In medicine, therapeutic interventions tend to fall into one of
three classes. Tertiary prevention means doing something to
reduce the impact of symptoms in a disease that already exists.
Secondary prevention is when you try to catch the disease at an
earlier stage, either before symptoms develop or before they
become severe. Routine blood pressure checks are an example of
secondary prevention because blood pressure measurement catches
hypertension (hopefully) before complications like stroke or
heart disease develop. Finally, primary prevention is when you
do something to keep the disease from starting to begin with.
Routine pap smears are a primary preventive measure for cervical
cancer---the idea is to catch abnormal cells before they
transform into cancer. So how does this all apply to psychiatry?
It's relevant because, unfortunately, in our specialty right now
almost all interventions are tertiary interventions. We see
patients after a disease has developed, when they are bothered
enough by their symptom