Admitting you’ve had electro-convulsive therapy (ECT) is a pretty good way to stop all conversation and take the air out of a room.
I know this for a fact. I’ve done it more than once.
Inducing seizures for treating psychiatric conditions began in the 16th century, the use of electricity in the process was refined by Drs. Cerletti and Bini at Sapienza University of Rome (1938), and modern brief-pulse ECT machines date from 1976. If you’ve read the book (1962) or seen the movie (1975) “One Flew Over the Cuckoo’s Nest,” you’ve witnessed the single most damaging piece of film produced to date for psychiatric treatment and ECT specifically.
When I saw the film in the 1990s, I said there no way, ever, in my life, that I would willingly consent to THAT. It was brutal and barbaric and wholly terrifying. Even today it remains the most stigmatized treatment available for severe mental illness. Because of that, people become curious to know what it’s like, but most don’t ask out of politeness. This month, I want to share my experience with ECT, the grandaddy of all psychiatric treatments, and how it impacted my journey.
When I was recommended for ECT, it was 2015 and I was in the middle of the second most severe depressive episode of my life. The first had been my bout of postpartum psychosis in 2005 which resulted in me receiving a cocktail of several medications, lots of individual and group therapy, a hospital stay, and having to live with my parents for a few months. The time from onset to feeling somewhat normal again took ten months, but I remained in intensive treatment for about three years.
In 2015 I had steadily slipped into a deep depression that my psychiatrist and I tried to manage with medication and therapy, but I grew worse by the day. Anxiety and depression caused me to lose a lot of weight, I wasn’t sleeping much, was so nauseated my diet mainly consisted of herbal tea and I couldn’t escape the torment of my thoughts. I had previously said I would never consent to ECT – and it had come up before from other doctors – but I was in so much pain. I wanted to let go of this world.
I’d read a number of online stories about ECT. There was lots of talk about brain damage; there were activist groups trying to get the treatment banned. One memorable article called it an electronic lobotomy. On another website which condemned ECT, anyone who’d received it was called a survivor. There were hardly any stories with positive outcomes, despite the overwhelming number of clinical articles stating it was still the best, fastest-working treatment for severe and treatment-resistant depression. In the end, I decided to take my doctor’s advice and put my trust in the modern process of ECT.
Once I consented, things moved swiftly. At the hospital, I met with the doctor who’d be administering my treatments. It would be two treatments a week for four weeks, then one treatment a week for four weeks. There was a special area in the hospital for people receiving ECT. It wasn’t scary; no rooms filled with tesla coils, flickering lights or sparking equipment. If anything, the office was like any other, non-descript… but surprisingly busy. I would have never guessed there were so many people receiving ECT on a given day, but the waiting room was usually half full or more any time I went in.
Because I’d be put under general anesthesia and given a muscle relaxant, I couldn’t drive home, so I always had someone with me. When it was my turn, I walked into a small room with my doctor, a nurse, and an anesthesiologist already waiting for me. I laid down on a gurney and was given an IV. They explained they’d put me under, inject the muscle relaxant, administer the shock (a pulse of 1.0 mSec), wait for my seizure to end, then reverse the anesthesia. I’d wake up in recovery and could leave whenever I felt ready.
My mother, who usually took me to my appointments, told me the whole process only took about 30 minutes. After the ECT I’d feel tired and emotionless. My head felt strange but there were no headaches, no pain. Just kind of fuzzy around the edges. That feeling would last the rest of the day; by morning I felt completely normal. I had the procedure 12 times over two months.
So did it work? For a very long time I wasn’t sure. The oddest thing about ECT is that for all the stigma and controversy, the positive results are subtle. One thing that wasn’t subtle was the memory loss. I knew it was a possible side effect but there’s no way to know if the memory loss is going to be temporary or permanent. In my case, everything between 2012 and 2015 was completely gone (and still is). Other holes in my memory go back decades. If there’s a picture of an event I can usually recall it, but I’ve had to be told about many of the smaller details.
When I originally asked about losing my memories, the doctor told me it was common, but with the number of years I’d been suffering with severe depression “I probably wouldn’t miss them.” I found the comment to be pretty cold and maybe even heartless. Looking back on it now, I can understand what he meant. I did lose good memories along with the bad but, to be fair, there was A LOT of bad in there. Today I’ve accepted it as a price I paid for a brain that is now at peace.
I had an embarrassing experience when I went back to work after my medical leave. The ECT had erased all my knowledge of the custom software program we used; I had no idea how to do my job anymore. I would need to be retrained by one of my teammates, so I had to explain what happened to me. Thankfully it didn’t take too long to pick it back up. There were still some fragments there. One day he gave me a number of documents to read and I commented, “These are really well written!”
He replied, “You wrote them all.”
In the aftermath of ECT, my intelligence did not suffer. I would have previously described myself as an overly emotional person; that’s gone now. I still feel emotions but they are more subdued. The emotional highs and lows I used to experience were very distracting, confusing, and exhausting when they provoked a physical response. Now I felt I could make decisions more logically and critically, without that emotional interference. I also felt stronger because I had survived the crucible of ECT and emerged changed but intact. Been there, done that, bought the t-shirt… if you will.
ECT did change me. Truthfully, it was a change I needed. The storms that used to rage were now more calm, and I can’t begin to express what a relief it was to have a mind that could find some occasions to rest. A regret is that the stigma surrounding ECT kept me from agreeing sooner and, as a result, I was unsuccessfully treated and labeled “treatment resistant” for over 20 years.
And so now I write and share some of what I’ve experienced as someone who’s reached the other side.
Turns out it’s nice over here.
Now that you’ve reached the end of this article, you might be saying, “That’s it?”
Yep, that’s it. That’s ECT. It’s important to note that like any treatment, my experience is not everyone’s experience. I’ve read stories of patients who had much more profound memory loss; others with none. I received brief pulse ECT which is an electric pulse of 1.0 mSec. There is also ultra-brief pulse (0.3 mSec) which is said to be just as effective with less of a chance for permanent memory loss.
In closing, I wanted to comment that I was conflicted about posting this information for the June edition of Mental Healthy. With all the stigma surrounding ECT, admitting you’ve had the treatment can feel like a bit of a gamble. I believe this is very important information to share, but it also exposes a controversial aspect of my medical history to the public. I do believe, however, that understanding and evolution cannot happen without the topic being brought into the light. And so, I would like to make a plea to all those out there who are supporting friends, family and colleagues with mental health struggles…
Please do not look upon us as fragile things who have been saddled with medication and other psychiatric treatments in an effort to seize control of our minds. The treatments are not evidence that we are broken. Treatments are tools so we can work to understand our challenges and find healthier coping skills. It takes strength to ask for help and to put yourself in the hands of medical professionals when they suggest long-term medication or interventions such as ECT. And it takes even more strength for us to follow through and take those treatments. Work with your friends, family and colleagues to normalize medical treatments for ALL illnesses, not just those that are physically evident or unrelated to mental health care.
We all deserve to find peace, health and happiness.
See you all next month!