Honnaiah had begun a relationship with fellow doctor Wrighton in 2008 while working in Liverpool. She later got a job in Australia but they stayed in touch and moved in together after she returned to Britain. The two doctors got engaged in 2010. But he did not inform about it to his parents.
He was wary of telling his parents about the relationship due to their cultural beliefs, investigating officer PC Huw Evans told the inquest.
"During a visit to Britain from India, his parents learned of the relationship and said they weren't happy about it. It was said his parents wanted him to marry someone from his caste or from the Bangalore area of India where he grew up," Evans said.
Honnaiah was alone when he injected himself with two drugs used in surgery seven months after their split.
"After the breakdown of his relationship, concerns about Dr Honnaiah's state of mind were raised by his colleagues," Evans said.