Symptoms of a major depressive episode usually develop over days to weeks, but mild depressive and anxiety symptoms may last for weeks to months prior to the onset of the full syndrome. Left untreated, major depressive episodes typically last 6 months or more, but a minority of patients experience chronic episodes that last at least 2 years. Approximately two-thirds of patients recover fully from major depressive episodes and return to normal mood and full functioning, whereas the other one-third have only partial remission.3

The course of MDD varies markedly from patient to patient. It is not uncommon for a patient to experience only a single major depressive episode, but most patients with MDD will experience multiple episodes. Some patients experience isolated episodes separated by many years, others have clusters of episodes, and still others suffer more frequent episodes as they age. The number of prior episodes predicts the likelihood of developing subsequent episodes. A patient experiencing a third major depressive episode has about a 90% chance of having a fourth one. MDD is associated with a high mortality rate because about 15% of patients ultimately commit suicide.

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