A 39-year-old-woman was admitted to the hospital after attempting to commit suicide by jumping off a bridge. She had been diagnosed with trigeminal neuralgia at the age of 19 years, which was refractory to medical therapy with carbamazepine and high doses of amitriptyline. She preferred to be self-medicated with benzodiazepines and alcohol to relieve her pain since she was 21 years old; nevertheless, such substance abuse led to impairment of depressive disorder induced by her rebel facial pain.

On admission, our patient fulfilled the criteria for major depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000), presenting with depressed …