Info/opinion re ECT

elkpark · Feb 13, 2005

I've been a psych nurse for ~20 years, and have seen ECT help many clients over the years when other treatments had not been effective. I have also met clients who came to the hospital(s) requesting ECT, saying, "It was the only thing that helped me several years ago, and I know it's the only thing that will help me now ..."

When you say, "ECT," everyone immediately thinks of "One Flew Over the Cuckoo's Nest," but for many years ECT has been used only under v. strict clinical guidelines, only for diagnoses for which it has been proven effective, and only after other treatment options have failed (unlike the "bad ol' days," when they shocked about anyone for about anything). Much lower "dosages" of electricity are used now, as the lower dosages were found to be just as effective as the high dosages that used to be used. Also, clients are typically anesthetized now for treatments, eliminating the former risk of fractures from the seizure induced by the treatment (as well as making it a more pleasant experience in general).

Quite frankly, I would take ECT myself before I would take a lot of the psych meds we give to people ... Best wishes for whatever you decide --

Liddle Noodnik · Feb 13, 2005

Quite frankly, I would take ECT myself before I would take a lot of the psych meds we give to people ... Best wishes for whatever you decide --

Thank you SO MUCH for answering! It is just such a scary prospect - But you're right, some of the meds, YIKES! Had SEVERE SEVERE reaction to Geodon last summer, akathesia to the MAX ...

elkpark · Feb 13, 2005

You're right, it is a scary prospect, and most people just cringe when they hear the word "ECT." And, of course, there are significant risks associated with the general anesthesia. It's not a choice to be made lightly (by you, or by your physician).

However, IMO, people (docs as well as the general public) are way, way, way too cavalier about the risks associated with the meds we give people -- and, as we've heard so much in the news over the years, often we don't find out about those risks until after the damage is done.

I've seen many, many people helped dramatically by ECT during my career, and haven't seen any bad outcomes (other than the occasional person who doesn't respond to ECT -- but even they didn't get hurt by it, they just didn't get the benefit they were hoping for). Sure can't say that for the psych meds everyone takes so much for granted!

ageless · Feb 13, 2005

The procedure has been perfected, but the severe side effect of memory loss has not. Many patients state they lost memory from 6+ months prior to the series of treatments.

Best wishes

Liddle Noodnik · Feb 13, 2005

The procedure has been perfected, but the severe side effect of memory loss has not. Many patients state they lost memory from 6+ months prior to the series of treatments.
Best wishes

Hey, this year has been so awful I'd be GLAD to not remember it! ha ha!

elkpark · Feb 13, 2005

I have known many patients who received ECT in the "bad ol' days" who complained of severe memory loss, but I have not encountered anyone who has received ECT in recent years who has complained of significant memory loss. Maybe the people I've worked with were just lucky; I'm sure there is literature out there on this.

StuPer · Feb 14, 2005

Yes memory loss continues to be a problem with ECT, however this has to be balanced against the benefits. In looking at your cognition, that is your overall awareness of things around you and your ability to interact with them, I would say you appear to be functioning well on the basis of the question you pose and the replies you have given. That would I think make the psychiatrists I work with reluctant to give you ECT, however I don't know your story and its not something you should disclose on a public website. Taken that you need ECT, I would agree with elkpark it is much safer nowadays compared to the past. I have helped in the administration of ECT many times and have seen the benefits in those given it, this is poles apart from my initial opinion about it though. When training I was vitriolically opposed to it... it was 'barbaric', however my interactions with one client changed all that. She was a lady in her 30's who normally functioned as a mother and shop assistant, but due to social circumstances and relationship issues would become almost catatonically depressed. I mean this was to the point of lying motionless staring at a wall all day long, being incontinent of urine and faeces. She was given ECT and literally within a week she was skipping and playing tag with another patient on the ward. In fact on of the problems we had with this lady was she came up so fast that she became alert enough to attempt suicide after the first few doses of ECT,it was that quick in effect (she was too depressed to even attempt suicide before).

Ultimately the question of having ECT or not is more about the alternatives, if you don't for example and try another antidepressant you may respond, although this tends to take a while. On the other hand you may not respond to an antidperessant and if you start getting persistant thoughts of suicide, the outcome maybe a personal tragedy and family disaster. Also ECT can help restore the 'balance' to a person with bipolar with a reduced risk of going 'high' because the ECT can be ceased immediately this becomes evident.

At the end of the day the choice is yours, just dont buy into the 'urban legends' regarding ECT when making your decision.

regards StuPer

donmurray · Feb 14, 2005

I believe that a lot of the associated "memory problems" can also be classified as urban legend. I work in the Alzheimers field nowadays, and one of the differential diagnoses we seek to exclude is depression. The depressed person will often suffer from lowered attention and concentration, as well as mood, and none of these are conducive to good memory. I seem to recall that unilateral as opposed to bilateral application showed less effect on memory.

All in all ECT is a relatively safe and effective treatment for severe depression which has proved resistant to other forms of treatment.

Liddle Noodnik · Feb 14, 2005

Thanks you guys, I really appreciate the feedback!

margo123 · Feb 15, 2005

I've been working one day a week for the past eighteen months helping administer ECT. I think the screening process is key. Some of the personality disorders slip by our docs and usually we see no improvement with them. Our clients who have real depression make amazing improvement. We treat a lady who is bipolar and can become catatonic. It truly has saved her life. The turnaround she has made is astounding. Our list of success stories is a very long and gratifying one. Many of our clients are troubled with memory loss immediately following the treatment ie not being able to remember where the dressing room is, who drove them to treatment, etc. They report that this is transient. Virtually all of them report what they have traded in memory loss for the immense relief from depression is well worth it. I can't think of a single case where severe memory loss has happened. A few have complained of headache and/or muscle soreness afterwards. We treat this with Toradol and usually our clients are soon comfortable. I can say with all honestly, that I would have it if needed. I'd recommend it to a loved one if they were suffering. The positive effects can subside after a few months of stopping treatment (not always). Those clients come back for more ECT because they know they're going to feel better again soon. Hope this helps and the best of luck to you.

My doc wants to do ECT on me for intractible (sp) depression/bipolar. I'm not functioning too well ie getting out of the house, going to support groups, ADL and socializing. I've been on several several meds.
Any feedback on how well you have seen this working, or other kinds of treatment/therapy for those for whom meds aren't effective?
I truly appreciate your help.
BTW I am an RN as well as the hair club president LOL

Liddle Noodnik · Feb 15, 2005

I've been working one day a week for the past eighteen months helping administer ECT. ...Hope this helps and the best of luck to you.

I am so SHOCKED to see so much positive feedback!

Well I have had improvement since my initial post, I think the prospect of the treatment scared me out of my funk for a minute or two, LOL!

I have hx of a suicide attempt (razor blades) in 85, no attempts since, altho in the past few months I get this flash of anger at myself and then BOOM, see myself shooting myself in the head with a gun - definitely blame myself for my illness. Yes I am safe and no I don't have a plan and yada yada (LOL)

Borderline was ruled out in 85 - I am a recovering alcoholic and had many successful years as a nurse (although not always back to back!)

I do have bipolar illness, mostly the depressive side, at first they said it was bipolar II because it seemed the SSRI's were guilty for the mania. Now they have upgraded me to bipolar I, yipee!

I would do ok if I didn't have to leave the house, organize things, do housework, interact with people. Initially with this relapse (Oct 2003) it was mostly major anxiety with depression, now I am too depressed to be anxious...

ANY way, thank you all so much for helping me. I will play it by ear - I may just go back to Lithium and Prozac which helped for a while and see how it goes.

God bless!