Intended for healthcare professionals

Personal Views Personal views

An insider's guide to depression

BMJ 2001; 323 doi: (Published 27 October 2001) Cite this as: BMJ 2001;323:1011

My Hideous Secret

Thankyou to Kay McKall for having the courage to write "An Insider's
Guide to Depression", and publically sharing her "hideous secret". She may
be "stuffed to the eyeballs with medication", (that phrase illustrates so
well the ambivalence which I suspect so many depressives have towards
their medication - on the one hand, literally life-saving, on the
other,resentment at having to rely on pills (rather than oneself)to remain
in touch with one's "normal" self), but her humour and clarity of thought
shine through.

I too am a doctor on the seemingly endless road to recovery from a
severe depressive illness. I have the added shame of being a
psychiatrist... I say "shame" because, whilst insightless and fighting the
diagnosis, I was convinced that I, of all people, should have been able to
prevent the downward spiral or at least haul myself out. My GP felt that
I, of all people, should have been able to make my own diagnosis. Kay
McKall is so right: "don't expect us to have insight...We are the last
people to give you a balanced account of how we are".

I cried with relief as I read the article to know that there was
someone else out there who could describe so articulately the hell through
which I had travelled.

I would only add don't just "feel free to ask us if we're suicidal"
but treat a negative answer with sceptism. In my personal and clinical
experience, suicidal thoughts ( 'though not necessarily intent)are the
norm in people who suffer severe depression, yet doctors may find them
particularly difficult to reveal in themselves.

Sadly, I don't feel able to come clean about my "hideous secret" with
collegues and patients, as I fear stigmatism is rife in hospital medicine,
and so will submit this anonymously. But thankyou Kay - I admire your

Competing interests: No competing interests

06 November 2001