Practice A Patient’s Journey

Psychotic depression

BMJ 2012; 345 doi: (Published 24 October 2012) Cite this as: BMJ 2012;345:e6994
  1. Rebecca Lawrence, psychiatrist and patient1,
  2. Stephen M Lawrie, professor2
  1. 1Ritson Clinic, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK
  2. 2Edinburgh University Division of Psychiatry, School of Clinical Sciences, Royal Edinburgh Hospital
  1. Correspondence to: R Lawrence Rebecca.Lawrence{at}
  • Accepted 4 July 2012

This patient works as a psychiatrist in the hospital where she is treated, and has been admitted, for depressive disorder. She tells her story, and describes her feelings about other health professionals’ attitudes towards her

I had an easy early life. My family was a combination of conservative and intellectual, and throughout medical school I fitted in. There were, perhaps, a number of warning signs of what was to come—a long period of blackness after a relationship ended, and one of poorly controlled mood before final exams—but hardly different from many others. I was unaware at that time of family history.

I coped well with the stress of house jobs followed by a number of senior house officer jobs and a period of travelling. I then decided, for romantic and literary reasons, to do my GP training year in Cornwall. It was hard work, but all went well until, after my marriage, I found myself rather unexpectedly—though not unhappily—pregnant. Quite suddenly my life fell apart. I don’t remember feeling depressed, but I became terrified of everything, afraid to eat, and convinced the baby would die. I saw a psychiatrist, who dispensed with note taking as it might apparently affect my career, and ended up briefly in a psychiatric hospital before being looked after by one of my fellow GPs, my husband, and my mother-in-law. I had no idea what was wrong with me.

When I was around five months pregnant, we moved back to Edinburgh and went to our GP, who immediately referred me to a psychiatrist, who sent me straight to the local hospital. I had last been there as a medical student, several of my friends and colleagues worked there, and my previous life as a doctor was instantly shattered. I had hoped to train as a psychiatrist …

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