketamine therapy – that can help you find relief.
How long does major depressive disorder last without treatment?
The average duration of an untreated major depressive episode is six to twelve months. But the reality is that symptoms can last anywhere from a few weeks or months, to years.
MDD is characterized by bouts of intense depression. So even if an episode only lasts a few weeks, without treatment it is more likely to keep recurring – and episodes can get longer and more severe over time.
Leaving depression untreated carries notable risks:
- A higher chance of the depression becoming chronic (lasting years).
- Increased risk of recurrent depression (episodes coming back again and again).
- Greater likelihood of complications such as substance use, strained relationships, or suicidal thoughts.
Unfortunately, many people hesitate to seek help for depression. It’s common to feel like you should “tough it out” or handle it alone, but this isn’t true – depression is an illness, not a weakness – and just like any other illness, it deserves proper treatment.
Safe and effective treatments exist for MDD, and with the right treatment plan, symptoms can often be eased within weeks, giving you back stability and allowing you to move forward with your life.
Treated vs untreated depression at a glance:
| With treatment | Without treatment |
| Initial symptom relief often within 4–8 weeks | Average episode lasts 6–12 months |
| Full recovery possible within several months | Risk of symptoms lasting years |
| Lower risk of recurrence | Higher risk of recurrent depression |
| Therapy builds long-term coping skills | Greater chance of complications (substance use, strained relationships, suicidal thoughts) |
| Medication or esketamine therapy can provide rapid relief | No structured way to manage or shorten symptoms |
How long does major depressive disorder last with treatment?
With treatment, major depressive disorder (MDD) typically improves within 4–8 weeks, though full recovery often takes several months. The exact timeline depends on the severity of symptoms, the type of treatment used, and how consistently it’s followed.
Most people respond best to a combination of therapy and medication, which not only shortens recovery time but also reduces the risk of relapse. For those with treatment-resistant depression, esketamine therapy has recently emerged as a highly effective option that can bring rapid relief – often within just 24 hours.
Here’s how the main treatments for MDD compare:
- Psychotherapy (talk therapy): Often the first line of treatment, talk therapy helps you explore the roots of depression, reframe unhelpful thought patterns, and develop long-term coping strategies. Evidence-based approaches like cognitive behavioral therapy (CBT) and interpersonal therapy (IPT) often bring noticeable progress within a few months of consistent sessions. More importantly, therapy supports lasting change, making it a vital depression relapse prevention tool.
- Antidepressant medication: Antidepressants target the chemical imbalances in the brain that are linked to depression. Many people start noticing improvement within 4–8 weeks. While medication doesn’t resolve the underlying causes, it can reduce symptoms enough to make daily life more manageable and allow therapy to be more effective.
- Combination therapy: Research consistently shows that therapy and medication together work better than either alone. Many people experience noticeable improvement within a couple of months, with sustained recovery often achieved over six months to a year of consistent treatment.
- Esketamine therapy (Spravato): For those whose depression hasn’t improved with standard treatments, esketamine can provide rapid relief – sometimes within 24 hours – with continued improvement over several sessions. It is always paired with an oral antidepressant, and again works best when combined with talk therapy for long-term stability.
At REACH, we provide both psychotherapy and psychiatry services under one roof. That means you don’t have to figure out what’s “right” for you alone – whether you start with therapy, psychiatry, or both, our team will guide you toward the treatment plan that best supports your recovery.
Factors that influence the duration of MDD
The main factor that determines how long major depressive disorder lasts is whether or not you seek treatment. Without it, episodes can stretch on for months or even years, whereas if you seek professional help, recovery is usually much faster, and the risk of recurrence much lower.
While treatment is the biggest influencing factor, other things can play a part in both the length and severity of depression. These include:
- The type and quality of treatment you receive.
- Genetics and family history of depression.
- Past experiences of trauma or chronic stress.
- The strength of your mental health support system.
- Lifestyle factors like sleep, exercise, and substance use.
No two people will experience MDD in exactly the same way, and for the same reason, every depression prognosis is unique – but with consistent treatment and the right support, it’s important to remember that recovery is always possible.
Is major depressive disorder the same as chronic depression?
Major depressive disorder isn’t the same as chronic depression, although there can be crossovers.
The distinction often causes confusion, so here’s how they differ:
- Major Depressive Disorder (MDD): Also known as Clinical Depression.
MDD is characterized by severe, often debilitating symptoms that last for at least two weeks. Episodes can come and go in bouts, with periods of relief in between. Symptoms can range greatly in severity, but are always significant enough to interfere with daily life in some way. - Persistent Depressive Disorder (PDD): Also known as Chronic Depression or Dysthymia.
This is a milder but more chronic (longer-lasting) form of depression. Symptoms are less severe than MDD but last continually for two years or more without any significant breaks. - Some people experience both: recurrent major depressive episodes (MDD) on top of a chronic, persistent low mood (PDD). This combination can feel particularly overwhelming, but with the right treatment plan, both conditions can be managed and treated.
There are also other forms of depression, including seasonal affective disorder (SAD), postpartum depression, and depression linked to medical conditions. No matter the type, it’s important to know that effective treatment is available, and recovery is possible.
When to seek professional help for major depressive disorder
If your depressive symptoms have lasted for more than a few weeks, or if they’re getting worse, it’s time to seek help.
It’s especially important to reach out if:
- Symptoms last longer than a month with little improvement.
- Daily routines or relationships are becoming difficult to maintain.
- You experience frequent or severe episodes of hopelessness, panic, or despair.
- You’re relying on alcohol, drugs, or isolation to cope.
- You’ve had thoughts of self-harm or suicide.
At REACH, you don’t have to decide on your own what type of care you need. For some, therapy alone is enough. For others, psychiatric treatment – including antidepressants or Spravato (esketamine therapy) – may be added.
Our integrated team will work with you to find the right plan and support you every step of the way.
Find relief from depression at REACH Behavioral Health Ohio
No matter how long major depressive disorder has affected your life, it’s not too late to reach out for treatment, and it is treatable.
Recovery from MDD doesn’t happen overnight, but with the right treatment and support, you can be feeling relief from your symptoms within less than a month – and with a little more time, achieve lasting recovery.
At REACH Behavioral Health Ohio, we provide both therapy and psychiatry services, including Spravato esketamine therapy for treatment-resistant depression. Our holistic approach means you’ll get the right help at the right time – whether that’s therapy, medication, or both.
You don’t have to face depression alone. Contact REACH today and get started on the road to calmer, happier days.
FAQ: Common questions about depression recovery
What is the average duration of a major depressive episode?
On average, untreated episodes last 6–12 months, and are likely to recur. With treatment, long-term recovery often begins within weeks to months.
Can MDD go away without treatment?
Yes, some people improve over time without formal treatment, but the risk of recurrence and severity of symptoms is much higher. Treatment significantly improves both recovery speed and long-term outcomes.
What is the difference between MDD and persistent depressive disorder?
MDD involves episodes of depression that may come and go. Persistent depressive disorder (PDD) is chronic depression lasting two years or more. Some people have both conditions.
How do I know if my depression is getting better?
Signs of improvement include: better sleep and appetite, increased energy, more interest in activities, improved concentration, and feeling more hopeful. Progress may be gradual, but even small shifts are important steps toward recovery.