I am a mother of a four-year-old and a seven-year-old. I have been a stay-at-home mom for seven years. Since my four-year-old was born, I yell and lose my temper a million times a day. I saw a therapist, who wants to treat me for depression. I don't feel depressed. I just feel overwhelmed, hateful and angry most of the time. Is this depression, or do you know of any other condition that this may be? My gynecologist is prescribing Xanax for PMS because my symptoms appear more severe a week or two before my period. However, I feel this way most of the time. I don't want my children to remember me this way. After I have a blowup, I usually feel ashamed and go off and cry. I can't control these outbursts!

-- Louise

Your situation is a good example of some of the problems with using a medical model to explain and address emotional difficulties. In the medical way of conceptualizing problems, there are categories of diseases or disorders into which every individual must be placed. Accurate diagnosis, it is hoped, leads to effective treatment for that type of problem. (You also need a specific diagnosis to receive insurance reimbursement.)

But the medical model, as it is applied to mental and emotional health, has often been criticized by therapists who believe that a complex individual and the troubles he or she experiences can't be boiled down into a label ... or even two or three. And there's concern that labeling an individual as having a certain disorder may lead others -- professionals or laypeople -- to see and treat the label rather than the real person.

You say that you feel "overwhelmed, hateful and angry most of the time." Yes, depression may manifest itself in that way. But without contradicting the opinion of your therapist -- who, after all, is the person who's actually seen you face-to-face and heard more of your story -- it seems to me that whether you call what you're experiencing depression or anything else is secondary to the fact that you feel "overwhelmed, hateful and angry most of the time," and you're needing and wanting help.

Talk with your therapist some more, and let him or her know of any questions or concerns you have about the diagnosis and recommended treatment. (Keep in mind that if you have a tendency to get angry easily, you might be easily aggravated in therapy and run the risk of prematurely terminating a potentially effective means of help.) Make sure the treatment includes psychotherapy and stress management.

You also may benefit from having some regular leisure time away from the kids -- whether it's a date with your husband, lunch with a friend, or quiet time by yourself. Those kinds of self-care activities replenish and restore us. If we're personally depleted, we're essentially running on empty and don't have energy to focus on those who depend on us, like children. When we're tired and run down, we're more easily irritated by things we might otherwise take in stride.

Please do talk more with your therapist about what you're experiencing, and work with him or her to find out what best helps YOU, the individual -- not the diagnosis. Good luck.