If you’re hooked on the show Yellowjackets, like me, then you’ll know that in season two, episode two, Yellowjackets showed an electroconvulsive therapy (ECT) scene (I believe it may be called “electroshock” in the show). In the scene, one character, Lottie, is forced onto a bed, an injection is given in her arm, a bite block is placed in her mouth, and she is shocked by electrodes on either side of her head. She violently convulses, clearly in nightmarish pain. Let’s talk about how the Yellowjackets‘ depiction of ECT is inaccurate and harms the mentally ill.

I have had ECT. It wasn’t a carnival ride. In fact, I had trouble with some of the side effects, and it didn’t work for me. So, when I talk about ECT, it’s not because it was a miracle for me, and it isn’t because I think everyone should run out and get it. I talk about ECT because it’s critical that people have the facts about ECT so they can make good decisions around that treatment.

And make no mistake, ECT is a treatment for mental illness. It is a medical procedure. It is an option for some people. It works for some people. In fact, it is a miracle for some people. It is not torture, nor is it used as punishment or for behavioral control. And keep in mind antipsychiatrists will tell you that it is all these things. Be careful who you believe regarding ECT. Remember, your psychiatrist is always your best resource.

My Experience with Electroconvulsive Therapy (ECT)

If you’d like to know about my experience with ECT, watch this video:

Now that we got that out of the way, let’s talk about what ECT is and how YellowJackets got it wrong.

What Does ECT Really Consist Of?

Electroconvulsive therapy is a procedure done primarily by a psychiatrist and an anesthesiologist. (There will likely be other people, like nurses, in the room too.) Essentially, from the patient’s perspective, the steps are this:

  1. Go to the ECT suite.
  2. Get an IV inserted.
  3. Lay down on a gurney. (You may talk to the treating doctor at this point to review how you’re doing and your goals for the treatment, or this may happen separately.)
  4. Get hooked up to machines that will monitor your heart and brain.
  5. Your lower leg may get tied off.
  6. Get injected through the IV and go to sleep.
  7. Wake up in the recovery room about 15 minutes later.

That’s it. Electroconvulsive therapy, unlike in Yellowjackets, is done when you’re anesthetized. You don’t feel a thing.

Now, from the doctor’s perspective, it’s a touch more complicated. Between the above steps six and seven, this happens:

  • Select the correct “dosage” of electricity, type of electrical wave, and placement of electrodes. (Selection criteria are beyond the scope of this post, but there are ways of mitigating side effects from ECT, and there are ways of making it more potent, depending on what is needed.)
  • Insert bite block.
  • Make sure all outputs are monitored.
  • Position the electrodes.
  • Send an electrical impulse through the patient’s head.
  • Watch for a seizure. (This is what they’re looking for, as it’s required for successful treatment.)
  • Watch for cessation of seizure.
  • Wheel the patient into recovery.

And that’s about it. It’s likely the easiest thing your psychiatrist will do all day.

Risks of ECT Not Shown on Yellowjackets

While Yellowjackets was quite good at providing a terrifying view of a medical procedure, they didn’t mention what can actually happen to you. The significant concerning risks of ECT are memory loss and cognitive dysfunction. (Things like headaches and jaw aches also occur but are temporary and not serious. This is not a complete list.) In most people’s experience, the cognitive dysfunction, if present, is transient. The memory loss improves over time, but memories of the time right around the treatment may never be recovered. (That is not to be considered medical advice. Always get the facts from your psychiatrist.)

So, while Yellowjackets shows pain during the treatment — something that doesn’t happen — it doesn’t mention the risks people actually face, which, honestly, as mentioned above, are quite scary in and of their own right.

Why Does Yellowjackets’ Depiction of ECT Harm the Mentally Ill?

It’s quite simple; the depiction of ECT in Yellowjackets is so scary that it will scare mentally ill people out of even trying this treatment when it can be a very important option for some. And by scaring everyone away from this treatment, they are literally killing those with a mental illness because those who get ECT are typically the ones who have exhausted other treatments and whose lives are on the line.

This is precisely what happened with One Flew Over the Cuckoo’s Nest in 1975. It took decades to educate people about how ECT is really done when Ccukoo’s Nest made it look like hell on Earth — and keep in mind; we are decades ahead in treatment modalities than we were then. I’ve heard psychiatrists say that movie killed people, too.

Thanks, Hollywood. You’ve spread stigma and fear and created prejudice nicely.

A Better Depiction of Electroconvulsive Therapy (ECT)

If you want to see a reasonably accurate depiction of ECT, check out Homeland. In season one, the main character gets ECT, and it’s treated responsibly. I just wish that other media were so responsible.

Please, please, don’t believe everything you see on the screen. Medical procedures are often portrayed incorrectly. If you’re thinking about ECT, please talk to your psychiatrist. It may or may not be right for you.

Image: Wikipedia