Surfacing After Silence

Life. After.

ECT (Electroconvulsive Therapy) aka “eat more broccoli”

So this picture has absolutely nothing to do with the topic of my post.  But if you type in “ECT” into google images, this one will appear.  As will a bunch of cartoon line drawings of a little girl smelling flowers and playing soccer.

ECT.  Electroconvulsive Therapy.  Also known as Shock Treatment or Electroconvulsive Shock Therapy.  Yup.  One Flew Over the Cuckoo’s Nest.  The Bell Jar. That ECT.

Except it’s not “that ECT” anymore.  When that movie and novel came out, they both represented ECT fairly accurately.  Patients did go into full blown seizures and needed to be restrained and it was painful and sometimes patients got injuries–broken bones, pulled muscles, bruises.  And there was significant memory loss and confusion and sometimes the patients came back subdued and not really themselves.

I’ve had ECT.  *gasp*  Three separate times.  *triple gasp*  I had it back in 1998, then we tried it in November of 2009 (I pulled out of it early because the anxiety that resulted from going off my mood stabilizer (a necessity for ECT) was too much) and then in April/May/June of 2010 (we changed my meds around to avoid the anxiety issue).  There were vast improvements from the ECT in the 60s to the ECT performed in 1998.  And there were improvements between the ECT I went through in 1998 and the ECT of today.

Some myths that need to be dispelled:

You will have a full blown seizure.

Technically, this is true, but not in the way we have come to think of seizure.  They induce a seizure in your brain by passing electricity through it.  They measure the length and severity of the seizure using an EEG, not by how much you are thrashing about on the gurney. They give you a muscle relaxer which prevents the body from going into a grand mal seizure.  They do put a blood pressure cuff around one ankle and prevent that muscle relaxer from reaching your foot so they can observe any adverse negative reactions.  No, your foot is not sore afterward.  No, you do not need to be restrained.  No, you will not get a broken bone–unless in wheeling you back to your room they tip the gurney over and you tumble to the floor.  But that would be unrelated to the ECT.

You are awake and experience Hell.

You are not awake.  They give you this wonderful medicine that puts you to sleep right before the seizure (otherwise known as anesthesia.  I like to call it “happy drug.”).  I like attempting to stay awake as long as possible and talking while they give me the anesthesia until it’s impossible to do anything but drift away.  I think I’m a little weird that way.  And there was no hell.  I went to sleep.  They did their thing.  I woke up back in post-op with a nurse asking me if I wanted pepsi or sprite.  I remember nothing in the interim.  There was one time my doctor told me that I had had a larger seizure than normal for some reason that day, so I might have a headache, but I don’t remember anything being different that day.  I don’t have nightmares about machines with weird faces being wheeled toward me like I did after I saw Return to Oz the first time and didn’t know Dorothy was about to have ECT before she escapes the hospital and runs into the woods.  (Does anyone remember that movie but me?  It was terrifying.)

You will not remember who you are afterward.

So there may be some residual memory loss or confusion.  You will not forget your name.  Unless something went wrong or you have a particularly bad reaction to ECT.  You will still remember how to lift a fork from the plate in front of you into your mouth.  I even remembered Latin, the date, the day, where I was, how to drive a car, what I had for dinner the previous night, and how to get dressed.  Apparently, my friend and I went to IHOP once afterward, which I have no recollection of.  My memory loss is weird like that.  Random events that I don’t remember, events that I wouldn’t probably recall unless someone else was talking about them around me.

You will have a new personality afterward.

Your personality will not change.  Nor will you gain an additional personality to carry along with you throughout the day.  Hopefully, you will begin to experience less depression and that will affect your overall mood and, for a lot of us with depression, how you relate to other people.  If you didn’t like rock music before hand, you most likely will not like rock music after.  Although I’m sure Oliver Sacks has some obscure example that will prove me wrong, but keep in mind that most of his tales are just that–obscure.  That’s why he writes about them and not the 99.99% of us who have ECT and come out of it the same exact person as we were before, just less depressed.

Your hair does not stand up on end.  You will not shock people who touch you.  You will where a hospital gown, and they will stick monitors all over you and they will monitor your blood pressure and heartrate the entire time.  You will have an IV for a sedative, muscle relaxer and anesthesia and pain medication.  You may have a headache (I only did after the first few sessions).

ECT is now a standard treatment method for depression.  There are different types of ECT (unilateral, bilateral, bifrontal) and each have varying degrees of side-effects and efficacy and are better suited for different populations.  It is the only thing that works for me when the depression reaches a certain point, and it is the only thing that has ever been able to pull me out of a suicidal depression.  It is not a cure all.  You will still have the normal ups and downs you always have, and you will most likely still have some depression.  The ECT will hopefully get you to a point where the medication is able to start working again.  It pulls you out of the worst–hell–and gets you to a better but still bad place–purgatory.  And there’s always a chance for redemption when you’re in purgatory.  Not so much when you’re in hell.

Would I have it again? Absolutely.  In fact, because I am bipolar, type I, I am not looking at something that will take away my Bipolar disorder.  It’s there.  It’s sticking.  Much like peanut butter on the roof of your mouth.  I will get depressed again.  Hopefully, we’ll be able to catch things in time for the medication to work.  That may not happen.  I may hit another hellish depressive episode at some point and will need something to reach down and wrap around me and drag me back up.  That thing will most likely be ECT.

Of course, they may come up with another treatment.  Doctors like to do this thing called research, which is why when I had ECT I didn’t thrash around and break any bones and suddenly decide broccoli is evil.  Broccoli is cute and tastes good and your body likes it.  Eat more broccoli.


August 21, 2010 - Posted by | bipolar disorder, depression, health, therapy | , , , , , , , , , , , ,


  1. I used to love “Return to Oz”! Haven’t seen it in a very long time.

    I think the fear of personality changes is there for a lot of people, for all types of treatment. When I was considering starting meds, my therapist reassured me that a change in personality is considered a negative side-effect. In other words, it’s NOT the goal of treatment, and not something that is supposed to happen.

    Comment by Millie | August 21, 2010 | Reply

  2. thank you. as soon as we have insurance again (9 more months, i think) i plan to ask about this as an option. every 3-4 years, there’s a deep dark season and i’m finding, as i get older, they seem to suck just that much more of my energy in between times. i’d rather blame the depression than age. 😉
    my gut says this can make a difference for me.

    Comment by marisa | August 21, 2010 | Reply

  3. have you heard of TMS? it’s a newish alternative to ECT, and it’s supposed to work WONDERS.

    Comment by anon | August 21, 2010 | Reply

    • I have heard of TMS. The long-term effects are still being studied, and its overall efficacy is being debated. So far, trends have shown it to be more effective with depression than with bipolar disorder. I could not have it because there are certain types of monitors that you cannot use while having TMS, and because of my heart and defibrillator, it would be a highly risky procedure

      Comment by surfacingaftersilence | August 21, 2010 | Reply

  4. ECT (Electroconvulsive Therapy) aka ?eat more broccoli?…

    I found your entry interesting do I’ve added a Trackback to it on my weblog :)…

    Trackback by Mental Disorders 101 | August 21, 2010 | Reply

  5. Thank you for posting this – things like “One Flew…” have given ECT such a terrible reputation, when it can be highly effective. I wish there were more people like you who told the objective truth about ECT, instead of horror stories from the past (there are so many “anti-ECT” sites)

    “It pulls you out of the worst–hell–and gets you to a better but still bad place–purgatory. And there’s always a chance for redemption when you’re in purgatory. Not so much when you’re in hell.”

    I’m so sorry you’ve had to go through this, but thank you so much for sharing that. I had ECT treatments as well, and for such a long time I’ve looked back in anger and regret, bitterly thinking “all that memory loss but I was still depressed in the end” (I only responded to bitemporal treatments, not bifrontal, and that has a lot more memory loss). Anyway, I never thought of it in those terms before. ECT brought me from the brink of being committed to a state hospital (b/c I practically lived in the hospital by that point), to a place where I was able to be discharged, and after that stayed out of the hospital for six months (a record for me at that time). I ultimately ended up back inpatient, again, and again, (and again), but for much shorter periods of time, and mostly due to rapid cycling/mixed episodes rather than depression (and my ED completely screwed up the way I metabolized and responded to meds = yet another motivation to stay healthy). Anyway, the point of my rambling is that your post reminded me that ECT did help me – it didn’t last forever, and the change wasn’t dramatic, but it kept me alive, and that’s all that matters in the end.

    Comment by anon | August 21, 2010 | Reply

  6. this is excellent

    Comment by Emily | August 22, 2010 | Reply

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