ECT - Treatment or Torture?

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.