Welcome to Back from the Abyss, where we bring you stories of hope and healing, recovery and redemption.

I'm Dr. Craig Hickcock, your host and resident psychiatrist.

Date of evaluation and date of dictation, March 1st, 2008. Identifying information.

35-year-old married white woman living with her husband and two children, ages 8 and 5,

self-referred to the clinic for a second opinion,

quote, I thought I needed to have someone else

look at my medications, end of quote.

History of present illness.

Maggie comes alone to the evaluation today

after having walked into the clinic last week

asking about a second opinion

or even an inpatient

stay to, quote, detoxify my system, end of quote.

The patient reports that she's been in treatment with Dr. A over the last eight years, but

is feeling like she's getting nowhere and continues to be very depressed.

She reports an onset of depressive symptoms going back as early as third grade, and since then she's had countless numbers of depressive episodes, lasting hours to months, some precipitated by clear stressors and others appearing out of the blue.

She experiences hopelessness and passive suicidality frequently, and this also goes back many years, although she was adamant that she would never try to kill herself.

Quote, I could never do that to my kids, end of quote.

I would never actually want to hurt myself.

She struggled with depressive symptoms through much of her life, but when she had her first child eight years ago,

she entered into a severe postpartum depression, and that is when she started seeing Dr. A. She says her mood has a very

strong seasonal component and she typically enters very significant depression in the fall and

...