A10-year boy presented with spontaneous episodes of oral bleeding for the last 6 
months. Detailed ENT examination showed no pathology, bleeding profile was 
normal, endoscopy and dental examination also did not reveal any abnormality. 
Child abuse or malingering was also ruled out. Initially the child was managed 
with platelet transfusion and fresh frozen plasma and then put on follow-up 
treatment with antifibrinolytics, Vitamin C but the episodes became recurrent. 
Psychiatric evaluation revealed that child was suffering from depression. 
Antidepressants were prescribed by the psychiatrist that not only cured the 
depression with time but also the bleeding episodes which were actually related 
to child's depression (Gardner-Diamond syndrome or psychogenic purpura). This is 
a diagnosis by exclusion where the patients bleed due to dysregulated steroid 
secretion secondary to stress; resulting in development of sensitization to RBC 
membrane, and dysregulated fibrinolytic system activity.