- Ernest Hemingway, Marilyn Monroe, Sylvia Plath...
- The first two of these prominent people affected by affective disorder had substance abuse. In general, affective disorder, especially bipolar disorder, promotes an increased tendency to take psychoactive substances such as alcohol. One mechanism for this phenomenon may be self-medication of depression. If the patient experiences that alcohol, for example, brings him/her relief, he/she reaches for a glass more and more often.

- Alcoholism is a disease of the emotions. Are 'borderline', depression and bipolar disorder on the same 'shelf'?
- Alcoholism belongs to a group of diseases whose main feature is the pathological use of a chemical substance that causes health and social damage. In contrast, intermittent depression and manic-depressive illness belong to affective disorders, also known as mood disorders. Borderline personality disorder in some people may precede the onset of bipolar affective disorder.

- 'Happiness pill', Professor - Prozac.
- Prozac's career has been linked to its efficacy in mild depression. In such cases, the previously available tricyclic antidepressants, which can sometimes cause significant side effects, were not resorted to. Psychological methods were mainly used, which often took a long time without producing the expected results. And here came a drug with an excellent effect after only three weeks. With Prozac, it was thus demonstrated that mild depression is not just a reaction to an unpleasant event, but that it is depression with a biological component, amenable to pharmacological action. And this was undeniably something of a breakthrough in thought. Prozac started a whole group of antidepressants, the so-called selective serotonin reuptake inhibitors (abbreviated SSRIs). There are now six of them. They are safer for the cardiovascular system, do not have anticholinergic effects and are therefore better for use in people with somatic diseases and in the elderly. It is for these reasons, it must be inferred, that one can find in the opinion of some Americans that it was with Prozac that psychopharmacology in general began.

- How much truth there is in this
- Even when it comes to SSRI drugs, fluvoxamine, which was used in Europe, was earlier than Prozac. In the United States, it is not used as an antidepressant and its introduction on the European market was not accompanied by such a huge advertising campaign as in the case of Prozac.

- Zyban, advertised as a miracle drug for anti-smoking treatment, has been on the market recently. In the United States, it is classed as an antidepressant. What explains this significant discrepancy?
- Bupropion, known to us as Zyban, is indeed one of the more popular antidepressants used in the USA and some European countries. Due to its specific mechanism of pharmacological action (action on the neurotransmitter dopamine), it may be useful in people wishing to quit smoking and was registered in Poland for such an indication. On the other hand, the introduction of an antidepressant in a given country depends on the policy of pharmaceutical companies, which cannot always be explained in a rational manner.

- On television, on the radio, in the press, on billboards and in thousands of leaflets, pharmaceutical companies try to convince us of their medicines, and doctors, hospitals, the parliament and the Ministry of Health try, by various means, to market and use them. Is this not an attempt to sell not only the drug, but also the illness for which the drug is supposed to help? Do you not think that depression, by its very nature, is an extremely fertile field for these gold-digging 'experiments'?
- Pharmaceutical companies have picked up on the market context of greater interest in depression - this is true. Since Prozac, there has been a major expansion of antidepressants and almost every company has a drug they promote. However, please note that the treatment of depression is still inadequate and insufficiently effective. In this sense, the emergence of new drugs seems very welcome. We already have third-generation drugs that are patient-friendly to a degree similar to serotonin drugs, and their therapeutic efficacy is greater, similar to tricyclics.

- However, something is grating here. The entire arsenal of second- and third-generation pills proves helpless in the treatment of major depression, and the effectiveness of classical drugs, even leaving aside the horror of their side-effects, is at a level of 70 per cent, which can hardly be considered satisfactory. The result is that those who are most in need of help are being electro-shocked as if they were in the time of King Punch!
- In fact, there is a certain increase in the number of patients for whom antidepressants, even over several treatments, are not effective. We then speak of so-called drug-resistant depression. Various methods are used to treat such depression, e.g. a combination of two drugs - this is usually done in a hospital setting. The electroconvulsive therapy method, however, despite the not very pleasant connotation of its name, remains one of the most effective methods of treating depression, especially its most severe forms, including drug-resistant depression. Its use with the involvement of an anaesthetist, with simultaneous anaesthesia and muscle relaxation also makes it very safe.