I have been diagnosed with major depression and a codependency problem. I was hospitalized for attempting suicide. I am now on Zoloft and am seeing a therapist once a month. I am still having huge mood swings. My therapist keeps insisting I try all kinds of techniques to help with stress and emotions. The thing is, my mood can swing in a split second. There isn't time to regroup and "do" a technique. I keep reading how female hormones can cause problems. How do I know if my problem is hormone-related or a true mental disorder? I need to know if I can be doing anything else to help myself get better. I have three kids and I am worried how my behavior will eventually affect them.

M.J.

Frankly, a once-a-month therapy session isn't enough, in my opinion, to address depression and codependency. The first thing I'd recommend is to meet with your therapist more often -- perhaps once a week or however frequently is needed to make progress. Perhaps you can bring up increasing your session frequency with your therapist, and also discuss your feeling that he or she is pushing you to do things you aren't capable of or that aren't working for you.

"Techniques" can sometimes be helpful in managing distressing feelings or experiences, but research has indicated that the most healing aspect of psychotherapy is the relationship between client and therapist. It can be difficult for a person to develop or maintain more than superficial trust and rapport with someone they see for only an hour a month.

To answer your question about whether your mood swings could be hormonal, see your gynecologist or, perhaps, an internist or endocrinologist. The gynecologist can assess your hormonal status and if, for instance, you might be entering or approaching menopause or have other hormonal changes that could be affecting your mood. Blood testing might also evaluate your blood sugar levels. Some people experience severe mood swings due to endocrine disorders such as diabetes or hypoglycemia, and proper treatment of such disorders (including any necessary diet and exercise changes) can often stop the emotional roller-coaster. Good luck!