Does anyone have first hand experience, or could they provide me some links to first hand experience, of Electroconvulsive (or Electroshock) Therapy?
Thank you!
I have treatment resistant depression, so ECT is kind of an, “Oh shit. I really hope I am never that severely depressed” prospect for me. I don’t think I have ever been so severely depressed that I would need ECT, as many of my depressive episodes are peppered with mania so I still walk, and move, and speak, but just claw at myself. I have suffered only one, I think, episode of catatonic depression. By that, I mean a depressive episode in which I was mute, rigid, unresponsive, unwashed and had stopped eating. But, the blessing of rapid-cycling is that mania came and dashed it away. At least, I think so. I don’t remember that time in my life so well. ECT is indicated for use in catatonic depression, basically for the risk of the person actually dying from food and water deprivation. So it’s not given lightly.
ECT fascinates me because it seems like the most ghoulish intervention imaginable. It almost seems to represent the bygone era of “asylum” days. It doesn’t seem to have changed much since its introduction.
For those reading who have no idea what I’m on about: ECT, popularised by Sylvia Plath in “The Bell Jar”, is a somewhat last-ditch treatment for catatonia, severe depression and sometimes mania. Like most other psychiatric treatments, nobody really knows how it works but, like some other psychiatric treatments, it does seem to work. It’s still used in Britain, although it’s not something you often hear about. It’s highly controversial as it’s known for causing loss of memory.
Filed under: Bipolar 1 Disorder, Bipolar Disorder, being mentally interesting, bipolar, ect | Tagged: bipolar, Bipolar Disorder
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You risk getting a real s**tstorm argument in your comments with this question….
…The Shrink (Lake Cocytus) had a post on the subject some time ago.
Liz Spikol (the trouble with Spikol) had ECT and she talks about it in various places in her blog – it didn’t do her much good I think.
The interestingly named “Dr Shock” (Dutch psychiatrist with a blog) is, not surprisingly given his moniker and website, ectweb.org, in favour of it.
Finally, the folks over at Furious Seasons hate it with a passion.
I think the controversy comes from two things:
* Long-term memory loss. Some people insist that it doesn’t happen, others that it does. The jury’s out on this one, but it does seem that some people have this problem.
* It seems to be common in the USA to force ECT on people under a section. Something that can only be done here in specific circumstances.
My psychiatrist in 1998 refused to give it to me on the grounds that I didn’t have severe enough “somatic” (ie physical) symptoms (not eating, not able to get up etc) and so he reckoned it wouldn’t do any good. Mind you, he wasn’t the sharpest tool in the shed.
The Liz Spikol videos are good.
The Trouble With Spikol: The ECT story
http://www.youtube.com/watch?v=d2bLbf4kBFE
The Trouble With Spikol: Post-ECT wrap-up
http://www.youtube.com/watch?v=qSZ1W6xKxaw
Part of the reason I avoided mental health services for a number of years what that I worried they would give me ECT. I find the subject quite frightening.
Oh. madpatient is me, by the way. I forgot to log out that identity. I have multiple web identity disorder.
Hey Tony and Dee!
Ahhh, Liz Spikol is just my hero. I love her.
There and back to see how far it is has done a great post on it http://thereandbacktoseehowfaritis.blogspot.com/2008/06/spotlight-on-ect.html
and bipolar male http://bipolarmale.blogspot.com/ has written alot about it too but i cannot find the exact posts
http://bipolarmale.blogspot.com/
writes about how it worked for a while but didnt finish the course of ECT because it damaged his back and there and back to see how far it is
http://thereandbacktoseehowfaritis.blogspot.com/2008/06/spotlight-on-ect.html
has done a spotlight on ECT post, its quite balenced concluding that if things got as desperate again she would have ECT again
http://www.youtube.com/watch?v=CCOSWkrmb1E&feature=related
Just listen to this. Great song and keep on flying.
Hey.
I had a friend who got ECT at the start of the year, she underwent a course of four or five sessions.
She described the after effect as being although her head had been whisked, not sore just a bit different, flushed through. She didn’t really experience any memory effects as the result of ECT but she doesn’t respond well to general anaesthetic. To sum up the experience was helpful but not one she would choose to repeat.
I second the Spikol recommendations though.
I had a course of ECT last October (as ‘colouredmind’ said I have ‘blogged’ about it). I was having a severe depressive episode and was reaching absolute desperation. That’s why I agreed to it really, a kind of ‘desperate times call for desperate measures’ situation. Though I was eating and drinking (albeit minimally), that was about the only level on which I was functioning,
I have to say, it definitely helped me. It got me out of the big black hole I was in, to a state where I stopped crying and was able to get up, washed, out of bed etc. I had ECT as an outpatient and was treated by a set of very supportive and understanding nurses and I think that helped. I have, however, experienced memory loss from having ECT, particularly, short term memory loss and I have struggled with that. I was given unilateral ECT as opposed to bilateral ECT which is supposed to reduce the memory loss symptoms, but didn’t in my case. It take a day to recover from the anaesthetic but I just felt slightly fuzzy as opposed to completely out of it.
People seem to have very polarised views of ECT; either it’s terrible, barbaric and awful or it’s a very good, life-saving treatment. Before having ECT I certainly felt the former but having experienced the treatment I can now see how the treatment can be helpful, used appropriately, with safeguards in place.
If I reached that level of desperation again I probably would have ECT again. It rapidly improved my quality of life, which is what I needed, and for me that has to come over and above everything else.
Hope that helps.
Your blog description of NHS services is suspiciously close to my ex blog tagline of” navigating her way through the labyrinth of NHS mental health services”
Thanks for sharing- it seems more common than I thought. I’m of the opinion too that it’s helpful rather than hurtful, though I guess it depends on experience.
Really?! That made me laugh! That’s what’s it’s like though isn’t it?!
Well, yep!
Sorry for being snappy, I am just paranoid about being plagiarised, it happens a lot more than you’d think and pisses me off.
I love your spotlight on ECT post, btw!
Sorry for being nosey, but how many treatments did you have?
Thanks :0)
Um…let me think…I had a course which lasted several weeks. I had three close together e.g. in a week and then three more, one each week, so six in total. Was reviewed weekly by my consultant though during that time and could have refused to have any more at any time.
Try the Crazymeds forum – I think there have been a fair few frank and honest accounts listing both the positives and negatives – including a checklist of things to do before you go (ie writing down passwords that you may forget etc).
I didn’t think it was common practice to give ECT for bipolar patients? Problem with anything with AD qualities is it tends to push the polar patient into mania. If you’ve been deemed more of a risk manic than depressed, I could well see them exploring other options first (such as atypical AD in combo with mood stabilisers/AAPs).
To be honest I haven’t read much into it as memory problems is the one side-effect I cannot stand – I’ll take weight, bad skin, GI problems, headaches, sleep problems (wouldn’t make any difference to me), hair loss, BP problems etc over memory problems.
That’s possibly something to think about – from what I know memory problems are the worst of the side effects – how much do you value your memory?
I think they would always explore other options first when it came to manic depression. I think ECT is really really really a last option in that case.
I’m more of a manic depressive than a depressive depressive. I wish I wasn’t, because ADs make me manic, even with mood stabilisers (both Lithium and Depakote), Lamictal on 100mg left me feeling dead (and 50mg, yet to be seen) and antipsychotics have no effect whatsoever on my depressions. I just feel like I’m left to be depressed. When it gets bad, yeah, call in the Crisis Team to make sure i don’t top myself, but medically, so far nothing is working.
I have severe memory problems due to medication and just the illness in general. I can’t stand it, because I don’t remember huge portions of my life and struggle to recall what I did even a few days before. And I always forget conversations with people.
Here’s a web video about ECT given by a neuroscientist who underwent the treatment himself as a patient in the 1960s, – informative, quite upbeat, he seems to think it worked for him at a time when not much else was available. ( though that’s getting on for 50 years ago now.)
http://blog.ted.com/2007/10/sherwin_nuland.php
Here is a post with 9 videos about ECT, regards, Dr Shock
http://ectweb.blogspot.com/2007/12/9-videos-on-ect-electroconvulsive.html
Seaneen,
The first link is to the site of a man who went through ECT. I haven’t read the book but would like to. It’s being made into a movie. He seems a bit much but the book may be helpful.
http://www.electroboy.com/biography.shtml
This link is to an article written by a woman whose teenage son went through ECT. Her first article described the descent into catatonia her autistic son suffered through overmedication with antipsychotics, then his miracle recovery after a stay at the Mayo Clinic. She didn’t say what they did for treatment, fearing stigma, so wrote this followup article about the ECT that helped. If you read through the letters, there are many personal responses by people who have done ECT; some loved it, some hated it.
http://www.salon.com/mwt/feature/2007/06/19/electroshock/index.html
My auntie has a manic depressive friend who undergoes ECT periodically pretty much as a means of saving his life, so it can be very helpful to people with bipolar disorder.
I’ve read about ECT with great interest as it is a far safer alternative to medication during pregnancy. I’m far more at the depressive end of the spectrum and spent many months in the catatonic state you described before I was put onto medication, and I have to accept that there is a very real chance I would become a danger to myself and even more importantly the baby, so I would gladly have ECT if it was needed. From what I’ve read the risks involved are very small, and I think me being ill would be far more harmful to the baby.
Hmm. Which of the AD have you tried thus far? SSRIs and those which screw with dopamine usually are a no-go for BPI (even for BPII). I’d consider Mirtazapine – it’s one of those for severe depression and also acts as a sedative – however, unlike something like Venlafaxine, it isn’t stimulating. Other than that, trazodone, another sedating rather than activating AD.
Although I can see why you/your doctors want to avoid them, but AD therapy usage in bipolar is very much hit and miss, you can get people who are manic-as-hell tollerate them with an AD, and some predominantly depressed BPII patients who flip into manic states with even a small dose of an SSRI.
If you’re considering ECT, read up on MAOIs – they require major dietry changes, but some see that as preferable to ECT, that said, they can be quite effective. Or TCAs? – Although they tend not to give these to patients thesedays (well, for on-label uses, they go mad with them for off-label uses) – particularly if you’re suicidal when depressed.
Have you tried an AAP in combo with an AD? It’s an odd treatment, but a possibility that the AD could elevate your mood, and the AAP would prevent a manic episode. It’s possible mood stabilisers aren’t for you (or at least the ones the NHS is willing to prescribe aren’t for you) – and more and more people now have AAP as either monotherapy, polytherapy or as a prn add-on for both BPI and II.
It might be an idea narrowing down the type of depressions you experiance – whether they’re characterized by anxiety or lethargy ect. If anxiety or agitation is prevalent, you might want to look into anxiolytics or prn low dosage AAPs.
Mental health is more than not being suicidal – it’s good not to be at an extreme where you are a danger to yourself – however, that should be a starting place – medication needs to be added to give a better quality of life (what’s the point in not being suicidal when you have no interest in life etc) – just remind your doctors that although your greatful that you aren’t suicidal, you still don’t feel ‘normal’.
Memory loss does indeed come with the medications and the disease (it damages your brain afterall) – but with ECT you’re looking at a different type of memory loss – I’d look into what sort of information is most commonly lost. I wouldn’t mind having some of my childhood memories erased, but things I need for my career I’d like to keep hold of.
I’d definately look into different med choices/combos – or even see if your pdoc has any unconventional treatments that he uses with other patients – or even ask if you could try certain meds as a voluntary inpatient – so if you do have a bad reaction, there are people around who can spot your mood changes, and can start administering treatment to correct it (or more likely hit you with some old-school APs and let you sleep it off).
Oh, and since you’re researching ECT, and there seems to be a lot of interest in it – how about an entry about all the things you find out? (plus your opinions on it all)
i don’t have first hand experience but i was in one hospital (the priory – just don’t believe the hype) where a fellow patient was having it quite regularly – she was always really confused and when her husband brought her little daughter in to see her once a week she often didn’t recognise them. i thought her whole case was desperately sad.
when i was in another unit, the smoking room was closed every friday morning so the ECT room next door could be in use. it was mainly for elderly or long term section patients – tbh i didn’t think about it much, i was too busy protesting that i had rights as a smoker.
as for whether it’s good or not – one nurse once told me it was like jump leads for the brain, which i think was a good description. i have to say, as someone who’s only experienced it in a vague sense, i tend to fall in the “barbaric” camp – that said i have been reasonably lucky in that lithium, valproate and various antipsychotics have worked quite well for me so it’s never been an option.
h x
My tuppence worth is here… http://bipolarmo.googlepages.com/ect
It is thought that the following might work in a manner similar to how ECT is thought to work perhaps you could try jumping into the Serpentine…………. then again perhaps not. might give people the wrong idea
“Adapted cold shower as a potential treatment for depression”
http://lib.bioinfo.pl/pmid:17993252
As a clinical psychologist, I’m not a big fan of ECT. At one time I was doing group therapy with a group of individuals with personality disorders and depression. Two of the severely depressed individuals got ECT during the course of the group. They completely lost their memories for 6 months prior to the treatment and were in a daze in the group for several months. At least now, ECT is only used in the most severe cases of depression. But this was not always the case. One patient told me about ECT being used essentially as punishment when he was an adolescent. That was 30+ years ago. In my opinion, ECT represents a severe punishment for depression. You can read more about it on my blog.
http://thecountryshrink.com
I must agree with thecountryshrink here. I once received ECT for whistling on a Tuesday and I subsequently lost my memory for 6 months, believing I was a haystack… I wish our health service was more like America and we could pay for private psychologists to tell us how good their treatment was.
i live in toronto, canada and i got myself some ECT back in november of last year – i had 10 sessions in total.
the first session, i lied to the anesthesiologist about my weight (as women do but what you must never do to an anesthesiologist who is trying to figure out how much anesthetic to knock you out with) and i was short changed and almost got zapped without being fully under. i had a muscle relaxant and couldn’t move to tell them but thankfully someone noticed something was off before i passed out from the shock.
i woke after the first one and immediately threw up and had the most excruciating headache and sore jaw that i had ever experienced. so much so that i almost gave up on further treatments.
i ended up holding out for the rest of the treatments and would end up taking an ibuprofen about a half hour before the session (with a tiny bit of water) and that seemed to help. by the third one i was good to go for the rest of the day in about an hour’s time.
it definitely helped lift my severe depression to a point of being able to function (i.e. shower, move). i had a relapse this february but then i was put on wellbutrin and that seemed to do wonders.
as for short term memory loss, my memory was shit to begin with – it’s just now i have something to blame it on.
would i do it again? probably not. it’s not after some time passes that you realize how traumatic the whole process was – the waiting room, the seeing other people coming from just getting shocked, hearing people come to from their treatment – it is an ECT conveyer belt/ assembly line – just moving people in and out and the wait and the getting electrodes goo-ily applied to your head comes back to haunt you for some time after.
but, i guess – if you’re treatment-resistant – there’s not much other choice, eh?
good luck to you and your decision – i feel for you,
c
I must apologise for my childish response to thecountryshrink last night but Seaneen had asked for first hand experiences of ECT rather than opinions and tales of the bad old days of which there are no shortage.
I don’t think suggestions of ECT being a punishment are helpful for a depressed person trying to make an objective decision on treatment, nonetheless, my wine induced knee-jerk reaction was rude and uncalled for. Sorry.
Have to thank you all for these responses. Fascinating and informative.
ECT freaks me out! My grandmother had ECT and my mum always said she was never the same since. That machine ugggghhhhhh.
I went through two different stages of it. The first time for 5 sessions and the last stage for one session. Turned out I have some disorder that made it take forever to come back around and the last time I stopped breathing for a bit. Anyway I did not have any success with it. I have seen a lot of people go through it and it is either the best thing to ever happen to their depression or it was a complete waste of time and effort.
http://www.untreatableonline.com/2008/04/shock-therapy-still-alive-and-well.html
Hi,
It is quite sometime that I visited you blog and I am now updated will all your posts. You look very calm, composed and relaxed in your video. I am happy about that. About ECT
Check this out
…one flew east, one flew west,
One flew over the cuckoo’s nest.
Ken Kesey.
Take care,
Sastha Prakash.