Depression and anxiety are well documented in patients with end-stage heart failure and correlate with a higher risk of suicide. We report a 69-year-old depressed patient who committed suicide by disconnecting the driveline of his left ventricular assist device almost 3 years after implantation. We provide the medical, psychologic, and psychiatric background of this unique case. This report highlights the importance of pre-implant psychologic screening, the need for regular and long-term psychologic support for this vulnerable patient population, and the need for more qualitative research on patients' views on living with a left ventricular assist device, together with research exploring risk profiles for depression and suicide.