Tuesday, August 08, 2006

TO READ: Electroconvulsive therapy (ECT) experiences

"You mean they still do that?" A new writing friend stared at me the other day, mouth agape. At lunch while attending a workshop together, we had discovered our mutual experience with depression. When she asked me what had helped me back to relative stability, I mentioned medicine, acupuncture, psychotherapy, magnetic treatments... and electroconvulsive therapy (ECT) or shock treatments.

Her horrified reaction is not uncommon when I disclose this part of my healing. And people's amazement is confounded by the fact that I speak of my ECT experiences without regret or resentment. Of course, I wish I hadn't needed those treatments (more than 100 over about 10 years), but I would get them again in a minute if I were severely depressed and nothing else was helping. ECT, like writing, probably saved my life a number of times. And these days it's not like something that makes you wince while watching an old movie. No pain, no broken bones.

ECT, in fact, is frequently referred to as psychiatry's "gold standard" treatment for depression. Nothing is more effective, and ECT tends to work more quickly than medication. Most people feel better within a series of six to twelve treatments (usually given three times per week). No one knows quite why ECT works. Administration of electricity to one or both sides of the brain causes a seizure -- that is, all the brain's nerve cells "fire," or send their messages, at the same time. Somehow this seems to "reset" the brain's mood centers.

What are ECT treatments like?
In my experience, it's pretty simple. I would go to a hospital treatment room, either as an inpatient or an outpatient, where nurses put in an IV line so that I could later receive medications. They attached wires to my head and body with little sticky pads so that the doctors could monitor my heart and brain activities. Then two doctors appeared -- a psychiatrist and an anesthesiologist. After I took a few breaths of pure oxygen, I got a general anesthetic by IV. After I was asleep, I received a muscle relaxant medication, which would act for only a few minutes, keeping me from moving and potentially hurting myself during the seizure. The psychiatrist connected a machine to those wires on my head, and it delivered a carefully-determined dose of electricity (usually to just one side of my head; occassionally we opted for two sides). The electricity caused a seizure, which lasted around 30 seconds. I've been told repeatedly that the patient's body scarcely moves. The anesthesiologist ensured I got enough oxygen until I could breathe on my own again.

How do you feel afterward...?
Stay tuned for next week's "TO READ" posting!


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