How can i tell if medication is needed for depression , or is just depression thorough life circumstances .taking pristiq (desvenlafaxine) but not feeling better?

Psychotherapy: Antidepressant medication is not optimal treatment. For most depressed patients, the effects of antidepressants are indistinguishable from placebo. Psychotherapy (ongoing, at least weekly) has proven effectiveness and will help you understand and address the causes of your depression (not just symptoms). Meds alone are obviously not working for you. See a psychologist and get meaningful help.

Talk to your dr...: If your dr prescribed pristiq, (desvenlafaxine) i assume he thought you were depressed and could benefit from an antidepressant. If you don't feel better and it's been a few weeks, please, go back and let your dr know how you're feeling. If this is your regular medical dr, ask to see a psychiatrist. You may also benefit from seeing a therapist to discuss your life circumstances. Meds don't take care of it all.