Looking back on her life, Bettie Davis thinks she may always have had depression, and her mother and grandmother may have lived under its cloud as well.
Ms. Davis, a 65-year-old chemistry professor at Saint Vincent College in Latrobe, did not get an official diagnosis until she was in her 50s. But she was often lonely and sad as a young woman, and even spent a week in a mental hospital after a suicide attempt with pills.
Yet it was not a subject anyone broached as she grew up on a family farm near Danville, Va. "We never talked about it. Occasionally my mom would say, 'Well, grandmother's got the blues.' It was just something women go through."
"Her mom probably was clinically depressed, but in the culture her mom grew up in, good Christians didn't get depressed," added her husband, fellow Saint Vincent chemistry professor Matt Fisher.
Today, Bettie Davis has a stable and often sunny life, thanks to psychotherapy and years of antidepressant treatments. And she also has decided to let the light shine on her condition. After the first part of the Post-Gazette's "Mysteries of the Mind" series was published in January, she and her husband contacted the newspaper, volunteering to tell their story.
She wanted people to know depression could be discussed like any other illness and that effective treatments are available. "I want people to realize there is help out there -- get it. We have good health insurance from where we work and the medications are not that expensive, and I'm hoping with the Affordable Care Act, maybe people will be able to get the medications and have this taken care of."
While she had episodes of sadness throughout her adult life, her illness didn't reach a crisis point until after she and her husband had moved to this area from Virginia.
It began with the longer and colder winters, triggering the emotional slump known as Seasonal Affective Disorder. But then, in 2001, her aunt died, and not long after, a beloved pet died as well, and soon, Ms. Davis was spiraling downward.
"I didn't want to go anywhere or do anything. I would go to work, I would come home and maybe watch the news, but my main thing was just go curl up in the bed and stay there. I didn't want to go anywhere or see anyone.
"I knew something was not right. I was watching other people say, 'Wasn't that a wonderful party the other night?' I would say, 'No,' because I sat in the corner all night. I started making excuses not to go out, and I started eating more and being less active."
Some of her thoughts were so dark she whispered them only to herself. "I kept thinking, the best thing for me to do is to stop it all right now and disappear, and there were so many times when I was driving home from the grocery I thought, 'You know, it wouldn't take much to turn the wheel and run this car into a wall.' "
Eventually, just before Christmas of 2001, her husband confronted her and told her she needed to seek help. "There was this permanent cloud over her and it was getting bigger and darker and it would not go away."
After the holiday vacation, she saw a psychotherapist at Excela Latrobe Hospital. "He was good. The next thing I realized I was pouring a lot of stuff out to him. And he said I think we need to talk again." Eventually, he put her in touch with a psychiatrist, "and everyone agreed I had moderate to severe depression." She began taking Celexa, an antidepressant.
It was the beginning of a long journey toward normality. In the past decade, she has tried six different antidepressants, complicated by the fact that she metabolizes medication rapidly and often needs higher doses than a typical person. She is currently taking Cymbalta, also known as duloxetine, and it seems to be working.
What have the medications done for her? After she began taking them, "I'd talk to people. I would do things; we would go to parties with people, or have people over here. We'd go to a movie. There were so many times before all this when I would go in my office and hide."
Before she and her husband volunteered to tell their story to a broader public, she already had taken an important first step to emerge from the shadows.
"In some of the classes I teach, we talk about being on antidepressants, and I mention that I am taking them, and it's amazing, as soon as I mention I am depressed, within 24 hours I will have several emails from students saying 'Thank you, because I also am on antidepressants.'
"Now students will come into my office and talk about their experiences, male and female, who will sit there and cry. They will say, 'Do you think I should be on medication or go talk to somebody?' There have been some people I've referred who were diagnosed and now are on medications."
"I think the medical community is better at identifying depression today," Mr. Fisher said, "and while there is still more work to be done, we are more open about it than we were 20 or 30 years ago. I'm extraordinarily proud of the way Bettie approaches it. She's very honest about it, but she's not overly dramatic. She says, 'This is part of my life and here's what we do to deal with it.' "
The lesson they have learned in their journey together, he said, is that "it is possible with the medications and psychotherapy to get to the point where the depression no longer rules your life, but has just become part of the rhythm of our marriage. Life goes on and it's been wonderful and rewarding, and it's no longer a situation where the depression is dominating everything else."