How Long Does Depression Last?

What Are Depressive Episodes?

A depressive episode is a period of two weeks or more in which an individual experiences a combination of sadness, low energy, inability to take pleasure in things, and feelings of hopelessness.¹ Some individuals may also have suicidal ideation. These symptoms of depression can become debilitating. Depressive episodes are a key feature of major depressive disorder but can also occur in bipolar disorder.

How Long Does Depression Last?

The duration of depression relates to the type of depression diagnosed and the severity of symptoms. There is no way to determine how long a depressive episode will last. Additionally, getting treatment at early stages can help alleviate symptoms of depression.

Does Depression Go Away?

In a comprehensive research study, 380 people who struggled with depression were followed for 15 years. The study reported that a recurrence of depression does not occur for all people, and therefore, depression can go away. Researchers highlighted certain factors that increased the risk of depressive episodes. They included a prior history of depression, not getting treatment, and being single and female.²

Factors that influence the likelihood that depression may not go away include:

• More severe types of depression are diagnosed
• Severity and range of symptoms are high
• The cause of the depression (situational or chemical imbalance). Chemical imbalance is harder to treat than situational depression.
• Previous history of depression. Those who are previously diagnosed with depression have an increased risk factor of getting it again.
• If a depressive episode occurs in conjunction with a chronic medical condition like stroke or chronic pain, then it makes it harder to treat

Why Does Depression Come & Go?

Depression sometimes begins after an unanticipated life event like a death, divorce, or the onset of a medical condition like a heart attack. It can be relieved with proper treatment interventions and the implementation of coping skills. A depressive relapse can occur prior to treatment completion. In some cases, depression is coupled with the onset of a medical condition like a heart attack.

How Long Different Types of Depression Last

All depression diagnoses have shared symptoms like sadness, low energy, and hopelessness. However, each type of depressive disorder has its own criteria, including a set of symptoms with specific severity and duration that distinguishes it from the others. Depression is considered chronic if it lasts for two years or more.

Here are the time frames associated with different types of depression:

Major Depressive Disorder

The criteria for a diagnosis of major depressive disorder (MDD) states that it must last for at least two weeks. It is the most frequent type of depression diagnosed. The World Health Organization reports MDD is one of the top three mental health diseases reported worldwide in 2008.³

Persistent Depressive Disorder

Persistent depressive disorder, or dysthymia, distinguishes itself from major depression in that it manifests as a more consistent level of depression rather than episodic. The intensity of the symptoms may not be as severe but this type of depression can last two years or more.

Situational or Reactive Depression

Reactive or situational depression is a response to a difficult life event. Examples include death, pregnancy, divorce, or loss of a job. The life-changing event can either be a positive or negative one. The duration of reactive depression is related to how quickly the circumstances related to the life event are resolved or addressed.

This type of depression can go on for several months or more after the life event.

Postpartum Depression

Postpartum depression can occur after the birth of a child, and about one in every eight people who recently gave birth experience symptoms of postpartum depression.⁴ It takes about six months for these hormone levels to return to their normal pre-pregnancy levels.

Factors that make postpartum depression more severe include limited social or family support, the birth of multiple babies, and birth complications causing additional medical health concerns.

Seasonal Affective Disorder

Seasonal affective disorder (SAD) is a kind of depression related to a change in seasons. Experts believe internal clocks are altered with reduced sunlight and increased darkness, resulting in depression. Decreased sunlight can cause reduced serotonin, the chemical that impacts mood and sleep. Most of the time, seasonal affective disorder symptoms appear late in fall or at the start of winter and go away during spring and summer.⁵

Bipolar Disorder

Bipolar disorder, or manic depression, is different from other types of depression in that it manifests as extreme mood swings. People with bipolar may feel sad or hopeless when depressed and lose interest in most activities. Then, when their mood shifts to mania or hypomania (less extreme than mania), they experience more energy, may feel euphoric, or unusually irritable.⁶ Bipolar disorder does not go away, but with the proper treatment, it can be managed, and symptom severity will decrease in intensity and frequency.

Why Different Causes Impact How Long Depression Lasts

How long depression lasts also directly relates to the cause of the depression. If the cause of the depression is external, like a life event, it may be treated with psychotherapy and, at times, medication, and it can have a successful outcome in a shorter time frame. Other types of depression caused by altered brain chemistry or genetics are more complicated to treat and have a more complex treatment course, often involving medication management as well as talk therapy.

Additional factors impacting the length of depression include family history, how healthy one’s lifestyle and environment are, and if a support network is available.

Here is how different causes can impact the length of a depressive episode:

• Biology: Changes in nerve cell connections, growth, and functioning directly impact and trigger depression.⁷ Researchers suggest that based on this theory, depression will remain until neurotransmitter balance is restored. Medication is used to treat this type of depression, and it takes time to find the right medication and dose to stabilize mood.
• Environment: Environmental factors like sunlight and airborne pollutants can affect the nervous system, negatively impacting mental health and resulting in depression. Depression can be treated more quickly when it is triggered by environmental causes, for example, by using a lightbox for someone not getting enough natural daylight.
• Drug use: Depression can be closely linked to alcohol or drug abuse. It is more difficult and takes longer to successfully treat depression with these complicating factors.
• Hormone changes: Life events like puberty, having a baby, or menopause can alter hormonal levels, resulting in depression for women. For many people, depression may improve when hormone levels stabilize, but some people continue to experience depression for years after the hormone changes stabilize.
• Family history: If there is a family history of depression, there is an increased risk for depression. Having a genetic disposition to depression can mean that the depression could recur or be more long-term, especially if there are life stressors and/or if alcohol and drugs are used to cope.
• Chronic health conditions: Chronic or severe medical diagnoses are life-changing and can cause anxiety, depression, and stress. People who simultaneously must cope with chronic illness and depression tend to have a more difficult time overcoming the depression. It is not uncommon for people to experience depression in conjunction with cancer, diabetes, or multiple sclerosis.

How Symptom Severity Impacts How Long Depression Lasts

People with more severe depression, like PDD, have more frequent serious symptoms that cause long-term challenges in maintaining relationships and doing necessary daily tasks. Other kinds of depression, like recurrent depression, may be episodic. No matter the severity of depression, the symptoms will almost never just go away if left untreated.

Here is how different symptom severities can impact the length of a depressive episode:

Mild Depression

People with mild depression may not even be aware they are depressed. They may just feel an ongoing sense of sadness or a decrease in their energy levels. They can still engage in daily activities. Symptoms of mild depression can last weeks to months and can recur. Even mild depression doesn’t generally go away without outside interventions.

Moderate Depression

Moderate depression can negatively impact relationships and hinder work or school performance. Concentration may be less, irritability can increase, and sleep and self-care can be diminished. Moderate depression can last months or longer, especially if no treatment is administered.

Severe Depression

Those with severe depression have five or more daily symptoms according to the DSM-5 criteria, and the ability to function can be severely compromised. Severe symptoms can include suicidal ideation, feelings of hopelessness, low energy, increased body aches, and little appetite. Severe depression can last months to years. Treatment should be sought out immediately in cases of severe depression.

Why Depression Treatment Is Important

Depression is a treatable diagnosis regardless of which type of depression you have. With proper treatment, the severity of symptoms and the frequency and length of depressive episodes can improve. Additionally, self-awareness that is gained from treatment can help people recognize their symptoms earlier for better outcomes. Psychotherapy also teaches coping skills for depression to manage potential future episodes.

If the proper treatment is not received, depressive symptoms can worsen and occur more frequently. Untreated depression can increase the possibility of thoughts of self-harm. People sometimes self-medicate their depression with alcohol and/or drugs, which can exacerbate the symptoms of depression.

Treatment Options for Depression

There are many different treatment options for depression. The type of treatment suggested will depend on the type and severity of diagnosed depression. Therapy for depression helps to recognize and build coping skills to manage symptoms. Antidepressants affect the levels and actions of neurotransmitters in the brain, which help to elevate mood. A comprehensive treatment plan often includes a combination of medication management and psychotherapy.

Treatment options for depression include:

• Psychodynamic therapy: Psychodynamic therapy explores past life experiences and how they impact current behaviors and thoughts. It helps people recognize how unconscious thoughts cause current behaviors, thoughts, and feelings.
• Medications: Medication treatment can lessen the duration of depression once the correct dose and medication are determined. There are several medications used to treat depression. Selective serotonin reuptake inhibitors (SSRIs), such as Prozac, are the most frequently prescribed. Serotonin-noradrenaline reuptake inhibitors (SNRIs), such as Effexor, are another class of antidepressants. Some people respond better to SNRIs than SSRIs, so if a person is not responsive to one, they should try the other.
• Cognitive behavioral therapy (CBT): CBT for depression is a short-term psychotherapeutic treatment (usually between 8-20 sessions). The philosophy is negative thoughts create negative feelings and behaviors. Treatment focuses on making people aware of their negative thinking and reframing these thoughts into a more positive framework, reducing depressive thinking and creating more positive behaviors and outcomes.
• Dialectical behavior therapy (DBT): DBT for depression raises awareness of how people’s feelings of sadness and helplessness can overwhelm them. Therapists use positive reinforcement techniques and teach positive life skills to change dynamics to create a more positive life view.
• Ketamine treatment: Ketamine was first used to treat depression in 2000. Ketamine treatment for depression can reduce suicidal ideation and depression in many cases when other classes of medication are not effective. It offers more immediate relief, but the benefits may be short-term. The FDA has approved its use in a nasal spray called esketamine (Spravato).
• Eye movement and desensitization and reprocessing (EMDR): EMDR for depression helps reframe feelings about past experiences in a more objective and less harmful way.
• Physical exercise: The value of physical exercise in terms of depression is often overlooked. When you exercise, it releases endorphins, which elevate mood. Also, it increases blood flow and helps oxygen to travel throughout your body, which helps your physical well-being.
• Alternative treatments: Alternative treatments for depression often involve using mindfulness techniques for depression, like yoga and meditation. These techniques help people to remain focused on the present and not ruminate about past negative life events. They can lower blood pressure and help improve sleep. Acupuncture is also used to treat depression. It helps release endorphins throughout the body. This can offer pain relief in addition to mood elevation.

How to Cope With a Depressive Episode

Coping with depression begins by identifying its cause. This will give insight into your depression triggers and allow you to develop strategies to cope with those triggers. For example, if you know you have seasonal affective disorder, have a lightbox ready for when the winter months arrive. Depression can make you feel out of control, but there are strategies that can help you regain control over your life.

Here are eight coping strategies to try during a depressive episode:

1. Reach out to supportive friends or family: One of the dangers of depression is it causes people to self-isolate, and it can create stress on existing relationships. Identify people in your life who you trust and know will listen to you talk in a supportive and non-judgmental way. Make a lunch date or make a phone call to strengthen connections.
2. Incorporate exercise into your regular routine: Set personal goals that involve a regular exercise routine. Invite a friend to join you. If someone goes with you, it is harder to say no to exercise.
3. Avoid alcohol and drugs: When people get depressed, they may turn to alcohol or drug use to try to make themselves feel better. In reality, drugs and alcohol can exacerbate a depressed mood. It is especially dangerous to mix drugs and alcohol with other medications.
4. Don’t be afraid to ask for help: Do not be afraid to seek out a mental health professional to help with depression. Having a mental health specialist guide and treat you increases the chances that relief from depression is possible.
5. Seek support group help: Support groups can be incredibly comforting because they let you know that others share your feelings and struggle with depression. They can be free or low-cost, and there are both in-person and online support group options. Some of them are led by a trained mental health facilitator, while others are peer support groups. When finding a support group, make sure you research it carefully. Examples of places to go include NAMI or Depression and Bipolar Support Alliance.
6. Be aware of your physical and mental health: Be proactive and pay close attention to your body, your behavior, your emotions, and your mind. If you notice negative changes, don’t ignore what is happening. The longer you wait to address depression, the worse it can get.
7. Eat healthy: Researchers have found that eating healthy, like a Mediterranean Diet, can reduce the onset of depression and decrease symptom intensity and duration. Foods that can help with depression include lots of fish, fresh fruits and vegetables, and whole grains.
8. Get plenty of sleep: There is a strong connection between sleep and depression. Sleep strengthens cognitive and coping skills, reduces irritability, and increases energy levels. Be consistent with sleep times, and improve your sleep hygiene by keeping the room dark and having no electronic devices or phones to distract you.

When to Seek Professional Support for Depression

If you recognize that you are exhibiting depressive symptoms and they do not go away or get worse, seek help from a mental health professional. When there are thoughts of self-harm or suicidal ideation, seek help immediately at a local mental health center or hospital.

An online therapist directory is a great way to find a therapist in your area who specializes in treating depression. You can also talk with your primary care doctor or contact a local mental health center or hospital. When speaking with a therapist, find out how long they have been in practice, what their treatment philosophy is, and make sure they accept your health insurance. If you’re ready to begin online therapy, Talkspace is an excellent choice for those with insurance. If you do not have insurance, there are several online depression therapy options to choose from, with one of the most accessible options being BetterHelp.