July 24, 2009
My psychiatrist Dr. A tore out for me a new article from this month’s Archives of General Psychiatry entitled “Effect of Concomitant Pharmacotherapy on Electroconvulsive Therapy Outcomes.” Written by Harold Sackeim, et al., their research found that “treatment with nortriptyline (a second-generation tricyclic) enhanced the efficacy and reduced the cognitive adverse effects of ECT relative to the placebo, and Venlafaxine (Effexor) resulted in weaker degree of improvement and tended to worsen cognitive adverse effects (but still better than placebo).” They also concluded that high-dosage right unilateral ECT equaled or surpassed in efficacy to bilateral ECT and caused less cognitive side effects. (Here’s an article about this study from Medical News Today.)
We’ve probably encountered the stats that the effectiveness of ECT is somewhere between 70-90%. Though I wasn’t led to believe that I would be free from medication after the ECT, but it wasn’t made that clear to me that without any augmentation the relapse rate for ECT is around 50%, and according to one 2007 study, the rate could be up to 100%. So, I’d like to think that ECT just eradicates our lifetime of madness, but we need to realize that there are still work to be done after the little sparks are over. That may mean just continuing with your old meds, adding lithium, or turning back to ECT. I know that by the time we’re considering ECT, we are barely able to make it through the day, but I think it’s better to ask and know upfront what turns your life could take post-ECT rather than be surprised by something that’s already been documented that it might happen.
Read other “lessons”
April 13, 2009
This is my futile attempt to write something worth even skimming. It feels like I’ve lost my thought-process mechanism for the last few days. My head is often just spinning with random thoughts and the voice in my head is constantly chatting away – but it’s mostly come to a halt. Maybe this silence should be a welcome break, but this is not a comfortable position to be in. There’s practically nothing to write about, and even if there is, I can’t put together a cogently written opinion that would accurately capture whatever it is that I thought.
But I can at least write down something I noticed that didn’t really require deep thinking on my part- just from me and the person that I was when I wrote in those journals from the past years. There’s a lot more to say about them, but there’s a state of mind I often wrote about for years and as recent as around the Obama inauguration: indifference. It’s that numb, deadened state when you know you should be excited, or at least somewhat engaged. The moment I become indifferent pretty much meant that I’ve lost the essence of myself, that passion.
I just can’t say that I’ve felt indifferent since the ECT. There are many emotions I’ve experienced since the little sparks that I thought would be gone after the treatment, but indifference just hasn’t been something I’ve struggled with for the last month or so. My mind honestly can’t seem to process anything today, so I don’t really feel much from realizing this. However, I know that it’s a very good thing.
Now, if I can just finish writing my thoughts on feminism and Meghan McCain…
April 2, 2009
It is the second day of April, and night has come. The rain’s been pouring on and off since the late afternoon.
My weekly session with the wonderful psychiatrist, Dr. A, was today. Among the many things we discussed in the hour-long session, there is one topic that is still on my mind and probably will be for the rest of this month. I told her just how much I could not believe it’s already April. Where did a third of a whole year already pass by? (Well, going through ECT would be the answer in my case.) The significance to most people about this time of the year is that there’s the tax deadline. But for me, the month of April is more than just the time to file your taxes. In fact, the tax day is also my birthday.
I wasn’t supposed to be alive on this month. In November, my plan was to not have any plans by the time I would be reaching this birthday month. I meant for me to be dead by this point. But here I am. It’s April, and I’m still alive.
I felt the tears welling up as I began speaking about it. A life that was not meant to be is still here. Had it not been for the ECT, I highly doubt that I would have made it this far, or maybe into 2009 at all. To be brutally honest, I am not ready to declare decisively that I am absolutely glad the plan didn’t work out, and maybe that conflict may never go out of my head. But at the same time, I will say that I felt like I had been given something that I did not deserve to have. The tears weren’t so much from this internal conflict, but rather, a sense of relief and– dare I say it –a bit of joy.
This day is coming to a close, and the tears start to fill up again as I think about then and now. I’ve made it through another day. The rain seems to still be coming down all across the city. Well, April showers bring May flowers, right? For now, I’ll take it one day at a time, but I wouldn’t mind seeing those flowers.
March 16, 2009
I don’t doubt ECT as a procedure. But I get afraid that it’s not going to hold for me when any single aberrant feeling seems to come over me. I’m well aware of the relapse rate, and I know that ECT is only a treatment, not a cure. So, when I felt this emotional distance, detached from everything and everyone around me, take over today and the day before, I began to count down those days against the number of consecutive days that you would have to have those sort of feelings in order to be considered clinically depressed, according to DSM-IV.
When you’ve been depressed/hypomanic (or whatever people consider as mentally-ill thought process) for most of your life, you don’t really have a gauge of what it’s like to be of normal mental state. I mean, what’s a normal emotional pattern? Just how up is too up, and how down is too down when you’re ‘normal’?
Various shades of gray have been the familiar scenery for the last four days in the sky. And that’s clearly not helped. I was so ready to just whine in the journal this afternoon. Then, that gray faded away and the sun showed up out of nowhere. Later, I begrudgingly followed my sister to the fitness room. She watched “Cash Cab” while she did her routine, as I caught up on TIME magazine as I trotted on that elliptical. I admit the column I read was about the Real Housewives of New York City (but the author does use words like schadenfreude). As my feet went round-and-round on those pedals, I actually began to feel a little calmer, as if some sun finally showed up in that gray mindset of mine.
On a side note, I am a bit annoyed with my six-year-old laptop. Maybe it’s not good for the plastic cover to start showing cracks…