On june 20, 2001, Andrea Yates of Houston, Texas, drowned her five children one by one in the bathtub in her home. She was clearly seriously ill and had been treated with the drugs sertraline (Zoloft), olanzapine (Zyprexa), haloperidol, and lorazepam among other remedies. Her attending psychiatrist had rejected electroconvulsive therapy (ECT) for her on the grounds that it was “for far more serious disorders” (Denno, 2003). She was said to have committed this terrible act in the grips of major depression. But that cannot be right. “Major depression” is not a specific illness. She had psychotic depression. She was improperly diagnosed, evaluated, and certainly inadequately treated. Her illness gave her an overwhelming compulsion or she would not have pushed the heads of her children underwater in the delusive belief that she was saving them from Hell.

Andrea Yates herself was caught in the jaws of Hell. An editorial in the British medical weekly Lancet in 1940 called depression “perhaps the most unpleasant illness that can fall to the lot of man” (Lancet, 1940), and in the midst of a psychotic depression, Yates had opportunity to experience this. Psychiatry could have rescued her, but confusion about her diagnosis and her treatment interfered.

The Andrea Yates story had one more chapter, in which the reality of her illness from psychotic depression was finally understood. An appeals court overturned her original conviction because of inaccurate evidence from Park Dietz, a forensic psychiatrist who had testified for the prosecution.