Tell me what you know about electro-shock therapy.

Factual Questions
1

GrizzWife has a close friend who, under suggestions from her therapist and other doctors, is now undergoing ECT (Electro Convulsive Therapy). Electro-shock therapy, for those of us (me!) who are not current on medical terminology.

Our friend doesn’t live near us (we’re in Ohio, she’s in Vermont). She’s had a series of problems (Like parental and sibling family issues. She’s not in a happy marriage. She cuts her arms with keys, pens and other quasi-sharp objects.) She’s had episodes where she’s existing in a non-real state; perhaps a sort of dementia. She’s in her early forties; doesn’t drink, smoke or abuse drugs. She’s had a hard time staying on meds to help balance out her mental state.

And, the next step is ECT. GrizzWife has read MANY horror stories about the side-effects. Loss of memory with may OR MAY NOT be temporary. Loss of short-term memory around the days of therapy. Loss of nerve sensation. Inability to speak or walk for long periods following the therapy. Inadvertant electrocution. Current crossing the heart causing arrythymia. PERMANENT brain damage.
The list goes on.

Obviously, we’re worried about her.

She called us last night and she sounded like HAL from 2001. A quiet monotone that doesn’t much sound like her at all. She didn’t remember the last time she talked to us. (It was two weeks ago… she thought it was around Thanksgiving.)

GrizzWife is so worried that she’s going to lose her closest friend, that she stayed up crying last night. (She’s able to control her emotions pretty well. In 13 years of marriage, I could count the number of times she’s cried in front of me on both hands. Last night, she did it twice!)

So, here’s what I need, please.
Tell me all you know about ECT.
Do you know anyone that’s gone through it?
Did it help?
Were there any long-term problems because of the therapy?
How many sessions are necessary to complete a course of treatment?
Does one have to return for “booster” shocks?
Or, if there’s any other information that you can provide outside of the questions I’ve asked, please feel free to provide it.

2

ECT is voodoo science. Unfortunately, it can work.
My father has been subjected to ECT treatments for several years now. He is manic depressive, and when he swings to either extreme, he can be dangerous. When he is in the middle, he’s fine.
The ECT puts him in nowhere. When he comes out of the treatment, he can’t even remember to look at the card we make him carry in his wallet that tells him his address, phone number and who is in the lobby to pick him up and take him home. He is a zombie.
The zombie state lasts for hours. The nowhere feeling lasts for days. After treatment, and without undue stress, he doesn’t hit the wild edge of the spectrum for 6-8 months.
He was a genius before ECT. He is still smarter than most people, but it is painful to see him after the treatments, and it’s even worse when, once in a while, the genius peeks back through.
He gets one treatment at a time, but he has been getting treatments for eight or nine years, and there is no end in sight.
I would rather he never have another treatment, but I realize he could not stay in society because he gets too dangerous, and I couldn’t stand to have him institutionalized.
Sometimes, I wish I had the money to set him up in a third world country where the locals would forgive his excesses in exchange for cash.

Look for options. The medication is designed to keep your wifes friend in the middle between dementia and depression. Unfortunately, the middle sucks and the majority of people that need it stop taking the medication. That’s why the ECT. They can’t stop taking the zombie effect. They are stuck with it.
But try to find options. Changes in scenery and environment, new challenges, a position where they are in charge but not a danger… these can keep them happy but not manic or demented for longer periods.

3

I speak as a patient, not as a physician.

ECT has changed greatly in the years since I had it – the early 1960’s. The first time I had it, I woke up with amnesia about who I was and where I was. That lasted only a couple of minutes. I had a treatment every day for a week and then every other day for a week. I remember very little about my stays in the hospital (separated by two years). I also don’t remember most of the courses I was taking in college for a couple of years and the names of most of my sorority sisters.

My father also had ECT and it helped him with depression too.

Even with all of that, it was worth it to get out of a state of depression – which has its own sense of unreality, forgetfulness, lack of concentration, zombie state.

My psychiatrist is nationally known and has been the Director of the State Mental Health Department. I respect his opinion more than anyone I know. In 1995 he suggested that I try shock treatment again, but I declined. (Medications are much more effective now.)

Recently he said that ECT is being used less now than it was five years ago. Some people do have memory problems and are in a zombie like state for a few days.

When I had the shock treatments, I was put to sleep so it wasn’t painful.

It may be that the success rate is better with depression than with manic depression. I don’t know. And I’m not certain what the diagnosis is for your friend.

Manic depressives (bi-polar) often refuse to take their medications because they can’t think straight about whether or not they are mentally ill. They misjudge their own conditions. Also, they miss the “highs” they get from the manic times.Why isn’t someone else in the family taking responsibility for seeing that she takes her medicine regularly? The meds should be hidden so that she can’t claim that she has already taken them.
I can tell you this. Mental illness was the most painful experience of my life. It can be a living hell.

Although things like that do help, this is not a disease of attitude or even saddness. It just looks that way. Saddness is only a small part of it. The problem is usually one of a chemical imbalance in the brain.. She can’t feel better because the brain that is in control of her attitude is busted.

Consider getting a second opinion or talking with the director of mental health for your state. But I would act quickly. Mental illness can be terminal because of the risk of suicide.

Private mental hospitals are actually pleasant and safe places to be. They are not like the image that many people have.

(Just as an aside, submitting an application for social security disability might be a wise thing. They may say no at first, but it is worth the effort and would help out with expenses.)

You are a wonderful friend to take the time to help make a decision!

God bless you all…

4

ECT is a last-ditch effort in all cases.
It made a bit of a resurgance in the mid nineties after finding that antidepressants weren’t as effective as hoped for some people.

In most hospitals that do it, ECT is treated like a surgical proceedure, mainly in that an anesthesiologist is present. The electrodes are placed in various places and when the juice is on, you can hardly tell that the person is having a seizure, except for, in some cases, a vibrating big toe or other digit. The main factor is not the amount of juice, but the length of the seizure, which for a single proceedure may only be 6 seconds. The patient usually needs several treatments in order to build up seizure time.
Memory loss is a common after-effect, but usually does not last more than a few days.

Treatments may have to be repeated every few years depending on the patient.

5

Because ECT “looks” scary and “sounds” scary–because it sort of reminds one of electrocution–because it works by inducing a condition, “seizure,” which otherwise is only mentioned as a bad thing–because it shows up in movies as a sort of torture-like punishment along the lines of the lobotomy… because of all this, one can know in advance that ECT will be surrounded by a fog of urban legends and bad PR.

I don’t know how effective it is for bipolars, but it is my impression that it is phenomenally successful in alleviating the miseries of severe, recalcitrant depression. From what I have read, loss of memory is minor and temporary. One or two treatments are generally sufficient, I recall reading.

A “zombie effect”? A procedure that abruptly relieves the crazy highs and immobilizing lows could well produce someone whose comparitive mildness seems odd and distressing. Perhaps it takes a while to rebuild one’s persona from scratch.

There are several books available on ECT, by the way.

6

Thanks, Scott. It’s good to know that wasn’t a zombie effect I saw when he came out of the treatment, that it only “seemed” odd and distressing to see someone who was once the biggest, smartest, cleverest person you knew go into a room and come out more addled than Jim Ignatowski.

Must have been crying because I had to put down that Reader’s Digest.

ECT works. I won’t deny it. But those crazy highs and immoblilizing lows were part and parcel of a person that family and friends loved, and it is distressing and painful to see the highs and lows stripped away, leaving only a confused, helpless, apathetic lump.

7

Howdy,

I love it…I use it all of the time, but not for my head? I use it as a massage therapy, in the form of my OSIM massager, which uses nothing more than electrical shock to contract the muscles in a manner resembling a massage. It was first used on me way back in 1985 after I dislocated both of my shoulders. Then later by a Chiropractor after I fractured my neck and later my back.

Now I use it on my back all of the time, because it is great.

But I do not think that I would care to place it any where near my head, other than my neck maybe.

8

I had a series of ECT treatments 6 months ago to treat a particularly strong bout of chronic depression.

For me, the treatment wasn’t painful or intimidating. You are put to sleep during the therapy and you wake up like nothing happened. I went through a series of six treatments over 2 weeks and only had mild memory loss after the last session. Your long term memories are fine, but I did forget a few things and people that I had met in the last few days (the people that I couldn’t remember were no longer around, and I didn’t remember meeting them. I’m sure if I saw them it would have rung a bell).

So it wasn’t scary, it had minimal side effects and best of all reduced the depression almost immediately. I just wish I had done it sooner. I don’t know how or why it works so well, but I’m glad it does. So when you hear that someone is having ECT, look at it as a good thing. It’s about a big a deal as going to get a cavity filled.