GRUNDY CENTER, Iowa — Michelle Kehoe’s defense opened its case Tuesday with description of the Coralville woman’s long history of mental illness.

“It is not faked, it is not feigned, it is not a story made up after the fact,” public defender Andrea Dryer said in her opening statement. “To a healthy person, death would not equal hope. To Michelle Kehoe, it did.”

Kehoe, 36, is charged with first-degree murder, attempted murder, and child endangerment causing injury. Authorities allege she killed 2-year-old Seth Kehoe and attempted to kill then 7-year-old Sean Kehoe by cutting their necks in October 2008. Afterwards, she cut her own neck.

The defense’s first witness, William Logan, a forensic psychologist, described 10 years of documented mental illness, during which Kehoe received treatment and tried both medication and as many as 44 treatments of electric-shock therapy. She had major depressive disorder and was not sane when she harmed her children, he said.

Alcoholic parents, childhood abuse, and two miscarriages contributed to her depression and two suicide attempts, Logan said. Kehoe likely developed some symptoms of post-traumatic stress disorder after her car — with her and both children inside — went into the Iowa River in December 2007. Though the incident was ruled an accident, Kehoe said in at least one instance that it was a suicide attempt, Logan said.

“She felt tremendous guilt for her sons and guilt for the men who risked their own lives to rescue them,” Logan said.

Despite worsening depression in the summer of 2008, she didn’t return to the therapist she’d been seeing, Logan said.

Logan believes Kehoe understood what she was doing the day she allegedly killed Seth Kehoe and injured his older brother, he said, but he concluded that she could not tell right from wrong during that time.

Assistant Iowa Attorney General Andrew Prosser countered in his cross-examination by pointing to Kehoe’s mental evaluations prior to the incident, which suggested she was doing better. Logan replied Kehoe’s depression had worsened after the last appointment, and she was extremely effective at hiding her symptoms from both doctors and family members.

“Maybe it was a façade, or maybe she really was normal,” Prosser asked Logan. “Maybe the family was deceived, but maybe it was you who was deceived.”

Logan replied that this was not a likely scenario.

Earlier in the day, the state closed its case.

Kehoe bowed her head and held a tissue to her eyes as autopsy photographs of her 2-year-old son were projected onto a screen.

Her husband, Gene Kehoe, looked away before glancing at the images as family members sobbed.

The prosecution’s final witness was Deputy State Medical Examiner Dennis Klein.

Klein said he determined the cause of death for Seth Kehoe was sharp-force injuries to the neck resulting in a critical amount of blood loss. The manner of death was homicide. He also identified several bruises and scrapes on the child’s chin, ear, and the left side of his head. They likely came either from impact or from someone “firmly manipulating” his head.

Only the veins in the 2-year-old’s neck were severed — not the arteries — which meant the blood loss was slower, he said. Klein speculated Seth Kehoe was conscious for several minutes, rather than just moments, after he was cut.

The defense’s final witness was a first-responder who helped transport Kehoe to the hospital for her own injuries. Dryer showed the jury pictures of Kehoe’s mutilated neck.

The case will resume today at 9 a.m. at the Grundy County Courthouse.