[Recurrent depression: episodes neurotoxicity and recurrences prevention]

Depression is a recurrent pathology with a self-induced vulnerability. To explain this spontaneous aggravation, we have been mainly focusing on the Kindling hypothesis. However, the kindling phenomenon only reflects the concept of vulnerability but omits explaining its mechanisms. Both data of imaging and clinical studies showed evidence that the length and the repetition of major depressive episodes increase the risk for more frequent new episodes, i.e. that depressive episodes could be neurotoxic per se. This neurotoxicity hypothesis of major depressive disorder, apart from allowing a different way of communicating with our patients and to facilitate their compliance, strengthen the necessity to prevent recurrent depressive episodes.