ECT aka ElectroShock Therapy for depression

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So after 13 years of intractable depression (meaning attempting to make the depression go away with antidepressants without success) I asked my psychiatrist about ECT. I had personally seen someone turn into a new person after treatment, and also there was a person here on WP years ago who got good results from it, so I was desperate enough to try it.

My psychiatrist was all for it, so the treatment began. Usually they try to schedule you for a "round" of it, say 3-10 treatments over a week or two. They keep evaluating your depression as it goes, until you're in remission. Because of my work schedule, I wasn't able to have enough treatments to achieve the blessed remission, but I did notice positive benefits, which is why I'm posting this thread (in case there are any others whose depression is not being helped by traditional ways).

And I intend to get treatments whenever my work schedule allows, including another one coming up this week.

So here are the changes I noticed within a week of the first ECT treatments:
-I used to wake up every morning with a feeling of dread about the day, and about life in general. That is gone completely. I sometimes even wake up excited. I think once I woke up looking forward to the day (for those of you with depression, you may be able to relate).

- I used to have random "I might as well be dead" or variations of that theme thoughts. Those are completely gone.

- Now this one is unexpected, but I seem to be able to function better with random social interactions. I used to be uncomfortable in every social situation, now I find I can have conversations with people without discomfort.

Side effects or other negative stuff:
- Random memory loss. As a professional, my short and long term memory are crucial to optimal functioning. I lost (as in - not having a single memory of certain events) some short-term memory of things that had happened the few months prior to the ECT. It was weird, especially for somebody who can remember a phone number of a random person from 30 years ago. But I had to make a decision, and decided that this side effect was worth it in order to function. Basically, as a typical aspie who is brighter than your average NT, it has leveled the playing field. Or to put it another way, I'm no less able to function with this minor cognitive impairment than your typical NT.

- I hate the procedure. You're in a hospital gown, they hook you up with an IV, there's an anesthesiologist who knocks you out, and they induce a seizure. Just knowing that puts me in a state of anxiety when I think about it, and I start to have a panic attack when all the medical staff are gathered around me with the monitor, etc., getting all serious. That's the worst part for me. And then you wake up in the recovery room, not having known what just happened. And I'm pretty much wiped out for the rest of the day.

But all in all, for me, it's the best thing to come along since, well, MDMA. But that's not an option. So ECT it is, and I'll keep doing it till I can pass their MMPI!

Thank you for sharing your experiences MsTriste. Did you happen to catch the recent article in Newsweek on antidepressants? In the future I think I may have to reference your post as I look for ways of treating things in myself. Thanks again!

No, I didn't see the article. Do you care to share?

Another thanks for posting that.

Did you notice any change in working memory? I.e. read a page in a book, then read the next page, and not be able to remember the first one by the end of the second? (IOW 0-10 minutes level of memory) I ask because I have pre-exisiting memory problems like that, and if it got worse I could see becoming really disabled by it.

i would rather use Repetitive Transcranial Magnetic Stimulation, a newer outpatient technique where an energized magnetic loop is placed a close distance over what the psychiatrist has determined the brain area needing the treatment. the only major side fx noted so far has been localized soreness of the scalp and underlying musculature. the process makes a loud noise so earplugs are usually part of the treatment. it has been FDA approved for treatment-resistant depression. just being in the hospital hooked-up with wires and caths and IVs and such gives me the heebie-jeebies.

No, no changes in working or immediate memory. Just several random things that had occurred in the previous month or so. No other memory problems. But as I said in my post, my memory is normally stellar. So...your results may vary, as they say.

Thanks for the info - I'll look into it. My first question has to do with WHERE the psychiatrist would determine is the "area". I believe that my entire brain needs rewiring. So I would wonder how that would be accomplished with localized (as opposed to generalized) magnets.

Second, if you have had this procedure, would you mind sharing your experience with it, including any benefits you've received?

mind care centers rtms procedure

the website link above has pics of the device over the left side of the head above the ears. this doesn't really tell what exact part of the brain is being targeted, maybe the left cerebral cortex? left temporal lobe? it might even have been a non-precise staged photo, for all i know. i am not a medic nor have i had the benefit of this procedure, just have known about it for several years. i live out in the sticks and this procedure generally is available only in the big urban areas.

Here's a picture of RTMS that's on Wikipedia (I fully expect to see this as someone's avatar some day). I thought it was amusing.

Apparently rTMS is not yet FDA approved in the US.


[img][650:800]http://upload.wikimedia.org/wikipedia/commons/1/16/Repetitive_transcranial_magnetic_stimulation_%28rTMS%29_is_a_technique_for_noninvasive_stimulation_of_the_adult_brain.jpg[/img]

i don't know how accurate wiki is in this regard but on their page it says"

"A TMS device was cleared by the Food and Drug Administration (FDA) in the United States for use in adult patients with major depression who have failed to benefit from prior antidepressant medications."

i know that the powers-that-be approved it years ago for experimental treatments, i have been reading about these since the early 00s. if the only side fx are localized discomfort, it would seem to be advantageous for those ECT patients who could not tolerate the memory disruption and who wanted to avoid the whole hospital scene.

it sure would be nice if they had such technology outside of the biggest cities, for us folk out in the sticks.

It's not exactly "available" in the big cities either unless you're wealthy enough to afford it. As of Feb, 2012, insurance companies are still scared of it, which I don't understand. Magnetic stimulation does not cause any tissue damage. The only open question about TMS is its effectiveness across the population. We know that all pharmaceuticals have side effects. We know that all antidepressant medications confer an increased risk of suicide in teenage patients. So we don't know precisely who will benefit the most from TMS, but I don't see it as very risky. TMS technology has been used in animal behavioral studies for decades. (I'm a former neuroscientist, though I never used TMS in my own work.)

That said, as a guy who's just completed (last week) my first full round of ECT for severe, refractory depression, I can appreciate the very real risk associated with having depression suddenly lifted. I'm honestly pretty freaked out right now. At least I was warned that this could happen.

I asked my psych about ECT when I was very depressed & after trying lots of meds & she told me it was only for people who were catatonic or were immediately dangerous to themselves or others. I've known a couple people offline & a few online who had it done & lots had bad permanent side-effects after like memory problems, problems focusing/paying attention, & some had motor-skills problems. I think Vagus Nerve Stimulation might be just as effective but more convenient long term & safer. It's a surgery where they attach some kind of electrode thing to the vagus nerve cluster & a wire from it goes to some pace-maker type device in the chest. It emits a very small electrical current every few minutes or seconds. I read a bit about it because I have Essential Tremors which it's approved to treat but it's also approved for Parkinson as well as depression of course. I couldn't get my psych or neurologist to approve it for my tremors or my depression thou. They kept pushing meds that kept made me feel bad; my depression & tremors got a lot better after I weaned myself off all the meds after being on them for 5 years.

That sounds like a personal opinion. It's certainly not a consensus, though it might represent insurance guidelines. I had to have my ECT done as an inpatient, and I know that's really expensive. There's a lot of misinformation out there about the physiological risks. It's much less risky than a surgical procedure, though both have the potential to lift the mood immediately, as opposed to doing so over a period of weeks. It's difficult for me to describe how that's actually a risk, but though words fail me, I'm certainly feeling it. It feels extremely disorienting, even though by every objective measure it's had a positive effect on my functioning.

I'm happy, though, that if a psychiatrist is imposing a personal opinion, at least it's an opinion that favors caution in her mind. I'm certainly not going to recommend ECT to anyone based on my experience. I think patients who are considering ECT are only doing so after reaching a somewhat desperate state, and only they can offer a meaningful guess as to whether their lives will be improved by such a radical intervention. IMO, the role of the psychiatrist should be as a consultant to make sure the patient is fully informed and truly able to give (or decline) informed consent.

I'm glad I chose to give ECT a try. It seems like it's working well so far. But my experience isn't enough to predict whether it would be a good decision for someone else. One thing I cannot abide is fear-mongers trying to convince people they know what's best for them. I'm a neuroscientist with a PhD, and I don't know what's best for someone else regarding ECT. It's a deeply personal decision, and I'm sorry your psychiatrist saw it as so absolutely black and white. I have no idea whether it would be helpful to you or not, but I reject the idea that it can be reduced to such a simple formula.

And thank you for giving me someone to talk to tonight. I'm still trying to process my own feelings about my recent ECT. That's really where I'm coming from, truth be told.

^^^ Your Welcome dcs002.

Most all the docs & psychs I saw for different things were a little arrogant & didn't listen to me a lot. Maybe they felt that I wasn't fully capable of making informed choices about my treatment due to me being depressed & having other mental issues. My depression got aLOT better after i had weaned myself off all the meds & I'm completely over it now. I think Vagus nerve stimulation might be safer because it doesn't involve actual brain surgery & it's a much much lower & it's a frequent electrical current instead of a sudden extremely strong shock. I'm thinking about trying to see a neurologist for the tremors again so maybe I'll get that eventually but I'm not going dwell on it too much rite now. Rather take things 1 step at a time rite now.