The Bipolar Burble thanks for everyone who took the time to read my electroconvulsive therapy primer and The Badger’s personal experience of ECT. Most people were really respectful in their opinions and asked great questions. As per the usual, however, electroconvulsive therapy is a controversial, contentious and polarizing topic that brings out people’s abusive side pretty quickly.
The Goal of Sharing a Personal ECT Experience
My goal in having a personal ECT experience shared here is to provide the perspective that many people silently have – ECT works, it works quickly, and it works with few side effects. (That’s few, not none.) This is not to say this is everyone’s experience, because it certainly isn’t, but statistically speaking, most (more than half of) people have a positive response to ECT.
I’m Promoting ECT
No, I’m not. For the record, neither is The Badger. Longtime readers know I did ECT and I didn’t like it. It didn’t work and it was painful. But that’s not the point. The point is to share an experience, in this case the experience of someone who has found ECT to be a repeatedly beneficial treatment for depression.
I’m not saying you’ll have the same positive experience. What I’m saying is that he did and unlike most people who get ECT, get better and don’t want to talk about it; he is willing to share his story. It’s a first-hand account of a real-life person.
Controversial Issues around Electroconvulsive Therapy
There are many issues people bring up when electroconvulsive therapy is mentioned. Common controversies include:
- ECT causes brain damage
- ECT applied without consent
- ECT is a short-term fix
For the record, I shall repeat exactly what I said in my ECT primer post:
- ECT kills brain cells, it’s risky
- I didn’t address this
- Yes, it generally is
ECT and Neurogenesis
ECT also appears to promote neurogenesis. Which actually increases neuron growth. But for some reason this gets glossed over. (There’s been study on neurogenesis and ECT for 11 years.)
ECT Can Kill You
Well, yes, but only insomuch as jaywalking can kill you too. As it turns out, you are 10 X less likely to die from ECT than you are from childbirth and ECT’s death rate is an order of magnitude smaller than the spontaneous death rate in the general population. So sheesh, if you’re going to say ECT can kill you, then at least cite a study, because right now I have no reason to think that at all.
I also mentioned that ECT has gotten safer over time, which is just common sense, but here’s a study.
ECT is Ineffective
Specifically for depression, which is why ECT is typically used, people cite between 60%-80% remission rates. That is stunning and far better than any antidepressant. Yes, ECT skeptics explain these numbers in many unscientific ways, but there are hundreds of studies on this stuff.
(However, ECT efficacy varies based on population to which it is applied and type of ECT. You have to know a specific situation to truly gauge efficacy.)
Patients have been Abused with ECT
Of this I have no doubt, particularly decades ago. However, there are unethical doctors just like there are unethical lawyers, police offices and garbage men. I fully support prosecuting them to the fullest extent of the law, just like anyone else.
So, Everyone Should Get ECT!
No, not at all. ECT has real dangers associated with it and those risks should be carefully weighed against the possible benefits by anyone considering the treatment. My point, is simply this, try to go by reputable data by reputable sources when you make this decision.
Too many people want to convince you of the heaven or hell of the procedure. Neither of these points of view are entirely accurate.
Good Sources of Information on ECT
The electroconvulsive therapy information provided by Mayo Clinic is easily understood but it’s not very detailed.
My new very favorite source of all things medical online is eMedicine. The downside is this is designed for medical professionals and so much of it can be difficult for some people to understand. I think it’s worth a look as it’s by doctors, for doctors and fully referenced. eMedicine ECT information includes lots on indications for usage, techniques, adverse effects and informed consent.
I thought I had read all your posts on ECT Natasha but I keep finding more.
As usual a great unbiased post from someone who’s been through ECT and not a keyboard warrior up in arms about a subject they aren’t qualified to comment on.
My wife has had over a 100 ECT treatments and doesn’t regret a single one. If she had to choose between living in a permanent psychosis in a hospital ward or dealing with some memory loss she will take the memory loss everyday.
ECT isn’t great and doesn’t fix everything. In fact for her it did exacerbate some of her OCD issues due to the memory loss.
We are committed to each and have worked hard over the last 13 years to find ways to help recover some of the lost memories with a reasonable level of success. We have shared our story athttp://www.queenslandmentalhealth.com/electroconvulsive-therapy-memory-loss and more recently we examined the long term effects ECT had on her memory and personality at http://www.queenslandmentalhealth.com/long-term-effects-of-ect-on-memory-personality/
We hope our positive stories about living with a mental illness and extensive ECT experiences can provide hope for others.
Keep up your great work. You do make a difference
If my comment is moderated, I feel the person who is writing this book is not being honest. My friend went through it: however after every treatment she ended up at the,” Liquor Store.”
The Hospital, [moderated] in Tennessee decided I should have ECT Therapy. The Dr’s conflicted. They told my Husband they should do it even though all my other Dr’s were saying,”No!” They made it worse, they said I was the first person to cry, and why was I crying. I lost cognitive skills did not know who I was, my child or my husband. I think you are “Toying” with a heck of a lot of people and their life. Ooh and by the way a nurse was asked to throw away not shred files and she threw my files in the tras with the rest of them and when I read them they did not say what the ORIGINALones said.
I have had three courses of ect. It wasn’t very helpful. The main reason I wanted to do it was so that I could be sedated even for a short time. That’s all I want these days is to be sedated. I can’t commit suicide because I have a young son. If I wasn’t a mom I would have been long gone. Even though I have other family my son is the only reason I stay alive.
I had ECT treatments at two different times of my life and for they worked wonderfully. I have no memory poss or experienced no side effects from the treatments. My advice is to look at both the pros and cons of the treatments and to discuss your feelings with your doctor.
I am currently getting ect treatments I have been going since Aug 24. For 3 times a week. I didn’ t go today because of a severe headache and the last time I went I woke up with a fat lip and a bruised and sore hand from where the iv was. I have gone 10 times and the only thing i think i have gotten out of it is memory loss, confussion, and headaches. If i stop going now will it start to help me in any way or just continue the way its been going? I am trying to keep a full time job that i have had for 1 1/2 yrs now and i can not remember what to do during the daily business day.
I had ECT when I was catatonic and completely immobile. Obviously it was not my decision as I was at the time unfit to make it. In fact I can say what not many people can, that I remember having it, I remember being restrained and convulsing. It is only a very brief memory but still one that haunts me. Regardless it did nothing to get me out of my catatonia. That was 3 and a half years ago and I’m still not sure how I feel about it.
Hi Jennifer,
I’m so sorry you had ECT and it didn’t work. It didn’t for me either. I’m a bit surprised as it works extremely well (statistically) in cases of catatonia. Unfortunately, “extremely well” still isn’t everyone.
I’m aghast you can remember it. If that happens, of course, it indicates someone made a mistake with your anaesthesia. I’m sorry you had to go through that.
I recently wrote that I do not regret the treatments I’ve had, even those that have failed, because if I hadn’t tried them, I never would have known the outcome. As you mentioned in your previous comment, you never really know with bipolar, well you never really know with bipolar treatment either. In that situation, likely the doctor had very good medical grounds for recommending that procedure, but you’d never know if it would work until you tried it. (Maybe that makes you feel better, maybe it doesn’t.) http://www.healthyplace.com/blogs/breakingbipolar/2011/08/how-to-keep-going-when-mental-illness-treatment-doesnt-work/
– Natasha Tracy
The involuntary administration of electroshock is not only the result of actions taken by individual psychiatrists deficient in morality. If it were, they might indeed be potentially prosecuted as you suggest. However, the involuntary administration of psychiatric interventions is sanctioned and governed by the state, not only by individual doctors, and thus it is the state you propose to sue for a violation of constitutional rights, rather than a malpractice suit.
Hi Hrahele,
As I mentioned above, I did not address the issue of electroconvulsive therapy without consent.
– Natasha Tracy
To others it could suggest a corrupt government, as well. But in this case I think it likely that the options would be mutually exclusive. How much corruption do you think is in our psyche system? I see lots. I am a person who is close to the system, having been in it for years. I see high mortalities, low quality of living, agencies taking profits at our (disabled) expense, And especially I see deference to exalted authority figures in the psyche industry. The psyche system is full of waste, fraud, and abuse. In my case the DA needed that psyche card to play to beat me, in a political case worth millions of dollars, and this is national news, not me. I believe the USSR used mental illness to punish their dissident trouble makers. It doesn’t exist? Read my work and see if it seems like “crazy” or “corrupt”. I don’t think it likely that it’s both. Or, if you don’t care, that’s ok too. Also, another may say, What’s the problem with getting an exculpatory dna test? And they would be right. Who, unless guilty would oppose a dna test?
The one single diagnosis in the realm of MI that I’m a little fond of is the Delusions Of Grandure. I was alway taught to dream big as a boy. The D.O.G was my first of many axis one Mental Illness diagnosis. I’m just a regular guy with no mental illness at all. My work is in planning and being a political activist, which requires vision. Part of my work is also societal services planning, but mostly it’s in fisheries and aquaculture and wind mill designs. I have solved the energy crisis. This work is called the Tripe System and it is on my web page http://www.environmentalfisherman.com . It’s good stuff. The report is 11 pages illustrated. I’m available for show and tell. The classic symptom of one with D.O.G. is that the mental patient does not at all believe they are mentally ill at all, and that would be me. Furthermore, I do claim and maintain that I can prove to a practical degree that I am not insane, using a dna test to mark the governments corruption, proving an evidence switch for political gain, and as a motive for the politically motivated diagnosis of the D.O.G, and other mental illnesses such as delusions of a jealous nature, homicidal, hypo-manic, bi-polar, schitzo affective, psychotic, paranoid, schtzophrenic. It is a bit much. I’m just a regular guy.
Hi Steven,
Dreaming big isn’t really the same thing as a “delusion.” Delusions, by their vary nature, are beliefs held contrary to facts:
“a fixed false belief that is resistant to reason or confrontation with actual fact”
Vision is not the same thing.
Now saying you have “solved the energy crisis,” and you’ll “dna test to mark the governments corruption, proving an evidence switch for political gain, and as a motive for the politically motivated diagnosis of the D.O.G,”
does certainly suggest delusion.
My diagnosis isn’t politically motivated. But that’s me.
– Natasha Tracy
Re: the $$ motivation. My brother had ECT in a hospital where only the head of psychiatry and one other doc on staff supported the procedure. The ER/nursing/anesthesiology staff had mounted a protest & refused to participate. So head of psych had to book out the ER before normal surgical hours (4:30 – 6:30am) and use contract ER/nursing/anesth staff. Docs told me the hospital was willing to forgo profits on the procedure in favor of honoring the wishes of the protesting personnel.
My personal fears about ECT evaporated when I witnessed, each time I accompanied my brother, that every other person in the waiting area was there because ECT was working for their loved one & that it was the only thing that had ever worked. And every single one of them were not telling anyone about the “secret” cure – not even telling other immediate family members. Felt humbled by the amount of prejudice I’d walked in with. Who knows, I could have been one of the arrogant, never-researched-the-facts protesters had my back not been pushed against against the wall by seeing the depth of my brother’s suffering through 3 years where no combination of treatments (therapy, meds, alternative etc) worked.
I invite anyone who is opposed to ECT to simply observe what happens in a waiting room full of loved ones who are standing by their spouses/parents/children/siblings while they get the procedure. Once people start talking about what brought them to ECT, one cannot help but at least recognize that for some it is a life-saving treatment – albeit typically a treatment-of-last-resort.
Hi Katie,
Such a great comment.
I _was_ one of the people who despised even the idea of ECT. Not in any protest-y kind of way, but certainly not for it. And to this day I consider zapping the brain full of electricity to be barbaric. Of course, that doesn’t mean it doesn’t work.
It’s odd that the hospital staff would protest like that. The people I’ve talked to (staff) involved in the procedure generally are quite happy about it because they get to see all the successes. I wonder how much political pressure was on the hospital.
“And every single one of them were not telling anyone about the “secret” cure – not even telling other immediate family members.”
Yes, that is the worst part. I didn’t tell anyone when I did it either. I was so scared and so ashamed that I just couldn’t. You’re right, the amount of prejudice is unbelievable.
I think one of the things that makes it so amazing is that it _is_ a treatment of last resort. This treatment isn’t about the average depressed person, this is about someone with an intractable illness that statistically, has very little chance of remission – and yet somehow, this works. It’s like magic. After years of torment and suffering. It’s like magic.
And I can only imagine what it must be like to watch a loved one suffer, often for years, and then suddenly get better. It’s astonishing for all involved.
I wish I could say that happened to me, but I’m grateful for everyone that has had that experience.
– Natasha Tracy
Natasha, I wanted to ask if you have written anything on the grandiose delusions that can occur with bipolar. I am refering to believing that you have super natural abilities or have been bestowed gifts from God that others don’t have. Something like that. Every site states that as a symptom but I have yet to find a site like yours that talks about it. I would like to find sites like yours or the bipolar badger. People who have experienced it. I have gone through this and I must admit I am hesitant to discuss it on my blog because I am not quite sure waht the reaction would be. However, I think it is something that needs to be talked about so I am working on trying to get my story typed up and hopefully posted in the next few days. If you know of any one who has talked about this or any sites with personal experiences if you could share those with me I would be very grateful.
Hi Maasiyat,
Great question.
Personally I’m not prone to particularly “grand” delusions. I usually think I’m really great, really hot, brilliant, that sort of thing. Naturally far more than I ever would normally, but nothing that raises to the level of delusion. I think I’m just too logical, too grounded to do that.
I’ll put a Tweet and Facebook out on it though and I’ll see if I can find you a personal story. It definitely happens, it’s just not part of my personal experience.
– Natasha
Hi Maasiyat,
I have had grand delusions with my mania. Oh in particular that stands out involves driving. As the week progressed and my mania increased everything started coming in brilliant detail. As I drove past fields of grass no longer could I see the wind blowing across a field, but instead as I looked out I saw millions of individual blades of grass blowing. It was like a clarity I have never seen. Everything was in super sharp focus. It was like a whole new world, and it was beautiful. But as it progressed the more I saw in detail the more I felt “one” with nature and it all. Finally to the point where I thought that I could BE one with the wind. One afternoon driving home from work I thought that I was so in tune to the nature around me that I could drive with my eyes closed. I rolled down my window and extended my arm out as far as I could, each finger spread out wide. I gently at first started letting the wind guide my arm up and down, then at the precise moment I felt it “carry” me I closed my eyes and let the wind guide me down the interstate. This abruptly ended when I hit the side of the road. I was so torn between some part of my mind telling me I was crazy and the utter disappointment I felt with the wind for not guiding me and keeping me on the road. I ended up in the hospital the next week.
Another time I was at the beach and again it involved the wind (hmm, wonder if I’m seeing a pattern here?) I told my sister in law that I was a kite and asked her to tie a string around me because I was going to climb the roof of the house we were renting and I didn’t want to accidentally get blown far away. Thankfully, I guess, she just thought I was drunk and being silly and didn’t realize how serious I was.
Some other delusions I’ve had were much scarier and not really “grand” in any way. Other than the grand plans I made. But they were based on fear, such as cashing in our home owner’s insurance and getting a passport in an attempt to take off to Europe for a year to get off the “grid” where I was sure people were watching us. So that was more a mix of paranoia with delusions and was actually scary. Where as the above ones I felt on top of the world and so in tune with everything around me.
Hannah
Hi Hannah,
Thank-you for sharing that. It’s quite remarkable how delusions overcome a person.
” I was so torn between some part of my mind telling me I was crazy and the utter disappointment I felt with the wind for not guiding me and keeping me on the road.”
This is utter brilliance. Because yes, crazy yells inside the brain and sometimes we can see it and yet are still controlled by it.
– Natasha Tracy
The argument that it is only done as a money maker for docs is moot here in Canada , which has social medicine and embraces ECT. One way people demonize it is to say it is only done for profits.
Hi Steven,
“One way people demonize it is to say it is only done for profits.”
I would tend to agree. I see no actual evidence of this happening, and I suspect if doctors were making so much from it insurance companies in the States would have issues paying for it, which they don’t to the best of my knowledge.
Gosh, I hope we in Canada don’t “embrace” it. I think I’d rather hug a porcupine ;)
– Natasha
Embracing may have been strong,but they do openly offer it as course of treatment and see it’s value.
Steven,
True.
Funny thing about my experience with ECT, only one out of about 10 doctors I’ve seen ever mentioned it (that’s in the US and Canada). When the one did, I told him I wasn’t interested and we never discussed it again. When I finally did end up getting it, I inquired about it because I was so desperate.
– Natasha Tracy
The thing is, there really aren’t a lot of objective, “reputable data by reputable sources”. Much of the foundational ECT literature was written by Max Fink et al., who has a vested interest in pushing ECT because he founded one of the companies that manufacturers the ECT machines. The others conducting the studies also have a vested interest since they clearly perform ECT on patients and it is the only billable procedure psychiatrists perform these days (read: brings them far more money than a regular old med check). Also, the statistics you cite are based on literature that, in my opinion, is biased and, therefore, the numbers are unreliable. Finally, even the FDA feels there is not enough solid scientific evidence to prove that ECT works and is safe, so I’m not jumping on the bandwagon, either. I respect your views, but I believe there needs to be far more evidence produced by people who do not have a vested interest in pushing ECT.
Hi Joe,
Well, I’m not sure about foundational literature seeing as the foundations were done almost 100 years ago.
I do know that in the last 100 years a lot has happened. In the last 30 years a lot has happened. In the last 10 years a lot has happened.
You would like someone with no interest in treatment run a study on treatment? And where would they get that funding from? If you have a million dollars and a year or so go right ahead and find some scientists somewhere with no ties you don’t like to try to do that. It’s a pretty high bar, however.
It’s considerably more reasonable to use recent research to make determinations. A preponderance of evidence. I know of no other way of making decisions. We only know what we know.
I’m not sure what the FDA feels but I haven’t heard that particular thing. If you would like to provide a link, I’m happy to take a look. Last I heard they were actually looking at reducing the rules around ECT, indicating they feel it’s _more_ safe. (Not that I’m suggesting this is a good idea, just what they’re doing.)
I’ve heard of the money argument before but so far I see no actual evidence that doctors are doing it for the money. There are a small number of doctors that administer most of the ECT. If ECT were such great money then you’d think all the doctors would be doing it.
If I had to guess I’d say doing ECT is a pretty big bother because:
1. You need to afford hospital time
2. You need nurses and anesthesiologists
3. You need a whole whack of insurance
4. You have to deal with constant controversy
Personally, I would be pretty happy to just sit in an office all day rather than do that. Psychiatrists make plenty of money in offices.
There’s really no bandwagon. No jumping necessary. And I agree, if every treatment in the world could be carried out by impartial parties that would be great, but that’s not what we have and it’s just not reasonable.
(I also don’t see evidence of doctors “pushing” ECT.)
– Natasha
This is why I like your site so much more than many other sites I have found. You give both sides of the story the pro’s and the con’s. While you might have an opinion regarding the subject, you don’t let that opinion cloud you from seeing that just because it wasn’t beneficial for you doesn’t mean it might not be for others. Thanks for bringing these topics out into the open.
Hi Maasiyat,
I’m pretty passionate about personal choice. We don’t always make the right decision, but at least we can make it with the best information available and it can be our own.
“…just because it wasn’t beneficial for you doesn’t mean it might not be for others.”
It’s really odd to be basically defending a treatment I didn’t like so much, but I think it puts me in the unique space of having more credibility on this issue.
“Thanks for bringing these topics out into the open.”
Thanks for reading, asking great questions and thinking about the issues. That’s my goal.
– Natasha
Thanks for bringing ECT into the open. Treating mental illness is not a “one-size-fits-all” prospect and the decisions those of us struggling with symptoms make with our doctors should be honored. Until far far more is understood about the brain and cures for schizophrenia, bipolar, depression, OCD etc are found – no one form of treatment should be demonized.
Former presidential candidate (& former Massachusetts governor) Mike Dukakis is an outspoken supporter of his wife Kitty’s decision to have ECT. For decades she struggled with symptoms, trying various medications and combinations of therapies that did not work. Only ECT has given her relief and she credits it with saving her life. Like so many, she has suffered with some memory impairment as a result, but she recently told me its a small price to pay to live her life again. She has written a book on her experience with ECT – “Shock” – and continues to speak publicly about how desperately our nation needs to provide people with mental illness access to ALL treatments.
Treatment works for the vast majority of us – anywhere from lessening the severity of symptoms on through granting us full health to become completely engaged in our lives again. How dare any of us agitate to block the people -for whom ECT is the only effective treatment- from the only means they have to be able to live their lives to the fullest.
Hi Katie,
“…no one form of treatment should be demonized.”
I couldn’t agree more, if the treatment is scientifically valid. That’s an important point because many people are selling many “treatments” for mental illness that do nothing and in some cases prevent people from receiving proper treatment.
“Only ECT has given her relief and she credits it with saving her life. Like so many, she has suffered with some memory impairment as a result, but she recently told me its a small price to pay to live her life again.”
And I’d say that’s pretty common.
I asked my current doctor how many people she saw who found ECT upsetting or disturbing, and she said none, unless something had gone wrong with the treatment. I was surprised; I rather found the effects disturbing myself.
But like in your comment, most people find the price is well worth what they get. And as The Badger said, the _procedure_ itself is not particularly terrible. You fall asleep, you wake up. It’s the fear that’s brutal. (And individual reaction. My body tends to overreact to _everything_.)
I suppose I would feel pretty happy about the price if I got the gains that others have.
“How dare any of us agitate to block the people -for whom ECT is the only effective treatment- from the only means they have to be able to live their lives to the fullest.”
I think you meant “attempt” :) And I agree.
One commenter said to the Badger that he had suffered brain damage but he just didn’t know it because he was brain damaged.
Well, that’s a circular argument if ever I heard one.
And I say how dare she say what is going on in someone else’s brain?
Thanks for your support here and helping me get the information out on Twitter. You (and your brother) are amazing people I’m thrilled to have met.
– Natasha
As with the original, great post, Natasha. My friend Dustin is guest blogging about ECT on “Ask a Bipolar’s” blog – it would be great if you two could post together on this, as you have similar goals and information. http://www.askabipolar.com/about-the-authors/dustin/
Hi Chrisa,
Thank-you for the compliment, and thank-you for your support on a controversial issue.
I’ve contacted Dustin so I’ll see if that is of interest to him. Thanks for the suggestion.
– Natasha
This is all really interesting, and it looks like you did your research. Since I am new to this site still, I honestly think that you are neutral in this post-you don’t seem to be promoting or condemning it. Thanks for all of the information on both sides.
hed
Hi Hed,
I like to think when I talk about a treatment I can present both sides to an issue. I do, certainly have opinions on treatment, but I always try to be clear and state them as such. My main goal is for people to make their own decision, not necessarily to agree with me.
I’m happy to provide information. Information is power.
– Natasha