Disorders and Treatment
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In preparation for Steven’s piece, I’ve written this primer.
Electroconvulsive therapy (ECT) is the second most controversial medical procedure. (Abortion is the first.) Certainly when I write about ECT it seems to prove the controversy of this topic. And it doesn’t matter what I say about ECT, even if it’s not pro or con, people insist on expressing very strong viewpoints on the use of ECT. And yes, I have had ECT.
And generally the strong viewpoints are anti-ECT. They are from the ECT-is-torture crowd. A prevalent crowd online, to be sure, but someone needs to actually talk about the facts of ECT.
ECT saves people absolutely nothing else can. And if you have ever looked down the long, dark, hallway of treatment only to see a black hole, you would know how essential it is to have it as an option.
I know people don’t want to hear this, but ECT saves lives. ECT brings people out of the deepest, darkest depressions that no medication can touch. ECT saves people who are suicidal. ECT saves people who are determined to kill themselves while in the hospital.
It is critical this be an option, no matter how untenable it may be.
That being said, electroconvulsive therapy induces a clonic seizure in the brain. You won’t feel it, you’ll be under anesthesia and other medications, but the whole point of treatment is to produce a seizure. And seizures cause brain damage. A friend of mine who’s epileptic will tell you how that goes. He spends an awful lot of time trying to prevent brain-damaging seizures.
ECT can cause memory loss and cognitive deficit. Mind you, there’s not a lot of science to back that up the kind of dramatic stories typically touted online.
In the end, ECT is a gamble. You are doing something unpredictable to your brain. Bad things could happen. Very bad things, in fact. But nasty treatments for severe, intractable depressions are like that. If depression could be cured with lollipops it wouldn’t be a problem, but to the best of my knowledge, lollipops don’t have a very high success rate.
There is no point in comparing modern ECT with ECT from 30 years ago. Everything has changed.
Which is to say modern ECT is safer and more effective than ever before (safety and efficacy are relative). Every year we learn more about the brain and how to target specific areas for treatment. It is now common to see ultra-brief-pulse unilateral ECT rather than bilateral ECT. This means the current runs through a small portion of your brain comparatively. Still a gamble, no doubt, but we’re getting better.
I have no doubt ECT has gone very wrong for some people. I have no doubt it has been terrible. It may very well be the case ECT has caused long-term problems. But this small handful of people are the ones filling up all the space on the internet. One person’s experience, good or bad, cannot be the basis for the opinion of a treatment in general. Chemotherapy and radiation kill people. But people do it because they are facing a horrible disease. Just like those who choose ECT.
People who have received ECT are scared to say so.
People who have had electroconvulsive therapy are scared of being judged. They are scared of all the vocal people mentioned above. They are scared of all the people who think something brutal, inhumane and akin to rape saved their lives. I don’t blame them for being scared. Standing up to loud opponents about such a delicate and fragile subject is tough. People have enough problems.
But of course people shouldn’t be afraid of admitting they had ECT. They shouldn’t feel bad about a treatment that did (or didn’t, for that matter) help them.
There are people with positive experiences with ECT even if they aren’t shouting it from the rooftops.
Which brings me to next week’s guest author: Steven Schwartz – the BiPolar Badger. Steve is in the middle of a series of six ECT treatments and he’ll be writing about his experiences thus far. Steve has had ECT in the past, has found it effective, and has chosen to do it again. His piece will be up later this week.
More on the BiPolar Badger:
Steven Schwartz is a former journalist living with BiPolar disorder and Borderline Personality Disorder. Writing about his personal experiences of life with Mental Illness to reduce its stigma, shame and misconceptions. Steven writes in a open, frank, humorous and sometimes brutally honest style as a way of showing the human side of living with Mental Illness.
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