DEPRESSION: WHAT IS IT? DOES PROZAC CORE DEPRESSION OR ANY OTHER ILLNESSES FOR WHICH IT IS GIVEN?
The concept of depression has entered the public’s consciousness so fully that many people today use the word “depressed” in the same way that they might once have described themselves as dejected, discouraged, or simply glum. At the same time, many people who believe they are in a temporary down or think they are reacting in a normal, healthy way to difficult circumstances are in fact clinically depressed and should seek both diagnosis and treatment.
Clinical depression does not simply go away. Depression is worse than unhappiness, more than malaise, and not in the least like a stubborn refusal to “buck up.” “Depression” is a term that can be applied to a collection of disorders, each of which is characterized by a constellation of specific and debilitating symptoms. It is not a monolithic disorder. Just as major (or clinical) depression is riot the same as simply feeling down, major depression is also not the same as minor depression (now categorized by psychiatrists as dysthymia). Likewise, feeling manic is not the same as feeling happy.
The concept of “cure,” so basic for physicians with other specialties, is an elusive one for psychiatrists. Prozac does not cure depression or any other chronic or recurrent illness for which it is prescribed; thus, it is similar to all other psychotropic drugs that alleviate illness but do not cure it. From 75% to 80% of depressed patients have depression that tends to recur.
On the other hand, Prozac and other antidepressants sometimes appear to cure. Perhaps 20% to 25% of the patients whose depression is relieved by Prozac or other medications are never destined to have a recurrence. This does not mean that the illness has been cured by the antidepressant drug, although it certainly looks that way. Rather, the patient was destined through genetics and environment to have only one depressive episode in his or her lifetime.
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