Archive for ‘ECT’

July 26, 2011

if not a magic bullet, then what is it?

The summer’s not yet over, but I’m already looking back at it. I think about the hypomanic episode I had and bouts of depression following it.  In fact, those moments of depression never seem to be that far away. Everyday I take medication in effort to keep all those things at bay, and see a therapist weekly. And, oh yes, the ‘little spark,’ too. Electroconvulsive therapy is still on the roster.

I’m not sure this is what I expected. It’s been over two years since my first series of ECT treatments, and I’m still just maintaining, not necessarily thriving. People talk about ECT being a life saver and the ‘magic bullet,’ but as time goes by, I’m not sure if that’s how I would view the experience anymore. Yes, I’m still alive, and that’s (I guess) a good thing, but—-Where would I be  had I not had those shock treatments? Would I be dead, or in a much worse shape than I am in now? Or would I have eventually found my way to this emotional point that I am currently at? I’m still taking mostly the same cocktail of meds. What criteria determines if, and to what degree, I’m doing better?

Perhaps I’m making some logical error in contemplating this whole thing. After all, constant suicidal thoughts did pretty much go away after all the ‘little sparks.’ And wasn’t that the point? Didn’t the treatments accomplish their goal? I may be asking a question that can’t really be answered. I could just as easily ask “what if I had never started taking meds,” but I don’t seem to be doing that. Instead, I keep coming back to whether ECT was the right treatment to have—and still be having.

I seem to give some people the perception that I am obviously an avid endorser of ECT because I have a journal/blog that talks about the subject. But I don’t think that’s what my purpose is in writing on this topic. While I admit that I’m not anti-ECT, I am constantly conflicted about getting this treatment. But maybe I should also be just as conflicted by the medication.

July 8, 2011

day after the shock

It’s a day after my 34th electroconvulsive therapy treatment, and I’m awake. I got up around 8am, which had been a really hard thing to do for the last week or so, but today, it really wasn’t bad. I drank some coffee and ate a biscuit, took my cocktail of bupropion SR, concerta and deplin (at night, instead of concerta, I take abilify), and then went on my errands. I ended up purchasing myself a Roomba (yes, the robot vacuum thing…), and signed up for a year-long Koko Fit Club gym membership. Now, I’m back home and sitting around thinking about what to get done next.

I must admit I feel much better today than I have this past week. My mind isn’t stuffed with guilt, disappointment, etc. Rather, I feel much calmer and tolerant of even the things that are frustrating in life, like the weight I can’t seem to lose or choosing a path in this life. Even my boyfriend thought I seemed a little happier, which is definitely a good sign. But what is ECT worth? Like practically any medical treatment, there are side effects to having it done. Though I’m not sure if the following is as a result of the ECT or I’ve always been this way, but I can remember having read something—-but not what they were about. Yesterday before ECT, I was talking with someone who had brought his mother to ECT. When I was about to leave, a man said something to me.  I had to be reminded by him that he talked to me before the treatment. I don’t think the memory loss that I’ve experienced has been that bad, but it’s certainly not a good sign, worse, if it has a cumulative effect. I agree that this most recent procedure has allowed me to feel much better than the last few previous days, but could I have reached this point without having this treatment? Would I rather have medication dictate the direction of my mental (and physical) health, even though they, too, have plenty of side effects to mention? Which is better, or should they both be a part of my treatment plan for now? Because I had some depressive and hypomanic episodes over the last few weeks, what was supposed to be close to the end of my ECT cycle now seems far away. But the fact remains that I get to decide which path to take, and right now, I don’t know.

Either way, I’m going to have a healthy dinner, and later in the evening, go workout at the gym. As much as I should  be frustrated over making this decision, it’s nice to be back to feeling better again……..thanks to ECT.

July 7, 2011

ECT #39 (24th maintenance treatment)

Today was another day for electroconvulsive therapy treatment. I haven’t felt very good lately, so I really did not feel like telling my ECT psychiatrist what’s been going on—but I knew I kind of had to. When Dr. F came to my stretcher/bed in the treatment room, I told him about how I experienced a sort of hypomania last two weeks and then reached a low this week. I guess he took my comments to mean that I can’t quite stop having ECT just yet (though I don’t think it was going to end today by any means). We’ve been spreading the treatments out to every eight weeks, but we compromised for the next ECT to be seven weeks from now. Until this week, Dr. F had been talking about how I’m coming close to the end of all this ECT, but I guess I ruined that chance now.

I usually have more to write on my treatment days, but I don’t really have much to say today. I came home and mostly slept for hours. I don’t usually feel that much better til tomorrow, so I guess I have to wait until then.

 

See the other ECT days here.

May 13, 2011

ECT #38 (my 23rd maintenance treatment)

My maintenance ECT treatment was yesterday, and since my parents are in town, they took me to the psychiatric hospital where I have ECT. I always feel awkward when they are the ones having to take me there, probably because it’s like giving them clear evidence that something is wrong with me—-at least wrong enough to have to take their daughter to a psych hospital. A part of me feels embarrassed, even though I’ve been through this nearly forty times. I just feel bad for my parents that they are having to do this for me. I acted like nothing was the matter, and when we got to the reception desk, I asked them if they wanted free breakfast from the hospital cafeteria. Then, I was whisked away to the inside.

One good news: because of the new parity laws, I get insurance coverage again for mental health stuff! I do wish someone told me about it since i’ve been doing this sans insurance for a while now,  but better late than never…

Otherwise, it’s mostly the usual. I get to the waiting room, use the bathroom, put on the gown and get my vitals checked. They weighed me, and I realized that I’ve gained over 30 lbs. since a little while ago. Then they usher me to the treatment area where they lead me to my bed/stretcher. The usual anesthesiologist wasn’t there, but Dr. F., my ECT psychiatrist came up to me to chat for a little bit. He said that I’ll be having the procedure a few more times but that it is coming to an end.  I’m happy to hear that, but at the same time, I’m very anxious. What if this is what’s been keeping me alive for the last two years. I remember the hiatus we took after the first set of ECT, and it was really horrible. I don’t want to experience that again. I said ok to Dr. F. and they almost immediately put me out, but I’m left with a feeling that I can’t quit this treatment.

April 8, 2011

FDA’s ECT panel meeting remarks online

PsychCentral.com has posted many of the remarks by various people who’ve spoken at the FDA neurological devices panel that’s examining the reclassification of ECT devices.

March 17, 2011

ECT #37 (my 22nd maintenance treatment)

This morning was another day for ECT. Since my mother is in town, she took me to the hospital. I really can’t recall much of what went on today except that the staff all came up to ask me if my family was okay from the earthquake and tsunami in Japan. When Dr. F, my ECT psychiatrist, came by, I think he did mention something about the eventual end to having ECT. Of course, it’s not quite over that soon, but at least he said something about it. He did kind of get on me about my not having seen my regular psychiatrist in months, because I had told him that I hadn’t been feeling all that up in the last week or so. He was reluctant to schedule the next one for eight weeks later instead of six weeks, but I told him I really didn’t want it any earlier. Otherwise, the anesthesiologist injected me with some anesthesia, and then I was awake and done. Not too much to recount today.

January 28, 2011

FDA Panel: More testing needed for ECT Machines

FDA panel advises more testing of ‘shock-therapy’ devices
by David Brown/Washington Post/1.28.2011

An expert panel advising the Food and Drug Administration decided Friday that electroconvulsive therapy (ECT) machines should undergo the same rigorous testing as new medical devices coming onto the market – a decision that could drastically affect the future of psychiatry’s most controversial treatment.

The majority of the 18-member committee said not enough is known about ECT, also known as “electroshock” or simply “shock” therapy, to allow the devices to be used without more research into its usefulness and hazards.

If the agency follows the panel’s advice, which it usually does, the two companies whose machines are used in the United States will have to provide evidence of the therapy’s safety and effectiveness either from existing research or new studies. If the FDA isn’t convinced, the devices could be removed from use.

The panel’s opinion is the latest chapter in ECT’s seven-decade history, during which the treatment has been lauded as a lifesaver, villified as a form of legally sanctioned torture, and has seen its popularity rise in recent years after a long decline.

ECT machines deliver an electrical current to the brain, inducing a generalized seizure in which the patient briefly loses consciousness. How that may be therapeutic or cause permanent memory loss – the side effect most frequently mentioned by patients – isn’t known. Read More

January 26, 2011

after-shock

photo taken while stopped at a red light

The sky is an eerie pale gray. Snowfall must be imminent, but right now it is raining.  I am driving through this rain that’s making everything around a blur. Such weather would understandably make anyone’s mood sink a bit, including mine, but today I feel fine.

People ask me what it feels like after ECT, and I always have a hard time putting it in some easy-to-understand example, but I feel like I just found it. Last week, everything seemed gray and a blur even when there wasn’t rain. My body moved a little slower amidst the rest of the world. Then, I had my ECT. It’s been almost a week since the treatment, and in general, my list of stuff-to-do and stressors hasn’t really been altered since before the little spark. But today, while I’m not seeing songbirds and butterflies, I don’t feel dragged down by a simple change in surroundings. I recognize the state around me, but I still feel awake, aware, and real.

Before having ECT, I think I kind of expected the post-ECT to be existing in a world that’s all shiny, bright and wonderful. Well, what I’ve found out is that I instead get to experience reality, not any better or worse, but for what it is. In short, I get life. And that’s ok with me.

January 24, 2011

Measuring the risk of ECT machines

UPDATE ON STORY–link here
This week, the FDA is re-evaluating the risk classification for electroshock devices/ECT machines, which is currently classified as high-risk. American Psychiatric Association and other specialists wants to see the devices downgraded to a medium-risk category, which would mean that the equipment could be promoted and sold without new testing. Such a downgrade would place the devices in the same risk category as syringes and surgical drills. If the F.D.A. leaves the devices in the high-risk category, however, manufacturers may, depending on the agency, have to withdraw them from the market. The F.D.A. could require safety and effectiveness tests that have not previously been done. By regulating the devices, the F.D.A. is indirectly regulating the procedure. The agency could make a formal decision later this year.

The F.D.A. usually, but not always, follows recommendations of its advisory panels. While that may often be the case, the road to actually getting there is filled with mixed comments from both sides.

Dr. James H. Scully Jr., medical director and chief executive of the American Psychiatric Association, wrote the F.D.A. recently to say the treatment was “extremely effective and safe.” It provides relief some 80 percent of the time, he wrote. Dr. Scully and the psychiatry association also say there is no evidence it causes brain damage.

A task force is updating the association’s 2001 recommendations on the treatment. Its report is at least a year away.

“People use it because it works,” said Dr. Laura J. Fochtmann, a member of the task force, professor and director of the Electroconvulsive Therapy Service at Stony Brook University Medical Center, Long Island.

“These disorders can be extremely life-threatening, and when it works, it can be dramatically effective,” she said.

Opponents of electroshock include some patient advocacy groups, but the opponents, clearly, are outnumbered among physicians.

Dr. Peter R. Breggin, author of more than a dozen books including one about electroshock and a consultant in personal injury cases involving drugs and the therapy, says he is the only American psychiatrist he knows who opposes the treatment.

“It’s a big money-maker,” he said. “I would say if anything it’s been on the increase because there’s a market that’s been exploited, that is the elderly depressed women on Medicare. The reason for that is they’re covered, and there’s no one to protect them. What commonly stops shock treatment is a family member saying ‘over my dead body.’ ”

Depressed older people, Dr. Breggin said, can be helped more by a pet or conversation.

Last year, two psychology professors, John Read of the University of Auckland, New Zealand, and Richard Bentall of Bangor University, Wales, criticized electroshock after reviewing studies comparing it with simulated treatment. Their findings were published in Epidemiologia e Psichiatria Sociale, a peer-reviewed European psychiatric journal. “The cost-benefit analysis is so poor that its use cannot be scientifically justified,” Dr. Read wrote in an e-mail.

John Breeding, a psychologist and member of the Coalition for Abolition of Electroshock in Texas, said that state had banned electroshock for youths under 16 and required second opinions for treating the elderly, giving it the strictest rules in the nation.

“It’s a very strong treatment for despair and hopelessness,” he said. “It’s a temporary blunting of your feelings, so you feel better for a while, then you feel worse, and now you’ve got the memory loss and brain damage.” (from NYTimes, FDA is Studying the Risk of Electroshock Devices)

While I don’t know if a syringe and a ECT machine have comparable risk factors, I can think of things like scalpels that could potentially cause huge physical harm. All I’m hoping for is that the FDA gives a ruling that would keep the option of electroconvulsive therapy open to all patients that are considering this treatment.

UPDATE (1.28.2011): FDA panel wants more testing

November 22, 2010

ECT #35: (my 20th maintenance treatment)

Today was my 35th electroconvulsive therapy.  When I got to the treatment prep room, there was another person that was closer to my age waiting for her turn, too. We sat next to each other as we got our vitals checked, and usually, the patients don’t really communicate with each other while waiting, but she and I ended up chatting for a little bit. We talked some about each other’s experiences with ECT, and she asked me questions about how I’ve been doing since starting ECT. I think she was relieved to hear that my personal ECT adventure hasn’t been quick, easy or miraculous as one might have been led to believe it will be. It was also nice for me to get to talk to her since it’s not very often that I get to talk to someone who’s shared this similar path.

I’m now back home, and even though I remembered the above conversation, I can’t remember anything else that’s going on in my life right now. I should be glad that I’m not really having problems with memory about past events, but wow, is it really weird to not even remember what classes I’m taking this semester. I’m still trying to figure out exactly what I need to do this week, or what day of the month it is. Good thing I wrote down stuff in my planner because I would have forgot about doing an assignment or even going to class tomorrow. And usually, the stuff I forget after usually comes back after several hours, so I’m counting on that.

I’d like to lounge around the rest of the day, but just realized I have an assignment due for tomorrow. I guess I’ll get started on resuming my life.

November 4, 2010

talking about ECT, sociologically

My professor, Dr. H, e-mailed me last week to see if I wanted to present my paper about the experiences of going through electroconvulsive therapy at a social science symposium that was going on at the school the following week. I agreed, so yesterday, I talked about ECT to a group of people at this symposium.

As I spoke about this sociological analysis of my ECT experience, I could also hear in my voice a little bit of frustration I’ve been feeling about the treatment lately. I think it’s been bothering me that, unless I quit first, I don’t really see an end in sight to having this procedure every few weeks.  And when I first started, it was just supposed to be a few weeks—-and perhaps have freedom from depression forever. Not that I was overpromised things, I feel like I was led and led myself to think that more could be achieved through this treatment in a short amount of time. But I find myself thinking that without being maintained on it, the other treatments wouldn’t be enough. And if they weren’t enough before all the ECT, I’m not sure if they would be enough now. I still believe firmly that ECT is an effective treatment against depression, but for me, who is going through maintenance ECT, is this going to be like taking medication—which could be for a lifetime?

Another point that bothered me yesterday: the fact that more women receive ECT than men. Why is that? I found myself feeling other frustrations, but I’m sure I’ll bring those up at a later point since I’m still working on this paper. This was the second time I’ve presented this paper in the past few weeks, and while I’m not necessarily great at talking in front of people, I really am glad that I was given a chance to speak to people about a treatment that they may otherwise never hear about.

 

 

October 19, 2010

ECT #34 (my 19th maintenance treatment)

The last two days have been the designated fall break from school, so what do I get to do? Have ECT.

Before going up to the treatment area, I had to stop by the business office. It so turns out that my insurance is going to expire at the end of this month, which I’m certainly glad that the insurance company even bothered to tell me about earlier.

Today must have not been a popular day to have ECT because there wasn’t that many people in the treatment room today. My usual anesthesiologist was on vacation, so another anesthesiologist introduced himself to me as I waited for my psychiatrist to get to the treatment room. I found him to be really cute, and I was so tempted to tell him—but I contained myself from making those comments.

My psychiatrist soon came to my bedside, and we talked about how it’s been going the last few weeks. I was supposed to have ECT two weeks ago, so as that date passed, I’ve started to feel increasingly tired. We agreed to have the next ECT in five weeks.

I’d like to write a little more, but I’m still nauseous from today’s treatment. I’m not sure if it’s because of the lortab or just from the ECT itself, but I guess I’ll save my other comments til later.

October 3, 2010

Let’s just give everyone ECT

Okay…that’s not what they said, but several sources that are covering this particular topic is addressing it as though we’re going to give away ECT like free ipods at a baseball game.

For the first time in a decade, the American Psychiatric Association released a new set of guidelines for how to treat depression. This is the first time the medical organization has ever updated its guidelines on the assessment and treatment of depression since 2000; the current guidelines are based on research conducted from 1999 through 2006.

The major changes in the guidelines have occurred  in rating scales, new strategies for treatment-resistance depression, exercise and other healthy behaviors and strengthened maintenance treatment recommendation. In addition to electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation and monoamine oxidase inhibitors have also been added as potential treatments for patients with severe major depression or treatment-resistant depression.

The guidelines also recognize that regular aerobic exercise or resistance training may modestly improve mood symptoms. This is such a great addition to the guideline, because we somehow need to get our butts off the couch or whatever seating element and get moving. And the thing is, this is the cheapest form of treatment for depression! And who wouldn’t want to save a little money these days?

But, as expected, this move to see ECT as a more acceptable form of treatment has angered a lot of people writing in comments. As the subject of electroconvulsive therapy becomes more ‘popular’ to talk about, does it become my responsibility to say something? Or will I immediately  be labeled as some ‘shock treatment advocate,’ which I don’t think I am.You don’t hear of other people who’ve had open heart surgery cheering for others to have it. Just like that, making a choice to have ECT is an intensely personal choice—and all I have to offer is my own experience, and no one else’s. As talk of ECT gets bigger, I also do not want to be labeled as some victim, having had the procedure. If I were such a victim of those evil brain-sucking psychiatrist just wanting to experiment on me, I would have shut up and have never written such detailed account of what goes on.

Cancer survivors can proudly proclaim that they’ve survived! And there’s public celebrations for surviving through cancer. For those of us that went through ECT, who do we become but random targets of opinionated people that claim that these ECT patients were coersed and tricked into ‘getting their brains fried.’ I’m frankly tired of this conception that I didn’t know what I was doing when I had ECT.

Is there a group/organization out there that brings together ECT patients, current and past?  Maybe I should start something like that…..any suggestions?h

September 16, 2010

looking for perf-ECT-ion

It’s been a little over a week since the last ECT, and I’ve been evaluating how I’ve been feeling lately. I guess it’s been okay, but I just haven’t been feeling great…like how I imagine how ‘great’ feels like. My concern isn’t without merit. The fantasy football league I looked forward to so much last year didn’t bring about a sort of enthusiasm I expected for this year. Okay, I just evaluated myself using NFL football, but it tells me that something just isn’t clicking. There is an inclination to ask myself why I’m not feeling better since I just had ECT. But I think I’m asking the wrong question.

There is obviously a lot of criticism and protest over electroconvulsive therapy, but at the same time, there’s also a lot of people who claim ECT to be some sort of a savior. After 30+ treatments, I’ve come to a realization that ECT is neither of those things, at least for me. And part of the process of recovery is up to me.  Likewise, we tend to put all of our faith on our medications and hold our breath until ‘it starts to work.’ But the thing is, our life is still going on regardless of how our meds are working on us (I just thought about that quote, “life is what happens when you’re busy making other plans.”) We can’t just focus on our treatments all the time because we’re missing life itself—because we’re more than just our illness, and we’re certainly much, much more than the drugs we take.

In short, it’s not always the fault of any treatment that’s causing me to feel or not feel a particular way. Maybe this is just being ‘normal.’ What I sometimes forget is that living a life doesn’t have to mean you feel happy and excited about it at all time. In fact, wasn’t it this ability to have a spectrum of emotions that I was looking for?

September 3, 2010

ECT #33 (my 18th maintenance treatment)

Yes, it’s time for another ECT. Before I get into stuff about today though, I thought I should note that I was finally able to refill my Ambien prescription yesterday. Hopefully, I can get my sleep schedule under control and then start to wean off of it gradually. Anyway…

Six years ago this week was the first time I was hospitalized at the same psych hospital where I have my ECT. As I was situated to my bed in the treatment room, I could only think about how interesting it is that I find myself in the same hospital six years later. By the time Dr. F, my ECT psychiatrist, came to talk to me at my bedside, I had become so nervous that I couldn’t contain the feeling. So, I babbled on about this coincidence. I also had to tell him about my issue I’ve been having with sleep and my mood change. He gave me a warning about using Ambien, though I don’t remember what he actually said. Thank goodness he didn’t related my low mood to not having ECT before today. The next ‘little spark’ won’t be for another six weeks.

I came home with a pretty bad headache, but it seems that Lortab’s doing its job. Now, I just hope I don’t start feeling nauseous, because tomorrow morning, I have to leave town to go see a college football game. But now all my memory about my life seems to be coming clear, because for the rest of the day, I need to read up on classical sociological theory.

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