Carol Kivler knows she is not alone.

First diagnosed with a mental illness in 1990, Kivler, 59, suffers from periodic acute bouts of medication-resistant depression that responds only to electric shock treatment.

Since her diagnosis, she has had long periods of recovery and also four acute episodes of depression, each time requiring hospitalization and electric shock treatment.

She has been in recovery for eight years and is the president of New Jersey-based Kivler Communications, a company that provides corporate training development and coaching. And she wrote a book, "Will I Ever Be The Same Again? Transforming the Face of ECT (shock therapy)."

QUESTION: Is depression — the acute stage that plunges you into a need for shock treatment — prevalent?ANSWER: One out of five people have it, but men are reluctant to seek help. It's embarrassing and humiliating. You believe you are going to be judged. The general population views it as a character flaw or a bid for attention.I hid my diagnosis for 10 years. I was afraid if the college where I worked found out I had been in a psychiatric hospital getting shock treatments, I would lose my job. I also was afraid neighbors wouldn't let children come to my home and play with my children.

QUESTION: What got you out of this box?ANSWER: I went to the National Alliance on Mental Illness conference and found out there are other people like me, people who understand depression and don't judge. I became a professional speaker because I thought I had a God-given ability to influence and persuade.I thought I could really make a difference. I've even opened a company, Courageous Recovery. I speak in nursing schools, medical schools, hospitals. My children are grown up and have told me it's OK to tell my story if I help one family going through what we went through.

QUESTION: You say being depressed made you more depressed?ANSWER: If I had a heart problem, I would need to take medications and I would take them for the rest of my life. But I kept wanting to go off the depression medications. The public has a skewed vision of clinical depression and electric shock treatment. It is a difficult illness to accept.

QUESTION: How do you live your daily life?ANSWER: With this illness, I have to exercise. It brings in endorphins. Also I need to watch my diet. With psychotropic drugs, weight gain is easy. I gained 30 pounds with my last medicine change. I have learned to make better food choices.I also have to really watch my sleep. It is deadly if I am deprived. I stay on East Coast time no matter where I am. I journal. I get things out of my head.I notice when I am helping others, I don't think about myself. So I volunteer quite a lot. Focusing on somebody else helps me a lot. And I'm into prayer and reading devotions. Also massage therapy and acupuncture. Acupuncture has helped immensely with my anxiety bouts.I'm always looking for things to be grateful for.When I'm sick, I lose three to four months of work and I am not able to stop the depression once it starts. I never know when it's going to come.

QUESTION: But it's been a long time?ANSWER: Yes, it's been 11 years since I had a very bad bout of depression. This depression is so acute. There are three to six weeks when a person with this illness is not engaged with life, is withdrawn and isolating, and not sleeping much.Depression is the number one cause of disability in America.It's hush-hush like AIDS or breast cancer used to be. Until it's out of the closet, mood disorders will continue to perpetuate a stigma that is the worst thing for sufferers they are isolated. People don't call or e-mail. Pretty soon the person doesn't care about appearance, seems irritable. There's a definite personality difference.

QUESTION: What is your goal by publicly speaking out?ANSWER: My goal is to really educate, advocate and instill hope in those afraid to get hope. I'd like to "normalize" depression, if you will. It's hard work to stay in wellness.And mental health disorders are genetic. My youngest son has had three bouts already.Stress is toxic to someone with a predisposition to clinical depression. We all have to learn coping skills.