Shock treatment

[coolestwhiteboy]

Cecil is right when he says electroshock is used and/or justified when the patient is otherwise doomed. My mother suffered a couple of strokes a few years back that affected her little physically but put her into a continual very-high-anxiety state that made it near impossible for her to function. In fact, we had to put her into a nursing home--this at the age of 74.

Diagnosed as having depression (I disagreed and said anxiety caused by brain damage), my mother had a series of six ECT sessions. The result? She drooled some and was real spaced out for a while, and she forgot about a year of her immediate past, and . . . she got a lot better for about a month--as perhaps anyone might feel better if he or she forgot the last crappy year of his or her life. Then she slowly slid back into her original anxiety state.

In some cases, electroshock can be helpful. But the benefits can be sustained only with serious aftercare therapy.

[C K Dexter Haven]

The link to the column under discussion is:
What happens in electroshock therapy?

Coolest, it's helpful if you provide the link to the column you're commenting on, so that others can read the column and follow what you're saying. Keeps us all on the same page.

[coolestwhiteboy]

10-4.

[ShibbOleth]

My understanding was that someone "thought up" electric shock therapy after witnessing the way cattle were thwacked in the head at the Chicago cattle yards. Apparently the practice was to use a sledge hammer to the forehead of the cattle as they came through a chute. This normally killed or incapacitated the animal, but sometimes sent them into a seizure. Since whacking patients in the forehead with a hammer might seem a bit extreme, electric current was used instead. Now this sounds a bit apochryphal, and I am too busy right now to try and find a cite, but if it's true it's a nice bit of trivia and would add a Chicago spin.

[sford]

"Another use of the Sledge-o-matic! You can cure a mental patient! But you gotta hit that sucker juuuuuuust right..."

(We now return you to your regularly scheduled serious discussion.)

[maralinn]

"Italian psychiatrist Ugo Cerletti was the first to try electricity to induce grand mal seizures after seeing how slaughterhouses stunned pigs into unconsciousness before turning them into pork.

"In 1938 he tried it on a clearly psychotic man who talked only in gibberish.

"'The third time was the charm,' said Timothy Kneeland, a history professor at Greenville College in Greenville, Ill., who has just completed a book on the history of ECT. 'He snapped out of it and asked where he was. But the cure was short-term.' It caught on very fast, Kneeland said, quickly replacing chemically induced shock treatments in England and the United States. It became popular in part because there were no other treatments. But it was also appealing, Kneeland said, because it was fast and simple."

http://www.ect.org/news/revised.html

[Morgasm]

Let's not forget that many, MANY genius's of jazz music were subjected to ECT in the forties for no other reason than they were black, anti-establishment and were carrying a message that white america simply could not get with. Two names spring to mind as the most affected by it. Charlie Parker and Bud Powell... It ruined Bud Powell's life, actually, but they couldn't destroy his mind. Listen to any Bud Powell record as proof. Just thought you'd like to know...

[coolestwhiteboy]

I can't figure out how the Italian guy got to humans from pigs, but I believe that other shock-inducing treatments were used before electroshock came along. I'm thinking insulin was used, and I figure medico-shrinks thought it was a way to "snap" people out of a mental condition that they seemed stuck in and which seemed incurable.

Electroshock DOES work for some cases of depression, but I would spend a lot of researching alternatives before going for this treatment.

For a worse example of crazy psychiatric methods, see lobotomy, for which I know of no practical use.

[DaveoRad]

My sister underwent ECT back in the '80s. This seemed to have little effect on her other than that some things she'd learnt years before -- e.g. religious teachings -- went right out of her head and she had to relearn them. Later, at a different facility, she was diagnosed with bipolar disorder and treated with medication.

[MonkeyMensch]

Morgasm, if you could gice a reference or two about your statements it would be helpful. I read many, MANY musicians as scores or hundreds of people. I'm sure that you would have to already be in an institution to be administered ECT so it seems like your number is just a bit too high. If you could give a reference it would be terrific.

MM

[coolestwhiteboy]

Mr. Morgasm--Yes, I am interested in learning more about Bud Powell, too. I looked at a couple of website articles and found this snippet:

The resident psychiatrist included "delusions of grandeur" in his assessment after Powell claimed to have composed a hundred songs. http://members.tripod.com/at_the_jazznote/powell.html

Thanks--

CWB

[Morgasm]

I have no numbers regarding just HOW many of the great jazz musicians of the forties were subjected to this treatment. A lot of black musicians of the bop era (mid forties to fifties) had problems with alchohol and or drugs, and were often committed to institutions like Bellvue or Camarillo for periods of time when their behaviour was at it's most outrageous. They were not crazy, nor were they suffering from any mental illness other than perhaps the frustration of being a black artist during that time. ECT was used as a tool of racism, by people who were scared of the radical ideas in music and art that they were bringing to America. It was often the MOST revolutionary, progressive and controversial figures that "required" ECT treatment. Charlie Parker, Charles Mingus, Bud Powell, Thelonius Monk, Coleman Hawkins, Lester Young... I believe were all some of the musicians that were subjected to this treatment. It was an obvious attemt to crush the most revolutionary figures of the movement they were involved in. In the case of Bud Powell, he had no delusions of grandeur. THE MAN WAS A GENIUS!!! He wrote not hundreds, but probably THOUSANDS of tunes, and every single one of them a gem. So sad he had to live his life in pain and misery, in part due to the misapplication of shock therapy he was subjected to. Artist's minds are fragile things...

[AHunter3]

Shock therapy and psychiatric medication are both horrid in their own ways, but what a difference.

Psych meds tend to have bad side effects, including permanent damage to brain tissue. But they are at least side effects. Taken in the short term, they may help some people get through what they have to get through long enough to gain some more permanent solutions to things.

Electroshock, however, has as its primary effect--the way it WORKS, without which it wouldn't do a bloody thing--the destruction of brain tissue. The memory loss is accompanied by a short-term mild euphoria that is the brain's own paradoxical reaction to brain damage. The euphoria doesn't last; the brain damage does, and in a great many cases permanent memory impairment and permanent flattening of affect are also permanent.

I'm sure there are a few people who were jolted out of a chronic depression that nothing else could touch and who didn't just sink back into it within the following 2 years, and also some who have no major complains regarding permanent loss of memories they would rather have kept; but there are far too many whose experience with the procedure has been unspeakably horrible.

Your mileage may vary of course. If you wish to believe that electroshock is a great boon for the 'mentally ill', you certainly have my permission to go lick the light socket next time you're feeling down.

http://members.aol.com/ahunter3

[DSeid]

Depression isn't just feeling a little down. It is a potentially life-threatening condition.

My wife had ECT.

Thank God for it. Meds weren't working; ECT did. The worst side effect was spotty memory loss and in ways that make no sense to me, and my biggest hobby is neuroscience. She's currently happy, intelligent, productive, and bossy.

I kinda think of it as being like when my computer freezes. Sometimes you just gotta restart the processor to get it to work right.

[AHunter3]

DSeid, as long as it is on the basis of fully informed consent (and no conditional coercions, either), I have no problem with that.

[Jeremytt]

Some of the attitudes toward ECT in this post are a little narrow-minded, I think. It's important to remember that ECT is only used as a last resort, when the patient's life is in danger.

People don't realize depression is a real live illness, life threatening at it's worst, something that sometimes isn't treatable by any other means than ECT.

Is it better to have ECT for long term treatment, or lose your life?

[AHunter3]

Some of the attitudes toward ECT in this post are a little narrow-minded, I think. It's important to remember that ECT is only used as a last resort, when the patient's life is in danger.

Horse doovers. ECT is used as a last resort when the patient's insurance coverage interval is about to run out. One last expensive treatment that also makes the patient briefly appear appropriate for discharge.

It is also used to punish patients whose "ideation" does not please the shrink. (Many published examples available on request).

It is used as a strong negative reinforcer for miserable patients, who often do not feel any less depressed when they stop appearing to be depressed...they just don't want to be shocked any more.

[DSeid]

AHunter,

Well, our family's personal experience was that it was a last resort, and an effective one.

You seem to have some anger directed against psychiatry in general. (You think that meds and ECT both damage the brain) Have you had some personal bad experiences?

Meds and induced seizures do NOT cause brain damage. They may be blunt instruments, but they more effective than talk therapy alone for some very real and very serious diseases.

[AHunter3]

You seem to have some anger directed against psychiatry in general.

Indeed. And I've noticed that the NYC Fire Department has seems to have some anger directed against Osama Bin Laden, too.

Meds and induced seizures do NOT cause brain damage.

Yes they do. Permanent and irreversible brain damage result from ongoing use of neuroleptic drugs in the phenothiazine, MAO Uptake inhibitor, butyrophenone, and several other major pharmaceutical categories. Tardive dyskenesia is the most commonly known (and the most visible), but iatrogenic dementias are also common.

Electroconvulsive therapy (i.e. electroshock) also not only causes brain damage but more or less depends on it.

[AHunter3]

DSeid, I should nevertheless say this: if your wife chose ECT and reports that she is glad that she did so, that it enabled her to function when nothing else would, I support her right to pursue whatever measures she finds necessary.

I also am libertarian (or anarchist) enough to think a procedure should not be illegal simply because it is dangerous, so I support the psychiatrists' right to provide the treatment.

However, it should only be administered under a voluntary basis (none of this "poor so-and-so doesn't understand her own condition well enough to know what she needs"); and that voluntary consent should be fully informed, which means that the person considering it should have full clinical and post-mortem study data pertaining to risks, common side effects, short-term and long-term statistical prognosis, mortality and morbidity, and so on.

Also, more information on my perspective on the mental health system is available here.

[Jeremytt]

AHunter, your perspective is a little narcissistic. Just because a given paradigm is anathema to you, that doesn't mean it's anathema to the rest of us.

I can say that biochemical deviations of seratonin uptake do indeed run in my family. Almost any one of us with X blood in us suffers from some variation of depression.

Thing is, seratonin deficiency can both be found in the blood and can be induced in laboratory animals.
The medical research behind the theory is sound, Ahunter.

That's not to say we know everything about clinical depression. Science is not static, and never has been. It's dynamic. We progress with scientific knowledge. Sometimes today's answers are tomorrow's regrets, but most often, we realize we are right. I'm sure new and better treatments for depression will come, eventually making ECT completely obsolete.

[DSeid]

Ahunter,

Thanks for the link to your site. It does explain your vehement perspective.

I certainly agree that there HAVE been abuses. And I can empathize with your feelings if you have percieved yourself, and/or those who you care for, to have been victims of such abuse. Involuntary committment/treatment generally requires that someone is felt to be a clear and present danger to themselves and/or others. I know of no-one who advocates such for anyone else. Nevertheless, the decision of what constitutes a clear and present danger is a subjective one. I'm sure that your research can document many examples were such asessments were biased by class and other status distinctions. (You may be interested in reading "The Insanity Files", which documents the case of Mary Todd Lincoln's committment, BTW.)

Still, your potrayal of psychiatrists as the enemy, and your lack of recognition of the tremendous good that modern psychiatry has done for so many ... your apparent denial of the biologic bases of many mental illnesses and their treatability ... this only fosters the unjustified stigma that mental illness still suffers and discourages people from receiving treatment that IS generally safe and effective.

[AHunter3]

Jeremy and DSeid,

If you would be so kind as to take a glance at the section titled "A Little Story About a Conference" on this page ...

OK, yes, my situation is a bit different. I would not describe myself as seeking help or treatment. (I actually went through a period of many years during which I wanted help pretty desperately, and might have been considered to be "depressed", but my experiences with psychiatry came later when I did not consider myself to be in need help).

I'm sorry that I so often come across as uncaring or insensitive to the suffering of others when it comes to these issues. I'm...well, at least mildly regretful? ...that my (warranted) skepticism about the psychiatric profession, its theories of biological-based "mental illness" and its "treatments" for same and so forth, are upsetting to people who want good treatment and care for their suffering loved ones.

I think there is probably common ground. Our concerns converge in places, especially with regards to quality of care issues and the prevention of abuse, and (hopefully) the attempts to empower the "consumer" of mental health services so that, on the one hand, the heavy-handedness of medical authority is ameliorated by an informed, organized, and aware population that insists on explanations, options, and choices; and, secondarily, so that funding for mental health services is no longer determined and allocated without the input of those who will be receiving and making use of it.

Hopefully, you would also agree that you and your loved ones benefit far more than you suffer from the existence of a vocal, angry, militant-radical contingent of pissed-off former mental patients screaming our heads off about callous disregard for patient welfare, unsafe treatments, misuse of coercive authority and violation of civil rights, and lack of adequate redress for malfeasance.

Jeremy is hoping for an improvement in the quality of the types of treatment and care that can be offered. While I remain unconvinced that the profession is even playing in the right etiological ballpark, I do think that candor and rigor plus research funded by other sources in addition to the pharmaceutical industry will stimulate new findings and improvements, and hopefully you, with your greater faith in their current knowledge base, would concur with that.

We are addressing the stigma by ripping the cover off the box: the profession, the patients, the condition(s) known as "mental illness", and the possibility of receiving treatment are ALL overshadowed with the stigma of how psychiatric treatment has been and continues to be used: as a means of dealing with those whose behavior disturbs society, for the benefit not of the patients but for the protection of society from them and the disturbances they create.

I don't think the stigma problem will ever go away until and unless we either quit dealing coercively with people except by charging them with violations of the law (unlikely and probably impossible) or else quit pretending that we don't do it by labeling the activity a form of "help" and imposing it on people who don't want it. Perhaps the police functions of psychiatry could be separated entirely from the provisions of mental health services for those who seek it--then we could go head-to-head with the police functions and have a better public debate over its abuses without the care systems being used as their shield and ending caught in the middle of the debate.

[Jeremytt]

Originally posted by AHunter3
.

I'm sorry that I so often come across as uncaring or insensitive to the suffering of others when it comes to these issues. I'm...well, at least mildly regretful? ...that my (warranted) skepticism about the psychiatric profession, its theories of biological-based "mental illness" and its "treatments" for same and so forth, are upsetting to people who want good treatment and care for their suffering loved ones.

With all due respect, AHunter, the biological-based "mental illness" is not a theory, it's based by hard science. Seratonin levels (in the case of depressed patients) and dopamine levels in terms of receptor sites(in case of psychotic patients) are very easily found in blood tests.

The funny thing here, AHunter, is that really we are talking about 2 different issues. I'm referring to psychopharmacology and ECT as a method of correcting seratonin levels, while you're talking about an almost-unrelated civil rights issue....(that is, involuntary treatment)

You might be right about abuses, and involuntary treatment, AHunter. But please don't throw out the good with the bad.

Without the help of ECT, at least one of my relatives believes she would be dead by now.

I wish I could talk to you about the civil rights issue, but it'd highjack the thread. In terms of social science, your topic is interesting, AHunter.

[DSeid]

JeremyT has a good point about your good points, AHunter!

Maybe a Great Debates thread devoted to civil rights abuses of the mentally ill and of those questionably labelled as such? (The "other side" being society's obligation to protect its citizens from danger, even danger from themselves.)

I am sure that you are correct that we'd find ourselves with a fair amount of common ground.