Former Maryland gubernatorial candidate and Montgomery County Executive Doug Duncan is trying to reclaim his old job. He discusses his family's history of mental illness and his personal battle with depression. (Nicki DeMarco and Nikki Kahn/The Washington Post)

Politics was always a passion and a joy for Doug Duncan, even as a boy campaigning with his mother in Rockville on behalf of John F. Kennedy. But by his third term as Montgomery County executive, elected life had become a miserable daily ritual: “Put on the suit, put on the smile, go home and sit in agony.”

Even as he led the way on projects such as the Music Center at Strathmore and a revitalized downtown Silver Spring — and served as a calming presence during the Beltway sniper attacks — Duncan was spiraling deeper into despair. In 2006, he aborted his campaign to become governor of Maryland, disclosing that he was severely depressed.

Now Duncan is back on the ballot, seeking his old job and competing against County Executive Isiah Leggett and County Council member Phil Andrews (Gaithersburg-Rockville) in the June Democratic primary. His descent into mental illness and his recovery are part of the story he tells.

“A not-so-funny thing happened to me on my way to Annapolis,” Duncan said recently to members of the Greater Bethesda-Chevy Chase Chamber of Commerce. “I was diagnosed with major depression. I pulled out of the race to get healthy for myself and for my family.”

Duncan always ends his narrative with a pitch for others who are in pain to get help in the form of therapy and medication. “I’m living proof,” he says, “that treatment works.”

Douglas M. Duncan is photographed in Rockville. Duncan has resurrected his political campaign after dropping out of the public eye in 2006 to cope with depression. (Nikki Kahn/The Washington Post)
A common illness

About 25 million Americans — between 5 and 8 percent of the adult population — will have an episode of major depression this year, according to the National Alliance on Mental Illness. The World Health Organization places the global reach of the disease at 350 million.

During a recent series of interviews, Duncan, 58, offered new details about his illness, different forms of which have afflicted his family for generations. He said his depression began earlier than he has previously acknowledged: in 2000, the midpoint of his 12-year tenure as county executive.

Duncan is the first candidate in the Washington region to make his mental illness an integral part of his presentation to voters. Although he is well known from his years as county executive and, before that, Rockville mayor, he faces an uphill climb in trying to unseat Leggett, a popular two-term incumbent. There has been no recent polling on the state of the race, but Duncan said that surveys conducted before he launched his candidacy showed that depression is “a non-factor” with likely Democratic primary voters.

If Duncan wins, he will join just a handful of American politicians elected after disclosing a psychological ailment, including Minnesota Gov. Mark Dayton (D), the late Florida governor Lawton Chiles (D), and former U.S. House members Lynn N. Rivers (D-Mich.) and Patrick J. Kennedy (D-R.I.).

Their successes illustrate a shift in public attitude since Sen. Thomas Eagleton (Mo.) was dropped from the vice-presidential spot on the Democratic ticket in 1972 after reports of his electroshock treatment for depression. Still, at least a few listeners at some of Duncan’s recent appearances said they were turned off by what he has to say.

“It’s a downer,” said Marcia Phyillaier, an Andrews supporter who lives in Leisure World. “People who are depressed, it can happen again. You don’t want someone like that in office.”

Experts say this attitude betrays a fundamental misunderstanding of depression and how it is treated. “It’s true that life stresses can trigger mood episodes, but that’s much less likely if they are appropriately treated,” said Nassir Ghaemi, director of the Mood Disorders Program at Tufts Medical Center in Boston. Ghaemi likened voter apprehension about depression to homophobia and racism and suggested that it will be generations before attitudes fully change.

On one level, Duncan has little choice but to try to address questions voters may have in the wake of his abrupt departure from the 2006 primary, followed by eight years off the political grid. But ultimately, Duncan said, his campaign will rise or fall on other issues: his ideas for the county’s future, for example, and whether voters agree with him that Leggett has not been a strong executive or visionary leader.

So why does he talk about depression virtually everywhere he goes?

“This is very personal to me.”

Family history

In the late 1970s, as an ambitious young Democrat dating Barbara Cumiskey, the Rockville county-courthouse worker who would soon become his wife, Duncan “sort of half-joked” that he’d dodged what he called “the family curse.”

His paternal grandfather, James Duncan, was an Olympic bronze medalist and World War I veteran who settled in France to work as a caretaker for an American military cemetery near Paris. In 1932, sinking into what was then called manic depression (now known as bipolar disorder), he shot himself in the stomach and chest. He spent much of the last 20 years of his life at St. Elizabeths Hospital in Southeast Washington.

Duncan’s father, also named James, was a National Security Agency analyst who took lithium for his bipolar condition. Doug Duncan remembers him as a loving but strict man for whom “no” was the default answer. Which made it easier to tell when he’d stopped taking his medication and was headed for a manic episode.

“You could tell he was getting sick again when he started to be nice,” said Duncan, the fifth of 13 children raised in Rockville’s Twinbrook neighborhood. Recalling out-of-the-blue offers of the keys to the family car, he said, “You knew it wasn’t going to end well.”

Visiting his father in the hospital after he’d crashed, Duncan said, “just tore me up.”

Mental illness cut a brutal swath through the Duncan family, so much so that its members were recruited for a 1960s study by the National Institutes of Health. Duncan said he can trace the evolution of treatment for mood disorders through his siblings’ collective history. Several of the older ones were hospitalized; several younger ones were prescribed medication that afforded them fairly normal lives.

Duncan always wondered when, or if, the sword would fall on him. He drove himself to earn a degree in psychology and political science at Columbia University in three years — in part to save money but also to see if he would break.

He felt no symptoms until 2000, when he took prednisone, a corticosteroid, to treat an allergic reaction. Mood changes are a well-documented side effect of prednisone, but at the time, Duncan wasn’t sure what was happening. He now believes that the drug triggered what was at first a chronic low-level depression.

“I just felt horrible,” he said. “Looking back, that was the beginning of something wrong with me.”

Paralyzing darkness

Barbara Duncan said she started noticing a new snappishness in her husband, who would erupt over seemingly small things. There were also crying jags.

“I was trying to exercise, trying to go on these runs, and all of a sudden I’d run up a hill and just start crying,” he said. “I’d wonder, what the heck is this all about?”

At the same time, Duncan was going full throttle at the job, which was his sanctuary. “The busier I was the better,” he said.

He was in Chicago at a conference in October 2002 when then-Police Chief Charles Moose called him about the first Montgomery sniper death. Four more would quickly follow. Duncan comforted grieving families and attended all the funerals, and it took a toll. “I remember seeing my mom outside of church one Sunday,” Duncan said, “and I just started sobbing in front of her about all these people being killed.”

Aides look back now and wonder if they should have spotted something — although the deeply interior nature of depression can make it hard for outsiders to identify. “I feel guilty as hell,” said former spokesman and political adviser David Weaver. “Doug is . . . a good poker player. You can’t always tell what he’s thinking by his facial expression.”

After Duncan won a third term as county executive, a gubernatorial run seemed a certainty. In 2005, as his campaign gained momentum, he started feeling what he calls “the pit” in his stomach, an anxiety he usually experienced only as election night approached.

The pace of the campaign accelerated the depression, triggering a relentless self-laceration — an interior drumbeat that he was unworthy and undeserving of victory.

Despite his reputation as an aggressive, and at times china-breaking, problem solver, Duncan found himself overwhelmed by the new landscape of statewide issues. “I’d say to myself, well, this is hopeless, we’re never going to fix this,” he recalled.

Small decisions — such as where to go to lunch — generated huge angst. He would sit alone in an office with a list of fundraising calls and emerge after two hours, none of them made. At night, he would retreat to the small den of his home on Forest Avenue in Rockville “and just sort of agonize.”

“I would sit and basically tell myself what a worthless human being, what a failure I was. What a loser I was,” he said.

His family saw a more distant, distracted man but, for a time, wrote it off to the twin pressures of the primary and governing the county. Barbara Duncan was reluctant to say anything that might derail the dreams of a man “who has only ever wanted to be an elected Democrat.” But when she heard her husband call his work to redevelop Silver Spring a failure, she knew something was desperately off.

She called Duncan’s sister Nellie Lide, who had also been treated for depression. Lide said that there was no question her brother was ill and that the only way he would recover would be to get out of the race.

Looking back, Duncan said he has no real explanation for why he waited so long to acknowledge how sick he was. Ambition? Denial? Fear? In an echo of his feverish self-recriminations, he calls it his greatest personal failure.

“Here I am, with this whole family history, and I’m just getting worse and worse,” Duncan said. “And I couldn’t figure out what it was.”

‘Never going back’

It took six to eight months of regular therapy and — after some trial and error — the right anti­depressant for Duncan to start to feel like himself again. He still takes Prozac daily and checks in with his therapist at Kaiser Permanente about once a quarter. His sons, including one who is an ex-Marine, developed an exercise regimen for him that includes weights, a stationary bike and lots of walking.

Duncan said he will stay on Prozac forever, if necessary, and do whatever else it takes to avoid a return to the darkness that almost consumed him. “I’m never going back.”

He said that his illness has changed him, probably for the better, and that he’s been moved by those who quietly approach him after events, asking where they can get help for a friend or family member.

“I find myself reaching out to more people now in a much more personal way,” Duncan said. “I hug people a lot more than I used to. I’ve sort of slowed myself down a little bit in social situations to listen more.”

His candor resonates with some voters, especially those who have had similar experiences in their own families.

“I am so grateful that he is talking about it,” said Tina Slater, a Silver Spring activist who has a bipolar adult daughter. “It’s so stigmatized. People need to talk about it.”

At the same time, Slater said, Duncan’s depression is not what she calls “a turning point issue” that will win voters otherwise disinclined. She said will probably vote for Duncan but not because of his medical history.

Rivers, who spoke publicly about her bipolar disorder while in Congress, said depression would not prevent Duncan from governing well. On the contrary, she said, he should get credit for seeking treatment.

“He’s not going to have the red phone in his office. He’s going to be county executive,” Rivers said. “What if he gets diagnosed with lupus tomorrow? What if he gets pneumonia? This is a man who recognized he was having a problem, and he got it under control.”