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.

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.

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.

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.

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.

• The Reliability of ECT Machines
• Informed Consent for ECT
• Donald Johnson on ECT
• Mary Rosedale on ECT
• Dr. David Boger on ECT
• Lauren Tenney on ECT
• Carol Jean Reynolds on ECT
• Dr. Daniel Fisher on ECT
• Dorothy Dundas on ECT
• Evelyn Scogin on ECT
• Dr. William Narrow on ECT
• Dr. Laura Fochtmann on ECT
• Dr. Richard Weiner on ECT
• Dr. Sarah Lisanby on ECT
• Dr. Robert Roca on ECT
• Leonard Roy Frank on ECT
• Dr. Pamela Sullivan on ECT
• Barbara Winkler on ECT
• Jan Eastgate on ECT
• Widower Loretta Wilson on ECT
• Attorney Kendrick Moxon on ECT

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.

still not guilt-free

“What are you writing your thesis on?” asks Jamie, as four sociology grad students drink beer and eat some dinner at a local restaurant. “I’m writing mine on electroconvulsive therapy,” I answer with a slight bit of hesitation. “Oh,” says Jamie. “I didn’t know they still did that.” Oh, yes, they do, I thought to myself as I try to gather my thoughts to answer her. But I couldn’t. She goes on to put ECT in the same sentence as lobotomies, but I leave the conversation there.

At this point in my life, I could almost recite the details of electroconvulsive therapy. I could go on about how it’s not like what you imagine from “One Flew Over the Cuckoo’s Nest” or practically anything that depicts ECT—not even the Broadway show “Next to Normal” gives a fair portrayal. I could tell Jamie about how I’ve had over 30 treatments of ECT and have helped me survive. I could say all of this but I didn’t.

It sometimes reminds me how a part of me is still, well, ashamed of having this procedure. And it’s not just the ECT that I’m afraid to tell people; it’s the fact that the reason I’m having ECT is obviously going to be connected to my depression, my bipolar disorder. What will people think?, I still wonder, even as I display myself on this journal as some kind of vocal advocate for mental health issues. I don’t think I need everyone in the world to know about this, because it’s not necessary information for people to know about me.  But when asked directly about it–and with whom I consider as ‘safe’ company, I shouldn’t feel so hesitant to say something about it.

I guess I still feel guilty about all of this.

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

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.

ECT Lessons-I’ve-Learned #10: When in doubt, talk.

I know I already have a “Lesson” titled “Communication is Key” but I thought I needed another lesson for myself to emphasize the importance of talking to your doctor. It’s been about two years since I first started ECT (about 1.5years since I started maintenance ECT), and I’m coming to a point where I am starting to question if I should keep on going with the process. After all, I am on medication and see a therapist…do I still need to have ECT?

As much as it is ultimately my decision to keep on going or stop the ECT, this really is something that should be discussed with your psychiatrist. S/he can evaluate your current condition to determine what treatment(s) would be best for you.  Quitting the process without talking to anyone may actually seriously affect your mental health….one that might cause you to have to go back to having ECT again.

In closing, I do think it’s a good thing to question your ECT treatments, because I don’t think this is something you should keep doing without putting any thought into it. But it’s really important that you open up to someone who has something to do with your treatments.

See the other “ECT Lessons-I’ve-Learned”

ECT=better math skills?

http://www.ebr.lib.la.us/teens/teenzone/math.png

As people may get relief from depression through electroconvulsive therapy, a study from the University of Oxford has found that ECT could enhance someone’s math performance, well, at least a jolt of electricity to the brain.

The participants didn’t really get the ‘full ECT treatment.’ But using a noninvasive method of brain stimulation known as transcranial direct current stimulation (tDCS), whereby a weak current is applied to the brain constantly over time to enhance or reduce neuron activity, the researchers targeted the parietal lobe – a region of the brain crucial for numerical understanding. They saw that the TDSC treatment improved the participants’ ability to learn the new numbers, with the improvements lasting six months after the treatment.

“We’ve shown before that we can temporarily induce dyscalculia [with another method of brain stimulation], and now it seems we might also be able to make someone better at math. Electrical stimulation will most likely not turn you into Albert Einstein, but if we’re successful, it might be able to help some people to cope better with maths,” said Roi Cohen Kadosh, Wellcome Research Career Development Fellow at Oxford’s Department of Experimental Psychology.

 

 

 

 

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.

 

 

I want to be sedated

I guess it’s a pity party, party of one.

I can feel the rise and fall of my own chest as I breathe in and out. The splashing of water and the chatter among the people at the pool sound loud and clear. And I hear the faint but consistent sound of my ceiling fan above me.  The shwish of the grass outside. Sometimes, I feel like I become aware on so many things going on in life that I just wish that this heightened sense of awareness could somehow be toned down a bit. Do I really need to be so alert when my mind’s spinning all the time? Can’t I just be numb or a little ignorant of what goes on around me? Couldn’t I live just a perfectly contempt life without internal and external conversations I have in my mind could just cease?

The problem is that this ‘heightened sense of  awareness’ doesn’t equal feeling sharp or invigorated. It just paralyzes me. I can’t move on from thinking about the ‘what if’ and ‘I can never be [insert a noun here] because….’ I envy people’s    obliviousness sometimes, because it seems like if you’re oblivious to something, you can just go on about your business without worrying about that issue.

ECT on ‘Law & Order’

A new episode of “Law and Order: Special Victims Unit” was on tonight, and they decided to ‘show’ electroconvulsive therapy going on at a psychiatric hospital. (Here’s a recap).

And they’ve got  it totally wrong.

The scene takes place in a psychiatric hospital where the police psychiatrist goes to interview a staff psychiatrist about a person of interest. The ECT happens to be taking place right by where they are conversing (looks like an open hallway). They just show the patient’s body seize up for several seconds. In current practice, we’re given muscle relaxants so that shouldn’t happen. Also, the patient made some loud noise during the seizure. Now, I do know that doesn’t happen because I have been next to ECTs going on close to me, and I’ve never heard people making any sounds.

I know the TV people need to make scenes look ‘active,’ but would they exaggerate any other medical procedure? It looked like it hurt, and if I had seen that before my ECTs, I would’ve been reluctant to have decided to have the procecedure. It was creepy to watch that happen.

People may not notice this very minute portion, but I think “Law and Order: SVU” did a huge disservice to a treatment that already conjures up inaccurate images.

need a job? put mental illness on the resume

Okay, not for all jobs, but it apparently helps in academia. There’s a really interesting article in The Guardian: For academic researchers, mental illness can be an advantage . According the article, “hiring of users of mental-health services are increasingly becoming a trend in academic circles. The “service-user perspective” is becoming recognized as an added value to certain research. “Your CV has gone from being patchy, with lots of gaps, to being interesting and full of potential,” says Debbie Mayes, a Lancaster University researcher and grant-holder on a £2m study into psychological approaches to bipolar disorder funded by the National Institute for Health Research.

The whole article was just fascinating and insightful. It was also very much of interest to me because of my status as a graduate student and that I have written papers in the past where I did utilize my “service-user perspective.” But I’m just that: a student. I never really thought about how one’s ‘out’ status as a mental-health service user may (positively)  influence one’s potential employment. But is having a mental illness something you’d want to disclose early in your career? The careers highlighted in this article all dealt with mental illness. So, could this advantage apply outside of the field? Obviously, one would have to be a good researcher to begin with to get these jobs, but unless you were good at what you do, I feel like having disclosed your condition may tacitly become a negative.