"Doctor, I Just Can't Go On"

Primary-care physicians in the Spanish system of public health care may find that they do not have either the means or the time to base their treatment of depression on diagnostic criteria. They proceed to the prescription of antidepressants even if patients are not clinically depressed, as a response to patients' reports of emotional suffering and assertions that their conditions require medical treatment in the form of antidepressant medication. In this system, encounters between physicians and patients become processes of negotiating explanatory models, such as when patients expect to receive medication because they believe that any severe emotional suffering and absence of energy that continues to limit their daily functioning is a medical problem. Directly observed interactions between patients and primary care physicians and open-ended follow-up interviews elucidate processes of interaction between their respective explanatory models.