|Most individuals with a major depressive episode will get better, responding favorably to at least one antidepressant medication. Individuals may also benefit from psychotherapy. With time, recovery is usually complete, though the risk of relapse increases with each episode. More than half of all individuals with one episode of major depression will have another, while those individuals with a history of three previous episodes have a 90% likelihood of having a fourth. Because of this high relapse rate, it is recommended that individuals with a history of multiple depressive episodes receive medication for the rest of their lives.|
Spontaneous recovery may take months, during which time the individual is at great risk of complications. According to the DSM-IV-TR, Risk of recurrence is about 70% at 5 years and at least 80% at 8 years. Among individuals with severe major depression, 76% on antidepressants recover, compared to 18% on sugar pills (placebo) or on psychotherapy without medication.
Poor outcome is associated with inadequate treatment, severe initial symptoms (including psychosis), early age of onset, greater number of previous episodes, incomplete recovery after 1 year, pre-existing severe mental or medical disorder, and family dysfunction.
Source: Medical Disability Advisor