A couple of months ago, I consulted because I was falling apart from all
the pressures. The MD said "anti-depressants would make you feel better,
but your symptoms are not bad enough to call for a diagnosis of clinical
depression, and antidepressants would risk hiding the symptoms enough to
prevent you from working on the real problems (my lifestyle). Try
psychotherapy, if it is not sufficient, we will add medication."
I think this is a lead: clinical depression (DSM IV), with symptoms so
incapacitating that one cannot deal with the others issues of life call
for medication with (hopefully) psychotherapy. Otherwise, the "talking"
provider, with medication if proved necessary.

Louise Denhez, M.D., M.P.H
Chargee d'enseignement clinique
Departement de medecine sociale et preventive