Activated from the disabled list on Tuesday in his hometown of Toronto before the Reds opened a three-game series with the Blue Jays, Votto sat in the visitors' dugout for 15 minutes and let assembled media into what had been a very private matter since he left the team on May 30.
The 25-year-old Votto revealed publicly that he was battling depression, anxiety attacks and issues that finally came to the surface several months after the sudden death of his 52-year-old father, Joseph, in August. Those issues led to some panicky moments and two hospital stays.
"They were overwhelming me to the point where I needed to go to the hospital on two separate occasions -- once in San Diego and once that nobody had been told about, I went to the hospital in Cincinnati when the team was on the road [in early June]," Votto explained. "It was a very, very scary and crazy night where I had to call 911 at three or four in the morning. It was probably the scariest moment I ever had dealt with in my life, and I went to the hospital that night."
Votto had his mother, Wendy, and three younger brothers with him at various times during his hiatus from baseball. He also was under a doctor's care. But that didn't always help -- especially when he was on his own.
"There were nights that I couldn't be alone," Votto said. "The one night I was alone, the very first night I was alone, was when I went to the hospital. I couldn't take it. It just got to the point where I felt I was going to die, really."
Votto went on the bereavement list from Aug. 9-15 after his father's passing, but he had never really faced what had to be faced.
"The first day back, I put that all on the back burner and just played baseball until the end of September," Votto said. "He was in my thoughts and I was dealing with it on a daily basis, but as powerful a moment that was to lose your father so young, in a way, I did suppress it. From the beginning of the offseason until Spring Training, I was pretty severely depressed and dealing with the anxieties of grief, sadness and fear and every single emotion you can imagine everyone goes through. I had a really difficult time with it. I was by myself down in Florida. I just was really looking forward to baseball. And when baseball started back up in February, I kind of did the same thing I did last August and threw it all on the side, threw all of my emotions on the backburner and just played baseball again."
It was when Votto didn't have baseball as a cloak of protection when the world crumbled around him. In early May, he missed several games with a bout of the flu. By the middle of the month, he suffered dizzy spells that were later diagnosed as a condition from an inner-ear infection.
"It was taking the time away from baseball, and recovering from being sick was when the first time all my emotions I had been pushing to the side -- that I had been dealing with and really struggling with on a daily basis in the winter -- they all hit me," Votto said. "And they hit me 100 times harder than I had been dealing with all offseason."
There were three occasions Votto had to be removed in the middle of a game: the first in Arizona on May 12, then in San Diego on May 16 and the last time at Milwaukee on May 29, just before he went on the DL.
"I literally couldn't stand up," Votto said. "The way you saw me in Arizona where Dusty [Baker] had to walk me off was similar to the two other occurrences in Milwaukee and San Diego. Although Arizona was a pretty rough time, Milwaukee was by far the worst. I thought I was going to go crazy."
It was after that game against the Brewers that Votto spent over 40 minutes in a closed-door meeting with Baker, general manager Walt Jocketty and head trainer Mark Mann. The true nature of his issues were kept in that office and not revealed to the team or the public. It was termed only as a "stress-related issue."
"We told the team as much as we could tell them at the time," Baker said. "The rest of it was for Joey to tell, because it was his business. I talked to them once or twice and explained as much as I could without betraying his confidentiality to me and Walt."
Last week before leaving on a Minor League rehab assignment, Votto addressed the team in a clubhouse meeting and revealed his bout with depression. He was aware of a potential stigma about opening up about a mental-health problem.
"I've been lumped into the Khalil Greene, Dontrelle Willis, Zack Greinke category," said Votto, talking about other big leaguers who have dealt with emotional issues. "I'm not saying one way or the other about those guys, because I don't know what they're dealing with. But I do know I've had a real struggle with my father's passing. It's really something I've had a real hard time with. It was my biggest hesitation coming out and letting people know, letting my teammates know. We're supposed to be known as mentally tough and able to withstand any type of adversity."
Votto was batting .357 with eight home runs and 33 RBIs in 38 games before taking his leave. Many of his home runs came in clutch moments interspersed between the flu, the inner-ear infection and the depression.
"He said his piece," Reds pitcher Bronson Arroyo said. "I think he wanted to let us know the problems he was having were significant enough that he feels bad about not being here with the team. But it was so severe that he had to walk away from the game for a while."
And now he's back, in Toronto of all places. Votto played in four Minor League games in Dayton and Sarasota, playing nine innings twice. He could have avoided the intensity of the spotlight of playing in his hometown, but he didn't want to wait.
"I didn't think we were going to get him back this soon," Baker said. "He said he felt ready. Nobody can really tell you when you're ready. You can feel it and believe it and just hope he's ready. I know he's ready psychologically to come back. I told him if he gets sore or anything happens physically to just let me know."
"Honestly, we could play in Timbuktu for all I care, just as long as I'm playing all nine innings and contributing," Votto said. "There's nothing like health. I look forward to feeling healthy on a consistent basis."
How did Votto know he was ready?
"I was having such a difficult time getting through the night that once I felt like I could get through two or three nights of sleep without having the phone beside me and worrying about having to call the hospital, I felt like I could start playing ball again," Votto said.
You never get over losing a parent suddenly. That part always will be tough. At least you never forget them, either. Votto always will have memories of his father and baseball intertwined.
"He was a very important person," Votto said of his father. "He would watch every single Reds game. He was the first one to teach me how to play baseball. I played catch with him on a daily basis when I was really young. He was a big fan. He was just in love with what I did and me. He was a great father to me."