ECT - Treatment or Torture?

Gabrielle having a peek

Since I have been treated with ECT (Electro-Convulsive Therapy), many people have asked me questions about it. When I have asked them what they imagined it was, I was horrified to discover that most people's imagined version of ECT bore a strong resemblance to execution by electric-chair!  

So here is a peek into what ECT treatment is like, as I have experienced it many times (23 times to be exact) myself.

Firstly, there is a specialised ECT Suite at Penn Psychiatric Hospital. It consists of six rooms:

  • The reception lounge area, with comfortable chairs and magazines
  • The administration office, where the ECT team secretary's desk is located
  • The ECT Senior Sister's office, where you can go to be weighed, etc
  • The ECT room itself, which resembles a very small surgical theatre, with a surgical bed and lots of equipment. 
  • The recovery room, where there are four to six beds (can't quite remember) and where ECT patients stay after their treatment until they wake up from the anaesthesia.
  • The tea/coffee and biscuit room, where the medical staff check that patients can eat and drink - i.e. can swallow - normally after the ECT.

 This is what happens when you are booked for ECT Treatment:

  • You are greeted warmly and asked to fill in a feed-back form to check whether/which after-effects you may have experienced since the last treatment. For me, the only real after-effect has been short-term memory disruption and longer term visual memory disruption - i.e. I KNOW I know somebody but it takes me a long time to remember their features. The great advantage of this short-term and relatively short-lasting memory disruption is that I have had superb value from my DVD collection! I KNOW I have seen the movie before but I can't remember anything about it so I can enjoy it all over again as if it were the first time. The medical staff also check that you have had nothing to eat or drink after midnight the night before because of the anaesthesia.
  • You are called in to the ECT room and asked to lay on the surgical table and the staff help you take off your top and your socks (if any) so that all sorts of little monitoring 'pads' attached to some of the equipment can be placed all over your body. These are like placing plasters on (except they feel a lot less sticky) and their job is to monitor all your major functions during the anaesthesia and the ECT treatment. I used to call that 'being wired for sound' which amused everyone. I used to always wear a track suit for convenience because its zipped up top was easy to remove and the staff used to tell me I should create a special ECT Fashion Line! For me, as I got better and better, there was always a lot of laughter during my ECT preparation.
  • Sometimes, there are observers present (students, junior doctors) and you are asked whether you object to their presence. I certainly never did.
  • One of the ECT nurses cleans your temples and pushes your hair out of the way if necessary. My ECT Treatment was always bi-lateral - i.e. applied to both temples.
  • The Doctor then inserts a cannula (a needle attached to what looks like a small funnel) into the top of your left hand (the hand closest to the equipment) and let me tell you:  these guys are cannula champions! Only once did I ever have a bruise from the cannula and I am an awkward customer with small veins.
  • Two padded panels are pulled up on both sides of the surgical bed to keep you safely in place.
  • An oxygen mask is then placed on your nose and mouth and you are asked to take a few deep breaths. One of my ECT doctors (I knew two different ones) used to tell me that Michael Jackson swore by this which I retorted wasn't much of a recommendation!!
  • The ECT team checks that all is in place as it should be and you are then asked whether you are ready to go to sleep. Once you say 'yes', the doctor inserts the short-term anaesthetic into the cannula and it's off to sleepy land you go.
  • Approximately twenty minutes later (I know that because there was a clock directly in front of the surgical bed and another clock in the recovery room), you wake up in the recovery room with a nurse sitting next to you and watching over you. You are welcomed back into the world.  When you feel ready to get up, the nurse helps you to get dressed again.
  • You are then accompanied into the tea/coffee room. Because I do not drink tea or coffee, the staff always made sure there was a bottle of diet Pepsi waiting for me (how wonderful is that!). You drink and you eat some biscuits in front of a member the ECT team who stays with you until you leave. When they are satisfied that all is well, you are ready to be released. Some ECT patients are then taken back to their hospital ward. For me, my husband used to ring the ECT secretary to ask whether I was ready to be picked up.  When he arrived, we went home.
  • When I got home, I used to feel chilly and sleepy for the rest of the day - the normal after-effetcs of the anaesthesia and my husband was always present for the following twenty-four hours.

And that's it folks! That is truly what you experience when you are treated with ECT. All you know about it is that you went to sleep for a short while.

As you can see, what I have described to you is as far removed from torture as daisies are from poison ivy!

If you want to know more about what happens while the patient is asleep, here is some authoritative information for you.

For me, ECT did something wonderful. It put my 'little chuff-chuff' back on its rails. It's as if my brain's internal cogs started to rotate again. My capacity to read, write and speak increased dramatically after ECT. I could function so much better.

The fact that I also need a medication cocktail to ensure my 'little chuff-chuff' runs along its rails under my control, rather than it behaving like a run-away train, takes nothing away from the benefits I gained from ECT.

The ECT team is THE best example of medical care I have ever encountered. I feel a great deal of affection for all of them.

My psychiatrist and my ECT team always discussed/monitored potential and actual side-effects with me and regularly checked whether I was happy to have and/or continue with my ECT treatment. I NEVER once felt under pressure to go ahead. In fact, I did not have my last (24th) ECT treatment because I did not want it.

I was always treated like a human being who was suffering - never as a mentally retarded number who needed to be expedited as quickly as possible.

I guess ECT is like any other form of treatment: it has evolved a great deal since its inception AND it is highly dependent on the people who administer it.

Thank you Anonymous

Yours is a comprehensive and informed view of ECT and I hope it helps people see this treatment in its proper light. All treatments are imperfect - unfortunately - but some that help the majority of people deal with profound suffering should not be dismissed because of ill informed prejudice. I welcome your contribution and I wish your mother all the very best in her recovery.

So Glad I Found This Page!

Hi, I just wanted to share that I am so glad that I have found this page!  I have been having a VERY hard time!  I'm 31 and was first diagnosed with depression at 14.  Ya, since then it's now anxiety, bipolar disorder and severe depression.  I feel like it's a fight within myself every single day.  I take a handful of pills every night and think to myself "WHY?" 

I have a beautiful five year old daughter that gives me so much strength to keep going.  I feel like I HAVE to get better for her, not just ME.  She needs me. 

ECT was mentioned to me a while back by my dr.  I will admit, I was thrown back.  I didn't know much about it.  Since then I've read up on it.  The memory loss thing kind of scares me a little.  Also, I was diagnosed with Multiple Sclerosis in late June of last year, more depressing.  So I'm not sure how safe ECT would be with that?  Seeing my Neurologist today.

But, I wanted to THANK YOU for sharing your story, it truly has helped me!!

Thank you Debby

My goodness! You sound like you are having a hard time... I have a sense of what you are going through and I wish you strength and wisdom - wisdom helps us know when to be strong and when not :0)

The memory loss is a bit of a bind that's for sure. My husband told me last week when we were watching TV that I had been in a glider with one of his 'flying' friends a few years ago and I have no recollection of it whatsoever! Having said that, I have never forgotten what is really important to me: the people I love and who love me. Besides my short term memory is now much better than it was when I was in the depth of depression so that's a plus. My longterm memory is normal so it's ony my mid-term memory that is 'playful'.

If you can avoid ECT all well and good. When nothing else gives you any relief then there's nothing else to turn to. I just hope that if you choose to go the ECT route it will give you some short-term relief and help medication work better for you (which is what it did for me).

Much love and encouragement.

Gabrielle 

It' a very hard decicion.

I have had 75 treatments (yes, 75) since 2007.
My short term memory is shot; I have forgotten bank accounts, the way to my daughters house, family functions, and worst of all...people. When I grocery shop, I keep my head down so I won't run into someone who knows me, I know I won't have a clue as to who he/she is. My long term memory is not as bad, but has also been very much affected. I used to be an excellent speller and now I find myself stuck on simple words. That being said, it is only fair to say I might not be here today if I didn’t have ECT. My last one was 5 months ago. I am on the verge of tears most of the time, but after my last experience (horrific) I am terrified to go back. Without the ECT my depression isn't being controlled. I feel I am slowly loosing my husband, my kids, and my friends. I don't really blame them, I know I must be difficult to live with - always crying.    I also know I will NEVER be the same person I was before 2007.

when i was training as a

when i was training as a mental health nurse i worked in an ECT clinic for 6 months and its my opinion that this treatment was very effective and a marked difference in the patients recieving it was noticed within 3-4 treatments. i never saw one patient who didnt do well by having it, but i do think that medication after the treatment does help in maintaining the chemical levels in the brain and continuing the positive results of the ECT. but i also believe that having councelling is crucial to a recovery from severe depression. i dont think just one treatment is as effective as having a mixture of the three.

what i will also say is that the image of ECT is gloryfied by films and horror stories. ECT is nothing like it was in the 50s and 60s. its the same procedure as having general surgery in a hospital. you have an anesthetic, you fall asleep, you wake up and its all done. also with general surgery there are side effects but these are short lived and do not leave a horrible visible scar where a surgeon has cut you open.

i also found that a lot of the patients that had ECT while i was working in the clinic were at the last end and the drugs had failed them and so had therapy and this was their last resort and it worked! i now see one of the patients about town, working in a local supermarket and getting on with her life.

unless people have seen it first hand, recieved it themselves or done significant research about ECT then i dont think they should be saying how bad and barbaric the treatment is (based on what they have seen in the movies). its more than fine to ask questions and be curious but to knock it before they've tried it (goes for everything in this world) is just closed mindedness.  

 

ECT - my experience of the treatment

Hi Gabrielle!

Thank you so much for this blog and the sincere support you offer to us all!!

I have recently completed my first course of ECT (last treatment was 22 June 2012).I live in South Africa and I found the experience very similar to yours: Kind, caring nursing staff, gentle and reassuring doctors and I can happily say that I did not find the treatment to be barbaric in the least!

So many people have a misconception of what ECT actually is and so did I, but my psychiatrist sat me down and patiently explained the procedure to me and answered all my questions. It is not the horror-treatment some people might imagine. Apparently, my toes wiggled a bit during the treatment, but other than that, my body was completely still. 

I can understand people's hesitance to see ECT as a humane treatment option, but in my honest opinion, it is a very humane attempt at helping people with severe problems. It was pain-free (aside from a headache after my third treatment) and the most traumatic thing about it was the confusion right after waking from anaesthetic.

It has only been a month since my last treatment and I feel it is too early to tell whether the treatment "worked" or not. I can however say that for the first time in months I feel OK. Not great, OK. I haven't felt OK in a very long time. It might not seem like much, but I am extremely grateful for that! 

Keep well!

Hello Karen

It's great to hear your news! I apologise for not responding sooner - I have had a truly awful 2012.

I wish you the very best and I hope your improvement will last a LONG time :0)

Bucketfuls of support and encouragement.

Gabrielle x

Thank You

I have also had two rounds of ECT treatments within the last two years. I have had a positive experience however, I do fear the treatments. These fears are my own fears about the unknown. As many of you have posted I also was on many medications that worked for a while but then stopped. After many suicide attempts and being hospitalized my Dr. and family (myself) felt that ECT was the right decision for me to save my life.
I just finished up my last round about 2 weeks ago. My short term memory is improving, but my long term and mid term memory is definately effected. Its very frustrating to rely on my family for memories. I still have problems with my vocabulary as well as visualization, but I know with time this will also improve.

Thank you for having the courage to post your experience. Gabrielle you gave me the courage to post of my own experience with ECT. I have more to say but, due to the ECT treatments my thoughts are a little jumbled.

Thank you Anonymous

Thank you so much for sharing your experience with ECT.

I know all about memory disruption and jumbled thoughts, provoked by both ECT and deep depression. In fact I have recovered the memory that was disrupted by ECT (long term and short term) but I have 'lost' the mid-term memory that was affected by the years of deep depression during which I tried 16 different medications to no avail.

Oh boy do I understand what you are saying about being frustrated relying on family for mid-term memory! In fact I became so frustrated that I decided to defuse my frustration with humour (my favourite tool :0)  My husband and I now make a game of the 6 year black hole where my mid-term memories hide. Interestingly, when no longer further blinded by frustation, and with my hubby giving me plenty of detail when he describes a particuar event or person, I have found that I can visualise those memories again and after a few times of visualising them I can remember them. It's a bit like describing a person two or three times before you can recognise them in a crowded street :0)

In fact it might interest you to know that, because I have been very depressed (suicidal) for most of this *year , I have been been unable to read or write until now and my thoughts have been so jumbled as to feel like I needed a hatchet to clear my way through them! People do not know or acknowledge this:  depression destroys neurones.

It is natural to be afraid of a treatment that has you hooked to a machine delivering short electric impulses to your temples. This is NOT a treatment to be taken nor given lightly but when when ALL ELSE has failed ....

Keep well my friend and remember to keep moving one funny little step at a time  :D

Gabrielle x

* [I eventually responded to gradually increasing the medication I take to the maximum daily dose allowed or else I would have had to go back to hospital for further ECT. As you can imagine, increasing meds to the highest level authorised has brought with it horrendous side effects ....]

Considering ECT

I am a 68=year old male with treatment-resistant depression primarily due to the fact that I also have a chronic pain condition which is exacerbated by psych meds that used to work for me in the past. I have tried other psych meds but I cannot tolerate the side effects so ect is being suggested. My fear of memory loss is great because I already have significant memory loss. I don't know if it's due to depression or not but I am extremely concerned that it will become even worse and I will wind up with very little memory at all. Nevertheless I am considering ect because right now every day is a living hell and I'm thinking even short-term relief trumps SOME additional memory loss (as long as I don't wind up a vegetable)/

Memory and ECT

I would definitely say that my memory has been severely affected. I will be in the middle of a convo, and my friend will just politely remind me we've discussed this before. I often forget, and also forget what I've forgotten.
I was coaching high schoolers, and had coached for years. My depression really took over. It got to a point where I was being hospitalized, which is never good for a coaching career--ECT carried a TON of stigma for that. I started ECT, even above my therapist's advice. My mom and twin sis, and especially my hubby and teen kids have been so supportive. They say it has truly been like supporting someone with Alzheimer's.
Lately (20 sessions or so), I have noticed I actually LIKE going out, even in the cold, which was NEVER the case before. I always get up in the morning. I feel smarter. I am very much more active.
Problems-- I feel too hyped up lately. My heart beats faster, and it's hard to go to sleep. The people around me do see ECT as some kind of shock torture because of the memory probs.
This all passes, and the overall, long term wellness has been great. Even my body and brain feels better in ways I never thought of before...

ECT received via Mom 5 weeks in her pregnancy

Anyone know what ECT does to an ebryo?

My Mom had ECT done while she was in her 1st trimester with me. I have many health problems, and I wonder if I can chalk most of them up to the ECT at approximately my 5th week in the womb.

Back then (1966) they apparently didn't bother to do pregnancy tests prior to treatment... I wonder if I'm one of the reasons they do now test.

ECT is a closed head injury

ECT is a closed head injury concussion to a delicate brain. It causes petichial hemorrhages and breeches the blood brain barrier. The "confusion" and "memory loss" are signs of a brain injury. Offering up "brain damage" as treatment is a human rights abuse. It is an assault and being happy the nurses are nice and offer tea or warm blankets does not change that. We know repeated concussions sustained by athletes lead to later life increased risk of Alzheimer's, mood swings, rages, depression, personality changes... But you want a "doctor" to be paid for giving you a treatment equal to a baseball bat to the head ( but worse, because of the blood boiling nature of cattle prod shock..)well, 12-24 baseball bats to the head... Our memories and experiences define us and you want to "joke" about a 6 year black hole?? Did you notice that hole wasn't there WHILE you took the med??? It just showed up after multiple head injuries???

Yes, Mr. Sheppard, the science is available, the books have been written; there is abundant proof that this "procedure" I injures far more people than it briefly helps. The "lucky" ones with thicker skulls, lower voltageenthroned cautious "doctors" ( and I use that term loosely, for anyone who pledges to 'first do no harm' can't really qualify if giving ECT, aka "shock". The minor euphoria or stunned compliance which head injury creates misleads people into thinking a person is "better". Then, when that wears off, let's up the drugs! Let's give more injury (maintenance)!!

Look up Bentall and Reid's review of ECT literature. They have the statistics, concluding this procedure can cause permanent brain injury, cannot be "scientifically justified" and is "no better" than "sham ECT", but minus the brain damage. Read Doctors of Deception by Linda Andre for some insight...

Most brain-damaged ECT patients who think they are better are unaware of the degree of the damage: see Kitty Dukakis as an example, praising ECT, but unable to recall a phone number and living on sticky notes and repeated calls to relatives to remind her of ALL the things she cannot recall or the appointments she has to go to. But kitty thinks shock has "healing" power!!

ECT is a barbaric assault; it diesn't matter if it LOOKS more Pleasant bc the patient is given paralysing and anaesthetic drugs and oxygen; that just means: look ma! No broken bones or teeth ( which is what would happen minus the drugs!! It is just suppressed!!). It lets "doctors" pretend they are not doing something catastrophic to the brain and body.

ECT should be banned. It is ridiculous to obscure the facts and use PR campaigns to promote this pathetic relic of torture first used in fascist Italy. Look up Peter Breggin's website.

People who have the "procedure" and aren't injured should keep it to themselves. ECT is unpredictable and dangerous.?publishing positive reports encourages vulnerable, desperate people. And, people having ECT , it has been documented, are MORE likely to end their lives, often in despair over loss of self, memories, IQ...

Getting ECT is not like getting a standard sundae at the DQ; the fact the doctor is untrained, the equipment is faulty, the voltage is too high, the patient is too sick to verbalized injury or decline ; all these are variables no one can control; it is playing Russian roulette with a dangerous taser. Studies show people who get a taser to the body, not directly to the brain, are too confused and mentally dazed to understand their legal rights. A patient with a head concussion smiling or "forgetting what was bothering her" bc of her head injury suggests a lack of control over deciding to continue; the family, usually unaware that this is stunned euphoria is pleased at the "change". All a recipe for disaster.

 
 
 

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