This morning I was visiting an online bipolar support group and saw a member asking people about their experience(s) with electroconvulsive therapy (ECT), more casually called “shock treatments”. That reminded me of my past research, before having ECT, when I found plenty of positive stories, as well as what I believe to be exaggerated horror stories. I’ll tell you now, that ECT is no longer what people saw in the movie One Flew Over the Cuckoo’s Nest, and hasn’t been since well before the movie was made in 1975. Nevertheless, it is still a serious treatment for some types of mental disorders, which should be done only after careful consideration.
Believe me when I say I had initial reservations about having such serious treatments. I remember the first time it was suggested I was manic with mixed features, meaning manic with also depressive symptoms mixed in. The mental healthcare professional that first suggested it was very new to me, and being manic, I was far from being an agreeable person. If I recall correctly, her suggestion even triggered me to have a major anger outburst so severe that I was dragged into an isolation room and sedated by medication injection. I was in the psychiatric hospital at the time.
During the above-mentioned hospitalization, I believe I was put on some rather high doses of antipsychotic medications that were also supposed to be helpful for mixed manic and depressive symptoms. The medications seemed to help bring down my mania rather quickly, so I was discharged in a couple of weeks to an Intensive Outpatient Program. My memory is a bit sketchy of that time, but I know my mood eventually switched to a pure depression, with no mania. The medication cocktail didn’t even touch my low moods, and over a short time it made me rapidly gain weight to the point of near obesity. Hopelessness set in and I became severely numb in spirit. Almost one year passed. I had been seeing my regular psychiatrist again for what had been severe depression. When he suggested ECT, I finally felt it was worth a try. It seemed like the last resort, and I trusted this psychiatrist.
ECT can be done in-patient or outpatient. My first ECT treatment was outpatient. My husband took me, waited, and then was home with me afterwards, as they suggested, because a light level anesthesia is administered. You are therefore unconscious during the actual procedure/seizure, so do not feel any pain or shock. A neuromuscular blocker is also administered to prevent injury. Some people receive unilateral treatments (on one side of the head), others bilateral (on both). I received unilateral, which is generally thought to cause fewer side effects. After the procedure is done, patients wake up a bit later and generally have a light snack and drink, since treatments must be done on an empty stomach.
People receiving ECT generally receive multiple treatments. I happened to receive seven in total. After my first treatment, my husband and I decided that I’d have the rest inpatient because, frankly, no one was available (or willing) to take me, wait, and stay with me afterwards. I confess that some of my treatments are absent from my memory. I only know the numbers from being told, afterwards. Yes, memory issues are experienced by some (not all) people receiving ECT, but usually just during the course of the treatments and/or slightly after. My minor memory issues seemed to start after my third treatment. The most notable were after my last, which included forgetting how my husband took his coffee, forgetting how to get to the phlebotomist office, forgetting where my husband was taking me on the way to a ballet in New York City, and forgetting that I had sworn off drinking. These may sound scary, but I did not forget anything bigger or more important, and when my husband would remind me of things, I would usually say “Yes, I remember!” Other people I know had even lesser issues. I’ve only read of a few with worse. My memory issues passed after a short bit.
My husband said I expressed a significant improvement in my depression after the fifth of seven ECT treatments. After my seventh, I returned home from the hospital. The psychiatrist wanted me to have maintenance treatments, but my husband and I decided that I wouldn’t. I felt better, we didn’t want the extra expense, the memory issues were a little disconcerting, and I would still have the issue of not having anyone to take me and stay with me on those days. Unfortunately, my depression crept back after a short while. I suppose I could have gone back for more ECT and found someone to take me. Perhaps. Instead, my Intensive Outpatient Program psychiatrist totally overhauled my medication mix. My regular psychiatrist added a couple additional medications, and I finally started to get relief again that lasted a while. I’m not sure, but I sometimes think that having had ECT made it possible for the new medication mix to work, where it might not have otherwise.
If I encounter a very long hard to treat depression in the future, I wouldn’t rule out ECT again. I wouldn’t rule it out, either, if I had a very long hard to treat full blown mania, or related issue. I would still use it as a last resort, though. In those cases, it can be a lifesaver.