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.
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I don't buy it
Wow. This story sounds like an ECT commercial. Screenplay written by psychiatrists. ECT is a brutal and primitive “treatment” that belongs to horror movies like other psychiatry experiments on people prefrontal lobotomy and their drugs. Psychiatrists gave people ecstasy, then LSD and their new drugs are worse than most street drugs.
You'd be surprised
If ECT was administered in the same way it was in the middle part of the 20th century, it would be brutal and primitive. However, I can testify that the team who treated Gabrielle were in no way brutal and in no way primitive.
Neither Gabrielle or I are psychiatrists. And she's not trying to sell you anything. Using ECT to treat depression is not taken lightly.
Are you suggesting Gabrielle merely typed this article as a lie?
The more I read your comment, the more I wonder what your position truly is and whether it's based on anything remotely scholarly!
On the morning of her first treatment, I was scared shitless. I was hiding my fear from Gabrielle, because I didn't want to make her feel nervous. She wasn't nervous at all though, to be honest.
If you have read any other parts of this blog, you'd know about her second-hand experience of her father having ECT and the positive changes it made to his behaviour. Had she not seen the difference it could make she'd have been more scared than me, I'm sure.
As far as I know, Gabrielle has two motivations for writing this blog:
She's not selling ECT, because you can't! Especially not in a civilised country with a nationalised health service! I'm the one that put the Google Adsense stuff on her site and to date, I've probably made about five dollars out of it.
If you have some real data to disprove current mental health treatments, please provide it. Your comments are that
You've made this judgement at the end of Gabrielle's account of ECT where she expressed gratitude towards her healing team for being so compassionate. At best this demonstrates that you didn't read Gabrielle's story. At worst that you're got some other weird agenda going on.
You don't buy it
When I read your comment I am reminded of why I decided to write about my ECT treatment: to dispel any UNFOUNDED fears. Was your comment driven by your personal experience of ECT treatment, either personally or through a person close to you? Where did you acquire your understanding and evaluation of ECT treatment? I understand that - as any 'normal' human being would - you dislike the idea of ECT. After all, you would have to be a little strange to think of it as an attractive proposition :0). As my husband wrote, choosing ECT treatment is not a decision that must be taken lightly. Generally speaking, you get offered ECT treatment when EVERYTHING ELSE HAS FAILED. This does not mean, however, that it is either a viable or indeed effective option for everybody. I will simply ask you this: do you consider it barbaric to shock the heart to restart it? If you do not, please consider that in extreme circumstances (such as my own), shocking the brain to reset it may not be the brutal psychiatric endeavour you imagine it to be - please read my blog entry again. I just hope my comment goes some way to lessening your fears. Thank you for your interest. I hope YOU are in excellent health :0)
I wonder??
I must ask after reading this section, if this therapy worked so well, why did you need to have it 23 times???? What is that all about? Also what were you being treated for? Mania, or something different.
These are really good questions.
Currently, Gabrielle is in Paris helping her parents move. I think she would be better placed to answer these questions, and I'm sure will be happy to do so when she gets back.
My hubby was right - you ask very good questions :0)
I don't know who you are but your question is an important one. I can only answer it for myself. ECT is not a one-off therapy anymore than any other therapy. As I am writing this, I cannot think of any therapy that is completed in one treatment, but of course I could be wrong :0). ECT is administered as a course of treatment, each course counting twelve sessions. In the UK, the medical limit is for two ECT courses of treatment (i.e. a maximum of 24 sessions.) In the US, maintenance ECT is practised but, at time of writing, it is not practised in the UK. All I am qualified to say about ECT is that, for me, it felt from the very first treatment as if my brain had been 'reset'. My language improved dramatically and my physical coordination improved also. My mind felt clearer. I was not treated with ECT for mania (even if bipolarism is also known as manic depression) but for very poor 'functioning'. I had a very severe break-down and I stopped functioning properly. As I have written before, the best way I can put it is that ECT put 'my little train back on its rails'. It is only after receiving ECT treatment that I responded well to drugs. Previously, I had got to ECT after having tried sixteen different medications with only one result: I kept getting worse. Receiving ECT was the beginning of a long road to recovery. I am still travelling on that road. Thank you for your interest - I hope YOU are in excellent health :0)
ect treatment
Hello! I'm a 51 year old uk male with treatment resistant anxiety & depression, since I was 12 years old I'm not takeing any meds because they don't work! Would you recermend sorry rorgotten how to spell that word put it another way would ect treatment be worth a go.Thank you. Tony.
A vote for ECT
I think this was the most lucid article I have read about ECT. I had many doubts about it since the same has been suggested for my wife 3 weeks ago. We took a second opinion but were still not sure. I think this has helped us make our decision in favour of ECT. I was also told that this isn't a one-time wonder treatment and she would require a few sessions. I would like to appreciate your honest and elaborate article on the same.
Thank you both for the above
Thank you both for the above comments. I am not a qualified psychiatrist and even if I were, I would not be able to recommend anything to you without having first got to know you and your personal/medical circumstances.
I can only share my story to help alleviate UNFOUNED fears abut ECT treatment. All I will add is that I got to that point where nothing else worked and I chose to give ECT a go. They say that necessity is the mother of invention: I think desperation is the mother of courage.....
ECT isn't a free ticket, even when it works. It has affected my memory (even if the effects have lessened through time) but I chose that evil over the evil of no life at all. Also, let's not forget that ECT doesn't always help.
I wish all of you, those who are ill and those who love you, the very best of good fortune coming your way. My heart holds your recovery as dearly as it does my own.
And remember, you are so much stronger than you think - this strength is not measured by your ability to lift huge weights or pull heavy trucks but by your willingness to consider that which is far beyond your current capabilities/circumstances. If someone had told me only two years ago (two years after the beginning of my illness) that I would be as I am now, I would have laughed them off, or worse I would I wanted to smack them in the mouth! And yet, here I am.
You can't see me but I am waving HUGE pompoms in your general direction to encourage you on YOUR journey of recovery :0)
Fellow travellers, I would love to know how you are all doing :0)
Gabrielle xxxxxxxxxxxxx
ECT is a wonderful life changing treatment
I absolutely agree with Gabrielle! ECT is the absolute best thing that has happened to my life! I spent many years on the bipolar rollercoaster and have been on every medication known to man with no results, however during my last disastrous manic episode I managed to ruin my entire life and with the crash came the suicidal ideations. I was hospitalized and given ECT and the results were amazing! My anxiety is completely gone, and I no longer need Klonopin or Ativan which I was on for mannnnnyyyyy years! My bipolar mood swings are also at bay...I have never been so even keeled in my entire life, and only a truly bipolar person would grasp what a miracle feeling even is! ECT has changed my life in sooo many ways, my anger (which was extreme and intense) is tremendously subdued, and my terrible lows have managed to disapear as well which is another amazing feat! I am so grateful for ECT, because of it I was able to stand on my own two feet and slowly rebuild the life I had destroyed while manic, and i mean destroyed! Two and a half years later I am relapse free and still quite even, and i only have to be on a low dose of minor medication. Most importantly now that my brain has been reset I can view life in a whole new almost normal way. You dont really realize how your perceptions are so off until they are fixed and now i am enjoying a life i never thought possible! The side effects are truley minimal, there is absolutely no pain, a little soreness after but that can be dealt with using Ibuprofen. My sleep is normal which it never was, my mood is wonderful (however not to up in a manic way) and my depression, anxiety, and anger have dissipated. Today I can accomplish anything I set my mind to which is a whole seperate wonder for a bipolar pt who never finished a thing she started. I am in school getting my masters, have a new career and a wonderful new life. The only other side effect is some minimal memory loss of the weeks preceeding the ECT, however I think of that as a godsend, because of those who have experienced a full blown manic episode it is usually something you do not want to remember, so for that side effect I am greatful!
Gabrielle I am so happy this has worked for you as well, and unfortunately most people will remain skeptics until they themselves have experienced the benefits or someone they love has. I would highly reccomend ECT treatment!
Thank you Colleen
It is good to hear a positive story about ECT because there is so much fear and bad press attached to this therapy. I fully understand how you feel about being able to lead a productive life: it does feel like a gift from the Gods, doesn't it? Long may you continue to enjoy your life :D xxx
Positives for ECT
I had ECT treatment when I was 17 years old, following a number of suicide attempts. Medication wasn't working and I can honestly say I would not be here to tell the tale without ECT. I found Gabrielle's account very enlightening as I can recall very little detail from this time. My only memories are of a very kind lady who would administer the anaestetic, and friendly nurses who would always be sitting next to me as I woke up. Apart from a little tenderness, there were no side affects following treatment. Six weeks later I left the hospital to begin a new life. Twenty years on, I still have bouts of depression which I recognise coming on early enough for medication to deal with, however, I would not think twice about having ECT again if it was the best course of action for me. The only downside I would mention is that I don't have the best memory and need to write down information, dates and telephone numbers to help me remember. However, that hasn't stopped me recently completing a degree, and I also have the joy of being able to read books and watch films over and over again as I can never remember the ending!!!!
Thank you Annie
I am so glad to read your story Annie - I sometimes feel like I am a lone voice in the wilderness! I do not advocate ECT per se but I do testify to the fact that it can be a life-saving treatment. Yours is a wonderful testimony :0)
Very best wishes for continued good health.
Gabrielle
I have had ECT...
I have experienced ECT first hand when I was in the grips of a severe post natal depressive episode after having my daughter in 2006. Like you have described it is not an old fashioned, barbaric treatment but a medical procedure which is proved to work.
I doubt I would be here now without ECT, I owe my life to this treatment. When it was suggested my only thought was 'one flew over the cuckoo nest' but it is not like that at all. I am actually speaking in Birmingham in September this year at the National ECT conference for the NHS about my experiences and am ECT poster girl in my trust!
I find that the greater proportion of society do not believe ECT still is used and that the few who do know believe it is outdated and barbaric, of which it is neither. I am open in telling people about my experiences because a few years ago nobody said cancer, it was always whispered 'the big C' but now people openly talk about it... I want mental health illness and treatments to be spoken about freely in that same way.
Best Wishes to you, I hope you stay well.
Keep your grin up :)
Claire
x
Thank you Claire
I am so glad to be hearing from you! I will contact you directly to see when you will be speaking in Septembe: I'd love to go and hear you if I am around :0)
Very best wishes
Gabrielle
I'm sorry that closed minded
I'm sorry that closed minded people are allowed to comment here. Perhaps if that person had a life threatening illness and medication didn't work, they'd see ECT as a treatment option and not a "barbaric experiment".
Thank you for your comment
I understand what you are saying...... Close mindedness is nearly always caused by an underlying fear. As such, I welcome any negative comment because it gives me an opportunity to do my best to alleviate that fear. ECT, as it is usually portrayed, is very scary: most people I know visualise terrible things when they think of electro-shock treatment,. Frankly, by its sustained public silence, the medical/psychiatric profession is not helping much in this regard :D xx
ECT # 6
As I write this post, I am furiously searching the internet for any sign of how long....My husband has had bipolar disorder for 10 years and was misdiagnosed for 8 years. Past 2 years he has tried all medications with no success. He has had 3 hospitalizations since February and this last time we heard of ECT. But he has had 6 sessions and nothing yet. We are worried that it may not work. Hope it will. Gabrielle, did you have all 23 right in succession before your symptoms lifted?
Thank you for your comment
Unfortunately, ECT doesn't work for everyone and, even when it does, it works differently for everyone. ECT improved my brain functionality straight away but it did not eradicate the helter-skelter ride of my BPD altogether. I have to take drugs for that.
In your husband's circumstance I encourage you both with all my heart to keep an open mind and, more importantly to keep a place for hope in his treatment. My father did not show improvement until his second set of ECT. Your husband may be showing improvement but so subtly that nothing is noticeable yet so he will be feeling better slowly over time OR he will suddenly feel better. Unfortunately, nobody can tell.
I will hope for the best for you both.
Gabrielle xxx
ECT and my son
Gabrielle, thank you for sharing your thoughts publically. At the moment my son has been ill for almost three years and no medication has touched his illness during this time. His psychiatrist has recommended ECT but he is so frightened of losing his memories. What is your experience of memory loss??
A worried Mum
ECT & Memory Loss
Hello worried Mum (boy! do I feel for you)
You don't say how old your son is and age does make a difference in the way memory is affected. Once again I will stress that no two people are identical and therefore no two people react to ECT in the same way.
This is only MY experience of memory loss:
I'll be honest here: I got upset about it at first - even if I was prepared to put up with it because ANYTHING was better than where I had been (let's not forget either that severe depression itself is a pretty awful black hole).
This is how I have coped with the disruption to my mid-term memory:
I can honestly say that my mid-term memory disruption is not too difficult to live with. Short-term memory loss is much more challenging (ask anybody who is suffering with early stage Alzheimer or dementia) and so is long-term memory loss because it eats into our sense of self (where we come from is an important part of who we are).
If your son chooses to go ahead with ECT, he needs to be prepared to have a 'playful' memory as a result. The most important thing is NOT TO GET UPSET about it because getting upset blocks memory improvement. Being relaxed, up front, and ready to laugh is very very important.
I hope this has been helpful to you and your son and I wish your son a magical recovery.
Gabrielle xx
PS: Please let me know how your son gets on.
A couple of questions...
I'm really glad to find this blog about your experience. I'm 43, have Major (Unipolar) Depression & I'm very seriously considering ECT. In fact it seems I haven't much other choice, as I've been treatment-resistant with medication 12 years & even MAOI doesn't help. I'm very concerned about the risk of memory loss, but on the other hand I can't continue suffering like this - so empty and devoid of joy, it's just no way to live. However there are other factors that would make ECT very difficult to choose right now, responsibilities in my life, I'm really struggling to find the right path.
I had always thought that if I had to do ECT, at least I'd have my husband there holding my hand as I was being put under, and there by my bedside to ressure me when I came to afterwards. However it seems that isn't allowed, or you'd had Richard in there with you. What is their reasoning? I'm in USA but I'd guess the limits are the same as the UK. It seems it would be a lot less traumatic on the patient to wake to their spouse in the room instead of just some strange nurse. I'm thinking at least I could write myself a large note with photos of hubby & pets, etc. ....
Also, I can't seem to find very much info online about "preparing" for ECT, I mean like in the weeks/months prior (if you have time). I wanted to start a journal, take photographs, etc. in case I permanently forget this time, but as I can barely function, I can't seem to get round to any of it. Are there any things you can recommend that you wish you had done beforehand?
I think it's very brave of you to be so open about your experience, especially in light of our society's prejudices. Do you have any regrets about this choice? Even the professionals reccomend we "limit" who we tell for our "best interests." I understand why, but I hate feeling that I must make up lies about myself & my life - it feels so "phoney," deciding who I should "trust" & remembering which is which is hard enough even without ECT memory loss! We should have no more reason to be ashamed about our mental illness & treatment than say, one with Cancer who takes Chemotherapy. Anyway, I hope I'll be able follow your example. It's a difficult road as it is, but I know attitudes will never change unless we educate people.
Thank you Patricia
Dear God! You have suffered so much, haven't you! My heart goes out to you and before I write anything else please allow me to send you bucketfuls of love and encouragement.
Now for your questions:
I do not advocate ECT and I do not encourage anyone to have it either. I do share my experience truthfully and openly in the hope that this will help another poor soul going through what I went through to make up his or her own mind.
I wish you all you would wish for yourself and I feel totally confident that you will make the right decision for you (and for your husband too).
Gabrielle :D xxxxxxxxx
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