Depression is neither curable nor very manageable in a lot of people. One problem is that meds tend to lose their effectiveness after a few years. You can experiment -- cut doses back, change to a different med, etc. -- and that is often helpful. But if you're going to rely entirely on meds, you're likely going to have an uphill battle.
Therapy can help (as can a spiritual practice), but if it's going to have longterm value, you pretty much have to continue it forever. As I noted on another thread, the most effective long-term treatment for both depression and anxiety seems to be daily exercise. If it's combined with some therapy, it works even better. But relapse rates are definitely lowest among people who exercise regularly. Most studies have been done with aerobic exercise, but other varieties work too, it appears.
Anxiety/panic attacks often spontaneously stop. Nobody knows why. I've seen it in many clients over the years. It's easy to find a reason they begin -- which should be a lesson in the way we narrativize experience -- but never easy to explain why they mysteriously stop. I had one client who refused to take meds but began treating himself with one beer a day. When the attacks stopped, he of course gave the beer credit. Unlikely.
Depression runs in my family and I had Skip's identical experience. When I went on Prozac, I recall the exact moment it kicked in and, like him, I was shocked and said to myself, "So this is the way other people feel." In that moment, I realized I'd been depressed most of my life. It was a mind-boggling experience.
I also had the full range of what Peter Kramer ("Listening to Prozac") calls "cosmetic effects." Only a minority have this experience. My productivity doubled, my social anxiety left, I stopped ruminating, etc. I went from writing one column a week to writing 3 weekly and two monthly and enrolled full-time in grad school.
The cost was, um, interest in sex. And the effects of Prozac stopped after a few years and I relapsed into mild depression. I've taken every drug on the market since then and they are, as Skip has experienced, somewhat helpful, but nothing like Prozac was in the beginning.
I've seen many clients go through this.
I also agree with Skip's comments about depression as being a name for a particular style in many people. This used to be called "melancholia," and was not pathologized in the way we turn everything into a disease now. Kramer makes the point that while it would be inhumane not to offer antidepressants to every "depressed" person who wants them, their widespread use could seriously impact artistic expression in particular. (At the time he wrote his book we did not yet know how temporary the effects could be.)
Many of the drugs are energizing, so they help the melancholic adapt to a society that values productivity above all else.